C09985470 / invoice 10000

WEIGHT: 5.30
HISTORY: Check up after anaphylactic reaction to bee sting 1/3 ( sunday)
Presented to emergency and had to stay overnight for supportive care (IVFT/adrenalin CRI)
Went home Monday morning and hasnt been her usual self
Posie has been very restless last 2 nights, scratching on doors, climbing/hiding in cupboards, agitated with other pup at home. Restless/shivering at home today
Owner noticed yesterday morning that Posie ahs enlarged/prominent mammary glands. 
Was in season +- 10 weeks ago. 
Eating at home. No vomiting/diarrhea
No current meds

EXAM
Alert in cons
Temp 38.2
HR 100, no audible murmur
RR 24, normal lung sounds
MM pink crt <2s
PLN: palpably normal
Abd palpation: relaxed, mammary glands developed and mild production evident
No vaginal discharge
Quick US check- no visible fetuses
MSK: ambulatory x4
Healthy skin and coat

ASSESSMENT
Anaphylactic reaction to bee sting- recommend referral to MVSC for desensitisation
> will dispense adrenalin to be given IM in case of bee sting ( 0.05 ml IM) ~ owner use to work as vet nurse

Suspected phantom pregnancy- recommended desexing before next heat

TREATMENT
Gabapentin to help to calm down at night- 50 mg 1-2 hours before bed time. Can increase to 75 mg
If still very restless, can add trazadone, but will need to order compounded 20 mg

HISTORY: HISTORY
iNGESTED GRAPE 30 MIN PRIOR TO PRESENTATION
Discussed risks and owner elected induction of emesis
Usual diet: Eukanuba kibble
Current medications: None

EXAMINATION
Alert
BCS: 5/9
HR: 150, no audible murmur
RR: 24, normal lung sounds
MM: pink CRT <2s
LNN: peripheral lnn palpably normal 
Teeth: excellent 
Abd palpation: relaxed
Skin/coat/ears: healthy
Eyes: clear, no discharge. 
MSK: Normal gait, no lameness.

Posie brought up large amount of food and whole grape.

ASSESSMENT
Induction of emesis following grape ingestion. 

TREATMENT
Redivom 0.5 ml SC
Metomide 0.5 ml IV
WEIGHT: 5.70

WEIGHT: 4.00
HISTORY: Ate tin of biscuits- unkown amount. Delta cream ( chocolate)  and  monte carlos 
No GIT signs or neuro signs observed
not sure what time pup ingested biscuits
No current meds, otherwise healthy pup

EXAM
Alert
HR 140, no murmur
Normal RR and lung sounds
MM pink crt <2s
PLN: palpably normal
Skin/coat good
Abd mod distended
MSK Normal, gait no lameness

TREATMENT
Apomorphine- redivom- 0.4 ml SC
Brought up large amts of biscuits
Metomide 0.4 ml IV

ASSESSMENT and PLAN
Pup alert with no neuro /caridac signs at discharge
Recommended monitoring at home for GI signs
Owner is vet nurse.