C10003151 / invoice 10000

Reason: V++ 5 Times Yesterday Then 5 Times Today -Not interested in food - passing fowl smelling gasReason:presentation for vomiting and diarrhoearecently started on prednisone and an antibiotic for a suspected utiowner reports lethargy and weight lossHistory:presenting for vomiting and diarrhoealast night vomited big chunks of food, today has been yellow bileepisode of black, loose stool in the carowner reports lethargy, sadness, and weight loss, with no interest in food this morningabdomen is audibly gurglingthe issues have been ongoing for five weekshas been started on prednisone and an antibiotic for a suspected urinary tract infection (uti) since last fridayvomiting appeared to start after the prednisone doseowner has withheld medications todayprevious episode of severe illness last year requiring hospitalisationdiet: turkeyno c+/s+/v+/d+ no, has vomiting and diarrhoeaEDDU: owner reports urination seemed to improve with cranberry, but appetite is poor todayparasite control: not mentionedpre-existing conditions: history of utis requiring surgery which owner feels has worsened the issuecurrent medications or supplements: has been on prednisone and an antibiotic, currently withheld, owner has also been giving a fibre supplementowner reports no other concerns todayExamination:Body Condition Score: owner reports weight loss, appears to have lost weight on visual inspectionGENERAL: BAR/QAR, appears sad, hydration status - well-hydrated, mm pink and moist, CRT <2sHEART: HR normal, regular heart sounds, no obvious murmurs or arrhythmias, strong and synchronous peripheral pulsesRESP: RR normal, lung fields clear on auscultation - no crackles or wheezing, normal effort and no obvious nasal dischargeEARS: external exam only - no discharge, no odour, no obvious inflammation or irritationEYES: clear chambers, no discharge, symmetrical pupils, pink conjunctivaABDO: soft and supple on palp, no palpable organomegaly, or masses, borborygmi notedLYMPH NODES: no peripheral lymph node enlargement on palpORAL: mild plaque build-up and gingivitis observedMSK: good general conformation and ambulatory on all four limbs, patellas bilaterally firm, no hind dew claws, good range of motionINTEGUMENT: fur and coat in good condition, no ectoparasites on skinUROGENITAL: entire, vulva appears grossly normalTemperature: normal on rectal examination 38.0Laboratory:bloods were taken for in-house testing:> CBC:significant findings: results pending> biochemistry:significant findings: results pending, thyroid level also requestedAssessment:suspected gastroenteritis secondary to medication (prednisone and/or antibiotic) vs ongoing primary gastrointestinal diseaserule out other systemic causes of vomiting and weight lossTreatment:carafate 0.5 tablet as a slurry administered po in consultanti-nausea injection maropitant administered sqPlan:discussed stopping all current medications (prednisolone, antibiotic) to allow the gastrointestinal tract to recoverrecommended a bland diet of turkey only for nowbloods have been taken to investigate for any other underlying issues, with results expected this afternoondispensed carafate to be given as a slurry (half a tablet mixed with 5ml of warm water) three times a day to help soothe the stomach liningthe anti-nausea injection should start working within 45 minutesowner advised to monitor for any further vomiting or bloody faecasrecheck scheduled for friday, but owner advised to call if there are any ongoing concerns before then    Vital Signs    Weight: 10.8;       HeartRate: 130;       DentalGrade: 2;       RespirationRate: 24;       PainScore: 0/10;       Temperature: 38.0;       CRT: 1;       MMColour: pink cinjuncitiva;       BodyScore: 3;