C10000403 / invoice 10000

Appointment Reason: Check Up - Unwell/Injured, Appointment Notes: Few days ago had bile hanging out from her mouthAte dinner yday nightNo D+Frothy when walking her this morningFlatIn with AlisaHistory: Few days ago had bile hanging out from her mouth- no V+Started about Tuesday- still getting walked alotLying down quiteAte dinner yesterday nightNo VDCS+Just pants but not struggling to walkDiet: fussy lab (Royal Canin dry food mixed with wet food). Giving smaller quantities.No human foodNo toxins in the hosuehold + no toxic plants outside. Doesn't usually grab things she's not meant to and isn't really a scavenger. Frothy when walking her this morning + no hypersalivation. Doesn't seem sore when getting up and moving aroundFlat- still not hundred present Examination: BAR, very sweet girlEyes, Ears, Nose: clear of discharge and symmetrical LNs: submandibular and prescap  LNs WNLOral: no obvious fractures, abscesses or infections present in mouth- no obvious FB able to be located either. Cardiovasc: pink mm, no murmurs or arrythmias detectedResp: clear lung fields on auscultationAbdo palp: soft, pain response in cranial abdomen (repeatable)MSK: good ROM able to extend and flex legs without any issueAssessment: Open ddx: nausea vs panreatitis vs toxin ingestion vs reaction to humidity vs other?Plan: Options given to Alisa: 1. Run full bloods + trial symptomatic treatment for nausea2 Continue to monitor as otherwise well on PEAlisa opted for option 1. --------------------------------------------------------------------------------------------------------LAB: cPL 53 (0-200)ALP 5 (20-150)Rest of bloods WNLAssessment: Nausea secondary to GIT vs other?Plan; To treat with ondansetron and monitor over the long weekend. To rv if no improvement or if getting worried to call emergency.     Vital Signs    Weight: 25.35;       MMColour: Pink;       Temperature: 38.3;       HeartRate: 144;       BodyScore: 5;       CRT: 1-2;