C10001597 / invoice 10000

Appointment Notes: Vomiting again following Ex Lap 3-4 weeks ago @ Eastwood house. Vomited twice this AM, has been fine until now.Being brought in by Jack who is house sitting for Owner while she is in the UK, Jack has full authority to make medical decisions for Lando.  cbHistory:Presenting for investigation into vomiting breakfast. 3 weeks ago had a foreign body surgically removed. Has also had a surgery in the past to remove a FB. Otherwise had been well and recovering since the previous procedure. This morning did 2 large vomits after breakfast with food, then one small one with just liquid. Given recent events his O's and the cat sitter are a little on edge and would like to run some testing.EDDU normallyNo V+ or D+No coughing or sneezingDiet: BiscuitsFleas/Ticks: UnsureIntestinal worms/Heart worm: unsureMedications - Examination:Behaviour: BAR, Anxious, ReactiveCoat & Skin: No abnormalities noted. Coat clean and dry, no evidence of external parasites.Eyes: No abnormalities noted, no discharge, swelling or erythema.Ears: No abnormalities noted, no discharge, swelling or erythema.Nose & Throat: No abnormalities noted Negative tracheal pinch.Mouth, Teeth & Gums: Minimal dental tartar. Gums are a normal colour. Normal hydration.Dental Disease Grade Scale: 1/4Musculoskeletal: No abnormalities noted, no neck or back pain. Normal gait. No joint or limb pain/swelling palpated.Neurological: No cranial nerve or conscious proprioceptive deficits detected.Cardiovascular: g3/6 Heart murmur noted. Normokinetic pulses.Respiratory: No abnormalities noted, clear Broncho vesicular chest sounds bilaterally.Abdomen: Tense and anxious, unable to palpate thoroughly.Lymph nodes: Submandibular/Prescapular/Popliteal normal size and non painfulGastrointestinal: No abnormalities notedUrogenital: No abnormalities notedLaboratory:None performed todayAssessment:Otherwise deemed fitAcute vomitingG3/6 Heart MurmurSuspect kidney diseaseAnxiety in clinicDifferential diagnoses for vomiting include foreign body, stricture, adhesions post-surgery, or dietary intolerance.Client communication:Discussed preventativesDiscussed general healthDiscussed diagnostic plan for investigation of vomiting. Lando is too anxious for conscious diagnostics. Plan is for sedation for imaging and bloods. Discussed estimate for sedation, x-rays, bloodwork, and anti-nausea injection, totalling $1138.60. Owner consented to proceed with this plan. Also discussed the possibility of trial feeding with small, frequent meals (4-6 times a day) as an alternative or initial step, considering his history of multiple procedures which could lead to strictures or adhesions. Discussed that if imaging is unremarkable, a contrast study would be the next step.Treatment:-Plan:Continue with preventativesWellness Check in 6 months time    Vital Signs    Weight: 5.3;       HeartRate: 140;       DentalGrade: 1;       RespirationRate: 30;       CRT: <2;       MMColour: pink;       BodyScore: 6;