C10000957 / invoice 10000

07/03/2026 HR 100 no murmur 
T 38.6

07/03/2026 Patient Information:
- Dog, Inflammatory bowel disease, bilateral cruciate disease with left meniscectomy

Reason:
- Diarrhoea since Thursday, bloody since yesterday

History:
- Diarrhoea since Thursday, became bloody yesterday
- On Baranza for arthritis - 3 injections to date, last 14/02/2026, next due next week
- Previous NSAIDs (Carprofen, Previcox) caused diarrhoea
- IBD diagnosed approximately 3 years ago, previously well managed with diet alone
- Diarrhoea more frequent recently, urgent in nature
- Procolon given at home - firmed slightly but still very runny
- Currently on Prime kangaroo (started post-hospitalisation) mixed with Royal Canin hypoallergenic
- Bilateral cruciate surgery - left meniscus removed, now has arthritis in left knee
- Still bright, happy, eating well
- No vomiting
- Never on budesonide or cortisone for IBD
- Previous bloods showed elevated liver enzymes and creatinine
- Ultrasound of kidneys November 2025

Examination:
Mentation: BAR
BCS (0-5):
mm: pmg               CRT: <2s
HR:                  RR: normal
Ln:
Dental Grade:
Temp: normal
Heart/lungs: NAD. Abdomen: NAD.

- Perianal area red, scald present
- Rectal exam performed

Assessment:
1. Diarrhoea - bloody
- Likely IBD flare vs dietary sensitivity (kangaroo)
- Check cobalamin levels - if low, supplementation required as can worsen diarrhoea
- Bloods: full health profile + cobalamin
- Stop Prime kangaroo, return to hypoallergenic diet only

2. Perianal scald
- Secondary to diarrhoea

Treatment:
- Abx dispensed
- Continue Procolon at home
- Sudocreme to perianal area with gloves

Plan:
- Bloods today - results Monday
- Stop kangaroo, return to hypoallergenic diet only
- Sudocreme to perianal area to prevent scald worsening
- Abx if not better
- Bland diet - cooked chicken breast/RC GI low fat food 3 days. Slowly back to normal diet after 3 days.
- Cu if worse

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