C09994674 / invoice 10000

HT - ARH history coming
Was @ emergency vet for 3 days, was peeing 30-40 times an hour and had surgery 2 days ago
Has come home last night and this morning still trying to wee all the time

Hx:
Check up after being at ARH for FB surgery, discharged last night. 
Overnight flat, inappetant. Needing to urinate a lot. No defecation. No regurgitation overnight 
Able to get small amount of chicken eaten this morning
Still on full medication doses for anxiety. Fent patch removed last night by O's. 
Home with cerenia, metoclopramide and ondansetron. None given at home yet. 
O able to collect free catch urine before consult
Not drinking excessive amount 

PE: flat, wagging tail
CRT <2 secs
MM pink and moist 
HR: 108bpm 
RR: 36bpm 
Temp: 38.7
Rectum: empty, faeces on glove, no blood 
Wound clean. 

Assessment:
Inappetance 
PU 
Urinalysis - leuk 500, blood 250, gluc 30. Neg crystals. Negative bacteria. Evidence of foamy macrophges, 1-2 neutrophils found. 

Plan: 
Trial amoxicillin, single NSAID injection, urgent care food, give cerenia at home. 
Call partner tomorrow for update 

Hx attached from ARH

FB ex lap performed 3/3/36 - small squeaker toy found small intestine. 
Hospitalised for 3 days. Discharge last night 5/3/26 due to not eating much (anxiety vs pain). 

AFAST - FF in abdomen (significantly less prior to discharge), small pocket near bladder, regurgitation overnight in hospital 
Discharged with paracetamol, metaclopramide, cerenia/maropitant. 
Fentanyl patch due for removal this afternoon/Sat AM 

Discussed with O at ARH prior to discharge: 
Discussed with owner that not much had changed for Millie over the last 12hrs. In general she seems less painful and more settled, however she has not commenced eating and still has free fluid within the caudal abdomen. Her lactate is lightly increased and her potassium is slightly low. Owner would like to take her home and do a food trial to see if she acts differently in a more comfortable and familiar
environment.
Advised we could trial doing so, but to be aware that she may need further intervention.
As alternative offered sedating Millie and sampling the fluid for cytology, +/- placing NG tube to provide enteral nutrition. May also just require more time on a metomide CRI.
Owner has declined this for now, will take her home for a food trial and represent if she is continuing to be inappetant or otherwise unwell.

HT approve - script provided. 
Review required before next dispense