C09990165 / invoice 20000

Reason: Constipated / Follow UpAppointment Notes: Paws App Details:Booking Type: ConsultationBooking Notes: Constipated Follow Up Pet Does your pet have more than 2 health concerns you'd like to discuss, or is this a complex case?: No - we'll be discussing 1-2 standard concernsHistory:Vomiting has stopped, but still eating minimal food and water.2 tiny wees since Monday, no poos. Seems otherwise well. Energy maybe a little low - sleeping a little more than usual. Appetite picked right up after prevomax on Monday, but eating less again. Examine:BAR - friendlyMMs pink, moist CRT >2Temp: unable to takeCOAT/SKIN: no abnormality detectedEYES/EARS: no abnormality detected, ears and eyes clean and clearMOUTH/TEETH: Oral exam normal, no mouth pain, dental score: c0.5G1HEART: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronous 180bpmLUNGS: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeABDOMEN/DIGESTIVE/URINARY: no abnormality on palpation - soft and comfortable on deep palpation, minimal faecal column palpatedCNS/MUSCULOSKELETAL: normal palpebrals and menace bilaterally; ambulating normally, no palpable neck pain, spine, limb, joint painPeripheral Lymph Nodes: no abnormality on palpationWEIGHT/DIET: Body Condition Score: 6/9REPRODUCTIVE: no significant abnormalitiesOther:Laboratory:  GHP Chem 17 incl lytes: low neut (1.51) & EOS (0.15); otherwise WNLDifferential Diagnosis:Post-gastritis vs constipation vs pain vs partial blockage (less likely)Treatment:Prevomax 0.58ml SCPlan:Attempted concious abdo radiographs today - unable to take - fractiousOffered sedated radiographs today to O, although discussed that given BAR, bloodwork good, abdo palpation WNL, I advised it was reasonable to continue to monitor at home. Encourage eating with high value food (incl cooked chicken), can add psyllium husk - start 0.5tsp - if drinking. If concerned or showing any deterioration recommend sedated abdo rads (+/- abdo U/S) Thurs or Friday.    Vital Signs    

Reason: VomitingAppointment Notes: Paws App Details:Booking Type: ConsultationBooking Notes: Vomiting Pet Does your pet have more than 2 health concerns you'd like to discuss, or is this a complex case?: No - we'll be discussing 1-2 standard concernsHistory:4 days ago noticed not eating as well as normal - had changed to a new flavour of food within the same brand and thought he didn't like itBecame lethargic over next two days and O sourced different food - still not eating wellVomited yesterday and this am has eaten only a few biscuits bit then vomited againIndoors onlySingle cat houseHas toys he plays with and chews but doesn't swallow anythingDoesn't eat hair bands or anythingUsually dry food only and occasional treat stickNo D+Drinking less, less urine in litter.  Less frequent faeces over last four daysO feels aside from reduced activity his behaviour/demeanour are normalBeen with this O less than 6m so unsure about hairballsExamination:COAT/SKIN: clean and not inflamedEYES/EARS:  clean and  clearMOUTH/TEETH: MM pink, moist, CRT 1 sec.  No dental issues.  No FB under tongue.No skin tent, hydration adequateHEART: HR 144 no murmur.  T 37.6LUNGS: chest clear, purringABDOMEN/DIGESTIVE/URINARY: No abdominal discomfort on palpation, normal amount of faeces in  colon.  No masses palpable, nothing to indicate FBCNS/MUSCULOSKELETAL: Ambulating normallyPERIPHERAL LYMPH NODES: WNLWEIGHT/DIET: Body Condition Score: 5/9.  Has gained weight since last hereREPRODUCTIVE: Assessment: Exam is normalLaboratory:  Discussed diagnostics but no clear concernTreatment: Maropitant injection and monitor appetite.  INI to come back for bloods/radsPlan:Pet Primary Diagnosis/Suspected Diagnosis/Location: VomitingSuspect cause: Dietary/unknownAny other conditions being treated (if any): Nil Known health concerns: NilDate of first clinical signs (if known): 27/2/26To be filled in prior to submitting claimAdditional notes can be added later    Vital Signs    Weight: 5.75;       Temperature: 37.6;