C10019978 / invoice 10000

Reason: V+ Foamy, Salivating Lots- Recheck, O WorriedAppointment Notes: Special payment terms exist, Overdue remindersSubjective and History:Has been having soft stools still. One was quite soft with some mucus and small amount of fresh blood. Also has had 3 vomitsEating really well. Quite hungryBARRunning around on walks etc. Doesn't seem to be drinking muchDiet: usually spd roll kangaroo and RC gastro low fat.Currently giving cooked chicken and turkey, white rice and pumpkin or sweet potato.Ella is going to have surgery next friday, worried that Maya is not well. Wants to get her well as she will be looked after by someone as Ella is having a knee replacement and will be recovering Objective:Mm pinkCrt< 2sec, moistHR 88, regular, no murmurThoracic auscultation wnlAbdominal palpation wnlT 38.8oCPeripheral Lns wnlTeeth: moderate calculus, mild gingivitis.Assessment:Ddx: colitis, gastroenteritis: 1o git vs metabolic causes. She is bright and well suspect dysbiosis high on listTreatment:Discussed giving it more time vs investigation.Ella was asking about anti inflammatory she has had for a previous dog. Was metronidazole. Discussed we try not to use this if possible these days as it can make dogs more prone to diarrhoea in their life. Discussed bloods, faecal pcr/ff, possible ultrasound.Wants to send off faeces today. Gave option of  metronidazole or prokolin again and then synbiotic. Due to going in to hospital elect metron    Vital Signs    

Reason: Tentative RecheckAppointment Notes: Special payment terms exist, Overdue remindersSubjective and history: O having a surgeyr soonWants her checkedNormal stools over the weekendStrong appetiteNot feeding dog food.Cooking chicken breast, pumpkin and riceStools more formed, some mucusObjective: Eyes ears chest abdo lns skin okPlan: Finish prokolinThen start synbiotic capsules dailyPsillium husk 1/2 teaspoon twice a day on food.Ella called back to say Maya passed soft stool with blood again.Continue same plan    Vital Signs    Weight: 10.3;       

Reason: Blood In StoolAppointment Notes: khSubjective and history: Lots of stools in laundry overnightFirm to runny with some fresh blood.Outside had a vomit with white frothStill hungry.Sees other dogs on walksSpd turkey, salmon, roo, chickenObjective:Mm pink, crt 1Abdomen ok.Lns okExpressed anal sacsNo blood on rectalT 38.7Assessment: Primary GIT disease likelyTreatment: Cerenia 1ml scProkolinBland food.    Vital Signs    Weight: 10.4;