C10018660 / invoice 10000

Reason: D+ V+SHIFT CHANGE 2100-0700VET: Sara BaileyASSESSMENT: Stable and comfortable overnight with no further vomitingDiarrhoea continuing overnightEating Prime 100TREATMENT PLAN.changes to plan:Start prokolin when eatingO Contact required overnight? - rang , no answer. Sent sms recommending transfer to TVH-Pass Rd in the morning.Transfer details/stay on/discharge from AES - TBC - transfer to Pass RdUPDATE @ 0700 - Large amount of slude, light brown diarrhoea in cage just prior to transport. Poo all over IVF so not sent with patient since almost outBathed and dried, re-wrapped tail ____________________________________________________________Millie has been treated/monitored at Animal Emergency Service for 1 vomit and 3 large diarrhoea episodes.She has been on meloxicam for approximately 4 weeks - last given Tuesday. Had recent OCD surgery.Overnight she has been stable and comfortable with no further vomiting.She has had further diarrhoea overnight and is eating wellPlease refer to *Smart Flow - Flowsheet* pdf for detailed clinical exam records and hospital notes.Treatments given & when next due are as follows:IV fluids at 40mL/hr (Hartmanns)* Maropitant 1mg/kg IV q24hr, last given 11/3 @ 2000* Pro-kolin paste 5mL given at midnight, due middayIf you have any queries relating to this case, please call 1300 302 912    Vital Signs    Weight: 31.4;       

HISTORY:- Presenting for diarrhoea which started this evening.- Had surgery for right-sided elbow OCD last Wednesday (04/03/2026).- The diarrhoea was a single episode of a large amount. No blood or mucus was noted. No vomiting.- Had been drooling today.- Bowel movements were normal at 8:30 am, then no movement until 4:00 pm.- A fentanyl patch was removed yesterday, which had caused an allergic reaction treated with flumazine cream.- Medications: Meloxicam (last dose at 4:00 pm today, has been on it for approx. 4 weeks pre- and post-op), pregabalin, trazodone, flamazine - Allergies: Allergic reaction to fentanyl patch.EXAMINATION:HR: 76 bpmRR: 24 bpmTemp: 38.6°CMM: Pink and moistCRT: 1 secondMentation: QARPain Scale: Not assessedWeight: 31.4 kgBody Condition Score: Not assessedCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal: - Oral: normal - Abdominal: Soft and non-painful on abdominal palpation, normal gut sounds - Rectal: no detectable abnormalities, Faeces: Large volume, no mucous or blood (just once) small intestinal diarrhoeaUrinary: bladder size not assessedIntegument/Ears: Allergic reaction to fentanyl patch site on right hind paw being treated with flamazineLymph Nodes: peripheral lymph nodes normal size/shape & not painfulEyes: clear corneas, nil discharge or blepharospasmASSESSMENT AND PLAN:1. Acute Diarrhoea- Possibly secondary to meloxicam administration.- Differential diagnoses include GI versus extra GI causes - Clinical examination is otherwise unremarkable.- Option 1 (recommended): Cease meloxicam. Commence a bland diet (boiled chicken and rice) for a few days. Encourage hydration. Can administer paracetamol (dose given) for pain relief if required.- Option 2 (offered): Admission for hospitalisation, IVFT, and blood tests to investigate for other causes.- Follow-up with regular vet, Dr. Gareth, on Monday as planned.CLIENT COMMUNICATION:- Discussed two options for management: conservative home management vs. hospitalisation for diagnostics.- The owner was advised that conservative management at home is a reasonable first step as Millie is clinically well, hydrated, and comfortable.- The estimated cost for hospitalisation and diagnostics was quoted at $1500-$1900.- The owner elected for conservative management at home.- Advised to cease meloxicam. For pain relief, can use paracetamol (dose given), Advised against using Nurofen.- Recommended a bland diet of boiled chicken and rice for a few days and to encourage hydration (e.g., with chicken water).- Advised that a free recheck is available within 24 hours if there are any concerns or if they wish to proceed with blood tests.DIAGNOSTICS:- None performed.TREATMENT:- Nil in-clinic.PLAN:- Discontinue meloxicam.- Continue pregabalin and trazodone as prescribed.- Start bland diet (boiled chicken and rice) for 2-3 days.- Monitor for comfort, appetite, and resolution of diarrhoea.- Re-present if there is any vomiting, worsening diarrhoea, lethargy, or inappetence. Free recheck within 24 hours. daily if signs of discomfort are noted.- Follow up with Dr. Gareth on Monday for post-operative reassessmentUpdate - had one large vomit in carpark when leaving + one large watery diarrhoea when rechecking in consult roomPLAN> ABL PENDINGChem 11 PENDING Faecal float PENDING Medication Hartmann BMR Maropitant 1mg/kg IV q24hrs Continue Trazadone - next due tomorrow AM Continue Pregabalin -next due tomorrow AMContinue flamazine - next due tonight To call owner with any results that are concerning, if not call in MA with update Estimate 1500-1900/12hrs 700-100 /12hrs ongoing    Vital Signs    Weight: 31.4;