C09990179 / invoice 10000

Reason: Unwell. VomitHistory: Picky with his food for the last few weeks. Owner changed his food two days ago, avoiding chicken to help with concerns about skin. Is fed raw. Moved to a new raw food. Added probiotics supplements. Since food change has had v+, d+. Vomit consists of clear liquid and some grass. But now off his food. No known FB ingestion. Parasite protection: simparica trio. Examination: General appearance: BARWeight: 10.3kg BCS: 5/9   MM: Pink and Moist   CRT: <2   Temp: 38.3 HR: 120 rr: 32Integument: Soft full coat with no lesions, ectoparasites or abnormalities evident. Ear: Clear with no discharge or abnormalities on external examination Ocular: Clear with no discharge or blepharospasm. Oral: Good teeth Cardiac: No murmurs or arrhythmias were identified on auscultation. Respiratory: Clear BV sounds.    Abdominal: Soft and no pain on palpation. Comfortable. No palpable FB. Urinary/ Reproductive: No discharge or abnormalities were identified on external examination.Peripheral lymph nodes: Small, symmetrical, and mobile.Musculoskeletal: Ambulating normally with no lameness apparent. Full MSK exam not performed.Nervous System: Appropriate mentation, posture, gait, and postural reactions all appear normal. A full neuro exam was not performed.Hydration: GoodRectal: Unremarkable. No masses/ strictures/ Fbs Laboratory: None. Discussed if worsening rv for bloods + scan - may need to refer to emergency Assessment: Primary GI (AHDS vs gastroenteritis vs dietary (indiscretion vs intolerance) vs gastrointestinal obstruction vs Infectious [bacterial vs viralvs parasitic vs protozoal] vs IBD vs other) vs Extra-GI (neoplastic vs hypoadrenocorticism vs other) vs gastric ulceration vs toxin vssnake bite vs coagulopathy vs otherMost likely dietary indiscretion given history and possible gastro due to raw feeding. Itchiness - need to RV this - consider food allergy vs atopy. As has previously had no GIT issues on chicken, ok to put him back on this for now to support gut. Discussed medical management - seek emergency care if worsening overnight or continuing to vomit through prevomax. O understanding and happy with plan. Treatment: Prevomax 1.03ml SQPro-kolin 3ml BID Hills i/d cans Can feed prime100 puppy long term Consent has been given by the client to proceed with this treatment  -  YesPlan:Feed small regular meals of hills i/d, cooked chicken and rice, or prime 100 puppy chicken and rice. Monitor for continue v+, d+ or straining, lethargy etc. Seek emergency advice if any concerns overnight. If worsening next steps abdo scan + bloods. Once stools improve can slowly reintroduce supplements/probiotics + puppy kibble. If itchiness continues, need to work this up with food trial. This still may be an ongoing issue but as no GIT concerns previously on chicken suspect i/d food and chicken should be ok for now. Provided some handouts regarding flare ups etc.    Vital Signs    Weight: 10.3;