C09990319 / invoice 10000

Appointment Notes: drop off - Very flat, nauseous, no v+ or d+ today but one vom yesterday off food. has a foam situation happening. has seemed off last few days a bit vomity on the weekendpanting more than usual since got desexed (6/2/26) - routine desexing no concernszactin for 4 days post spey and settled,started panting more last night. timid this am at 4.30 amdrooled this amtried spew but nothing came updrank a heapof water after a big playate last night and this am but looks nauseousnot normally a chewer and no access to the usual foam. poos normal and no d+ etc.panting more on weekend, subsided monday and then was quiet.Small Animal ConsultationHISTORYPresenting problem:Onset/Duration/Progression:Vaccines/Preventatives (F/T/W/HW):Meds/Supplements:Diet:EDDU:Energy/Behaviour:Previous medical history:Owners Concerns:MAIN FINDINGS OF PHYSICAL EXAMDemeanour:TPR:MM/CRT:BCS:Heart / Lungs auscultation:Eyes / Ears:Nose / Oral Cavity:Abdominal palpation: Musculoskeletal:Neuro: Mentation / CNs / ReflexesLymph Nodes:Skin/Coat/Genitals: Rectal (if indicated): ASSESSMENTDiagnostics: Problem List:Differentials (Dx): Clinical interpretation: Prognosis: Good / Fair / Guarded / PoorTREATMENTPLAN    Vital Signs    Weight: 26.1;       

Follow up call on BeatriceGoing well at home, o thinks the pain relief really helped alot LS    Vital Signs    

Appointment Notes: Had pups 2 weeks ago. normal discharge up until today she has bright red discharge and is off colour. 2 weeks ago caesarian - was in hospital for 4 days due to bleedinghas ended up with 7 pups going wellfresh blood discharge today and increased pantingziwi/dry/patties/ all puppy fooddoesnt want to drink a lotwas put on clav/doxy and was feeding pups at the same timeSmall Animal ConsultationPE; BAR, shiny coat, BCS 4/9 good muscle tonepanting quite heavily through all of the consult, even though seemed to be low on stress;mm pink moist crt< 2 sec; HR 120/min; heart and lungs NADabdo palpation - large bladder palpable, COMFORTABLE ON palpation; T 38.7vaginal exam - NADsmall amount serous/blood discharge on towel in hospitalchem 18 - increased reticulocytes (presume from prev bleeding intra/post-op)?increased urea. SDMA and creat WNLCa WNLurine sample - USG 1.045, mid yellow in colouru/s of uterus - LARGE bladder present; no obvious FF and no large uterus obviousmammary chain  - LOTS of mild present; caudal teats particularly full and sl red. not hot to touch, and milked easily expressed out of all teatsDDx - panting  - from pain vs early mastitis vs other?? bloody discharge - normal vs failure SIPS??PLANgiven intermittently poor appetite and traumatic first few week, reluctant to put on antibiotics without due cause1. ondansetron 8mg PO bid 2-5 days2. paracetamol 250mg sid/bid 1-3 days as required and ensure pups are feeding 3. r/v INI or if signs of mastitis present4. NO PLAN to breed from her ever again - to keep in touch re whether she continues with vaginal discharge ; may need to be desexed if discharge continues beyond 6 weeks    Vital Signs    Weight: 26.4;