C09989250 / invoice 10000

<p>Consulting with Vet Nurse: yes - Steph</p><p>PRESENTING COMPLAINT: <br>- Vomiting and diarrhoea with blood spots</p><p>HISTORY:<br>- 10 week old puppy, owned for 2 weeks<br>- had first vax with breeder in Melb, O has paperwork at home<br>- Vomiting started middle of night, multiple vomits. <br>- Diarrhoea initially brown coloured, now small watery blood tinged pools<br>- Not interested in food this morning. ate well, was bright yesterday<br>- Given worming tablet Tuesday 02/30, 7.5kg dose. contains levamisole and niclosamide<br>- No contact with other dogs in 2 weeks<br>- Walks only in backyard, picks up leaves but owners remove from mouth<br>- May chew on towel in pen outside, O vigilant</p><p>Current medications: calcium supplement<br>Parasite prevention used: intestinal worming tablet given Tuesday 02/30<br>Current diet: raw mince with pumpkin, puppy food in morning</p><p>Temperature: 38.3</p><p>EXAMINATION: <br>Abdo: firm mass palpable in mid abdomen, estimate 2cm diam<br>pain on insertion of rectal thermomenter<br>heart sounds NAD<br>mm pink, moist, CRT < 1 sec<br>Otherwise NAD<br>Demeanour: QAR</p><p>PROBLEM LIST:<br>- Vomiting and bloody watery diarrhoea<br>- Palpable abdominal mass<br>- Inappetence</p><p>DDx:<br>Intussusception<br>Foreign body obstruction<br>Bacterial gastroenteritis</p><p>ASSESSMENT: Suspected intussusception based on palpable firm mass in mid abdomen of young puppy with acute gastroenteritis. Surgical correction likely required. needs work up to confirm</p><p>TREATMENT in consult room/Meds dispensed:<br>IV catheter placed<br>IV fluids commenced 20 ml/hr<br>Methadone 0.1mg/kg IM 10am<br>maropitant 0.73ml SC 10am</p><p>VET TECH actions:</p><p>Email handout: none needed</p><p>PLAN:<br>- Parvo test at O request <br>- Bloods incl electrolytes<br>- X-ray and potentially ultrasound imaging<br>- Surgical correction if intussusception confirmed<br>- Option of referral to specialist surgeon discussed<br>- Hospitalisation for 1-2 days post surgery<br>- Monitor eating and defecation post operatively<br>- potential for wound breakdown and recurring intussuception discussed</p><p>Call back scheduled? Yes - in few hours with test results and imaging findings</p>