C10009833 / invoice 10000

Reason: Not EatingAppointment Notes: Overdue remindersPrimary Presenting Complaint:Chronic diarrhea and inappetenceOther Complaint:Weight loss (2kg), severe halitosis, lethargyHistory:3-4 weeks of GI symptoms, initially vomiting which resolved but ongoing intermittent diarrhea with varying consistency (soft serve to liquid - no blood or mucus) Prev had good appetite, would eat dog biscuits wellBut not refusing biscuits, selective eating - owner feeding rice with sweet potato/pumpkin. Will eat with gusto if cheese/treatsEnergy lvls reduced - quieter than normal  Last Ate - Eating boiled chicken breast, refusing regular biscuits and commercial dietsDrinking - Decreased water intake - owner reports not seeing patient drink todayExamination:Demeanour: BARBCS: 5/9MM: PM - slightly paleCRT: 1-2sHR: 140RR:  32LN: Periph WNLTemp: 38.8Eyes: No discharge or erythemaEars: No discharge or erythema on external examOral: G3/4 dental dz - some teeth missingCV: no murmur or arrhythmia auscultated - pulse quality good and synchronousResp: Normal effort, no crackles or wheezes on thoracic auscGI:   discomfort present, gurgling noted, painful on palpation, Integ: No lesions, good coat qualityMSK: Ambulatory in consult, full exam not doneNeuro: Mentation normal, full neuro exam not doneProblem listDiarrhoeaLoss of appetite Weight loss Lethargy Assessment:Ddx: GI vs extraGIRecommend bloodwork to screen for organ pathology to startHowever concern with ongoing duration of diarrhoea Treatment Plan:Commence prokolinPending bloodwork may req further abdo u/s or faecal PCR as next stage of diagnostics    Vital Signs