C10021500 / invoice 10000

Patient seen by:Where: SASHWhen: 11/3/26Why: v+ & d+Summary of report (copy attached)PROBLEM LIST:Vomiting/diarrhoeaAnorexiaLeg twitchingWeight loss (5.9 kg to 5.4 kg since last week)Unknown exposure during missing periodDIFFERENTIAL DIAGNOSIS:Gastrointestinal issues: (toxin ingestion, foreign body/bone from mouse causing obstruction), infectious disease, extra-GI disease (Pancreatitis, triaditis, AKI etc) , cat/ animal bite (less likely due to normal temperature and absence of visible wounds).Neurological disease: Partial/ focal seizures, neurological toxins, metabolic disease, infectious CNS disease (e.g. FIP vs neospora), vascular event, CNS neoplasiaAnorexia: likely secondary to one of the above systemsASSESSMENT:Florence presents with acute onset vomiting, diarrhoea, anorexia, and leg twitching following an unknown period of being missing. While her vitals are currently stable and her physical examination is largely unremarkable, the history raises concerns about possible toxin ingestion or a gastrointestinal foreign body or other unknown trauma.PlansIVCTRIAGE PROFLE3 VIEW CHEST ABDO RADS+/- specialist ultrasound MONITOR IN ICU SEIZURE WATCHTREATMENT:Maropitant 1mg/kg IVSedate medetomidine 0.005mg/kg IV and methadone 0.2mg/kg IV radiographs Fluid therapy based on radiometer

are the policy details on file Y/N: YIs this the clients first claim Y/N: Ne-claimWhich visits are we claiming?: 11 03 26Claim submitted (please initial and date):

Assessment:Mild ALT elevation (119) - GI upset, parasites, hyporexia, dehydrationLow platelet count - likely due to lab artefact, platelet clumpingTP (81) - mild dehydrationEosinopenia (0.04) - acute inflammation/stress responseAction taken/Client communication:Hyporexia rather than complete anorexia. If extremely ill expect complete food refusal. Stress in clinic can suppress appetiteIN HOUSEPCV/TP 47/88HEAMATOLOGY all WNL exceptRBC              x10^12/l (6.54-12.20)HCT               % (0.303-0.523)HGB              g/L (98-162)MCV              fL (35.9-53.1)MCH              pg (11.8-17.3)MCHC             g/L (281-358)RDW              % (15.0-27.0)Reticulocyte         % Reticulocyte ABS     K/uL (3 - 50) Reticulocyte Hg      pg (22.3-29.6)WCC              X10^9/l (2.87-17.02)Neutrophil           % Lymphocyte         %Monocyte           %Eosinophil     0.04     %Basophil            %Neutrophil ABS       X10^9/l (2.30-10.29)Lymphocyte ABS     X10^9/l (0.92-6.88)Monocyte ABS       X10^9/l (0.05-67) Eosinophil ABS       X10^9/l (0.17-1.57) Basophil ABS        X10^9/l (0.01-0.26) Platelet Count        X10^9/l (151-600) MPV               fL (11.4-21.6)Plateletcrit           % (0.00-0.79)Platelets: 49BIOCHEMISTRY/LYTES all WNL exceptSMDA              g/dL (0 - 14)Glu                mmol/L (4.11-8.84)Creatinine           umol/L (71-212)UREA              mmol/l (5.7-12.9)BUN:Creat RatioPhosporus           mmol/l (1.00-2.42)Ca                 mmol/l (1.95-2.83)Sodium              mmol/l (150-165)Potassium           mmol/l (3.5-5.8)Na/K Ratio Chloride             mmol/l (112-129)Total Protein   81      g/L (57-89)ALB                g/L (22-40)Gloulin              g/L (28-51)Alb:Glob Ratio ALT          119     U/L (12-130)ALP                u/L (14-111)GGT                u/L (0-4)Bilirubin             umol/L (0-15)Cholesterol           mmol/L (1.68-5.81)Osmolality           mmol/kgT4                  nmol/L (10-60)