C09984402 / invoice 10000

Reason: Unsettled Appointment Notes: panting lots and not herselfHistory: Changed Zia's diet last week and a few days later she had 4 vomits overnight (yellow bile in it) She then settled but this morning was restless again with eating grass, passed stools with mucous covering them and then had a v+ with froth and pieces of grass in it. Energy wise she's happy and well. Did have a tense tummy and yelped when picked up a few days ago (at time of initial v+) but that has settled. Been panting more at home and restlessUTD with monthly Simparica trioNo other food fedExamination: BAR (very energetic and bouncy here)MM pink CRT< 2secAbdo palp: not firm, no gas in git and not painful, no mass feltThoracic ausc very unsuccessful (vocalising and panting all the time, struggling to hear her heart)Tracheal pinch NEGRectal exam: no stools in rectum (had just been to the toilet this morning twice, second bout had the mucous coating it). No git in rectum - glove cleanAnal sacs very full - manually evacuated vis rectum - not infected, liquid brown (normal)PLN NADDental score 1/4BCS 7-8/9 (gained another 600g at least)Spinal palpation NADWalking well, jumping up all the time, chasing ball in consult room tooAssessment: Restlessness, panting and v+ - GIT upset after change in diet most likely cause ddx pancreatitis, FB etcPlan: Pro Kolin BID for 2 days, chicken/rice little and often then reintroduce food slowly. If ongoing may need another food - new food may not be good for her systemRecomm anti-nausea but o elected to hold off for now as only had the one v+ after eating grass - will RV if ongoing v+ and then may also need pancreatic profile +/- abdo U/S Weight loss NB (reduce amount of new food from 3/4 cup to 1/2 cup per day with veggies added) and lots of exercise    Vital Signs    Weight: 12.5;