C10006313 / invoice 10000

Reason: NPC - D+, Multiple Days (AH)History:Presenting for: Rosie presented for a 3 day history of diarrhoea with vomiting that started this morning.Diet: Currently being fed chicken and rice due to gastrointestinal upset. Patient not eating the chicken and rice well, whereas she usually loves it. Normally accepts treats from people in the park but currently declining treats.V/D/C/S: Diarrhoea for 3 days, sometimes lumpy consistency, little bit of colour, small amount blood noted. Frequency approximately 3-4 times per day. Vomiting occurred this morning, described as yellowish and runny with nothing solid present.Current Meds: No current medications mentioned.Examination:Mentation: Bright and happy, still barking and running aroundWt: 9.7 kg (previous weight 8.7 kg - gained 1 kg)T: 39.4°C (elevated, patient walked 15 minutes to clinic)HR: 140 BPMMM: Nice pink and moist membranesHydration: Not dehydratedBehavioural: Cooperative during examination, panting due to elevated temperatureCardiovascular: No murmur detectedAbdominal: Gut sounds slightly more gurgling than normal but not hyperactive. No pain on palpation, no masses palpable, abdomen does not feel gassyLymph Nodes: Normal sizeRectal: Anal glands expressed - left gland contained very thick material, both glands were full and required expressionAssessment:Gastroenteritis - likely viral, bacterial, or protozoal infection possibly acquired from environmental exposure during walks. Patient remains systemically well despite elevated temperature.Impacted anal glands - bilateral, with thick secretions expressedPlan:New Meds/Tx:- 1ml prevomax administered today to prevent further vomiting and reduce nausea- Pro-Kolin 3 mL BID for 3 days starting tomorrow to bind loose stools and provide probiotics. Treatment to be discontinued after 3 days to prevent constipationDiet Recs:- Continue chicken and rice diet, served warm to increase palatability- ID canned food offered as alternative if chicken and rice continues to be refusedAdditional Discussion:- Faecal sample collection pot provided for testing if diarrhoea persists beyond Pro-Kolin treatment- Antibiotics to be considered only if no response to current treatment, pending faecal analysis results- Blood work recommended if patient becomes lethargic, stops eating, or appears systemically unwellClient Comms:- Monitor for lethargy, continued vomiting, or worsening of clinical signs overnight- Return immediately if patient becomes flat or stops eating entirely- Recheck appointment needed if no improvement after 3 days of Pro-Kolin treatment- Bring faecal sample if diarrhoea continues despite treatment    Vital Signs    Weight: 9.7;