C10027094 / invoice 10000

Reason: Blood Test Post Grape IngestionAppointment Notes: Gap only--- 13/03/2026 07:52:23 CH8:Hi Koce, Frankie has had another greart night with us overnight. We will repeat his bloods around 12-1pm again and I will give you a call with the results thereafter! Feel free to come in for a visit this morning if you wish.  Dr. Cristina (AES ICU)--- 13/03/2026 1:02:11 PM CH8:-  discussed bloods, increase in creat again - recommend additional 24-48h of fluids if being complete vs discharge and repeat bloods in 24h, any further increase recommend readmission - sending cystatuin B --- 13/03/2026 1:38:29 PM CH8:O pref for dischareg today - discussed feeding at home- return for bloods tomorrow - rest at home th enext 24h, wet food only - avoid ANY dehydration    Vital Signs    

Reason: Blood Test Post Grape IngestionAppointment Notes: Gap onlyHospitalisation time period: 2300 - 0700:HISTORY:Night 4 hospitalisation for AKI secondary to grape ingestion.Creatinine and urea: - 9/3: 12, 11.8- 10/3: 136, 7.6 - 11/3: 229, 10.4- 12/3: 100, 7.4 Clinically well, eating in hospital consistently. Had an episode of haemorrhagic diarrhoea 12/3 AM but none since. See previous history for full details EXAMINATION: @2330BAR, sweet boyHR 80 at rest, RR 24, Mm pink/moist, CRT <2s, Temp 38Weight = 20.2kgBCS 6/9Pain 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. Urinary: urinating comfortably on toilet walk +++ Reproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normal Eyes: NSFPROBLEM LIST: AKI - Grape ingestion - Azotaemia - resolving - Casts on in-house UA - Diarrhoea - none overnight ASSESSMENT: Frankie remains CVS stable, clinically BAR overnight.No ongoing diarrhoea overnight, and continues to eat well. Progressive weaning down of IVFT, stopped at 7am Repeat bloods due in the morning and if renal values static then reasonable to discharge home TREATMENT: 1/ LRS weaning down from 30ml/hr -> 15ml/hr @ 0300   >> Weaned off at 7am 13/3 Trazodone 100mg PO given @ 0300 PLAN: Repeat chem 11 tomorrow at 11am (off IVFT) CLIENT COMMUNICATION:    Vital Signs    

HOSPITALISATION PERIOD:  0700 - 1700HISTORY SUMMARY:  Hospitalisation Day 4 for AKI post grape ingestion Saturday Diagnostic Summary:  Creatinine and urea: - 8/3: CREAT 86, UREA 10.5- 9/3: CREAT 120, UREA 11.8- 10/3: CREAT 136, UREA 7.6 - 11/3: CREAT 229, UREA 10.4TRIAGE: HR: 90RR: 20Temp: 37.9MM: Pink, moistCRT: < 2 seconds Mentation: BAR, anxious Pain Scale (MGCS):  0/24Dehydration status (%): euhydratedBCS (1-9):  6/9Weight: 19.8kg @ 0700     ; 199.9kg @ 1500EXAMINATION:? 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, eating very well - Rectal: formed stool with bloody mucous passed on walk with owner 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:  38/65Blood Gas: all WNL, AG 9.0CREAT 100, UREA  7.4 PROBLEM LIST: AKI post grape ingestion - crreat normal todayASSESSMENT:  This hospitalisation period, Frankie has been stable. He has shown a marked reduction in creatinine in the last 24h. Reasonable to commence weaning of IVF and reassess in 24h   TREATMENT: IVFT - LRS @ 60 mL/hr  --> 50mL/hrTrazodone 100mg PO TID PRN For detailed hospital record including vital signs and TPR frequency, please see patient Smartflow chart.  PLAN:  Diagnostic Plan:  Repeat chem 11 tomorrow Treatment Plan:  Wean IVF by 25% q6-8Nutrition Plan:  Wet foodCLIENT COMMUNICATION: --- 12/03/2026 10:16:51 AM CH8:Advised stable, eating well. Diarrhoea - started probiotics Bloods again today - recommend q48 bloods Likely additional 48h minimum in patient care Discussed reduce IVF when creat normal or plateauO happy with plan. Coming for a visit --- 12/03/2026 12:49:55 PM CH8:Advised azotaemia now resolved, kidney markers normal. Need to slowly reduce IVF over the next 24-48h and reassess bloods, if increase in creat then need to increase IVF    Vital Signs