C09984106 / invoice 10000

Reason: FB IngestionAppointment Notes: Special payment terms exist, Overdue remindersHISTORY:Lulu presented for induced emesis following ingestion of contents from a rubbish bag. The owner reported that the bag contained chocolate ruffles, chocolate biscuit ruffles, Tic Tac cases.This is reportedly the fourth occurrence of such an incident. The owner believes the quantity ingested was minimal. Monitoring of gastrointestinal signs was advised.Specific History Questions:- Vomiting: Nil v+/r+- Mentation/Behaviour: Energy levels normal- Defecation: Nil d+- Urination: U+ wnl- Diet & Appetite: Indiscriminate eating of rubbish bag contents.- Drinking: Drinking normallyCurrent meds:- nilProphylaxis: unknownPre-existing conditions:- nil, healthy priorToxins: Potential ingestion of chocolate from a rubbish bag.Triage:HR: 120 RR: pantingTemp: 38.3Mm: pinkCrt: 1-2secMentation: BAREXAMINATION:Body Condition Score: 4/9Hydration status (%): clinically euhydratedPain score: 0/4Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Mentation appropriate. Full exam not performed.Musculoskeletal: ambulating normally x4, nil back/neck painGastrointestinal:- Oral: NSF, dental score 2/4- Abdominal: comfortable- Rectal: Not performedUrinary: nsfReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:- Inappropriate ingestion of potentially toxic materials (chocolate)DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Toxin ingestionDIAGNOSTICS:NilASSESSMENT:Lulu presented for ingestion of potentially toxic substances from a rubbish bag, including chocolate. Emesis was induced as a primary decontamination measure. The owner was counselled on the need for close monitoring of gastrointestinal signs at home.TREATMENT (Fluid Therapy & Medications refer to Smartflow):Emesis was induced with 1/2 tablet or apomorphine brought up 2 pieces papaper/wraper but nothing muchEmesis reversed with metomide 0.5mg/kg SCPLAN:The owner is to monitor Lulu closely at home for any signs of gastrointestinal upset, lethargy, or other abnormal behaviour. Further veterinary care should be sought if any concerns arise.CLIENT COMMUNICATION:The situation regarding Lulu's ingestion of items from the rubbish bin was discussed with the owner. The potential toxicities of chocolate were explained. The treatment plan of inducing emesis was discussed and consented to. The owner was advised to monitor for gastrointestinal signs at home and to seek further veterinary attention if any abnormalities are noted.--------------------------------------------------------------------------------    Vital Signs