C09983792 / invoice 10000

Reason: V+HISTORY:Macy, a ~3-4 y.o.(Exact age unknown)  female Bull Arab, presented for acute onset ataxia.Owner returned from work at ~1700-1730 and found Macy to be abnormal. She was found upstairs on the couch when normally she would be at the dinner table. Owner's wife noted Macy was "wobbly" and "uneasy on her feet" with her back legs giving way. She was also observed doing an unusual movement with her nose. Macy has a history of pica, eating non-food items like coat-hangers and shoes. No V/D reported. Eating and drinking well this morning. Appeared completely normal this morning. Last vet visit was >6/12 ago for worming.Current meds: none.NUTD with FTW and vaccPre-existing conditions: Pica.Access to toxins: Potential access to THC, a chewed vape, and ADHD medications (dexamphetamine) and other unknown medication. Owner reports the bin in their daughter's room was burst open. Unknown contents, but daughter's boyfriend was visiting.TRIAGE:Temp: 40 C. - 38.8 after 2 hours of active cooling Mentation: Neurologically altered, hyperaesthetic. Ataxic.Demeanour/Behaviour: Drooling, hunched, appears uncomfortable.EXAMINATION:AnxiousHR 80RR 16PL ssfp Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Ataxic, wobbly. Hyperaesthesia noted.- Abdominal: no detectable pain on abdominal palpationPROBLEM LIST:- Ataxia- Hyperthermia (40 C)- Hyperaesthesia- Potential toxin ingestionDIFFERENTIAL DIAGNOSIS/DIAGNOSIS:- Drug intoxication (THC, amphetamines, other unknown substances from vape/bin)DIAGNOSTICS:Urine drug screen performed: negative for all tested substances. Noted that test is designed for humans and may not detect low/dog-specific doses.NEG for THC, COC, OPI, AMP, MET, MDMA, TCA, BAR, BZO and MTD CBC/Biochem NSFPCV/TP 57/72 clearEPOCK+ 3.3 (L) (3.4 - 4.9)Lac 3.71 (H) (0.6 - 2.9) ASSESSMENT:Maxie presented for acute ataxia and neurological signs. Examination revealed marked hyperthermia (40 C), ataxia, and hyperaesthesia. Given the history of potential access to toxins (THC, dexamphetamine, vape contents), a drug intoxication is highly suspected despite a negative human urine drug screen. The high temperature is a significant concern. Abdomen is soft and non-painful, reducing concern for a GI foreign body obstruction at this stage.TREATMENT:Please refer to in clinic software e.g., smartflow for admitted patients.Maropitant 1mg/kg IV PLAN:- Admit to hospital for overnight monitoring and supportive care.- If neurological signs worsen (e.g., seizures), will administer further medication to manage.- Home into owner's care post-stabilisation.CLIENT COMMUNICATION:Discussed the suspicion of drug intoxication and the reasons for recommending hospitalisation, primarily the significant hyperthermia. Explained that IV fluids would help flush out potential toxins and manage her temperature. The plan for blood tests to check organ function was outlined. The limitations of the urine drug test in dogs were explained. Advised the owner to search the house and yard for any evidence of chewed substances or packaging.Provided an estimate for hospitalisation and diagnostics of $1800-$2300 on top of the initial consultation/urine test fee. Discussed pet insurance and gap-only payment process, requiring a 20% deposit. Owner consented to the plan.================================================================Overnight Veterinary Report: STRepeated Drug test THC positive Resting comfortably Remains hyperaesthetic with occasional head tremoring, altered mentation Injected conjunctivaAtaxia improving Dropped IVFT to 80ml/hr LRSNil V+ though episodes nausea that resolve with inactivity Client Communication:Recommended continuing in care until more neurologically norm. GP vs AEC option given Suspect THC + other medication/ drug given progression overnightOwner informed of costs (600-1000), happy to stay with AEC todayPlan: Continued supportive care    Vital Signs    Weight: 36.7;