C09982322 / invoice 10000

Reason: Vomiting, diarrhoea, inappetanceHISTORY:Presented following development of vomiting, diarrhoea and inappetance.Initially was seen at PVE on 23/2/26 for anaphylactic shock - responded well to treatment and was discharged (see previous history).Was well at home and had gone back to normal, although stools were still slightly soft.Today, started to have complete diarrhoea/runny stools with haematochezia (frank blood noted within).Had been taken to regular vet today, and at that point was prescribed prokolin.After returning home, he started drinking some water and shortly vomited this up. Since then, over the evening, he has had 4 vomits.He has also become inappetant. Appetite had initially been fine following discharge. No further collapse episode noted by ownerCurrent meds: prokolin dispensed but yet to dose. Prophylaxis: not discussedPre-existing conditions: recent anaphylatic shockAccess to toxins eg. Rodenticide: no known accessTRIAGE:HR: 128bpmRR: 28bpmTemp: 37.9Mm: pink moistCrt: 2sMentation: QARPain Scale (0-4): 1/4Hydration status (%): <5% dehydratedBP: 158/92 (101), 125/82 (100)SpO2: 97%EXAMINATION:Body Condition Score: 4/9Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal - Abdominal: no detectable pain on abdominal palpation although lip licking and slightly uncomfortable on deep abdominal palpation, normal gut sounds- Rectal: not performedUrinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normalEyes: NSFPROBLEM LIST:1) Diarrhoea with haematochezia2) Vomiting3) Anorexia4) Recent anaphylaxisDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Most likely gastrointestinal signs secondary to recent anaphylactic shock vs. Other primary gastrointestinal vs. Extragastrointestinal causes unrelated to recent episodeDIAGNOSTICS:NIL performedASSESSMENT:Lenny represented for development of clinical signs again shortly after marked improvement was noted following his recent anaphylatic shock 2 days prior. On examination, he was otherwise stable with vitals. It is unlikely that he is experiencing a full biphasic reaction, but rather gastrointestinal signs given that the shock organ is the gastrointestinal tract during causes of anaphylaxis. It is highly unlikely that the clinical signs is unrelated to the recent anaphylactic episode, although this cannot be entirely ruled out without further diagnostics. TREATMENT:Maropitant 1mg/kg SCOndansetron 4mg OTM BIDContinue prokolin as dispensed PLAN:Offered admission for continued supportive care and close monitoring vs. Outpatient management and monitoring. Owner opted for the latter.Advised for revisit/seek veterinary advice immediately if no improvements, any worsening or if collapse episode reoccurs. DISCHARGE INSTRUCTIONSPlease read through the following instructions to help guide your pet’s recovery. Do not hesitate to contact us at any time if you have any concerns or questions, and please let your vet or our client care team know if you have any questions about this information before you take your pet home today. Treatment summary: Lovely Lenny presented following acute vomiting and diarrhoea following his anaphylactic episode on Monday evening. This can be expected secondary to the anaphylaxis, as the gut/gastrointestinal tract is a shock organ for anaphylactic shocks. On presentation today, despite being extremely nauseous and drooly, his vitals were all within normal limits. The option for outpatient management with close monitoring for now has been chosen, and to represent if he worsens/collapses/remains inappetant. Exercise:- Please follow the instruction of your veterinarian with regards to reintroduction of exercise.- If no specific instructions have been provided please keep your pet rested for the next 3 days then gradually reintroduce normal activity.Diet:- If your pet has suffered any gastrointestinal upset (vomiting or diarrhoea) please feed your pet bland food with no access to high fat foods or scraps. We recommend either a low fat commercial diet or boiled, skinless chicken with rice. Continue this diet for 3 days and then slowly reintroduce normal food. Recheck:- Please organise a recheck for your pet with your primary care veterinarian in THREE days to assess your pet's improvement unless otherwise advised by your veterinarian.Medications at discharge:6.00 x Ondansetron Wafer 4mgPlease give 1 wafer under tongue or into cheek pouch TWICE daily. If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital. If your pet’s condition is not improving or if other problems develop, please call your primary care veterinarian or if it is outside their normal working hours, please call Perth Vet Emergency.  We are open from 6pm until 8am Monday to Friday and 24h over weekends and public holidays. Phone 1300 040 400    Vital Signs