C09998707 / invoice 10000

Reason: V+ 8x Today, Coughing. CMHistory Admitted to hospital following several episodes of vomiting bloods showed a hepatopathy unknown  origin further testing declined . Has been eating overnight . AsessmentGiven how dehydrated and liver enzymes would recommend continued hosp at least today. Spoke with owner around 9 30 am when she finished work . Owner consents to stay here the day . Repeat bloods alt and tbil tonight . Probably not alkp . If still eating and bright could consider outpatient care this evening . Will discuss bloods with them and how she has been and then owners can make decision later this evening . Didn't go on fluids till 10 pm last night so try and keep on fluids till later. Treatment Continue iv fluids increased to 25 mls an hour at midday as has not urinated since arrived in hospital yesterday. And was haemoconcentrated yesterday Switch to amoxyclav 125 mg bid as is eating Maropitant 24 mg tablet halved so 12.5 mg sid Examination Vitals as per smart flow I cannot hear a hear murmur myself but i'm old and deaf so could be that .  Abdomen bit uncomforatble with deep palpation . Expect it given liver likely enlarged Bright and anxious . Eating well. Urinated at midday Plan owners are a bit cost constrained so suggested if still clinically well this evening and alt and tbil coming down could take as outpatient if costs are an issue . Bindi does have insurance but owners dont want to spend to much . I have estimated for just alt and tbil bloods--- 06/03/2026 17:47:53 KIA:ALT 3766TBIL 98Called O (no answer) to advise sadly of the increase in the liver parameters. It would be recommended that Bindi continue to stay in hospital for ongoing supportive care, especially as we do not have a diagnosis as to what the liver pathology is.    Vital Signs    

Reason: V+ 8x Today, Coughing. CMCoughing has been going on for years - like has something going on in throat - episodic - goes through phases where it doesn't happened Just before 6am woke up to Bindi vomiting - looked like pureed food - has vomited 8 times today - last time was 4:30am - tiny bits of food, mainly bile Has urinated.  No poo since yesterday morning.  Normal yesterday morning.  Has been offered small treats throughout the day but took reluctantly.  Reduced reguarity of defecation - but then went 4-5 times on walk.  Vaccinations / worming - UTD - due worming this week Medications:  None Toxin - no access - not an indiscriminate eater - not a scavenger Diet - Owner cooks chicken mince with rice and veggies plus some dry food - little bit last night, dried liver treats - given a little bit of canned tuna - table spoon Prior history of GI upset - suspected liver issue - vomited - this happened a few years ago so has diet sensitivity Has been extremely lethargic todayExamination Findings:General demeanour: quiet but standingTemperature: 38.6 degCardiovascular: 160, murmur g 2, PQ normal.  Respiratory:  RR 36, crackles Right lung Oral exam: mm-pi, tacky, crt 1-2sAbdomen:  Peripheral LNs: WNLEyes/Ears: WNLIntegument: WNLNormal defecation during examInitial Assessment:- Vomiting - acute onset-  Lethargy - acute onset-  Cough - longer duration, episodic-  Heart murmur, tachycardia -  Tacky mmLaboratory:ALT 4877 on 1:5 dilutionALP 1275Communication:Advised owner of blood test findings.  Recommended admit for IVFT and supportive care overnight.  Advised can perform pocus ONLY due to limited staff and busy shift to rule out FF / mass.  O declines abdominal  POCUS but will consider full ultrasound INI.  Owner suspects has been drinking from an plant with algae in the pot and apparently preferentially drinks from this.   Revised Assessment -  Marked biochemical hepatopathy-  Vomiting, lethargy-  tacky mm-  heart murmur-  coughTreatment:-  IVFT @ maintenance-  hepatoadvanced-  cereniaAdd omeprazole if continues vomitingPlan: Daily update emailed to referring vet: YES/NOFinancial update provided to owner: YES/ NO-------------------------------------Night shift--- 06/03/2026 05:15:02 EXB:Laboratory: Further labs run  as per KSTBIl 60 elevatedQCpl normal at 117.Assessment: Marked hepatopathyLytes and renal okActive hepatic damage ongoing.KS had concern over possible inc lung noise on right side.Plan: Continue with treatment trial as per o request.Examination Findings: See sf for full recordAte chicken well overnight.Treatment: AmpicillinMaropitant DenamarinIvft- inc rate slightly to 18ml/hr as not urinated and haemoconcentrated on bloods.    Vital Signs