C10012510 / invoice 10000

Appointment Reason: Bloody diarrhoea, Appointment Notes: has been unwell on and off the last few weeks but now has blood in poo Hx:Chronic intermittent diarrhoea- v sensitive stomachallergies to beef and lambgoing to hydro (has helped a lot with strength - increasing intensity lately) frequently since Nov.Last 2-3 sessions has had diarrhoea for 4 days after, drinks a tiny bit of water at hydro, gets lots of freeze dried chicken (needs high value treat as anxious),responds well eventually to chicken and rice diet and O starts prokolin after 24hrs if D+ not resolving. Blood in D+ this morning,m has been straining. Sometimes constipated (strains then produces small firm faeces) - O adds water to diet. Diet: Hill's skin and stomach, freeze dried chicken at hydro for treats (as anxious), no leftovers ever, no bones, not a scavengerEDU normal, no V+Problem list:1. Acute diarrhoea Ddx: Dietary indiscretion/intolerance, partial GI obstruction, infectious, otherTx: Prokolin (as soon as D+ starts now) BID 6ml until D+ resolves then stop. Trial prime salmon or chicken rolls in cubes for hydro treats or smaller pieces of freeze dried chicken. *label is incorrect - O knows is BID not SID - uses frequently)RV INI to consider next steps- bloods/metro?    Vital Signs    Weight: 26;