C09982520 / invoice 10000

Appointment Notes: Overdue remindersHistory: - Presented with O for annual vaccination- The past 12 months has a reduced interest in food but is still eating.- O used to make home cooked meals for Laicee, but she has lost interest in that- The past 4-6 weeks has started offering SPD kangaroo roll, is eating but still not showing interest. But has gained weight since starting on this.- On some nights, will start making vomiting noises but nothing is bought up. Will be let outside to eat grass, but doens't vomit it back up. Will continue to have vomiting motion throughout the night. - unknown triggers/events that happen prior- O noticed scratching around the back, will scratch for a period of time. Not scratching at the ears.- Still drinking, urinating and defecating.- Medical history: PancreatitisPhysical Exam: Subjective- BAR. NervousObjective- BWT: 6.4kg. BCS 4/9- Vitals - MM pink + moist. CRT <2 sec. HR 200. RR 40. Temp 39.2- Cardiovascular: NAD. No murmurs or arrhythmias detected.- Respiratory: Clear bronchovesicular lung sounds in all quadrants.- Gastrointestinal: Very tense when caudal abdomen palpated bilaterally, repeatable.- Musculoskeletal: Ambulatory x4. Full musculoskeletal examination not performed.- Integument: NAD. No thinning of coat.- Urogenital: NAD- Otic: Mild build up of debris- Ocular: NAD.- Neurological: Normal mentation. Full neurological examination not performed.- Oral: Moderate dental disease C2G1Laboratory: Biochemistry (in house) - wnlAssessment: Problem list: Reduced interest in food. Abdominal pain.DDx: Neoplasia vs pancreatitis vs othersPlan: - Hold off on vaccination and HW injection today- Ondansetron 4mg PO q12hrs PRN- Recheck in a week, if improvements then vaccinate and HW injectionDiscussion: - Further diagnotics to be performed - Abdominal ultrasound vs radiographs (limitations) - To be confirmed a full abdominal ultrasound can be performed at Napean - Will follow up with O-> Recall : To book abdominal ultrasound appointment with Anthon at Napean or arrange VSOS to come do an ultrasound, need estimate for both options.    Vital Signs    Weight: 6.4;