C09997776 / invoice 10000

Reason: Unwell, D+ Since Tues And Now V+Appointment Notes: has been having D+ since tuesday and been on pro-kolin. no improvement. now started V+History: Has IBD. Has been fine since Nov. Started to try different diet and treats. Started d+ 3 days ago. Vomited twice over the last 3 days. Vomited bile. No blood in v+. Appetite is ok. Wants to eat but not eating a lot. Stools are light brown with mucus. No blood in d+. Started prokolin soon after d+ started. Current diet: chicken, pimpkin and carrot. Billie and Margo salmon kibbles.Has been on this kibbles in last 6 weeks and she has been fine. Started on probiotic treats recently too (main ingredient: kangaroo, sweet potato, lactobacillus). Examine: BAR, nervous BCS 5/9 DG 1/4 mild tartar mm pink, slightly dry <5% dehydrated.  HR 108 T 38.2 Abdo palp soft and comfortable. Rectal palp- no mucus or blood. Assessment: Likely primary GI dz- Dysbiosis, IBD flare up etc. Treatment:Metomide 0.4 ml S/cContinue prokolin BID. Leave out treats. Maintain on current dry food, chicken, pumpkin +/- probiotic treat.If there is loss of appetite or lethargy, may need hsopital admit for IVF and supportive care.    Vital Signs    Weight: 4.1;