C09984380 / invoice 10000

Reason: Ate 200g Butter 01/02 V+++Grade 2 murmur B1, mitral valve insufficiency, acho last tuesday Ate 200g of salted butter 7pm last night, 2 x vomits, O gave ondansetron wafer 8mg, 20mg omeprasole- vomitied omeprazole- kibble and dark bile V+ this AM V+ chicken and rice and bright yellow bile- three x V+ this AM, still BAR and appetant but slightly flatter than usual No D+, no stools passed yet Fluoxetine 20mg SID Physical Exam: HR 100, grade 2/6 murmur RR panting, lung auscultation WNLAbdomen tense but not painful on palpation MM pink, tacky, CRT2s, no skin tent Temp axilla 38Did not attempt rectal due to FASBP: 125/91 (95) 114/76 (84) 151/120 (128)Current Medications: Methadone 0.2mg/kg IMMedetomidine 0.005mg/kg IM Assessment: Mild lethargy and several episodes of vomiting post eating 200g of salted butter Plan: 1. CBC, chem 17 + SDMA, radiometer, cpl2. Sedated POCUS 3. IVFT4. Analgesia as indicated 5. Maropitant 1mg/kg IV q24h 6. Gaba 600mg PO q6h for anxiolysis 7. Pro-kolin if D+ developsLaboratory:Packed cell volume (37 - 55 %): 46Total protein (55 - 75%): 62Serum colour: clearElectrolytes, metabolites, acid-base, blood gas & oximetry (Radiometer panel)Canine:		Sodium	149	 (137 - 150 mmol/L): Potassium 3.5		 (3.3 - 4.6 mmol/L): Chloride	116	 (105 - 120 mmol/L): Ionised calcium 1.35 (1.25 - 1.50 mmol/L): Lactate	2.1	 (0.0 - 2.5 mmol/L): Glucose	4.7	 (3.3 - 6.4 mmol/L): pH	7.364	 (7.350 - 7.460): pCO2	40.6	 (38 - 47 mmHg): SBE	-2.3	 (-4.0 - 4.0 mmol/L): HCO3	23.1	 (18 - 24 mmol/L): Anion gap 12.9		 (12 - 24): Venous		PvO2	35.5	 (54 - 65 mmHg): PvCO2	40.6	 (38 - 47 mmHg):    Vital Signs    Weight: 28.3;