C10012590 / invoice 10000

Reason: EcC - V+ BileADE -- 10/3/26 -- EVENING SHIFTTime of consult: 20:21pm on 10/3/26 History:O (Dan and Shavala) ) presents todayPresents for acute V+Today, came home and found some suspected vomitus (no blood, no food, some human hair in it). Otherwise behaviourally is completely himself. Has not witnessed any further V+. BIOP for 2 weeks. Has noticed since BIOP then when lying down on his side, he may cough/splutter, and then wake up. Tends to only happen when sleeping. Otherwise when awake he does not seem to be bothered at all. No reported dysphagia associated. No signs of discomfort. Does scavenge - including inorganic thingsRecent Indiscretion: changed diet this morningDiet: blackhawk puppy originally, now has been gradually introducing advance (kibble + wet)Vax: most recent on 28th Sat - received C7 (is second vax)  Preventative: nexgard spectra - utdExamination findings:BAR - normal excitably puppy behaviourWeight: 4.5kg BCS: 4.5/9HR = 132, HR=PR, pulse strongRR = 32, RE=0/3Mm/crt: pink, 1.5secTemp: 38.7 Eyes/ears/oral: unremarkableTolerated laryngeal palpation PLNs: wnlCVS: no obvious murmurs/arrythmia heardResp: clear in all lung fields, no crackles/wheezes notedAbdomen: soft, pliable, comfortable, NSFAssessment:Acute onset V+ Primary GI most likely. Consider indiscretion given the history. Cannot r/o other ddx eg: obstructive (esp given the history of scavenging), infectious etc)Extra GI considered unlikelyThe intermittent spluttering when lying down is interesting. Further investigation should be performed when vomiting resolvesClient communications:- Discussed with O about presentation- Discussed re: vomiting and ddx - Options offered:1) outpatient trial2) initial screening diagnostics O elects for option 1 - Discussed re: the chronic spluttering- Discussed this warrants investigation, would recommend after resolution of V+- Options either:1) with ref vet initially2) with IM at ARH O will discuss with ref vet first and be guided from there Treatment:1. Ondasentron 2mg TMS q12hrs, first dose give in consultPlan:1. Follow up if persistent symptomsHx sent to ref vet    Vital Signs    Weight: 4.5;