C10001103 / invoice 20000

Reason: V+ This Morning, Not Eating, Soft Stool. LethargicAppointment Notes: 06.03.26 TLE - O rang asking for advise. Bailey Vommited this morning, then owner gave cerenia and it stopped but she has not eaten anything or been interested in food. Some soft stool was noticed and she has been lethargic and not herself. Advised Vera that if her symptoms worsen overnight she will need to take her to ARH for hospitalisation. O was happy to wait until tomorrow this stage and let us know in the morning if she has had to taker her to emergency.History: Bailey presents today for vomiting, hyporexia, lethargy & diarrhoea. Bailey has a chronic history of gastrointestinal upset with any dietary indiscretion, so is fed exclusively Royal Canin Anallergenic. There is a very slim chance that Bailey may have eaten something in the yard (faeces, earthworm etc), though it is unlikely. Around 24 hours ago, Bailey had a single vomit & was hyporexic. She was given a maropitant, with no further vomiting since. Bailey then had 2 loose stools yesterday afternoon (FCS 6/7), with no blood or mucous. Overnight Bailey ate a small amount of her usual dinner. She has not experienced any ptaylism or regurgitation. This morning, Bailey appears much better, with a normal formed stool & no further vomiting. She ate the majority of her breakfast this morning & was not given her morning medications. Current meds: - Trilostane 40mg PO BID - Maropitant 16mg PO SID PRN -- last given 6/3/26- Telmisartan PO SID- Fenofibrate 24mg PO SID- Cytopoint 20mg SC PRNPertinent hx: - Hyperadrenocorticism, atopic dermatitis, proteinuria, hyperlipidaemia, chronic enteropathy (FRE)- History of pancreatitis Diet: RC Anallergenic Examination: T: 38.1 C           MM: pigmented pink & moistP: 112 bpm      CRT: 1-2s R: 20 bpmDemeanour: QARHydration: euhydratedWeight: 10.4 kgBCS: 6/9MCS: 3/3Cardiovascular: no murmur auscultated, normal rhythm, SSFPRespiratory: normal bronchovesicular sounds bilaterally, normal effortAbdomen: mild generalised abdominal discomfort Peripheral LNs: WNLOcular: clear & brightEars: clean with nil discharge or erythemaIntegument: clean healthy coatOral exam: periodontal disease 2/4Musculoskeletal: no evidence of spinal hyperpathiaGait: no overt gait abnormalitiesNeurological: mentation appropriate, full exam deferredRectal: - soft loose formed stool, yellow FCS 6-7/7- well tolerated, nil blood or mucousLaboratory: Nil Assessment: Bailey has presented for assessment of presumed relapse of her gastrointestinal disease. Given protracted history, dietary indiscretion resulting in secondary gastroenteritis is presumed. However, other differentials such as pancreatitis or biliary tract disease cannot be excluded. Given Bailey has improved clinically over the past 24 hours, she will be managed as an outpatient on anti-emetics, anti-nausea & probiotics. If there is no improvement, recheck with repeat bloodwork & abdominal ultrasound is recommended. Treatment: Maropitant 24mg PO SID PRN -- to collect from front counterMaropitant 30mg PO SID PRN -- dispensed (no 24mg in stock)Ondansetron 4mg PO TID -- script written Fortiflora 1g PO SID Consent has been given by the client to proceed with this treatment  -  YesPlan:Recheck if no improvement (bloodwork + abdominal ultrasound) ACTH stimulation 12/3/26 with KC    Vital Signs    Weight: 10.4;       

Reason: Med Request - Cerenia Tabs Pls- Name of medication: Cerenia- Previous dose/freq: 24mg PO PRN (Advised to administer Cerenia once every 24 hours, for no more than 5 consecutive days - as per KC) - Number of Tablets Requested: 4 - Doing well on this dose? Yes- Date of last vet check: December 2025VET TO AUTHORISEVet initials: WH    Vital Signs