C09994149 / invoice 10000

REASON:Time: 0800AES Vet: Dr Nerida Warburg BVSc(Hon) Regular clinic: LindisfarneHISTORY:- Acute onset of crying, hesitation to move, shaking, and panting upon waking this morning.- Stools have been soft - on special diet - No vomiting. Ate normally yesterday. Not offered this am, straight to AES- Generally healthy with no significant pre-existing conditions or history of back issues. Vaccinations are up to date.- Diet changed from chicken to turkey meat three months ago. A new food was introduced five days ago. Currently fed turkey meat with sensitive stomach and skin dry food. Probiotic powder is used intermittently.- Stays at home during the day and has regular walks. No exposure to bushland. On tick prevention.- Chill day y/d- Not on any current medications.- No known allergies.- Breathing loud ~10min post exercise but no exercise intolerance- On tick px, no snake riskEXAMINATION:HR: 120RR: Panting, clearTemp: 38.3 CMM: bright pink, hypersalivation CRT: ~1 secondMentation: Bright and aware, but behaviourally subdued (normally bark at other dog in waiting room) Pain Scale: Mod abdo pain Hydration status (%): Appears adequately hydrated.Weight: 14.1Body Condition Score: 5/9 Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal , no nasal dischargeNeurological: neurologically ambulatory, will correct knuckling quickly but can place HL's partic LHL in abnormal position & not or very slow to correct, no cranial nerve deficits/gait. Pupils are responsive to light.Musculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal: - Oral: normal, no mouth pain, Hypersalivating. - Abdominal: Tense on palpation with evidence of pain. normal gut sounds - Rectal: no detectable abnormalities, faeces: normal Urinary: bladder size unable to assess as too tense & pain Reproductive (incl ext genitalia): NP Integument/Ears: clean furcoat no evidence of otitis. Ears feel warm.Lymph Nodes: peripheral lymph nodes normal size/shape & not painfulEyes: clear corneas, nil discharge or blepharospasm. Pupils normal.ASSESSMENT AND PLAN:1. Acute Abdominal Pain vs spinal pain sometimes hard to differentiate- The primary concern is acute abdominal pain. Spinal pain is a key differential diagnosis, given the breed and the subtle left hind limb proprioceptive deficit. Hypersalivation, panting, and behavioural changes are likely secondary to pain or nausea. - Options discussed with the owner include: 1. Outpatient management with pain relief (methadone) and anti-nausea medication (maropitant), with close monitoring at home. The risk of masking a more serious condition like a foreign body was explained. 2. In-house diagnostics, including blood tests (blood gas, biochemistry, haematology) and imaging (X-ray or ultrasound), which would require sedation. 3. Referral to reg vet for further diagnostics and care.- Advised methadone for pain relief in the interim. Anti-inflammatories like meloxicam are contraindicated if gastrointestinal issues.CLIENT COMMUNICATION:- Extensive discussion with the owner regarding clinical signs, potential causes (abdominal vs. spinal pain), diagnostic options, and associated costs. The owner is considering the options and understands the plan.DIAGNOSTICS: None TREATMENT:Methadone 0.2mg/kg IM 0900Maropitant 1mg/kg SC 0900PLAN:- Owner to decide on the preferred plan: outpatient management, in-house diagnostics, or referral.NW recommended see own vet today BUT is an anxious dog in hospital so may monitor at home for next hour or full dayLindisfarne has capacity today for monitoring +/- workup/txHx completed    Vital Signs    Weight: 14.1;       

Visit Vet: Dr Olivia Swannote details from 2021-12-18:REGULAR VET CLINIC: TIME: 2450 VET: OS REASON FOR PRESENTATION:HISTORY: Have had for 2 weeks. Vaxed 5pm this afternoon, started vomiting 9pm, a couple of times - food then froth, no blood. No Hx of vomiting/ regurg previously No diarrhoea, no collapse, Current breathing sounds normal Usual Diet: chicken mince - previously raw, started feeding cooked tonight, puppy dry food. Fed lots of treats at vets today. No known dietary indiscretion Current Medications: C5 today, worming tx - chewable.  EXAMINATION:Mentation - BAR, Very inquisitive BCS - 2/5 Temp - 37.9 CVS - HR 140, normal rhythm, no murmur Resp - Normal BV sounds, normal effort, RR 25, moderate stertor Abdo - soft, stomach moderately distended, no palpable abnormalities  Mouth - mm p,m. crt 1. Musculoskeletal - NAD Neuro - NADEyes - NAD Ears - NADSkin - NADUrogenital - NAD  Lymph nodes - NAD ASSESSMENT: Gastric distention, history of vomiting, 4hrs post-vax. DDX: Vaccine reaction, gastrointestinal causes. Client communication: Rec symptomatic mangement and INI RV.  TREATMENT:0.3mg/kg chlorpheniramine SC 1mg/kg maropitant sc Visit Vet: Dr Olivia Swannote details from 2021-12-18:REGULAR VET CLINIC: TIME: 2450 VET: OS REASON FOR PRESENTATION:HISTORY: Have had for 2 weeks. Vaxed 5pm this afternoon, started vomiting 9pm, a couple of times - food then froth, no blood. No Hx of vomiting/ regurg previously No diarrhoea, no collapse, Current breathing sounds normal Usual Diet: chicken mince - previously raw, started feeding cooked tonight, puppy dry food. Fed lots of treats at vets today. No known dietary indiscretion Current Medications: C5 today, worming tx - chewable.  EXAMINATION:Mentation - BAR, Very inquisitive BCS - 2/5 Temp - 37.9 CVS - HR 140, normal rhythm, no murmur Resp - Normal BV sounds, normal effort, RR 25, moderate stertor Abdo - soft, stomach moderately distended, no palpable abnormalities  Mouth - mm p,m. crt 1. Musculoskeletal - NAD Neuro - NADEyes - NAD Ears - NADSkin - NADUrogenital - NAD  Lymph nodes - NAD ASSESSMENT: Gastric distention, history of vomiting, 4hrs post-vax. DDX: Vaccine reaction, gastrointestinal causes. Client communication: Rec symptomatic mangement and INI RV.  TREATMENT:0.3mg/kg chlorpheniramine SC 1mg/kg maropitant sc -------------------- Fees Charged: --------------------Item Code: 203308 Item Name: Pro-Kolin 15ml Qty: 1.000Item Code: 7591 Item Name: Maropitant Citrate 10mg/mL Qty: 0.320Item Code: 2280 Item Name: Chlorpheniramine 7mg/mL (Niram Qty: 0.130Item Code: 149649 Item Name: Consultation - Weeknights Qty: 1.000    Vital Signs    Weight: 0.1;