C09999307 / invoice 10000

Reason: L3 UWR V+ (Chonic D+, IBD+/-?)  EDAppointment Notes: Overdue remindersPresented and seen by Dr     @ Time/DateRegular Vet:Presenting Problem:History:Any current medications:Any access to potential toxins?:E/D/U/D:Any known conditions:Diet:Preventatives up to date? Y/NExamination Findings:General demeanour:Temperature:Cardiovascular:Respiratory:Oral exam:Abdomen:Peripheral LNs:Eyes/Ears:Integument:Musculoskeletal:Gait:Neurological:Rectal exam:Urogenital:Body Condition Score:Initial Assessment:Client Communication:Laboratory:Radiographic Findings:Ultrasound Report:Current problems:Differentials:Prognosis:Treatment:Plan: Daily update emailed to referring vet: YES/NOFinancial update provided to owner: YES/ NO    Vital Signs    

Reason: X2 Seizures Since Last Night - Consult 3Appointment Notes: Referral from Essendon vet - buckley streetTime and Date of Consultation: Reason: Regular Vet Clinic: Referring Clinician's name if direct referral: History:First seizure at night 6 weeks ago-  full gran mal - approx 2 min. Walked around carpark (came to ARH but settled and long wait so fine by time vet free - went home) Saw normal vet - full bloods normal and urine - WBC in urine - went on abx - resolved This am woken up to a him barking - let outside - heavy panting . Check camera - previous this had seizure lasting bout 50sec - gran mal but not as severe. Another seizure 1.30pm - similar to this mornings seizure - in between seizures was normal On lead walks - no access to toxins Very anxious dog - especially at vet Examination Findings: Examination:General demeanour: BAR Temperature 38.6Cardiovascular: 120 no murmur reg pulseRespiratory: panting normal bronchovesicular sounds Abdomen: soft nad Eyes: PLR nad visual Ears: nad Oral exam: mmpink CRt 1Peripheral LNs: nad Musculoskeletal: nad Gait: ambulatory Neurological: appropriate, cranial nerves nad Rectal exam: not performed Assessment/ Problem listCluster seizures Bloods normalToxins unlikely Intracranial issues  - idiopathic epilepsy more likely Plan: Advised need to start medication for cluster seizuresGiven the anxiety of Locky in hospital discussed both  - started oral meds and monitoring  - return if further seizures tonight - admit for IV loading of the medicationsWe will try to treat as outpatient given this will be least stressful for Locky Treatment: Keppra 30mg/kg q8 hours for 5 days Pexion 18mg/kg PO BID - can increase to 30mg/kg if not workingPlan: Recommended referral to medicine or neurologist for MRI and CSF to rule out other intracranial diseses - owner can call VRH and ARH monday to find earliest appt Dispensed 2 doses of 0.5mg/kg diazepam for PR use if seizure lasts more than 2 min Call if any concerns    Vital Signs    Weight: 33.4;       MMColour: pink;       Temperature: 38.6;       HeartRate: 120;       BodyScore: 5/9;       DentalGrade: 0;       RespirationRate: pant;       PainScore: 0;       CRT: 1;       

Reason: L3: Ate Boxer Shorts Poss Induce EmsisPresented and seen by Dr    Nicole Trigg  @  4.30pm  28/12Regular Vet:Presenting Problem: History:Ate half a pair of boxer shorts shortly prior to presentationExamination Findings:General demeanour: BARTemperature: dnpCardiovascular: HR 00, NAD ausc MM pink and shiny CRT 1sRespiratory: RR 32, NAD auscAbdomen: NSFPeripheral LNs: nadEyes/Ears: nadIntegument:nadOral exam: nadMusculoskeletal: nadGait: nadNeurological: BARRectal exam: dnpAssessment: Foreign body ingestion - half a pair of boxer shortsTreatment:Apomorphine tablets given s/c in 0.5ml water for injectionEmesis produced many pieces of black fabric - appears to be enough for half a pair of boxer shorts but cannot be 100% certain as is in so many pieces. Discussed with O that recommend monitoring over the next few days, if further vomiting, inappetance etc, recommend r/v with reg vet or ARH for reassessment and imaging, still risk of obstruction. Given maropitant 1mg/kg SC once to cease vomitiing (had vomited many times and now only vomiting up bile and froth). Referring Veterinarian Communication: no reg vetClient communication:As above    Vital Signs    Weight: 30;