C10006610 / invoice 10000

Reason: Vomiting, diarrhoea, haematocheziaHISTORY:Presented as initially hyporexic yesterday morning, and since developed vomiting and diarrhoea with haematochezia.Owner had given chicken and rice yesterday which he ate, but vomited this up. He still ate some for dinner and this morning. This morning he had vomited about 3 times and brought up all of his food.He has not wanted to eat dinner tonight.He then started to have some haematochezia (pink-tinged) diarrhoea this evening. A similar episode had happened when he was about 5 months old, which was reported to ahve resolved with supportive care.He is not a known scavenger and has not eaten anything unusual/anything fatty.He is not as excited to eat, but otherwise not lethargic and still acting his normal self at home. Current meds: nilProphylaxis: not discussedPre-existing conditions: no known conditionsAccess to toxins eg. Rodenticide: no known accessTRIAGE:HR: 132bpmRR: pantingTemp: 37.8Mm: pink, slight tackyCrt: 2sMentation: BAR, slightly nervousPain Scale (0-4): 1/4Hydration status (%): estimated 5% dehydratedEXAMINATION:Body Condition Score: 4/9Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal - Abdominal: minimal pain and tensing on abdominal palpation although did appear slightly nauseous with lip-licking, no obvious masses or mass effects palpable- Rectal: relatively empty in rectum, small amounts of frank blood stainingUrinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normalEyes: NSFPROBLEM LIST:1) Vomiting2) Diarrhoea3) Haematochezia4) HyporexiaDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Primary gastrointestinal causes vs. Extra-gastrointestinal causes, including acute haemorrhagic diarhoea syndrome (AHDS), infectious gastroenteritis, dietary indiscretion, foreign body, pancreatitis, other systemic causes. DIAGNOSTICS:NIL performedASSESSMENT:Teddy presented for history of vomiting, hyporexia and diarrhoea with progressive haematochezia. Despite this, he is noted to still be bright and acting his usual self at home. Further diagnostics incluiding bloodwork and imaging were offered today but declined in favour of outpatient management with close monitoring at this stage. Teddy will require a reassessment, hospitalisation for supportive care and further diagnostics if he deteriorates or does not improve.TREATMENT:Maropitant 1mg/kg SCParacetamol 500mg PO BIDProkolin 6ml PO BIDPLAN:Owner to monitor closely at homeRevisit or seek vet advice overnight if vomiting through maropitant, worsening, more lethargic or any other concernsFurther diagnostics if no resolution of cliical signs including bloodwork and imaging. Faecal pot provided for faecal sample collection in order to run a faecal PCR as owners are keen. DISCHARGE INSTRUCTIONSPlease read through the following instructions to help guide your pet’s recovery. Do not hesitate to contact us at any time if you have any concerns or questions, and please let your vet or our client care team know if you have any questions about this information before you take your pet home today. Diagnosis: GastroenteritisYour pet has been diagnosed with vomiting and diarrhoea of unknown cause. Often this is the result of something unusual in the diet (which may or may not have been directly fed to the patient) that has not been well tolerated.  Diet:To facilitate your pets recovery it is recommended that you feed small frequent meals of boiled chicken over the next 3-4 days. Ensure that water is available at all times.  If after this time your pet is well, then gradually transition them back to their normal diet - mix the normal diet with chicken and rice in increasing proportions over the next 3 days.Exercise:Please keep your pet rested for the next 2-5 days then gradually reintroduce normal activity over the following week.Recheck:Once your pet is discharged home, we advise a reassessment with your primary care veterinarian within 48 hours to monitor your pets progress.  Medications:10.00 x Paracetamol 500mg TabletPlease give 1 tablet by mouth TWICE daily for pain relief. 1.00 x Pro-kolin + Probiotic Paste 60mLPlease give 6ml by mouth TWICE daily for diarrhoea. An anti-nausea injection has also been administered which will last about 24 hours. If your pet's condition deteriorates, they become flat or lethargic, go off their food and water, have continued vomiting or diarrhoea or if you have any concerns please contact our team or your primary care veterinarian immediately. If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital.Thank you for trusting our hospital with the care of your pet.    Vital Signs