C09971086 / invoice 10000

To the Practice Manager,
 
Regarding the pre-approval request for Ellie, with reference to estimate # 201886.
 
Pet's Name:  Ellie
DOB:    01/12/2021

Customer Name: Su Wu
Customer Address: 5 CLANMEL RD FLOREAT WA 6014
 
The expected gap amount to be paid by the client (based on the estimate submitted) is: $254.79.
 
Please note that the gap amount is an estimate and may vary from the pre-approval if the benefit amounts available under the policy change before the claim is submitted or if the finalised invoice for the treatment submitted differs from the estimate previously supplied. We reserve our rights to apply the applicable pet insurance policy terms and conditions to the claim in the event that further relevant information becomes available.
  
The policyholder has been provided with a letter regarding this pre-approval outcome. Should the policyholder require further information, the details for contacting us have been provided to them in that letter. 
 
Thank you.
 
Yours sincerely,
Belindah

Admitted: emesis
puffer fish 1 hour and 15min ago ( another 1hr to go) driving from country 


Reason: ate a pufferfish

History: O was out camping and Ellie ate a pufferfish, the immediately loaded her in the car and came down to EVH
Past history: 
Travel: was on holiday at the beach
Other animals at home: 
Current Medications (including heartworm and flea):  none
Presence of toxins (compost, plants, outside yard access): pufferfish

Patient Data: 
Physical Examination:  BAR
Weight:  15.2
Temp: not taken
HR:  not taken  
Pulse quality: strong and sync 
MM colour:  pink and moist
CRT: < 1 sec
RR:  panting 
Respiratory effort: normal effort
Lung sounds: clear bilaterally
Cardiac ausc:  no arrthymia or murmurs
Abdo palpation:  soft and relaxed
Gut sounds:  not assessed
Rectal: not done
EENO: no abnromalities noticed
Skin (including turgor): normal
LNs:  WNL
MSK:  normal mobility 
NEURO:  BAR but not fully assessed

Treatments given: 
Gave apomorphine 1 tablet dissolved in 1 ml saline SC
started vomint and produced 2 pieces of pufferfish
reversed with metroclopramide 1.5ml SC

Assessment: tetrodotoxin ingestion
Problem List
1. tetrodotoxin


Plan:
admit to hospital for 12 hr monitoring for any signs for neurological symptoms
administer 75 ml activated charcoal per os


Exercise:  as per normal
Nutrition:  as per normal
Medications provided at discharge:  none

Home instructions: 
Diet and/or exercise restrictions: 

Client Communication: LIB discharged to Os with letter no meds rest
Estimate: 
Financial concerns: 

Discharge letter sent to referring vet?   Yes or No  Email 

SHIFT CHANGE: Day             AM/PM        VET IN CHARGE:
Working Diagnosis:
In Hospital Vet Consult entered in Smartflow? YES/NO
Last time Estimate updated and O informed: 
Plan for this shift:
Discharge letter YES / Started /NO