C09990745 / invoice 10000

Reason: VomitingAppointment Notes: Pls call if any appts come up sooner - wants GAP onlyHistory: Intermittent vomiting 1-2X daily past 3dBile stained fluid vomitus; apparently unrelated to eating?Still eatingUsual diet-> mixed veg, chicken mince, lamb steak; Hills weight management dietStools formed but soft- owner brought in sampleAte last night2 small fluid vomits o/n and early this morningExamine:8.1kgMinor dental tartarGums pink and moistChest ausc NSAIncreased GI motility on auscT39.1CQuite bright in cons room; ambulatoryAssessment: GastroenteropathyPrimary vs secondary? Acute gastritis / GI vs otherTreatment: Monitor at homeBland diet3ml prokolin po bid5mg Losec po sidLectadeReexam INI    Vital Signs    Weight: 8.1;       Temperature: 39.1;       

Reason: Owner Concerned Re Tick (was not a tick)Appointment Notes: owner cant come earlier, wil call if they can come soonerHistory: lump noted on tummy last nightVomited 2d ago, fine sinceUp to date with vacc- Had c5 18/8/25- canigen DHa2.., canigen KCOn simparica trio monthlySees a mobile vet for vaccinationWas Desexed 28/5/2-24Has had since a puppyExamine: bright but nervous, not aggressive at allMm pink, crt 1 secDs 0-1/4HR 128 bpm, regularBCS 6-7/9Nad on palpation of abdomenVentral abdomen, midline- there is a small 3mm slight raised dermal lump with a small hole in the surface, there is an old healed spey wound running under the lump, gently squeezed lump and expressed a small amt of dark thick dry debris, only a very minor amt of this debris remains visible at the edge of the lesion/lump, not a tickAssessment: lump - cyst vs dried blood blister/trauma vs other lesionPlan: expressed lesion, cleaned with wound flush, iodine appliedSupplied iodine- apply to the area bid for a few days, rc if not improving/recurs. May need sx to surgically remove.    Vital Signs    Weight: 8;