C09994193 / invoice 10000

HISTORYPresenting for: Intermittent diarrhoea for the past month, with previous episodes containing mucus, blood and jelly-like material. Today's stool is normal.Historical Conditions: Dog was looked after by other people during the past month when diarrhoea occurred.V/D/C/S: Diarrhoea on and off for the past month. Previously contained mucus, blood and jelly-like material. Today's stool is normal.EXAMMentation: BARLymph Nodes: NormalAbdominal: Palpation normalIntegumentary: Responds well to Superlion, not aggressiveDiagnostics: Faecal examination normalASSESSMENTIntermittent diarrhoea - ResolvedPLANMedications/Treatments:- Superlion 12 injection administered today

HISTORY: client 20 minutes late for consultPresenting Complaint:Lip smacking, refuses to eat except high value treatsFaeces - intially formed with blood and then watery diarrhoea.Vomited last night - specks of blood. 3 x small vomits over last 24 hrsLethargic.Reported to be urination and drinking wellDiet: EPI - blackhawk grain free diet, wet food brown rice and chickenOngoing Medical Conditions: EPICurrent Medications: recently finished metronidazole course ; Vit B12 and Creon10,000 daily for EPIPHYSICAL EXAM: limited exam, untrustowrthy demeanorQAR, mm pink/moist, crt <2secBCS 4/9Temp: not taken as per owners recommendationEyes: clear OU, no squinting, no discharge, pupils responsive and symmetricalEars: clear AU, no discharge or swellingNose: clear, no dischargeOral: dental disease 1/4, no ulcerations/masses presentHeart: HR: 116, no murmur, no arrythmia, strong/synchronous pulsesLungs: RR: pant no dyspnea, no trouble breathing, clear lung sounds all fieldsAbdomen: No pain on palpation, no mass effect, no fluid wave, no abnormalities; no obvious discomfort but lip smackingPLN: WNLMSK: ambulatory x4Neuro: mentation appropriateIntegument: NAFUrogenital: WNLRectal: not performedDIAGNOSTICSDiscussed bloods and faecal sample as owner would like answers for why this keep recurring, but would like to try medical management onlyASSESSMENTDDx Mild HGE vs Gastroenetritis vs pancreatitis vs open diagnosisDog has EPI - O would like to get to bottom of recurrences of GI issue - have recommended referral to internal medicine at MVSCTREATMENT1mg/kg maropitant SC16mg ondansetroon TM BId for 5 days6ml prokolin BID for 5 daysLectade sachetPLANRevisit if ongoing concerns for bloods, faceecs +/- in house abodminal US vs referral to IM at MVSC 

HISTORYPresenting for: Vomiting with blood and bloody diarrhoea after ingesting kangaroo and duck faeces while camping over the weekendV/D/C/S: Two episodes of haematemesis and haematochezia todayOther: - Camping Saturday and Sunday- Ingested kangaroo and duck faeces while campingEXAMMentation: BART: NormalAbdominal: Normal on palpationMM: PinkCardiovascular: No heart murmurASSESSMENTHaemorrhagic gastroenteritis - Likely due to ingestion of faecal materialPLANNew Meds/Tx:- Metronidazole 400mg BID