C09988126 / invoice 30000

05/03/2026 NURSE: EL

REASON:
Restlessness overnight.
Stretching and discomfort this morning.
Owner concerned about seizure activity.

HISTORY:
Unsettled and restless overnight from around 4:00 AM.
This morning, seemed uncomfortable and was stretching after eating.
The owner was concerned about seizure activity, but she was coherent throughout.
Maggie was given one scoop of ice cream last night, which is unusual for her.
There is no history of eating inappropriate items.

APPETITE:
Ate Metacam off the top of her food this morning, then ate the rest of her meal.
Appetite is normal.

ACTIVITY:
Restless overnight.
This morning, she was lying down, stretching, and seemed uncomfortable.
Slept for 30 minutes around 6:30 AM, then started stretching again.

DIET:
Usually has 130g of biscuits for breakfast.
Owner typically gives Metacam with 30g of biscuits one hour after the main breakfast, but this was not done this morning.
Was given one scoop of ice cream last night.

TOILETING:
Soft poo this morning, but not overt diarrhoea.
Passed "jelly beans" this morning.

CURRENT MEDICATIONS:
Metacam.
Peridone prn for settling, but has not had it for a while.

CLINICAL EXAMINATION:
Mentation: BAR
MM: Nice pigmented gums.
CRT: <2
Oral and Dental Score: G1/4.
Eyes: Bright and clear.
Ears: Externally clean.
BCS: 5/9
Lumps: None found.
Abdominal: Comfortable on palpation, but appears to have a sore tummy.
Lymph nodes: WNL.
HR: 120 bpm, regular sounds/rhythm.
RR: Panting, chest clear.
Temp: 39.2°C.
Urogenital: WNL. Surgical site is healing perfectly.
MSK: NAD. Ambulating well, excellent HLMM. Stretching noted by owner.
Skin: Healthy coat and skin.

**ASSESSMENT:**
Mild gastrointestinal upset, likely secondary to dietary indiscretion (ice cream).
Clinically well with no major concerns on examination.

DISCUSSION:
Reassured owner regarding Metacam administration with food; it is fine as long as she ate the full meal immediately after.
Discussed the risk of xylitol in some ice creams.
Advised that some dogs have sensitive stomachs and ice cream can cause an upset.

TREATMENT:
Bland diet recommended for the next few days.

PLAN:
Continue Metacam for now. If diarrhoea continues or worsens, cease Metacam and she will be switched to different pain relief.
Monitor for ongoing diarrhoea. The owner can collect anti-diarrhoea medication if needed.
No immediate recheck is necessary unless signs worsen.