C10002112 / invoice 10000

Presenting problem: Sakura presented for vomiting, hypersalivation, and diarrhoea, with a deterioration in clinical signs since yesterday.
History
Onset of signs yesterday with vomiting water and hypersalivation. Today, the hypersalivation is worse, and watery diarrhoea has developed.
Generally off-colour and lethargic, more clingy than usual.
Not eating since yesterday, despite being offered ham and favourite foods. Is drinking water but vomits it back up shortly after, with minimal heaving.
Vomiting and diarrhoea present. No coughing or sneezing mentioned.
Was fine 2 days ago
Other dog is fine
Diet: Prime 100 roll and cooked giblets or chicken hearts. No change in diet prior to signs. No bones offered
Not a dog to chew/eat toys/bedding and nothing is missing
No known access to baits
Current parasite prevention: Not currently on any prevention.
Not UTD with vax
Normal vet is Blacktown Mylonas & O'Callaghan.
O took Sakura to Nth Richmond Vets yesterday afternoon due to V+/hypersalivation - verbal hx given by O is that vitals were normal at the time, prescribed cerenia tablet which he gave at 6pm last night but bringing up of watery material persisted despite that, and still no appetite. Also given probiotic powder but hasn't had any as not eating.
Physical Examination:
Dripping rose water diarrhoea when came in
Immediately placed into a consult room and did a parvo test first - O gave consent for this.
Parvo/corona/giardia test returned NEG for all 3
Rest of exam:
Mentation: Quiet but alert.
MM pink, hypersalivation - strings of saliva. No FB noted in oral cavity. Teeth - mod tartar. Gag normal
Did bring up yellowy watery material 2x in consult - neither time had any obvious abdominal heaving - just a small gag then water came up.
Chest HR: 160, RR: panting
abdo palp unremarkable, GI noise reduced
Rose water diarrhoea dripping from bottom.
T: 39.0. Rectal exam no formed faeces - watery D+ only
BCS 6/9
Diagnostics:
parvo/corona/giardia test NEG for all 3.
Assessment:
Deterioration since yesterday, with progression from vomiting and hypersalivation to include watery diarrhoea with poss blood.
Inappetence and inability to retain water + diarrhoea raises concern for dehydration (fluid loss both ends)
The lack of heaving with vomiting may suggest regurgitation
Differentials include Primary GI (infectious, obstruction) vs extra GI.
Plan:
Recommended work up (bloods, imaging) + admit for inpatient supportive tx with fluid therapy support. This is best pursued at a 24-hour emergency clinic due to weekend hours.
Owner agree and ok with referral - insured pet, aware costs may be significant.
A clinical history summary will be emailed to the referral hospital (Sash Prospect).
Owner advised to contact the referral hospital to inform them they are on their way.
No medications given here