C10020923 / invoice 10000

HOSPITALISATION PERIOD:  0700 - 1700HISTORY SUMMARY:  Hospitalisation Day Diagnostic Summary:  Physical Examination @  TRIAGE: HR: RR:Temp:MM: Pink, moistCRT: < 2 seconds Mentation: Pain Scale (MGCS):  Dehydration status (%): BCS (1-9):  Weight: EXAMINATION:? CARDIOVASCULAR:? NAD; normal rate and rhythm, no murmurs or arrhythmias auscultated, pulses strong and synchronous. RESPIRATORY:??NAD; no nasal discharge noted, normal respiratory rate and effort, bronchovesicular sounds are normal to all fields NEUROLOGICAL:? NAD; normal gait, posture and mentation; full neurologic exam not performed GASTROINTESTINAL:? - Oral: Oral mucosa appears normal, no lesions noted. - Abdominal: Normal on abdominal palpation, no obvious masses noted, comfortable? - Rectal: normal faeces on digital rectal exam, no obvious masses noted MUSCULOSKELETAL:?NAD; no evidence of lameness or pain. Full MSK exam not performed. EARS:?NAD; pinnae normal EYES:?Eyes clear with no obvious discharge or changes associated LYMPH NODES:?NAD; peripheral LNs normal in size, no firm or painful LNs identified? UROGENITAL:? NAD, INTEGUMENT:? NAD; coat normal, no obvious masses or other lesions; full exam not performed  DOG DIAGNOSTICS:  PCV/TP:  Blood Gas: VENOUS Acid/Base: pH   [7.345 - 7.433], PCO2 [40.0 - 46.0], BE [-6.0 - 0.4], HCO3- [19.0 -26.0], AG [8.0 - 16.0] Metabolic: Glu [3.6 - 6.2], Lact [0.0 - 2.0] Electrolyte: K+ [3.6 - 4.7], Na+ [144 – 152], Ca2+ [ 1.20 - 1.50], Cl- [111 – 121]   CAT DIAGNOSTICS:  PCV/TP:  Blood Gas: VENOUS Acid/Base: pH   [7.380- 7.4000], PCO2 [36.0 - 39.0], BE [-5..0 - 0.0], HCO3- [20.0 - 23.0], AG [16.0 - 20] Metabolic: Glu [3.7 - 4.7], Lact [0.0 - 2.0] Electrolyte: K+ [3.4 - 4.7], Na+ [148 – 156], Ca2+ [ 1.10 - 1.40], Cl- [115 – 125] AFAST: TFAST: PROBLEM LIST: ASSESSMENT:  This hospitalisation period, [Patient] has been......  TREATMENT: IVFT - LRS @  mL/hr  For detailed hospital record including vital signs and TPR frequency, please see patient Smartflow chart.  PLAN:  Diagnostic Plan:  Treatment Plan:  Nutrition Plan:  CLIENT COMMUNICATION: First 12-hour Estimate:  Global Estimate Provided:  CPR Status: --- 12/03/2026 10:16:51 AM CH8:Advised stable, eating well. Diarrhoea - started probiotics Bloods again today - recommedn q48Likely additional 48h minimum in patietn care Discused reduce IVF at normal or plataeuO happy woith plan--- 12/03/2026 12:49:55 PM CH8:Advisd azotaemia now resolved, kidney markers normal. Need to slowly reduce IVF over the next 24-48h and reassess.    Vital Signs    

Reason: Blood Test Post Grape IngestionHospitalisation time period: 2300 - 0700:HISTORY:Night 3 hospitalisation for AKI secondary to grape ingestion.Creatinine and urea: - 9/3: 12, 11.8- 10/3: 136, 7.6 - 11/3: 229, 10.4SDMA static. Clinically well, eating in hospital consistently with no GI symptoms of concernSee previous history for full details EXAMINATION: @2330BAR, sweet boyHR 68 at rest, RR 28, Mm pink/moist, CRT <2s, Temp 38.3Weight = 19.9kgBCS 69Pain score 1/24Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronous Respiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge Neurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gait Musculoskeletal: ambulating normally, no palpable neck, spine, limb or joint pain Gastrointestinal: - Abdominal: no detectable pain on abdominal palpation, increased gut sounds >> Eaten enthusiastically @ 2330 with no vomits.   >> Diarrhoea @ 0530 Urinary: urinating comfortably on toilet walk +++ Reproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normal Eyes: NSFPROBLEM LIST: AKI - Increasing Creatinine (Grape ingestion)- Casts on in-house UA - Diarrhoea DIAGNOSTICS: Urinalysis (in-house) USG = 1.020 Dipstick: pH 7, all else negativeSediment exam: granular casts present ++ ASSESSMENT: Frankie remains CVS stable, clinically BAR overnight.Despite increasing creatinine values (AKI), she continues to eat well with no vomits. Maropitant discontinued this evening for this reason. She has started to develop diarrhoea from 5am this morning - to monitor volume/frequency and adjust fluid rate as required. UA performed in-house confirms granular casts -consistent with active renal tubular injury Ongoing supportive care in hospital indicatedTREATMENT: 1/ LRS maintenance rates (52ml/hr)Maropitant and trazodone withheld overnight - not required as he continues to eat well and is settled PLAN: Repeat chem 11 tomorrow midday as per previous discussion with owner Ongoing supportive care until able to wean IVFT off Adjust fluid plan as required CLIENT COMMUNICATION:--- 12/03/2026 6:32:03 AM ADC:Attempted to call owner - straight to voicemailHi Koce, Frankie has been well overnight. He has started to have a bit of diarrhoea this morning that can happen with kidney injury, but thankfully is still eating well with us. As you have discussed with Tristan last night, we will repeat his bloods at midday today and touch base with you after this. - Dr Desiree (AES ICU)    Vital Signs    

Reason: Blood Test Post Grape IngestionHospital/Inpatient Hospitalisation Period:History Summary:Dog remains bright and responsive in hospitalEating and drinking well in hospital  Diagnostic Summary:Creatinine continuing to trend up (229 <-- 136)Urea trending up (10.4 < -- 7.6)Physical Examination @ VITALS:HR: 80RR: 24Temp:MM: PinkCRT: <2sMentation: NormalPain Scale (MGCS): 0Dehydration status (%): <5%BCS (1-9): 5 Examination:Cardiovascular: NAD - normal rate and rhythm, no murmurs or arrhythmias auscultated, pulses strong and synchronous.Respiratory: NAD - no nasal discharge noted, normal respiratory rate and effort, bronchovesicular sounds are normal to all fieldsNeurological: NAD - normal gait, posture and mentation; full neurologic exam not performed.Gastrointestinal:- Oral: Oral mucosa appears normal, no lesions noted.- Abdominal: Normal on abdominal palpation, no obvious masses noted, comfortable- Rectal: normal faeces on rectal examinationMusculoskeletal: NAD - no evidence of lameness or pain. Full MSK exam not performed.Ears: NAD - pinnae normalEyes: Eyes clear with no obvious discharge or changes associatedLymph Nodes: NAD - peripheral LNs normal in size, no firm or painful LNs identifiedUrogenital: NADIntegument: NAD - coat normal, no obvious masses or other lesions; full exam not performedOther: Client Communication: Had a long discussion with the owner regarding grape toxicity, what rising enzymes mean, difference between aki, chronic renal failure and acute renal faliure. Potential outcomes etc. Discussed the nature of supportive therapy as the toxicity has already occurred.    Vital Signs