C10013779 / invoice 10000

Reason: Diarrhoea And Vomitting, Not Keeping Anything In Appointment Notes: diarrhoea since monday, vomitting started last nightHistory: Questions:Abdominal effort:Eats the V+ afterwards?:UTD with vax/worming:Dietary indiscretion?: eats plants in backyard?Duration:Frequency:Diet:Weight loss:Appetant vs inappetant: D+?:Lethargic?: Medications: Bile? (yes = V+, no = regurg?):Determine Vomiting OR RegurgMonday: kid were looking after him. Bit of D+Then on D+ 6 times tht dayLast night picking up and more energy. Gave him boiled chicken rice. During night V+.Havent tried to give him breakfast this mornig. Some D+ yesterday morning.No Blood in D= or V+.Bit lethargic this morning.Abdiminal effort.Chases cane toads.No toxins. Not into the bin. Not fed huamn food.Diet: chicken breast or liver treats, RC puppy kibble and blackhawk kibble.Havnt seen anything missing. Examination: temperature, abdominal palp. Mm + CRT, Skin tentLaboratory: Dx:Bloods +/- c/fPLI, TLIImaging (US/ rads, endoscopy if chronic)Faecal float/ smearGiardia testing, parvo testingEndoscopy +/- bxCoagulation profile?UAAssessment: DDx:GIT (Infectious/parasitic, dietary, motility disorder, gastritis, GDV, HGE, Gastric ulcer, obstruction, toxins, FB) vs Extra GIT (nephropathy, hypoadrenocorticism, DKA, toxins, drugs, neurologic/ vestibular dz, hepatopathy, pancreatitis, peritonitis, pyometra)Treatment: Consent has been given by the client to proceed with this treatment - YesAntinausea - Maropitant (1mg/kg SC SID) vs ondansetron (0.5 - 1mg/kg PO Q8-12hrs) - if worried about FB use ondansPain relief: panadol (10-20mg/kg IV,PO Q6-8hrs) vs Gastric protectants - if evidence of stomach bleed (blood in V+)Ranitidine 2mg/kg BIDCarafate 0.5-1gm PO TIDPPIPlain diet/ GIT diet. If chronic then diet trial?Pro-kolin?/ fortiflora?Worming Fluids + day stay +/- USPlan:Reason: Nurse: -vaccination -heartworm -worming -flea/ticks Exam: Lab: Assessment: Treatment: Plan:    Vital Signs    Weight: 25.5;       

Presented to NQ care. Acute vomitting.    Vital Signs    

Reason: Ghc + VaccHISTORY:  Presented for a routine check. The owner reports that Ralph has a morning routine of having his eyes and ears cleaned, which he enjoys. He has been generally well. The owner notes occasional redness around the eyes, which varies day to day. There has been some excessive drooling today, attributed to excitement. A request was made to clip his nails as some are overgrown. Current meds: noneVaccination: Not mentionedParasite Prevention: Not mentionedPre-existing conditions: noneAccess to toxins eg. Rodenticide: none EXAMINATION:Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: not examinedMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:Oral: normal, no mouth pain, dental score (1-4): not gradedAbdominal: no detectable pain on abdominal palpationRectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: Ears are cleaned regularly. A few nails are overgrown.Lymph Nodes: NSFEyes: Owner reports intermittent bilateral ocular redness. Examination revealed no evidence of entropion or significant conjunctivitis. No epiphora noted. Mild droopiness of the lower eyelids is present.Demeanour/Behaviour: Bright, alert, and responsive. Cooperative for examination. PROBLEM LIST:Overgrown nails.Mild intermittent bilateral conjunctival redness reported by owner. DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Mild conjunctivitis secondary to eyelid conformation. DIAGNOSTICS:None ASSESSMENT: Ralph is a healthy dog presenting for a routine check and nail trim. The main concerns are overgrown nails and owner-reported intermittent ocular redness. Examination findings are largely unremarkable, apart from some overgrown nails. The ocular redness is likely secondary to his eyelid conformation causing mild, occasional conjunctivitis. No signs of entropion were noted today. TREATMENT:  Nails were trimmed.Recommended using an artificial tear lubricant to help flush and moisturise the eyes.Final C4 vaccine given PLAN:Monitor eyes for any worsening of redness, discharge, or discomfort.Continue with routine care.--- 08/12/2025 09:20:58 AM LGN:Vaccinations - Resolved - No recall req-MFI--- 08/12/2025 10:38:55 AM LGN:Examinations - Resolved -    Vital Signs    Weight: 16.4;