C10015053 / invoice 10000

Reason: Struggling To Urinate CCCBAppointment Notes: Urinating only small amounts currelty and in unsual places. Has had a few vomits the past few days but still eating well and energy is wellReason: History: TBC Nurse: MRPresented by: TivEating/drinking: NormalUrinating/defecating: Urinating only small amounts currelty and in unsual placesVomiting/diarrhoea: V+ 4x in the last 3 daysWhat are your concerns today?: V+ and urinating issues. - Presents for vomiting. Vomited four times over the last couple of days (twice yesterday, once this morning). Vomitus contains undigested food, large volume. - Episode of pollakiuria a couple of days ago, which has now resolved. Was observed making multiple trips to the litter box in a short period. Urination is now normal. - Appetite and water intake are normal. Continues to eat after vomiting. - Energy levels are normal. - Diet consists of a mix of wet and dry food, an oral supplement, and a ketogenic supplement. Has been on this diet for a year. No recent dietary changes or new treats. - Defecation is reportedly normal. - Kept 100% indoors. No access to chewable toys.Examination: qar. Nervous. High grade murmur best heard over the sternum, lungs clear. Eyes and ears nad. Mild-moderate tartar/calculus with gingivitis on upper premolars. Abdominal palpation soft with no obvious organomegaly and non-painful. Peripheral LNs not enlarged and non-painful on palpation. Assessment: Vomiting - ddx: gastritis (stress, dietary, infectious), FB, pancreatitis, other systemic disease Heart murmur - ddx: physiological (stress) vs pathological Treatment: Consent has been given by the client to proceed with this treatment  -  Yes - Administered anti-nausea injection, which lasts for 24 hours. - Blood sample collected for a comprehensive external panel to assess systemic health. - Recommended feeding a highly digestible, low-fat diet (e.g., Hills I/D canned food) in small, frequent meals (3-4 times a day) for the next couple of days to allow the gastrointestinal tract to rest. - If vomiting persists despite the injection, advised to return for further diagnostics such as an abdominal ultrasound. - A heart ultrasound was recommended to investigate the heart murmur.Communications: - Discussed potential causes for vomiting including dietary indiscretion, gastrointestinal upset (e.g., stomach bug), stress, infection (e.g., worms, parasites), pancreatitis, or foreign body ingestion (though considered less likely). - Discussed the plan for diagnostics (blood test) and symptomatic treatment (anti-nausea injection). - Provided an estimate for the blood test ($233) and the anti-nausea injection ($51). - Advised that blood test results are expected by the end of the week and a follow-up call will be made. - Instructed on the feeding plan with Hills I/D.    Vital Signs    MMColour: pink;       Weight: 4.33;       Temperature: 39.1;       HeartRate: 240;       BodyScore: 5;       DentalGrade: 1;       RespirationRate: sniffing;       CRT: <2s;