C10018672 / invoice 10000

Reason: TVH-S 	Suspected pancreatitisSHIFT CHANGE 2100-0700VET:  Sara BaileyASSESSMENT: Nervous, stable, improving hydrationAbdomen comfortable on palpationNot interested in food overnightTREATMENT PLAN.changes to plan:NilO Contact required overnight? - no Transfer details/stay on/discharge from AES - vetbiz to TVH S__________________________________________________________________Case SummaryToby has been treated/monitored at Animal Emergency Service for suspected pancreatitis.Overnight, he was stable and quiet, alert, and responsive. His abdomen has been comfortable on fentanyl.He has remained inappetant overnightPlease 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 Hartmanns 95ml/hr.- Fentanyl CRI at 2-4 mcg/kg/hr. - weaned from 3am - off at 6am- Fentanyl patch (75mcg/hr) active from 3:30 a.m. on 12/03/2026.- Ondansetron 16mg TM every 12 hours, given 6am, next due at 6 pm- Maropitant to be continued IV every 24 hours, next due 1430 12/3If you have any queries relating to this case, please call 1300 302 912.    Vital Signs    

REFERRALS TEMPLATEREASON FOR REFERRAL:Hospitalisation for management of suspected pancreatitis.DIAGNOSTIC SUMMARY:Hospitalised for suspected pancreatitis. Presented with several days of lethargy, intermittent vomiting, and hyperthermia. In-house bloods show lipase >4000 and a slight increase in ALP. An abdominal ultrasound is planned if there is no response to initial treatment.MEDICATION PLAN - WHEN LAST GIVEN & WHEN DUE NEXT:* Maropitant (Prevomax) - last given 2.6ml (1mg/kg) SC at 2:30 p.m. 11/03/2026, due to be continued IV every 24 hours.* Ondansetron - last given 16mg transbucally at 5:15 p.m. 11/03/2026, next due at 6:00 a.m. 12/03/2026 (every 12 hours).* Fentanyl patch (75mcg/hr) - placed at 3:30 p.m. 11/03/2026, will be active from 3:30 a.m. 12/03/2026.* Fentanyl CRI - commenced at 3 mcg/kg/hr.EXAMINATION:TIME: 18:40Mentation: QARCardiovascular: Cardiac auscultation normal, normal rhythm (respiratory sinus arrhythmia), pulse pressures normal and synchronous. HR: 82 bpm.Respiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge. RR: 28 brpm.Temperature: 38.8 CWeight: 26.1 kgAbdo: Very mild pain on abdominal palpation, normal gut sounds.Musculoskeletal: Ambulating normally, no palpable neck, spine, limb or joint pain.Neurological: No significant findings, no cranial nerve or proprioceptive deficits/gait.Eyes/Ears/Skin: Clean furcoat, no evidence of otitis. Clear corneas, nil discharge or blepharospasm.Urogenital: Desexed, prepuce normal anatomy.Lymph nodes: Peripheral lymph nodes normal size/shape and not painful.Hydration/volume status: Mucous membranes pink and moist, CRT 1-2 seconds.PROBLEM LIST:1. Suspected Pancreatitis2. Occasional inflammatory bowel syndromeASSESSMENT:Presented with lethargy, vomiting, and hyperthermia. In-house bloods show lipase >4000 and a slight increase in ALP, consistent with suspected pancreatitis. History of occasional inflammatory bowel syndrome reportedly in response to a chicken and rice diet.PLAN:Continue hospitalisation on IV fluids (Hartmanns at 170ml/hr).Continue fentanyl CRI at 3 mcg/kg/hr.Continue medications as prescribed.Monitor vital signs, pain score and comfort overnight.Patient to be transferred back to regular clinic (TVH-S) in the morning.Abdominal ultrasound planned for tomorrow if no response to initial treatment.Tempt with low-fat i/d or chicken if seems appropriate.Client communication and account update:Discussed plan for overnight hospitalisation and transfer in the morning with the owner. Provided an estimate for overnight care of $700 - $1,000.Mode of transfer:VetBiz to TVH-S    Vital Signs    Weight: 26.1;