C09991950 / invoice 10000

1) feces back to normal. 2) drinking way more than usual and toileting 4-5times a day, urine. some normal size some smaller. 3) seems otherwise OK. a: as have multiple abnormal paramters on bloods including renal + lytes ect, probably worth rechecking those levels + UA if concern. Owner to nbook soon.

STO - Louis having harder faeces of a morning, by afternoon cow pat style. Is eating, drinking, urinating.As per NY start 1/4 of 200mg metrogyl twice a day for 5 days for diarrhoea for suspect ibd flare upIf no better need to r/check + admit fluidsOwner still had tablets at home as previously dispensed but not used so no need to dispense meds.NY: owner reports he seems better, but still not 100% due to temperament, trial abx metronidazole 50mg BID @ home. INB or worse, needs to be admitted to hospital, as quite a few electrolyte derangements, likely from ongoing acute d+ and vomiting, but cannot r/out other new disease ect 

ate food last night no defacation since visita bit lethargic but perked up a bit from yesterdaydiscuss CATPCBC: unremarkableCHEM: - azoatemia with CREA 0.23, UREA 25 -->pre-renal vs renal, most likely prerenal dehydration form dehydration- hypoNa 130 hyperK 6 hypoCl 92 --> most likely GI loss, Na:K ratio 21.7 cannot r/o addison's A: most likely dehydration, cannot r/o other underlying disease (renal, addison's etc )ideally admit for IVF, however Louis is a very nervous cat will need CRI med to calm him down while in hosp P: monitor for clinical signs, awaits fPLO's having difficulty to give prokolin and purina probioticsdispense vege capsules O to trial giving probiotic powder in capsule?-----sto@16:00soft faeces today no diarrhoea, have better appetite overall todayfpl wnlO to monitor for Gi signs, revisit/O to call if concerns repeat blood in 4 weeks if diarrhoea resolved?