C10005354 / invoice 10000

Reason: V++ Bile>RCAppointment Notes: Overdue remindersHistory:Presenting for: Maya presented for acute onset vomiting since Saturday eveningV/D/C/S: Vomiting started Saturday evening around 7pm after being taken outside. Patient slept well Friday night and ate at 5pm Saturday. Has vomited 7 x todayPassed normal stoolCurrent Medication: nexgard spectra 7.5-15kg due in a few days Examine: T=38.2Quiet gut soundsAbdo nad on palpationMM: pink, crt<1sP= 108QARLooking for food in consultAssessment:Acute vomiting - DDx: dietary indiscretion (ingestion of rotten fish, mushrooms, or other toxins), less likely tick paralysis. Concern for possible hepatotoxicity given acute onsetPlan:Medications/Treatments:- Anti-emetic injection administeredDiagnostics:- In-house blood panel to assess liver enzymes and rule out hepatotoxicity. Results available in 20 minutesAdditional Discussion:- Mushroom toxicity considered given seasonal emergence and previous cases of elevated liver enzymes associated with mushroom ingestion- If blood results normal and dietary indiscretion (rotten fish), patient expected to recover within 24 hours- Bath and grooming planned once patient recoversClient Comms:- Owner to wait in clinic until blood results available before discharge- Further treatment plan dependent on blood panel resultsLab Results: results suggest pancreatitis as lipase >2500, amylase also Looks like it was from adding fatty mince to already high in fat kibblePlan: treat as outpatientSend bloods to ownerLow fatCerenia dailyIVF etc INI    Vital Signs    Weight: 11.2;