C10001619 / invoice 10000

Reason: Y/G- Suspected AddisonsAppointment Notes: evervet labs attached- GAPONLYSubjective: Ivy has had a history of GI disease first starting back in 2021--was concerned for a GI obstruction and went in at RV with a negative ex lap. Then was referred down to Penvet and had some GI biopsies which came back for initially some concern for lymphoma but then upon assessment seemed more likely to have IBD. Was initially on prednisolone for 6 months but weaned her off as she hasn't done very well on it. Last time was on medication was end of 2021. Since then not been on any long term medication other than pro kolin and intermittent ondansetron and omeprazole. Is on a strict diet of kangaroo. Has been vomiting intermittently over the last few days, went to RV where bloods showed a hyperkalemia of 7.1. Otherwise has still been eating and drinking. Os would like ongoing workup for Addisons disease. Objective: BARHR 92, no murmur/arrythmia, MM pink CRT 2 secRR 32, NAD on auscultation Abdo comfortable on palpation Msk NADInteg NADEENT NADTemp 37.6Neuro NADRectal NSFAssessment: Vomiting ddx IBD vs dietary indiscretion vs pancreatitis vs GIFBO vs Addisons diseasePlan: Os would like to admit for bloods and rehydration Bloods to be taken: Blood gas PCV/TPT4 and B12 at Os requestACTH stim Vet Check baseline cortisol Laboratory: 49/70PH 7.4PCO2 37.1PO2 46.3K_ 4.1Na 149Ca 1.34Cl 117Glu 4.5Lac 1.5SBE -1.3HCO3 23.3Vet check T4 normalBaseline cortisol 65 nmo/L ACTH stim test sent to ASAP (didn't have the right code on file)Treatment: IVFT 85 ml/hr Await ACTH stim test resultsSend home to continue on ondansetron (O has some at home)Await results then make rejpeat medicine appointme with AB if no improvement seen to follow up results-    Vital Signs    Weight: 32.2;