C10031837 / invoice 10000

Reason: UnwellHistory:D+ in the past week. Not eating well. Bloody D+. 17/02 - UVTHS, had another GI signs. Resolved for a little bit then a few weeks later flare up again. Appetite is never been great but worse when she had D+. V+ once or twice in the past week - usually bile or a bit food. Tend to V+ when she hasn't eaten for prolonged period. Diet: RC hypoallergenic dry to graze + Prime 100 kangaroo + green beans Has had chicken during that period since Dec. Examine:Verified: NoHistory:Luna has been experiencing diarrhoea and vomiting for approximately one week. She was previously diagnosed with chronic enteropathy and has a history of similar episodes. Last visit was in January for vaccination when she was doing well. Prior to that, she was unwell in December. On February 17, she had another inflammatory episode and was seen at Sydney Uni vet for liquid, bloody diarrhoea which resolved temporarily but flared up again a few weeks later. Current episode involves very liquid diarrhoea with fresh blood and frequent defecation. Owner noticed what appeared to be a missing tooth on the left side.V, D, S or C - Yes. Vomiting 1-2 times in the past week, usually bile or food contents, particularly when stomach is empty for prolonged periods.Appetite constantly poor, worsens significantly during diarrhoea episodes. Drinking lots of water. Energy levels variable - excited on walks but lethargic at home.Parasite control: Up to date, last worming 2 weeks ago.Diet: Prime 100 kangaroo dry food for grazing, occasional green beans (2 pieces). Has been receiving boiled chicken and rice recently due to poor appetite. Previously had chicken, beef, lamb, egg, and fish.Lifestyle - Indoor, has doggy door but hasn't been using it for 6 months, not fully toilet trained.Any medications?- Vitamin B12 capsule, half capsule every second day (sometimes missed)Owner limitations: Recent parental divorce, owner at university full-time, mother caring for dog alone, considering rehoming due to intensive care requirements.Examine:BARMM pink/moist CRT slightly slow due to mild dehydrationEyes - clearEars - clearDental grade - dental disease present with plaque, no obvious missing teeth notedHR=PR= No murmur/arrhythmiaAll lung fields sound clear. Normal REAbdomen soft and comfortableSkin - sore bottom from dried fecesAll peripheral LNs normalAmbulatory - no lameness or ataxia, full ortho exam not performedTemp - 39.8°CAssessment:- Chronic enteropathy with acute flare-up- Possible food intolerance (chicken suspected)- Poor appetite and mild dehydration- Elevated liver enzymes (historical)- Possible inadequate B12 absorption- Dental diseaseTreatment:- Anti-nausea injection given- Topical cream applied to sore perianal areaPlan:- Discontinue chicken completely from diet- Trial kangaroo wet food and hypoallergenic wet food- Start Pro-Kolin 2mL BID for symptomatic diarrhoea control- Antiparasitic liquid 1.6mL once daily for 5 consecutive days- Continue B12 supplementation- Monitor closely over next 24 hours- Consider B12 level testing and liver enzyme recheck if no improvement- If continues to be lethargic, not eating, vomiting, or diarrhoea worsens, present to emergency clinic or return Monday for further investigation- Owner to consider long-term management options given home circumstances    Vital Signs    Weight: 3.02;       Temperature: 39.28;