C10014631 / invoice 10000

Consult nurse: Robbie

Reason for presentation: Bloody diarrhoea post dental on Friday

History for today:
Developed bloody diarrhoea over the weekend following a dental procedure on Friday. Stomach was initially good post-anaesthetic but deteriorated over the weekend. Has not been eating well. No vomiting reported. Bright and alert.

Previous medical/surgical concerns:
06/03/2026: Dental procedure - extracted 407 fragments. Started Meloxicam for 3-5 days.
12/02/2026: Grade 1-2 dental disease.
10/2025: RH lameness investigation under GA. Diagnosed with mild bilateral stifle OA, borderline HD, and suspected age-related MSK pain.
Known bilateral stifle OA and borderline HD.
Age-related musculoskeletal changes.

Current medications:
Meloxicam 2.2mL PRN.
Cartrophen course previously.

Diet: Usually eats anything.

Examination:
Demeanour: BAR
Eyes: clear
Ears: NAD
Nose and Throat: no abnormalities detected
Mouth/teeth/gums/dental grade: Pink and moist, degree of dental disease graded 1 - 4
Resp rate: lung fields clear
Heart rate: pulses strong and synchronous
Abdominal palpation: Feels empty, slightly tense, not bloated or gassy.
Urogenital: no abnormalities detected
Musculoskeletal: ambulating well but not thoroughly examined
BCS:
Coat/skin: healthy
Palpate lymph nodes: within normal limits
Temp: 28.6C

Assessment: 
Colitis with haematochezia - secondary to hospital visit and dental procedure - medication reaction to NSAIDs?

Treatment:
Gastrointestinal diet - hills biome wet (10 cans provided).
Probiotic supplement (7mL twice daily) containing kaolin clay supplement to help firm stools.
Panadol available PRN for pain, though not currently required.

Next vaccination due:

Discussion:
Colitis is inflammation of the large bowel, causing fresh blood and mucus in the stool.
Possible causes include diet, medication (Meloxicam), or an infectious agent from the hospital.
Supportive care with an easily digestible diet and probiotics to restore gut bacteria balance.
Expect stool to firm within 48 hours.
Recheck if diarrhoea persists or if vomiting occurs.
Low risk of infectious cause but possible.
Feeding guide: start with 3 cans per day (breakfast, lunch, dinner), no more than 1 can per meal initially.
Dental extraction site healing well, no further recheck needed unless bleeding or pain occurs.

Plan:
Commence gastrointestinal diet and probiotics.
Monitor stool consistency and appetite.
Recheck if no improvement in 48 hours or if vomiting occurs.

Next revisit: 19/03/2026 for general check-up.

Staff member making call : SP
Which family member spoken with: Sarah

Recall reason: Dental w ext

Patient Report:
Demeanour - BAR
eating - y, pureed food and ate well
drinking - y
urine - y
faeces - y

any problems with medicating? 
Meloxicam 2.2mls SID 3-5d - y
wound/s healing OK ? no blood or discomfort 
appointment made for revisit ? 19/03 dental recheck - y