C10005875 / invoice 10000

V++ and D++
Happening since yesterday afternoon

HISTORY
Presenting for: Winnie, a 5 year old FN blue heeler cross Kelpie presented for vomiting and diarrhoea since Saturday evening/Sunday morning.

Historical Conditions:
- Surrendered from previous owner, BIOP for 6m. Settling in well

Diet:
- Normal diet: cooked chicken/turkey pet mince from Spudshed with frozen vegetables and potato
- Previously fed turkey mince with frozen vegetables (Thursday/Friday)
- Given triple smoked ham recently - Thur/Friday from left over meals
- Last ate dinner last night (handful of biscuits)
- Appetite not tested today

V/D/C/S:
- Vomiting: 2 episodes observed this morning in house
- Diarrhoea: yellow colour, no blood or mucus, some white soppy material, accident in house yesterday when owners returned home, unable to hold until outside

Current Meds:
- NexGard Spectra - not due until 17th (up to date)
- UTD vaccination

Lifestyle Risk Factors:
- Indoor dog
- Kept in cool environment

Other:
- Recent treats include pig's ears, dentastix (she does bury), Schmacko's 
- No scavenging behaviour noted
- Buries and retrieves chew toys in yard which may become softened

EXAM
Mentation: Anxious, O reports mildly flat at home but very boisterous in clinic
T: 38.3¡C
HR: 140 bpm
R: Panting
MM: Pink and moist
Hydration: Normal
Behavioural: Nervous and anxious, displays anxiety for injections and temperature taking, allowed examination
Cardiovascular: No murmurs detected
Abdominal: Mild tensing on palpation consistent with abdominal discomfort

ASSESSMENT
Mild gastroenteritis - likely dietary indiscretion secondary to recent fatty ham consumption or bacterial contamination from softened buried treats

PLAN
Medications/Treatments:
- Prevomax 2ml injection given subcutaneously for anti-nausea (24 hour duration)
- Gabapentin 300mg capsules - one capsule BID to TID for abdominal pain relief
- Pro-Kolin paste as probiotic to reestablish gut flora balance

Diet Recs:
- Bland diet of cooked chicken and rice with extra moisture
- Overcook rice and add chicken cooking juices to increase hydration
- No fatty foods or oil in cooking
- Encourage increased water intake

Additional Discussion:
- Blood tests available if no improvement in 24-48 hours to assess hydration, organ function and blood parameters
- Further imaging may be required if condition worsens or foreign body ingestion suspected
- Diarrhoea may take several days to resolve
- Return if watery diarrhoea, blood in stool, continued lethargy, or food refusal develops

Medication:

"Prevomax" Maropitant 10mg/ml @ 1mg/kg = 2ml SC @ 2:40pm

Gabapentin 300mg x 20 capsules - Give 1 (or 2) capsules by mouth TWICE (or 3x) DAILY, as required for pain relief. May cause mild sedation. Analgesia
Can be given with or without food, opened or whole or in a syringe with a small amount of water

Pro-Kolin 30ml paste