C10009324 / invoice 10000

    Vital Signs    

History:- Diagnosed via GVH Medicine department with intestinal hemangiosarcoma, currently on palliative care- Presenting for acute inappetence and vomitingExamination:- BAR; MM pale pink; CRT <2s; 200 bpm; 30 brpm- Abdomen: Comfortable on deep palpationAssessment;- Stable. Mucous membranes are subjectively paler, but PCV not performed as blood transfusion will not be performed even if Ben has any further bleeding episodes.- Inappetence may be due to progression of hemangiosarcoma, but other causes such as non-specific gastroenteritis cannot be ruled out.- Given that Ben is already on palliative care, conservative management is elected.Plan:- Outpatient- Rx: - Maropitant - Ondansetron - Mirtazepine- Advised to start all 3. If eating well, can wean in the order of ondansetron, mirtazepine, then maropitant.- Also advised that if Ben needs to be on prolonged antinausea, he can have this for the rest of his life.- Owner also requested for pain relief. Syringes of buprenorphine has been provided to the owner. (see next note). Advised only to start this if she is concerned about Ben being in pain. Can cause mild sedation.    Vital Signs