C10028730 / invoice 10000

Reason: Lethargic SSAppointment Notes: Overdue remindersInc breathing- ongoing over last year- seen jan for this- did not identify the problemMainly at night and when restingWill run and active normallyNo cough, no vomit /diarrhoeaNew pup- playing well, yesterday10pm - last night then would not settle, declined food, staring in a corner, appeared in pain, trembling when o tried to feel legsO gave gaba 400mg- took 3 hr to settleDrueling, wouldnt eat or settleNot on any medsNo v/dAte dinner last night- seemed ok 5 pmThis morn a little betterSeems vacant and dull and listlessUtd vacc and wormerExamination: Gasy distended abdo Poss mid abdo massHr/rr normSalivationGiven maropitantDull and listlessRectum- empty and distendedRadiographs: Large amount gasStomach distensionPattern suggestive of GDVThorax- multiple small nodules- very white- poss calcification-MetastasisUltrasound: Splenic mass mid abdoGas right side of abdoSmall amount free fluidLaboratory: Unremarkable bloodsClient Communication: Discussed with RennaeGDV and Splenic mass with poss metastasis lungsO does not want to proceed to sx or further diagnostics- will come into clinic with family and have put to sleep    Vital Signs    Weight: 43;       MMColour: pink;       Temperature: 37.8;       HeartRate: 140;       BodyScore: 5/9;       RespirationRate: 20;       CRT: <2;