C10004314 / invoice 10000

Reason: No Stools Passed For 5 Days- Is EatingAppointment Notes: MDSubjective and History:Normally defecates several times a day.For the last few days has had diarrhoea, soft stool only  in small amounts and straining to defecate at night. No vomiting.Eating normally. Feeding dry food as  normalNo known food indiscretion or fb ingestion. Has been known to eat socks in the past. Physical Exam:Mm pinkCrt< 2secMoistEyes/ ears wnlSkin goodPeripheral LNs wnlAbdominal palpation wnl, empty, no build up of faecal matter. Rectal exam: wnlBART 37.7oCAssessment:Ddx: colitis/enteritis : metabolic vs 1o git causes. Fb not off the list but is eating really well and has not vomited at all so feel intestinal fb less likely, could be in colon but again can't palpate anything there. Plan:Prokolin 6mls q12h Chicken and rice/ or RC gastro tinsIni 48h/ r/v with faecal sample so can send to lab. Also ideally admit for sedation, xray abdomen, consider ultrasound if needed.    Vital Signs    Weight: 29.5;       

Reason: AHC, VaccAppointment Notes: Overdue remindersHistory:Diet: Purina kibble; tuna BID; occasional apple.NGS monthly. No concerns.Physical exam:Boisterous.Heart & lungs: ok MM pink & moist; CRT <2s. Lns: wnls. Abdo soft, non-painful.Mild crepitus R stifle; hips feel wnls. Lick mat required to examine HLs.Ambulating comfortably.Significant intentional weight loss; BCS good.Assessment:OK to proceed with vaccination.Treatment:PiBb Nobivac SC.Lepto Nobivac SC.Good with lick mat.Plan:Consider fish oil 3000mg PO SID.Monitor for HL stiffness.Maintain current weight (target 32-33kg).    Vital Signs    Weight: 32.2;       

Reason: Lepto BoosterAppointment Notes: EDReason: Leptospirosis VaccinationHistory: Recent cases of Leptospirosis in dogs on the Northern Beaches. We recommend all dogs are vaccinated against Leptospirosis. BAR, currently up todate with vaccinations.C2i vaccination given SC by DCPlan:C2I Required in 12 months    Vital Signs