C10016662 / invoice 10000

Reason: Has Been V+Appointment Notes: Overdue remindersHISTORY:  Presented for vomiting over the last few days, occurring after meals. The owner finds spots of vomit upon returning from work. A hairball was vomited approximately one month ago. A change in diet to a urinary and hairball formula did not resolve the issue, and the previous diet was resumed a few days ago with continued vomiting.Appetite and water intake are normal. No weight loss has been noted. Faecal consistency is normal and firm, though differentiating between the two cats in the household is difficult. There is an increase in shedding over the last few days.History of a blocked bladder approximately one year ago, which was manually expressed and treated with anti-inflammatory medication. There have been no recurrent urinary issues. Current meds: noneVaccination: UTD.Parasite Prevention: Overdue. Last dose of Revolution Plus was due in November 2025.Pre-existing conditions: History of blocked bladder approximately one year ago.Access to toxins eg. Rodenticide: none EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0/4Hydration status (%): Mildly dehydrated, gums feel slightly dry.Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:Oral: normal, no mouth pain, dental score (1-4): 1/4Abdominal: mild tensing on palpation, faeces palpable in the colon.Rectal: not performedUrinary: Bladder palpated, not hard or distended.Reproductive: NSFIntegument/Ears: Increased shedding noted during consultation. NSFLymph Nodes: NSFEyes: NSFDemeanour/Behaviour: Tense and not tolerant of handling for diagnostics. PROBLEM LIST:Vomiting post-prandiallyMild dehydrationOverdue for parasite preventionHistory of blocked bladderAnxious temperament precluding conscious diagnostics DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Dietary intoleranceForeign body obstructionMetabolic disease (e.g., renal, hepatic) DIAGNOSTICS:X-rays and blood tests were recommended to investigate the vomiting. Due to the patient's temperament, sedation was required. - oral sedation trialed but not successful, O did not want to proceed with injectable sedation  ASSESSMENT:  Ziggy presented for investigation of vomiting. Examination revealed mild dehydration and a tense abdomen, but was otherwise unremarkable. Given the history of vomiting every meal, further investigation is warranted to rule out significant underlying causes such as foreign body obstruction or metabolic disease. The patient was not compliant for conscious diagnostics. TREATMENT:  Oral sedation (Gabapentin) was administered in-clinic to facilitate diagnostics. - 200mg Gaba oral  PLAN:Admitted to hospital for oral sedation to work.Plan is to perform blood tests and abdominal radiographs once adequately sedated.Owner to be contacted with results and further plan.If sedation is ineffective, the owner will return for a drop-off admission on Thursday for injectable sedation and diagnostics.Discharge home into owner's care post-procedure, likely around 5:00-6:00 PM. CLIENT COMMUNICATION:Discussed the concern for vomiting after every meal and the need for further investigation. The plan for blood tests and X-rays was explained to rule out foreign body obstruction and underlying metabolic issues. The costs for consultation, diagnostics, and potential sedation were discussed, estimated at $977 without sedation, $1000 with oral sedation, and $1300 with injectable sedation. The owner has insurance and a gap payment will be processed.The risks of injectable sedation with recent food intake (aspiration) were discussed. The owner elected to proceed with oral sedation. Consent forms were signed for hospitalisation, diagnostics, and potential emergency treatment. The owner was advised that pick-up would likely be around 5:00-6:00 PM and that the clinic would call with an update. The option of rescheduling for Thursday was also discussed if oral sedation is unsuccessful.    Vital Signs    Weight: 5.3;       HeartRate: 144;       DentalGrade: 1/4;       CRT: 2;       MMColour: pink;       Temperature: 38.1;       BodyScore: 5/9;