C10007550 / invoice 10000

Reason: VomitingHistory: V+ O thinks grass and bile V+ dinner last night Very lethargic- usually activeHiding under the bedWas here for not eating and V+ beforeExamination: Vitals wnlHeart, abnormally loud S1 sound. No evidence of mururLungs wnlLn wnlMsk wnlAbdo: soft and comfortable on palp, Borbourigmi sounds present (not hypermotile)Eyes clearCoat clean, no scaleSkin, no sigsn of inflammtionDifferential Diagnosis: Partial obstuction vs full obstruction vs ingestion of critter vs food allergen consumptionDiagnosis: Ingestion of critterTreatment: Paracetamol 12.5 mg/kg q 12hr 3d (1/2 of 250 mg tablet or 1/4 500 mg tablet)Plan:Talked to O about risk of being obstruction and that imaging is required to rule in/out. Informed costs would be 300-600 for x-rays and sedation. Does not want to do straight away and wait a day or two more. O acknowledge the risks and will return to PVC in 24hr if no defecation adn still V+ or 48hr if defecation normal but still V+    Vital Signs    Weight: 10.3;       MMColour: pm;       Temperature: 39.1;       HeartRate: 120;       BodyScore: 7/9;       DentalGrade: 2/4;       RespirationRate: 30;       CRT: <2;