C10000650 / invoice 10000

Reason: Bloated AbdomenConsult Time: Triage - 0040   Consult - 0205History:- Presented on 07/03/2026 for assessment of acute restlessness and discomfort starting at approximately 7:30 PM.- Behaviours include attention-seeking, turning in circles, inability to lie down comfortably, panting, and whimpering.- Three weeks prior, presented to regular vet for head shaking and wobbliness, reluctance to use stairs, not walking a lot at all; No ear infection was identified. A neurological problem was suspected - IVDD/spinal pain was considered likely - no meds provided at the time- A referral was made to a neurology specialist, but the appointment was cancelled as symptoms improved over 7-10 days with rest. Was noted to be walking and sitting with difficulty during this period, but had been improving since, including using stairs again in the last few days.- Past history of sensitive gut, managed with diet - main symptom is flatulence- History of swelling under the jaw after chewing dense bones, which resolves over 2-3 days.- Vaccinations and parasite prevention status not discussed. - no vomiting or regurgitation- no diarrhoea, passed normal faeces this evening- ate dinner with enthusiasmObjective:HR 80, RR panting, mm pink, moist, CRT 1.5 sec, temp 38.4CV – Clear heart sounds, no murmur or arrhythmia noted, strong synchronous pulses.Resp – panting with normal RE, normal bronchovesicular sounds, no crackles or wheezes heard.GIT – Abdomen soft on palpation with no pain response or palpable abnormality. Hollow, gassy sounds auscultated over the intestines but gut sounds are not hypermotile. No tympanic sounds. Abdomen is symmetrical and not visibly distended on examinationUG – Bladder soft on palpation with no abnormality of external genitalia.Neuro – Normal mentation, no ataxia, appropriate cranial and peripheral nerve responses. Coordinated gait.MSK – No lameness, no pain on manipulation or palpation of neck, spine, limbs, hips/pelvis.Integ – Clean coat, no wounds or lesions, no ectoparasites noted.Eyes – Clear corneas, no discolouration, swelling or discharge. Mild lens opacity bilaterallyAssessment:Abdominal x-ray performed (primarily to rule out GD/V and to assist triage level.  The stomach is small with some food material present, but no evidence of gastric dilatation or volvulus (GDV). There is some gas present in the intestines. Clinical signs of restlessness and discomfort may be related to visceral pain, cramping or nausea. Spinal pain (e.g., intervertebral disc disease) remains a differential diagnosis for the historical and current clinical signs, however, there are no neurological deficits or spinal pain on palpation at present.Plan:- Administer anti-nausea medication with visceral analgesic properties.- Administer general analgesic medication.- Monitor response to treatment.- Advised owner on potential side effects of medication, including panting and altered mentation.Treatment:- Maropitant 1 mg/kg SC- Methadone 0.1 mg/kg SCClient communication:Discussed examination and x-ray findings with the owner. Ruled out gastric dilatation-volvulus which was a concern for owner and DDx based on description of behaviours at home. Discussed plan to treat for presumptive gastrointestinal discomfort/nausea and general pain. Discussed potential side effects of medications. Owner is aware that clinical signs may persist or change due to medication effects and to monitor closely. Owner understands that Archie appears more settled in the clinic environment but may show more signs of discomfort upon returning home.    Vital Signs    Weight: 29.8;