C10005265 / invoice 10000

--- 09/03/2026 11:54:49 OSG:O will call back to make an appointment today. Billie has been V+ and D+ and went to sash last night. O wants to see a vet to get B12, discuss prokolin and a HCVerified: NoHistory: Owner reports recent vomiting of bile and low energy levels. Concerns about potential ingestion of something harmful during walks. V/D/S/C - Vomiting bile, no diarrhoea, stool normal to slightly softer than usual. Appetite normal, eating hypoallergenic food. Drinking and urination habits . Energy levels lower than usual, mobility not specifically mentioned.Parasite control: as discussed.Diet: Hypoallergenic food, increased wet food recently. Feeding frequency twice daily (morning and night).Current medication:- Anti-nausea medication (specific name and dosage )- Vitamin B12 (specific dosage )Examine:BARMM pink/moist CRT 1-2sEyes - clearEars - clearDental grade - HR=PR= All lung fields sound clear. Normal REAbdomen soft and comfortableSkin - normal hair coatAll peripheral LNs normalAmbulatory - no lameness or ataxia, full ortho exam not performedTemp - Assessment:Not fit for vax due to current condition of vomiting and lethargy.Treatment:Plan: Monitor closely, administer Vitamin B12 as discussed. Hold off on vaccines until improvement in condition. Recheck energy levels and general health before proceeding with vaccinations. Consider dietary adjustments if gastrointestinal symptoms persist.    Vital Signs    

Reason: Hc + B12History:Went to SASH last night - V+ bile yesterday twice. Defecation normal to a bit softer than usual. Has eaten a bit last night and this morning. Energy level a bit reduced. Hasn't introduced any new food.O did increase RC hypo wet since last spoke to get her to put weight on. Had maropitant last night but not B12. Examine:    Vital Signs    Weight: 6.45;       

Reason: B12 VITAMIN B12 AND FOLATE STUDIES   Vitamin B12                      323   pmol/L        (99-503)Assessment:B12 level within range after the course of B12 injection - this indicates ongoing supplementation as likely unable to maintain once it is discontinue. Will still to cont diet management long term - given her lack of interest to hypoallergenic food and recent weight loss, should consider trialling single novel protein challenge to hopefully increase interest ie crocodile, kangaroo? Plan:O elected for monthly B12 injection  ongoingly to ensure she gets what she needs. O will trial feeding her more RC hypo wet (1-1.25 cans daily) and will introduce Prime 100 Kangaroo slowly. Adv there's a possibility that she may get flare up of her GI signs, in which it means kangaroo is not suitable for her. --- 02/03/2026 15:45:50 LTL:Spoke to Louise, relayed B12 result, assessment and plan.O happy to bring her in monthly for B12, adv nurse can do this unless O has concerns.O reported that she doesn't like the RC hypo food, but will eat if hungry. She only eat 50-75% of what O offer her on average and continuously scavenge for other type of food ie cheese etc. O gave her RC hypo wet less than 1/2 can daily + a handful of dry BID + carrots. LTL suggested to feed her RC hypo wet primarily to see if she likes this better - need to feed her 1-1.25 tins daily.Also disc introducing other single novel protein - kangaroo or croc. O will try kangaroo first and see.Also booked for vax and B12 on 14/03.Also texted O afterwards:Hi Louise, just a thought on the food for Billie, it might not be a bad idea to keep her on just RC hypoallergenic wet mainly until her vaccination appointment just in case if she gets diarrhoea/vomiting from introduction of prime 100 kangaroo. Because we will not be able to vaccinate her and might have to reschedule. Lani (BVH)--- 02/03/2026 15:59:41 OSG:Sms from OOkay that's sounds like a good plan. Thanks so much    Vital Signs