C09994788 / invoice 10000

DATE/TIME of CONSULTATION: 23:10hrs, Thu 05/03/26
CLINICIAN: SaCh
PRESENTING COMPLAINT: Acting strange
HISTORY:
On saturday vomited under daughter's bed. 
Has been given chicken last 2 weeks with cheese. 
Has history of pancreatitis- so normally on low fat diet (not cheese). 
Tonight vomited also and then did C-shaped position and seemed very uncomfortable. 
Very fussy eater. 
When owner arrive at AVC Mylo has returned to normal and seems very happy. 

CLINICAL FINDINGS: Mentation: BAR  HR: 100 RR:44 MM: pink CRT: unable to determine  Temp 39.4
Very bright and running around/jumping
Limited/muzzled exam as bites. 
Some resent on abdominal exam, tensing and growling (may be behavioural as highly anxious). 
LN's unremarkable
Rectal: scant faeces only

PROBLEM LIST:
Pyrexia
Abdominal pain
Historical vomiting

DIFFERENTIALS: Pancreattis/HGE/FB/other

OPTIONS PROVIDED:1. Admit for IVFT/EPOC/abdominal Ultrasound and supportive care
2. Supportive care only
3. Analgesia and anti-nausea and see RV in morning INI for hospitalisation for supportive care/imaging. This option elected. 

DIAGNOSTIC TESTS: N/A

TREATMENT: Maropitant 1mg/kg sc. 
Methadone 0.3mg/kg s
CLIENT COMMUNICATION/PLAN:R/V INI. Ensure eating/happy and no further vomiting over the next 24 hrs. If vomiting - see RV. 

Eaten used tampon in last 2 hrs - successful emesis induced with apomorphine to conjunctiva of the eye - flushed post emesis - home - no further treatment. 

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HISTORY
Presenting for tampon ingestion within the last hr
No other medical or surgical history
Worming and vaccinations: UTD
 
SUB: BAR
OBJ: HR: 140, MM pink, moist CRT<2 T: 39.3
CARDIOVASCULAR: no notable murmurs or arrythmias auscultated, femoral pulses good and synchronous
RESPIRATORY: normal respiratory rate and effort, normal bronchovesicular sounds on auscultation, no visible nasal discharge
GASTROINTESTINAL: soft comfortable abdomen on palpation, no strong repeatable focus of pain, 
MUSCULOSKELETAL: ambulatory x 4
NEUROLOGICAL: cranial nerves intact, no notable ataxia
INTEGUMENT: no obvious lesions
OTIC/OCULAR: normal ocular and otic structures
 
ASSESSMENT
emesis induced with apomorphine L subconjunctival sac - successful - flushed post emesos
 

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