C10029561 / invoice 10000

Reason: D+    Vital Signs    

Reason: D+Verified: NoHistory:Presenting for: Waffles, a puppy, presented for straining to defecate with multiple unsuccessful attempts, vomiting twice this morning (once frothy with some blood), decreased appetite, reduced energy levels, and scooting behaviour.Diet:- Currently fed puppy kibble and wet food for kidney failure- Did not finish dinner last night- Refused food this morningV/D/C/S:- Vomiting: 2 episodes this morning, one frothy with some blood- Defecation: Straining with difficulty, multiple unsuccessful attempts, normal stool passed at 8AMCurrent Meds:- Puppy kibble and wet food (regular diet)- Vaccination 3 weeks agoLifestyle Risk Factors:- Puppy with access to various objects that could be chewed and ingestedOther:- Usually very active but quiet today, hiding under couch- Scooting behaviour observed (rubbing bum on ground)Examine:Mentation: BARBehavioural: Crying during examination, particularly during rectal temperature and anal gland examinationMM: Normal colour, CRT <2 secondsHydration: Euhydrated - skin tent returns immediately, nose moist, gums normal\Abd palpation: soft, but start screaming - ( behaviour vs actual pain??? )Rectal: anus rectum area painful on palpation. Small amount of blood noted from anal glands after expression, likely secondary to straining. Patient vocalised significantly during anal gland expression and area cleaning.Assessment:Irritated anal glands - bilateral glands were painful to expressed, successfully expressed with some blood present likely secondary to excessive straining efforts. Vomiting episodes this morning likely related to pain and straining rather than gastrointestinal obstruction given normal faeces passage today.Plan:New Meds/Tx:- Anti-nausea injection administered -maropitant 2mg SC ; should prevent vomiting for next 24 hours- Panadol (paracetamol) 100mg/mL concentration: 0.2mL twice daily for pain relief (client to obtain from pharmacy)Diet Recs:- Bland diet: boiled chicken breast (no skin, no bones) and white rice for next few days OR RC puppy gastro - Alternative: prescription gastrointestinal puppy food available- Small frequent mealsAdditional Discussion:- Anal gland expression frequency varies by individual - some dogs require every 6 weeks- Future fibre supplementation with cooked vegetables (broccoli, carrots, celery, pumpkin) in small amounts once current episode resolved- Monitor for continued straining or vomiting through anti-nausea medicationClient Comms:- Return for recheck before final vaccination (due Wednesday 19th or 20th) to assess anal gland status and overall condition- If vomiting continues despite anti-nausea injection, return immediately for further investigation including possible ultrasound- Watch for scooting behaviour as indicator of anal gland issues- Keep anal area clean- Vaccination can be completed here or at regular clinic - cost comparison discussed ($173 vs $90)    Vital Signs    Weight: 2.08;       

Reason: Puppy--- 29/01/2026 13:03:29 JPP: New puppy text placed.-Jeddha    Vital Signs