C10006434 / invoice 10000

HISTORY: HISTORY - 
was playing around with other dog first.
gave a treat after.
- seem really sluggiest and not interested in treat again.
- seems really quite and breathing shallow for a bit. 

last year - something similar happened - seem like a spider bite?
- had some hive like episodes. 

couple weeks ago - went all limp and reluctant to move when first meeting a new people at home.
 
Appetite: fine 
Water intake: fine 
Energy levels: sudden quietness. 
Coughing or sneezing: none 
Vomiting: none
Diet: hill dental kibbles 
Parasite Control: unsure 
Vaccination status: UTD
Current Medications: none

EXAMINATION
Demeanour: BAR - nervous ,does shiver. 
BCS: 4/9 
Integument: nad
Eyes: nad
Ears: nad
Nose: nad
Mouth:-
CRT: 1-2 sec 
MM: pale pink  
Dental disease: Grade 1 /4
HR: 156  BPM,    Rhythm: reg
RR: ~ 16  BPM,    Effort:
Temp:  38.2 C
Peripheral LN's: WNL 
Abdomen: tense. but comfortable on palaption. 
Musculoskeletal: ambulating well. 
 
ASSESSMENT:
insect bite / seizure like episodes - start with EPOC and reassess. 
EPOC - elevated lactate. advice hospital IVFT + repeat EPOC. 
- O keen. 
- transfer to hospital 

CLIENT COMMUNICATION:
- estimate for repeat EPOC - if lactate still high - need further workup or longer hospital stay. 
- to record episodes next time when it happens. 


O called at 12am - discuss that recent EPOC results show significant inprovement with lactate since starting on fluids. not normal results yet, but on improvement of lactate, eating and nervousness - offered dischaage tonight - O keen. coming at 12.30am. 

TREATMENT:
none. 

BBG overnight 9/3/26
O came to collect. Tacky and mild tachycardia. Disc persistant hyperlactaemia and possibility of recurrence of symptoms. O wanting best management for piper so recommend stay in ON for ongoing IVFT

ON settled in kennel but can be anxious for exam. 
G2/6 HM, reg HR but very easily excitable
Intermittent tacky mm, single episode of injection so 10ml/kg fluid bolus, cont on 8% rehydration
Eating well

AM EPOC-persistant hyperkalaemia despite eating well and lactate still elevated (though decr to 3.15)

CC: Adv brighter in self, anxious. Option to keep in, supplement potassium and consider further w/u v dc with close monitoring. O consented to continue hosp care

Plan: Supplement K+, cont IVFT support, consider further w/u

GAP PRE APPROVAL - CLAIM $2583.70 CLIENT TO PAY $716.74 

CC 9/3
WEIGHT: 8.20

HISTORY: REASON – In for annual health check and vaccination

BIOP: 15 Months 
HISTORY - Doing well. Rescued from a dog pound. 

Appetite: WNL 
Water intake: WNL 
Urination: WNL
Faeces: WNL 
Energy levels: WNL 
Coughing or sneezing: nil
Vomiting: nil 
Diet: Royal canin small dog dry food , veggies
Parasite Control: UTD 
Last Vaccination: due 
Current Medications: nil 

EXAMINATION
Demeanour: BAR 
BCS: 5 /9
Integument: normal no lesions detected 
Eyes: bright, clear 
Ears: clean ,no discharge 
Nose: clean, moist 
Mouth: normal 
CRT:   < 2 sec        
MM: pink and moist 
Dental disease: Grade -1 /4
HR: 110  BPM,    Rhythm: no murmur, no arrhythmia 
RR:  normal bronchovesicular sounds ,    Effort: none 
Temp:   not taken 
Peripheral LN's: normal
Abdomen: comfortable 
Musculoskeletal: weight bearing on 4 limbs 
Neurological: normal 
Urogenital: normal 
Rectal: normal 

ASSESSMENT:
Fit for vaccination 
Dental disease

CLIENT COMMUNICATION:
1. May benefit from a COHAT in the next 12 months. 

TREATMENT:
      C4 injection    Batch: 5260010 Exp: 21.08.2026
      CC Oral Batch: 5245046A Exp: 24.09.2026
Parasite control: UTD 

PLAN: To book in COHAT with us. 
KC in a years time 

ESTIMATES:

REVISIT: Kennel cough in 12 months 

ADDITIONAL DISCUSSED:
1, Dental COHAT: YES
2, Desexing: Not applicable
3, Insurance NO
4. Vaccination Reaction: YES
5. Given relevant handouts and pet report card YES
6. Booked for next vaccination  (            )    in 12 months time  NO
WEIGHT: 8.2

HISTORY: Regular vet: BVH
History:
2pm was outside, vomited in garden. Vomited 3 times. 
Was shaking and trembling this evening. Little bit lethargic. 
Soft stool this PM. 
Was flea and wormed last night  - skin seemed a little pink this PM under neck.
Scratching and licking at area. 
No swelling observed. 
Rescue dog. O has had her for 6 months
No dietary changes 
Took some food this evening - seems to be eating okay. 
O hasn't seen her drink this afternoon. 
No coughing. 
No other concerns. 

Ongoing meds: NIL 
Observation:
Mentation: BAR, very nervous 
BCS:  2.5 /5
MM: Pink/moist
CRT: <2
LN: WNL
H/L: NAD, normal heart and lung sounds
HR: 120
RR: 24
Abdo palp: NAD, comfortable on palpation 
MsK: weight bearing on all 4, no limp
Skin: Mild erythema and slight bruising on ventral neck region, otherwise NAD 
Temp: 38.5
Rectal: NAD

Assessment:
1) Acute vomiting 
Ddx: gastritis/gastroenteritis, allergic reaction/anaphylaxis, dietary related/sensitivity, foreign body, toxin, other. 

2) Soft faeces - one this evening 
Ddx: any of above ddx, parasites. 

3) Mild erythema and very slight bruising on ventral neck region (may be from rubbing at area)
Neocort applied to area. TGH on Neocort BID for 7 days. 
O to monitor - if bruising worsens to revisit asap. Can run clotting times incase of a coagulopathy issue. 

Lactate: 2.63 - WNL 
Vitals normal - can give an anti-histamine and anti-nausea & monitor at home. 
If no improvement or if worsens at all to revisit asap for further work-up. 

Plan: 
1) 0.5mls Niramine injection given IM for anti-histamine incase of allergic reaction. 
2) 0.72mls Maropitant injection given SC for anti-nausea.
3) TGH on Neocort - apply to affected area BID for 7 days.
4) Recheck if no improvement, vomits through injection or if worsens at all. If bruising on neck worsens to revisit asap.
WEIGHT: 7.20