C09993513 / invoice 10000

Reason: Ate Zinc StickHISTORY:Muffin is a one-year-old female spayed Cavalier King Charles Spaniel who presented for the ingestion of a zinc stick at approximately 6:30 p.m. this evening. The owner estimates she consumed about half of the stick. Shortly after ingestion, Muffin began vomiting. Initially, it was a small amount, after which she went outside and hid in the corner of the yard, which is uncharacteristic behaviour for her. She was reluctant to come back inside. Once inside, she went to her bed and had multiple episodes of vomiting. The vomiting has since ceased, and the last episode was well over an hour prior to presentation. Muffin appeared to liven up after the vomiting stopped. She was noted to be shaking after one of the vomiting episodes. The owner researched the toxicity of the zinc stick online and was advised to seek emergency veterinary care. Muffin is usually a picky eater and refuses her Royal Canin diet but will eat other items like lettuce.Current medications: None.Prophylaxis: Not mentioned.Pre-existing conditions: None.Access to toxins eg. Rodenticide:- What: Zinc stick.- When: Approximately 6:00 - 6:30 p.m. on 06/03/2026.- How much: Approximately half of the stick.TRIAGE:HR: 200 bpmRR: 24 breaths/minTemp: 39.4 degrees CelsiusMm: pinkCrt: 2 secondsMentation: BAREXAMINATION:Body Condition Score: 4/9Pain Scale (0-4): 0Hydration status (%): euhydratedCardiovascular: Tachycardic at 200 bpm. Normal rhythm, pulse pressures normal and synchronous.Respiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge.Neurological: Neurologically no significant findings, no cranial nerve or proprioceptive deficits/gait detected.Musculoskeletal: Ambulating normally, no palpable neck, spine, limb or joint pain.Gastrointestinal:- Oral: No significant findings, no mouth pain.- Abdominal: No detectable pain on abdominal palpation, normal gut sounds.- Rectal: Not performed.Urinary: No significant findings.Reproductive (incl ext genitalia): No significant findings.Integument/Ears: No significant findings.Lymph Nodes: No significant findings.Eyes: No significant findings.PROBLEM LIST:- Zinc toxicity- Vomiting- PyrexiaDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Zinc toxicity: Secondary to ingestion of a zinc stick.- Gastroenteritis: Secondary to zinc toxicity.- Pyrexia: Secondary to inflammatory response from zinc toxicity vs emesisDIAGNOSTICS:PCV/TP:PCV: 47%TP: 64 g/LSerum: ClearInterpretation: wnlBlood Gas Analysis Results - source: venousFindings: PCO2 44, CO 108, Lactate 4.3, Bicarbonate 26.5Interpretation: Mild metabolic acidosis.Bloods were taken for in-house testing:- Please find attached to the patient record.	- Complete blood count	- Significant findings: Platelets 85, MPV 16.2.	- Biochemistry	- Significant findings: No significant findings.		Blood smear:- RBC: NSF- WBC: NSF- Platelets: macroplatelets notesInterpretation: The blood results show a mild metabolic acidosis, thrombocytopenia, and evidence of macrocytic red blood cells, which can be consistent with early changes seen in zinc toxicity. Organ function appears within normal limits at this time.ASSESSMENT:Muffin presented for ingestion of a zinc stick, followed by multiple episodes of vomiting. On examination, Muffin is bright and alert but is tachycardic and pyrexic. Initial bloodwork shows a thrombocytopenia, macrocytosis, and a mild metabolic acidosis, which are concerning for systemic effects of zinc toxicity. The Animal Poisons Centre was consulted. They advised that the toxic dose of zinc is 20 mg/kg, and Muffin's estimated dose is 160 mg/kg. While the form of zinc in these sticks may not readily cross the gastric wall, and vomiting has likely reduced the absorbed dose, the clinical signs and bloodwork changes are significant enough to warrant treatment and monitoring for complications such as haemolytic anaemia and liver damage.ANIMAL POISONS ADVISEHistory & clinical examination: Muffin has ingested half of a Surf Life Saving Zinc Stick 12g. She vomited several times  after the ingestion, but is clinically normal now. Ingredients: Zinc Oxide 150mgg, titanium Dioxide 140mgg, Octyl Methoxycinnamate 90mgg, Diethylamino hydroxybenzoyl Hexyl Benzoate 30mgg Exposure Dose: 205 mg/kg zinc oxide = 164 mg/kg elemental zinc Risk assessment & advice: The most significant ingredient is zinc oxide. Zinc oxide is very poorly absorbed from the gastrointestinal tract and even large acute ingestions are not typically associated with systemic zinc poisoning. Signs seen are variable and range from abdominal pain, poor appetite, vomiting and diarrhoea. Haemolytic anaemia has been reported from repeated or  chronic ingestion of products containing zinc, but is rarely seen after acute once-off  ingestions. Activate charcoal is not indicated in this case. We recommend prescribing omeprazole at 1 mg/kg PO q12hr x 7 days, as well as an anti-emetic. Whilst not expected, Muffin should then be monitored for clinical signs of haemolytic anaemia over the next 7 days at home (pale gums, darkened urine, lethargy, panting at rest). If these signs develop, then veterinary reassessment is indicated.TREATMENT:Called - Maropitant 1 mg/kg SC administered.- Omeprazole 1 mg/kg PO BID 7 daysPLAN:- Hospitalisation for intravenous fluid therapy and ongoing monitoring is recommended.- Repeat blood tests (CBC and biochemistry) in 8-10 hours to monitor for development of haemolytic anaemia and hepatopathy.- Continue to monitor temperature and vital signs.- Discussed pet insurance coverage with the owner.CLIENT COMMUNICATION:Discussed the risks of zinc toxicity, including the potential for severe complications such as haemolytic anaemia and liver damage. The owner was advised of the treatment plan including hospitalisation, IV fluids, and medications. The importance of monitoring blood parameters was explained. Advised owner that while Muffin has vomited, significant absorption may have still occurred. The owner consents to the proposed diagnostic and treatment plan. To represent to Animal Emergency Service or primary care veterinary clinic as soon as practical if Muffin is noted to deteriorate.    Vital Signs