C10009486 / invoice 10000

Reason: HGEAppointment Notes: Overdue remindersPresented and seen by Dr Pragya    @ 1am 10/03/2026Regular Vet:REASON: Acute onset of lethargy and haemorrhagic diarrhoea.HISTORY:- Twix was fed dinner at approximately 7:30 PM.- The first episode of runny diarrhoea occurred at approximately 9:30 PM.- There have been approximately five episodes of diarrhoea since, which has become progressively worse and is now bloody and mucoid.- Twix has been very lethargic and slow at home, having difficulty getting up.- Twix has been on a Lyka diet for the last 2-3 months for weight loss. The protein source (e.g., beef, chicken, kangaroo) alternates with each meal.- There has been no vomiting.- Pre-existing conditions: No known pre-existing conditions- Access to toxins: No known access to any toxins, bait, rubbish, medications, chemicals nor anything else that could have been scavenged.- Current vaccination status: Believed to be up to date.- Current medications: nil mentionedTRIAGE:- HR: 140 bpm- Temp: 40.1 C- Mentation: QAR- Pain Scale (0-4): 2- MM pink and tacky - CRT 2sec EXAMINATION:Body Condition Score: 5/9Cardiovascular: Tachycardic - 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: NSF- Abdominal: Mildly uncomfortable on mid - abdo palpation.- Rectal: not performed - bloody feces Urinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: NSF, delayed skin tent Lymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:1. Haemorrhagic diarrhoea2. Lethargy3. Abdominal pain4. Shock ASSESSMENT AND DIFFERENTIAL DIAGNOSIS:The presentation is consistent with acute haemorrhagic diarrhoea syndrome. Differentials include:- Haemorrhagic gastroenteritis: Can be triggered by dietary indiscretion, stress, or protein sensitivity. The frequent change in protein source in the diet may be a contributing factor.- Partial intestinal obstruction: Could cause discomfort and diarrhoea.The patient is also presenting with signs of hypovolaemic shock due to rapid fluid loss from the diarrhoea.Options:1. Conservative management 2. Supportive care 3. Diagnostics The owner has consented to hospitalisation for supportive care.DIAGNOSTICS:AFAST - No FF % Blood gas table - DOGSPCV/TS:	58/65	Serum - clearBlood gas valuesHct:	59.8	%pH:	7.390	(7.366 - 7.453)pCO2:	32.1	(29.0 - 51.3)pO2:	45.4	(28.9 - 59.9)Acid-base statuscBase(Ecf)c:	-5.6	mmol/LcHCO3- (P,St)c:	20.6	(17.0 - 24.0 mmol/L)Electrolyte valuescK+:	3.4	(3.6 - 4.4 mmol/L)cNa+:	144	(143 - 150 mmol/L)cCa2+:	1.24	(1.28 - 1.43 mmol/L)cCl-:	114	(112 - 122 mmol/L)Metabolite valuescGlu:	5.0	(4.4 - 6.8 mmol/L)cLac:	2.9	(0.6 - 1.8 mmol/L)cCr:	47	(62 - 105 µmol/L)cTbil:		(-20 - 1000 µmol/L)Urea:	7.0	(2.5 - 9.6 mmol/L)TREATMENT:- IVFT LRS 5% rehydration over 12hours; 2 boluses - 10ml/kg over 15 mins ( Temp resolved but still tachycardic- HR 220bpm and bounding pulses) + 5ml/kg over 15 mins ( Tachycardia, pulses resolved)- Buprenorphine 0.02mg/kg IV q8h - Paracetamol 15mg/kg IV q8h - Trazodone 25mg PO q8hTwix ate the chicken offered at 4am and has kept this down PLAN:- Continue supportive care - Discharge once comfortable and euhydrated  Daily update emailed to referring vet: YES/NOFinancial update provided to owner: YES/ NO    Vital Signs    Weight: 7.5;       

Reason: HGEAppointment Notes: Overdue remindersRecord is CompleteReason:Hospital Day: 2ICU DAYTIME SOAP day shiftCase Summary:Examination: Subjective: Objective: Temperature: CVS: Respiratory: Abdomen: Genito-Urinary: M/Skeletal:Neurological: Eyes/Ears: Integument: LN's:  BWT: Nutrition: Fluid therapy: Laboratory: Other: Assessment: Plan: Client Communication: Update 1 (start of shift)- Vet Name:- Client Name:- Time:- Medical update:- Financial update: (check estimates, do per 12 hr estimates or any additional tests/procedures need to be quoted for or is a new consent form required?) Please comment on what has been discussed.Update 2 (end of shift)- Vet Name:- Client Name:- Time:- Medical update:- Financial update: (check estimates, do per 12 hr estimates or any additional tests/procedures need to be quoted for or is a new consent form required?) Please comment on what has been discussed.Referring Veterinarian Communication: Daily update emailed to referring vet : YES/NO Time:    Vital Signs