C10003413 / invoice 10000

Triage: KLReason: Vomiting BloodPresenting problem:Normally healthy happy girl. Didn't eat dinner last night, had a single clear foamy vomit. Ate treats afterwards. Has vomited approx 3 times this morning - foamy and blood tinged. Has diagnosis of elbow dysplasia - is on 4cyte and Meloxicam from Main Ridge. Has only had 3 doses of Meloxicam, last being two days ago. Examine:T: 39.1    P:  240 (tiny little girl and SUPER anxious away from O's)   R: 28    MM: pink      CRT: <2sTriage level: YellowClient communication:Spoke to O's and advised vet is currently in emergency procedure so no one available to consult. Current wait time approx 2 hours. Offered option of calling other emergency hospitals. Appt booked for 1000hrs at Rosebud, will keep close eye on her at home and call/re-present if any changes.-----------------------------------Consultation time:  09 05  History:Presenting problem:  Vomited blood.Owner reports that last night (6/3) Marjorie didnt show much interest in food. Then over night she vomited bile'ish liquid initially. Then started vomiting bloody / brownish + yellow liquid couple of times . O brought Marjorie 4 am to the clinic and as it was long wait time , gone back. But after going back she vomited again couple more times with orangy/ red colour. ( O had photos of the vomit) Seemed lethargic after this.No diarrhoea reported .Owner mentioned that they had placed rat bait , but confident that Marjorie has not accessed this.Previous medical history/medications:  Diagnosed elbow dysplasia at reg Vet last week after limping on the RF. Started on Metacam and has given three doses of oral medication on 3/3. 4/3 and 5/3. Examine:  Demeanour - BART: 39.1       HR:   180    RR: 40/ pant   mm: pink     CRT:< 2 secWeight: 3.25 kg       BCS: 5 /9Cardiovascular: No murmur or arrhythmia, synchronous femoral pulsesRespiratory: Normal BVS and effort bilaterally Gastrointestinal: NAD. No pain on palpationUrogenital: NSF outwardly.  MSK:NADNeuro: Normal mentation, no ataxia. Full neurological exam not performed.Eyes: NSF Integument: NSFLNs: Peripheral LNs WNR Problem list:Vomiting Haematemesis?Assessment:NSAID toxicity is highly likely.Other DDX: Primary GIT Vs secondary GIT including rat bait poisoning, coagulation abnormalities, thrombocytopenia or other .Client communication:Offered admission for fluid therapy, diagnostics and treatment as needed.2. Symptomatic Tx and manage as outpatient.Owner declined any further medication including , pain relief, gastric protectant or other.O decided to take Marjorie home after initial treatment and will revisit should there be any concerns.Treatment: Prevomax 0.32 ml SC inj Plan:Home to monitor and revisit should there be any concerns -Recommend reassessing with reg vet in 2-3 days time or sooner.Bland diet for 24- 48 hrs.    Vital Signs    Weight: 3.25;