C09992437 / invoice 10000

Reason: caught a snakeHISTORY:Seen with a snake in her mouth. Dropped the snake and it slithered away. Was a light brown in appearance.. Maybe resembled a small eye- snake or whip snake, but no ID> No clinical signs noted Current meds: none Prophylaxis: not asked Pre-existing conditions: not asked Access to toxins eg. Rodenticide: none TRIAGE:HR: 188RR: 24Temp: not taken Mm:  pink Crt: <2Mentation: BAR Pain Scale (0-4): 0Hydration status (%): hydration clinically adequateEXAMINATION:Body Condition Score: 5/9Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal, no mouth pain, dental score (1-4):   1- Abdominal: no detectable pain on abdominal palpation, normal gut sounds- Rectal: not performed Urinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normalEyes: NSFPROBLEM LIST:Asymptomatic DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Elapid snake envenomation vs not DIAGNOSTIC/MANAGEMENT PLAN:Coagulation + CK + SVDK to look for evidence of EBs/rbbs/SMALL eyed snake DIAGNOSTICS:A blood sample was collected for a coagulation analysis.PT      18               (14-19 sec)APTT     111.8            (75-115 sec)This result is wnlPT/aPTT - clotting test - normal Urine - clear CK -  382 (0-314)  - not indicative of small eyed snake Snake venom Detection Test - NEGATIVE ASSESSMENT: no evidence of elapid envenomation TREATMENT:Nil PLAN:We have rule out to the best of ability of snake envenomation by elapid snakes which we seen around Brisbane area. We can not rule out a whip snake which can have 24 hour delay in clinical signs (flacid paralysis). Please monitor for any signs of weakness, going off food or water. If these occur please get her veterinary assessed. CLIENT COMMUNICATION:Monitor for any clinical signs weakness/ lethagy etc    Vital Signs    Weight: 5.5;