C10008200 / invoice 10000

Reason: Blood In V+ CR2SIGNALMENT: 8-year-old, male neutered, Burmese HISTORY:Presents for haematemesis. There is a chronic history of intermittent vomiting since young, which has become more frequent over the last 1-2 years. The vomiting is inconsistent, sometimes occurring post-prandially and other times overnight. At times, it has been a daily occurrence. One year ago (March 2025), radiographs were performed with no significant findings, and a presumptive diagnosis of IBD was made. August 2025, blood tests (CBC, biochemistry and B12/folate) were unremarkable and an abdominal ultrasound were performed, which is suggestive of pancreatitis . The cat was trialled on a z/d and i/d diet but was never on a strict elimination diet. A week ago, started on prednisolone (5mg tablets): 1/4 tablet twice daily for three days, then once daily for one day. Owner then spaced out doses due to perceived personality changes. Last dose was yesterday morning. Last night, there were two episodes of vomiting. This morning, another episode of vomiting occurred, which contained blood for the first time, followed another episode of haematemesis. The owner administered subcutaneous maropitant and a quarter tablet of prednisolone after this morning's vomit. Appetite is variable. No diarrhoea reported. He is an indoor-only cat with access to house plants, which he occasionally chews. No known access to toxins or rodenticide. Not up to date with vaccinations (due to severe reaction when vaccinated at young), flea/tick, or worming treatments. No weight loss. TRIAGE:HR: 180RR: 36Temp: 38.4MM: Pink & moistCRT: < 2 secondsMentation: Quiet, alert, responsivePain Scale: 0Hydration status (%): <5% dehydration EXAMINATION:Body Condition Score: 5/9Cardiovascular: 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/gait, full neurological exam not performedMusculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performedGastrointestinal:- Oral: right upper canine fractured, grade 2 dental disease - Abdominal: no pain elicited on abdominal palpation, no obvious mass palpated - Rectal: not performedUrinary: NSFReproductive (incl ext genitalia): NSFIntegument/ears: NSFLymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:HaematemesisChronic vomitingDIFFERENTIAL DIAGNOSIS:Differentials for acute vomiting would include gastric and intestinal causes (eg. dietary indiscretion, foreign body, infectious, inflammatory, neoplastic, or toxic causes), abdominal disorders (eg pancreatic, hepatobillary, or renal disease or peritonitis) as well as metabolic and endocrine disease.DIAGNOSTICS:Nil performedASSESSMENT:TREATMENT:Gabapentin 100mg PO for vet visit sedatives Omeprazole 5mg PO Q24H PLAN:Recommended repeat bloods and imaging to start off with, owner elected to repeat at her clinic (she is a PM at vet clinic) tomorrow. Owner asked about endoscopic biopsies, recommended having a consult with CSS for further diagnostics and to discuss options for biopsies if required.    Vital Signs    Weight: 4.31;