C10003518 / invoice 10000

HISTORY:
Presented for: watery D+ throughout night, shaking and not herself
Was panting and shaking at night
Had watery d+ few times throughout night and today, brown colour initially then red
No v+
Diet: fresh salmon, chicken cooked, canned meat lamb (has once every 2-3wks), kibble. Yest had a puppychino normally has lactose free but unsure if yest given full cream by new staff member 
Is drinking fine 
Can scavenge 
Is due for annual bloods soon
No meds 
F&W: utd 

EXAM:
BAR, sweet girl
HR 100bpm, no m/a, ssfp
RR 20, normal effort, lung sounds clear
Temp 39.1
Abdomen soft, comfy
MM pink, moist, crt<2sec
Rectal: empty 

ASSESSMENT:
Haematochezia - ddx GI vs extra-GI

PLAN:
Offered inpatient vs outpatient mgmt - O elected latter
Declined bloods today as due at reg vets soon, adv to consider basal cortisol too
Pro-kolin 5ml PO BID until d+ resolves
Bland diet

COMMUNICATION:
RV if any deterioration 

Jumped out of car yesterday & has a sore foot. 
Subjective: Jumped out of car and yelped holding up left front leg - massaged by owner. Seemed fine afterwards and went for a walk afterwards without problems. Also seems fine today. Seen elsewhere a couple of weeks ago for ear infection and full anal glands. Feeding steamed chicken, kangaroo and digestive dry food, rice and steamed veges, cooked egg, bread/toast etc. Also gets beef jerky, Prime 100 SPD kangaroo loaf, and kebab meat and puppachinos occasionally. Faeces sometimes solid and occasionally runny. Good appetite. No vomiting.
Objective: Legs fine - no pain/swelling/lesions detected. Not lame in consult.  Ears good - no discharge/inflammation. Anal glands full - not infected - soft faeces in rectum. 
Diagnosis: Impacted anal glands. Soft faeces.
Plan: Recco try strict diet of RC Digestive, rice and pumpkin for next 2-3 weeks and see if this helps with faeces and anal glands - can then start to add in one new food every 2 weeks and monitor faeces if doing well.
Express anal glands.

HISTORY:
Presented for: diarrhoea
OR softer stool for the past couple of days 
O concerned has fed too many liver treats 
Scooted along the kitchen floor this morning 
Otherwise well, eating and drinking normally, no vomiting 
No current medication 
No underlying health conditions 

EXAM:
Mentation: BAR
BCS: 4/9
Hydration status: NAD
Eyes: NAD
Mouth: NAD
MM: pink, moist, <2
LNs: WNL
CV: HR: 100, regular rhythm, no murmur 
Resp: regular rate, effort, pattern and all lung fields clear 
Abdo: soft and comfortable 
MSK: ambulatory x 4
Genitourinary: AGs slightly full but easily expressed 
T: 38.4

ASSESSMENT:
Diarrhoea ddx: intra-GIT (dietary indiscretion vs dietary intolerance vs gastroenteritis vs other) vs extra-GIT (renal vs hepatic vs metabolic vs other)

PLAN:
Pro-Kolin 4mL PO BID until finished 
Bland diet e.g., boiled chicken 

COMMUNICATION:
As above