C09998628 / invoice 10000

Abdo U/S + IVFT

HISTORY
Sore abdomen noted on Wednesday 4/4/26. Ate well last night, but has a slightly reduced appetite. No V/D. Started on Gabapentin 300mg BID, started on Hepatoadvanced large 1 tablet daily. No previous anaesthetic reactions. Vaccinated. Has pet insurance. 

CLINICAL EXAM
MM: Pink, moist
CRT: <2 sec
LN: WNL
HR: 92, no murmurs
RR: 12
Abdo: Tensed, more comfortable than yesterday
Temp: 

IVC placed. 
Medications;
Buprenorphine (0.3mg/ml) @ 0.01mg/kg = 0.91ml IV @ 9am

IV sedation:
Medetomidine (1mg/ml) @ 0.005mg/kg = 0.15ml IV 
Alfax titrated to effect - 1ml given to facilitate smooth abdo US. 

IVFT with hartmann's @ 89ml/kr. 

Abdo US: Performed by Dr. Jarrad @ PVU
Impressions.
1. Assessing imaging findings in conjunction with the increased hepatic biochemistry an underlying inflammatory/infectious hepatopathy must be considered most likely. Consider hepatic supportive medical management and if there is clinical concern monitoring coagulation parameters and fine needle hepatic biopsy.
2. Mild gastric stasis. The gastric contents have the appearance of ingesta. Mild duodenal ileus was also noted.
3. Scaring and fibrosis of the pancreas is consistent with recently or previously resolved episodes of pancreatitis. If warranted consider dietary modification.

Assessment:




Anti-emetics:
Metoclopramide (5mg/ml) @ 0.5mg/kg = 2.7ml SC @ 11:30am
Maropitant (10mg/ml) @ 1mg/kg = 2.7ml IV @ 4pm prior to discharge

Medications:

Hepatoadvanced Large Chew - Liver Support/Supplement Chew - Previously dispensed
Give 1 tablet by mouth ONCE DAILY. 
Give on an EMPTY stomach 1 hour BEFORE food. 
Next dose due Friday evening, 1 hour BEFORE a meal on an empty stomach (6/3/26).

Amoxy-clav 500mg x 20 Tablets - Antibiotic Tablet
Give 1 tablet by mouth TWICE DAILY until finished. 
Can be given with food. 
Next dose due Friday evening (6/3/26). 

Metoclopramide 10mg x 10 Tablets - Anti-nausea & Pro-kinetic
Give 1 tablet by mouth TWICE DAILY until finished. 
Reduce nausea and increase appetite. 
Next dose due Friday evening (6/3/26). 

Ondansetron 8mg Wafers x 12 Tablets  - Anti-nausea Tablet
Give 2 tablets by mouth TWICE DAILY, to reduce nausea. 
Next dose due Friday evening (6/3/26).  

Gabapentin 300mg - Pain Relief Capsule - Previously dispensed
 Give 1 capsule by mouth TWICE to THREE TIMES daily, as required for pain relief. 
May cause mild sedation. Can be given with or without food, opened or whole or in a syringe with a small amount of water. 
Next dose due Friday evening (6/3/25). 


Plan:
Charlie's liver is inflammed, and causing him to feel unwell, nauseous and flat. 
Supportive care is required to reduce this inflammation, including pain relief, antibiotics and anti-emetics/anti-nausea agents. 
Encourage Charlie to eat and drink is important. 
Please feed Charlie a bland diet (no raw meat) for the next 2 - 4 weeks. 
Please monitor for any vomiting, inappetence, lethargy, bruising, collapse, or other signs of concern.
A blood sample has been sent to the lab to check Charlie's coagulation parameters. These results will be available early next week and we will contact you with the results. 
A follow up recheck is recommended in 1 weeks time (or earlier if concerned).
Repeat blood test to check liver parameters is recommended in 4 weeks time - at the end of the Hepatoadvanced liver supplement box.