C09993482 / invoice 10000

Reason: Overnight MonitoringAdmitted by Dr SkilbeckHistory:Phoebe is a five-year-old female neutered Labrador who has been sent for overnight monitoring due to her gastroenteritis. See referring vet history for full details.Phoebe has a known chronic history of multiple midline defects including cleft palate, bilateral ectopic ureters, and a small vaginal rectal fistula. She has a history of prior HGE episodes and she is normal on single protein prime 100. However, she will scavenge. She has been hospitalised for haemorrhagic diarrhoea and vomiting. Referral vet's plan to continue a metoclopramide CRI, to continue intravenous fluids, to continue ondansetron TID, to continue Prokolin. Regular vet requests no antibiotics at this stage as is becoming multi-drug resistant due to previous antibiotic usage.Examination Findings: Phoebe is stable. She is a bit quiet for a Labrador. Overnight, she has urinated, she has also leaked urine. At approximately 2:00 AM, she had a large episode of haemorrhagic diarrhoea on her walk and became quite drooly afterwards. She has drunk overnight and kept that down. She has had no vomiting or regurgitation. She is leaking diarrhoea and very keen to lick and clean around her bum.Has been offered her own food on several occasions overnight and is not interested in eating at this stage.Assessment: She meets the criteria for overnight care package.Treatment: propalin at 1:00 AM. Prokolin 1:00 AM. Ondnsetron wafer 8mg as provided by regular vet clinic at 8 mg metoclopramide CRI 0.08 mg per kg per hour. Symptomatic DC also given.Ivft reduced rate to 72ml/hr. Gave a 5ml/kg bolus after d+Plan: stable, able to be returned back to her regular vet for ongoing care through them.    Vital Signs    Weight: 31.4;       MMColour: pink drool;       Temperature: dng;       HeartRate: 140;       RespirationRate: 76;       CRT: <2;       

Reason: Transfer From EHV. CMAppointment Notes: Overdue reminders    Vital Signs    

Reason: Bloody D+History Phoebe has a long and varied history of urinary tract problems a thin out pouched sac in rectum . History from ref vet only last visit for lepto vacc and all wsas well . In sept . Owner reports she is on apoquel , propalin and supplements This morning Phoebe went to the beach abnd she started to have some diarrhoea on the way back . It was initially just loose then progreesed to runny . Last lot was followed by a small amount of blood . Sample provided was kahki i in colour not blood obvious . Was gravy consistency . Looked like flecks of black sandy  material through it . There has been no vomiting and ate breakfast well this morning Examination Quiet but alert Heart rate 134/min Mmpink Crt 1 sec Temp 38.5 Rectal exam nil on glove . Abdominal palpation comfortable . No signs of dehydration at this point and is still drinking water , Assessment Possibility of ingesting something at beach which has produced diarrheoa , could be developing AHDS, or other gastrointestinal upset . Seems to be limited to gastrointestinal Give bright drinking , rectal neg for ongoing blood could treat conservatively Treatment Maropitant 1 mg /kg scProkololin owner well versed in use of this .Bland diet is already on prime 100 slmon and prime 100 turkey . To feed smalll amounts of this every 4 hours and monitor for worsening signs and development of bloody diarrhoea / Owner is very diligent and will return if needed    Vital Signs    Weight: 32;