C09999208 / invoice 10000

Reason: V+ D+Appointment Notes: STABILISATION06.03.26 AHRecord Entered by: Ilse Huinink (DVM4 student)Record Checked by: HCHistory:James, a 6 years old male spayed Beagle, presented to the ECC unit due to vomiting and diarrhea since 1 day.Three days ago, James was seen by the dog walker around a tupperware box of chicken, possibly eating something. Last night, they found small piles of diarrhea (cowpad consistency, higher frequency, smaller volume, no defecation witnessed, mucus, specks of blood). This morning, the owners also found small amounts of vomit with some grass and flecks of blood. He ate yesterday evening for the last time, but did show interest in treats. No lethargy. No coughing/sneezing. The owners have 1 other dog (Dachshund), they show no symptoms. Parasite prevention: UTD (last time 1 month ago)Vaccinations: UTD (last time July/August 2025)Diet: dry biscuits 2x dailyMedications: noneMedical history: history of dietary indiscretion and scavenging (paracetamol, cupcakes (--> pancreatitis))Physical Examination Temperature: 			38.2 CBody condition score: 	            5/9Body weight: 			20.3 kgDemeanour: 			BAREyes/Ears/Nose/Throat: 	No increased epiphora or exudate from eyes or ears, 				ears clean without scent, no reaction on palpation of 				throat and no palpable abnormalitiesPeripheral lymph nodes: 	Mandibular, retropharyngeal, prescapular, axial, inguinal and 				popliteal lymph nodes normal size and consistency, no painIntegument: 			No lesions or parasites. Healthy coat and skin.Cardiovascular: 		120 /min, MM pink and moist, CRT <2sec, no heart murmurs 				or arrhythmias, femoral pulses strong and synchronous.Respiratory: 			pantingAbdominal: 			Comfortable on palpation, but can cause lip smacking. Bladder small and 				comfortable, kidney palpation unremarkable. Musculoskeletal: 		No lameness or ataxia appreciated. Full MSK exam not 				performed.Neurological: 			Normal, appropriate mentation. Full neuro exam not 				performed.Rectal: 			            Perineal area clean, no inflammation. Rectal exam: no 				abnormalities.Urogenital: 			No discharges from prepuce. Desexed animal. Problem list & AssessmentLarge intestinal diarrheaVomitingHyporexia.All problems listed are most likely caused by primary GI disease.. This, however, can have multiple origins. Considering the story of eating something in the bushes, and the history of scavenging, dietary indiscretion or a foreign body are high on the differentials list. Other possible diagnoses are inflammatory causes, ileus, infectious gastro-enteritis, pancreatitis, endocrine. TreatmentInjection Maropitant (1 mg/kg) SC @ 1:30pmPlanSince the symptoms have only developed very recently, and James is not showing any signs of shock or dehydration, hospitalisation is not indicated at this point. Further diagnostics in the form of Xray’s or specialist ultrasounds, to identify the root cause of the issues and possibly find a foreign object, have been discussed with the owner. They have chosen to first try therapeutic measures, and if the diarrhea/vomiting does not resolve, to come back for further diagnostics. Therapy:Ondansetron 	8mg - 1 wafer (0.4 mg/kg) TIDPro-Kolin 	- 5 ml BID    Vital Signs    Weight: 20;       MMColour: Pink;       RespirationRate: 28;       HeartRate: 120;       Temperature: 38.2;       BodyScore: 6;       CRT: < 2 sec;