C10023961 / invoice 10000

Reason: Vomiting Today Cant Keep Water Down. Diarrhoea ToAppointment Notes: please call if anyone cancels earlierHistory: - Woke up this AM with soft faeces around the home - Lethargic today - Has not eaten since last night - Vomiting up water when drinking - Royal Canine dry kibble - Scavenges in the past (goes for walks with dog walker) - Ice cream (a little bit) last night - Has cheese nightl;y - Has boneVerified: NoHistory:Presenting for: Louie presented for a 24-hour History: of vomiting and soft faeces, with inappetence.Historical Conditions: Previous episodes of elevated pancreatic enzymes. Previous pancreatitis ruled out on last visit but was allowed to go home. History: of scavenging behaviour.Diet: Has not eaten dinner last night or today. Normally fed kibble. Recently given ice cream (high fat content). Owner reports dog goes on walks with dog walker and may scavenge unknown items.V/D/C/S: Soft faeces started the night before presentation, progressed to not defecating today. Vomiting started approximately 24 hours ago - every time he drinks water, vomits within 5 minutes.Current Meds: Flea and tick prevention overdue. Vaccinations due but being held due to current illness.Examination:Mentation: BARBehavioural: Cooperative for examinationAbdominal: Very tense abdomen. Firmness palpated in cranial abdomen just under ribs in region of stomach and small intestine.Assessment:Acute gastroenteritis with possible pancreatitis - DDx: dietary indiscretion, pancreatitis, foreign body obstruction, inflammatory bowel disease, infectious gastroenteritisPlan:Diagnostics:- Blood work to assess pancreatic enzymes and rule out pancreatitisMedications/Treatments:- Anti-nausea injection (maropitant) administered subcutaneously. If vomiting occurs within one hour post-injection, client advised to return immediately or present to emergency hospital- Probiotic dispensed to aid gastrointestinal recoveryDiet Recs:- Strict bland diet for 5 days: chicken and rice with pumpkin, or canned bland diet- No high-fat foods including ice cream, cheese, dairy, or bones- Avoid fatty treats and bones due to risk of pancreatitisAdditional Discussion:- Cost estimate provided: $600 for consultation, blood work, and anti-nausea medication- Vaccinations postponed until patient recovered- If blood work confirms pancreatitis, will require IV fluids, pain medication, and strictly managed low-fat diet long-term- If no pancreatitis detected, will investigate for infection or inflammation, potentially requiring ultrasoundClient Comms:- Call tomorrow with blood results- Monitor closely for 24 hours post-injection- Return immediately if vomiting occurs within one hour of anti-nausea injection- Contact clinic if any concerns arise    Vital Signs