C09991888 / invoice 10000

Reason: Diarhoea - Needs Urgent Support Appointment Notes: KMURGENT consult under VRH care -Subjective: Complex treatment at VRH for seizuresStarted to develop diarrhoeaO suspect that Scout gets diarrhoea when stressedAttacked by rottweiler in Sept 2024 - severe diarrhoea afterwardsAlso had diarrhoea last year after a vestibular event Has had KBr increased recently as well as a UTICurrently having seizures every 8 days at the minimum - had some serious seizures recently, hence increased seizure meds.Reduced seizure meds per VRH instructions as of 3 days ago, back to new baseline medication doseOn one keppra TID currently, as well as KBrOne week since last seizure at this stage. Diarrhoea started this morning - 2 days ago stool started looking soft, but still formed.Not fully liquid this morning - soft serve consistencyNo blood. Did vomit 2 days ago after taking high dose of seizure meds.Appetite is currently quite good.Very dopey from seizure meds, falling over all the time.Examine:QAREyes NADEars NADOral; MMs pink CRT <2sLNNs WNLCardiac: HR 120 gr 3/6 murmurAbdomen comfortableInteg skin tent WNLMSK NE Temp 38.0Rectal: empty, trace soft stoolsAssessment: Early diarrhoea - stress vs infectious vs medication related vs otherPlan: O very worried about Scout esp since had severe HGE last yearPlace on supportive care - tried to give a dose of buscopan but Scout started screaming after only 0.2mL - avoid this in futurePlace on I/D and probiotic and monitor; INI esp over weekend consider VRH visit.Treatment: ProkolinI/DMonitor closely    Vital Signs    Weight: 12;