C09987368 / invoice 10000

Reason: D+, Lump On TummyVETERINARIAN: asrHISTORY:Acute onset lethargy (quiet all day) and innapatence (no interest in normal food or treat (pig ear)) + d+ flare. Retching/cough + clear liquid yesterady. Incr freq, urgency, small volume. Chronic diarrhoea few weeks - AES on 21/01/26 -> prokolin dispensed -> resolved - again today started - soft -> liquid, light brown no mucus - appetite over last month changed (unusre if puppy thing or changed, sometimes Known to chew toys Normal diet - RC medium puppy kibble, boiled chicken and rice, quality cooked treats Lump on abdomen - hernia?Pre-existing conditions: chronic d+ few weeks Current medications: nil Antiparasitic prophylaxis: nexgard mothly Vaccination status: utd  TRIAGE:HR:  144RR: pantTemp: utg MM: Pink, moistCRT: 1-2 secondsMentation: BARPain Scale (1-4): Dehydration status (%):BCS (1-9): EXAM:? CARDIOVASCULAR:NAD; normal rate and rhythm, no murmurs auscultated, pulses strong and synchronous. RESPIRATORY:?NAD; no nasal discharge, no evidence of increased respiratory rate or effort, bronchovesicular sounds are normal. NEURO:?NAD; normal gait, posture, and mentation; full neurologic exam not performed GASTRO-INTESTINAL:?Oral: Oral mucosa appears normal, no lesions noted. Abdominal: Normal on abdominal palpation, no obvious masses noted, comfortable? Rectal: Normal feces per rectum, no obvious masses noted MUSCULO-SKELETAL:?NAD; no evidence of lameness or pain, well muscled with good symmetry, no obvious swelling. Full exam not performed. EARS:?NAD; pinnae normal EYES:?Eyes clear with no obvious changes associated LYMPH NODES:?NAD; peripheral LNs normal in size, no firm or painful LNs identified? UROGENITAL:?NAD INTEGUMENT:?NAD; coat normal, no obvious masses or other lesions; full exam not performed PROBLEM LIST:DIFFERENTIAL DIAGNOSIS:Primary - HGE/AHDS, dietary (intolerance, rapid diet change), FBO,  infx (bacteria viral parasitism), IBD, inflammation, toxin...Secondary - pancreatitis, hypoadrenocorticism, metabolic other, hepatobiliary, renal, neoplasia..COMMUNICATION:Gave options:1. Hospitalization, bloods to investigate extra-gastrointestinal causes, IVFT, pain relief, antinausea 12 hours, radiographs to r/o FBO2. Supportive care at home, reassess with rDVM or here INI. Warned risks of signs worsening and deterioration.Owners opted for hospitalization.  DIAGNOSTIC/TREATMENT PLAN:Parvo Corona virus test result:    Vital Signs    Weight: 19.2;