C09999046 / invoice 10000

Reason: Ate 3 Slices Of OnionHistory: Frankie is a generally well young dog, BAR EDUD normally. Not on medications. Within the last 40minutes, she ate 3x cooked slices of onion from a mostly eaten plate of fried rice. O brought her straight down.Examination: T: Not toleratedP: 200, normal pulses (very stressed!)R: 32, clear with normal effortAbdomen comfortable upon palpationMM pink, moist CRT < 2 secAmbulatory with bright but fearful mentationNot overtly nauseousLaboratory: None todayAssessment: Frankie has presented bright, stressed and clinically healthy. Ingestion of 3-4 slices of onion - risk of toxicosis, difficult to be certain on dose ingested - emesis recommended.Treatment: Emesis induction - Apomorphine IV solution 0.03mL IVInduced emesis - large amount of partially digested dog food, 4 large slices of unchewed/undigested onion, and a small chewed rubber piece (toy?)Reversed with metoclopramide 0.5mg/kg SCConsent has been given by the client to proceed with this treatment  -  YesPlan:Discharged home - expect some lethargy and mild nausea tonight post apomorphine treatment.O confirmed that 4 onion slices was max ingested - risk of toxicosis is now minimal, no indication for charcoal treatment.If any concerns over the next few days, revisit and reassess, but should likely be OK.    Vital Signs    Weight: 5.7;       

Appointment Notes: Overdue remindersHistory:Presented for assessment following several recent visits for inappetence and nausea. A gulping, abnormal breathing pattern was previously noted. Monitored since 03:00 this morning. Ate last night and passed a solid stool this morning. Subsequently became unsettled, shaking, wincing, and unable to get comfortable. A small unproductive regurgitation was noted. Increased borborygmi observed by owner. No vomiting since the first presentation. Diet was changed approximately one month ago to a tinned superfood diet (Billy and Margot) with three different protein flavours rotated daily. Chews on rope toys and rubber toys, and may ingest small pieces. History of eating grass.A previous episode of apparent pain in July last year was noted, where the patient was crying, jumping, and then became limp with eyes rolling back. This was treated with pain relief.Objective:- General demeanour: QAR, panting, barking, and lunged during consult.- Temperature: 39.0°C.- Cardiovascular: Heart rate 160 bpm, no murmur or arrhythmia, FP synchronous and adequate. Mucous membranes pink.- Respiratory: Lungs clear on auscultation. No overt bronchovesicular sounds, normal effort, no cough/sneeze witnessed.- Abdomen: Soft, doughy abdomen, no pain elicited, no mass effect.- Oral exam: Within normal limits.- Musculoskeletal: Reactive to palpation over the caudal lumbar / cranial sacral spine.- Gait: Ambulatory.- Neurological: Within normal limits.Assessment:1. Spinal Pain:- Differential diagnoses include intervertebral disc disease (IVDD), soft tissue sprain/strain.2. Gastrointestinal Upset / Possible Oesophagitis:- Differential diagnoses include dietary indiscretion, gastritis, oesophageal irritation secondary to reflux/vomiting.Plan:Discussed Xrays vs advanced imaging (CT scan) for definitive diagnosis of spinal condition, which was declined at this stage.Plan is to proceed with medical management and strict rest.- Dispensed gabapentin 100mg, one tablet twice daily for neuropathic pain.- Dispensed carafate, half a tablet in a slurry twice daily as a gastroprotectant.- Dispensed paracetamol 48mg/mL solution, 1mL twice daily for analgesia.- Recommended strict rest for 4-5 days. Leash-only toileting, no running or jumping. Crate rest discussed.- Recommended transitioning to a bland diet (chicken and rice) to assess for dietary component to GI signs.Client communication:Discussed the clinical findings, particularly the lumbar spinal pain. Explained that this could be a soft tissue injury or a sign of IVDD, which is common in the breed. Discussed the grading system for IVDD and that Frankie's signs (pain only) represent the mildest grade. Advised that strict rest and pain relief can be effective but that the condition can progress. The option of referral for a CT scan for a definitive diagnosis was discussed, including the associated costs. The owners' pet insurance policy was discussed, noting it may cover IVDD, but they were advised to check their policy limits. The rationale for a multi-modal treatment approach (pain relief and gastroprotectants) was explained. Advised to monitor for any worsening of signs, such as wobbliness or inability to walk, and to seek immediate veterinary attention if these occur.--- 15/10/2025 15:21:19 PM JD6:Treatment - Resolved -    Vital Signs    

Appointment Notes: Overdue remindersHistory:Presented two days ago (10/10/2025) here for a vomiting episode. Received maropitant inj. Subsequently was slightly lethargic for 24 hours with no further vomiting. Re-presenting today for abnormal upper respiratory sounds, described as a gulping noise. No vomiting today. No diarrhoea. Ate a large quantity of grass this afternoon. Appetite is good. Vaccinations are current. No recent exposure to high-density dog areas. Diet was recently changed from Royal Canin wet food different brand 1 month ago. No known food allergies. Last heat was in June.Objective:HR 180RR 24 Shaking PL normalT 39.0Vulva Mm pale pink crt <2s (oral unable to be performed due to temperment)- General demeanour: Bright, alert, and responsive, though very anxious and trembling during examination. Becomes aggressive when attempting for mm - Cardiovascular: No murmur or arrhythmia, FP synchronous and adequate. - Respiratory: No overt bronchovesicular sounds, normal effort, no cough/sneeze witnessed. Lungs clear on auscultation. Tracheal pinch NEG, not irritated when palpated- Abdomen: Soft, doughy abdomen, no pain elicited, no mass effect.- Musculoskeletal: Within normal limits.- Gait: Ambulatory.- Neurological: Within normal limits.O concerned of gulping and noise at sleep - has only vid of noise at sleep taken hour ago - likely snoring. Assessment:1. Abnormal upper respiratory noise (gulping):   - Differentials include pharyngeal/laryngeal irritation secondary to recent vomiting (reflux oesophagitis/pharyngitis), foreign body (e.g., grass), or infectious tracheobronchitis (kennel cough - less likely given history and vaccination status).Plan:Monitoring at this stage is reasonable given the stable clinical signs.Options discussed if clinical signs persist or worsen include:1. Trial of medications2. Sedated oral and upper airway examination to assess for foreign material, ulceration, or other abnormalities.3. Chest radiography if respiratory signs develop.Agreed plan is to monitor at home.Client communication:Discussed examination findings and assessment. Reassured that based on normal temperature and clear lung sounds, immediate concern is low. Advised that the noise could be due to throat irritation from the previous vomiting episode or from ingesting grass. Instructed owner to monitor for any worsening of signs, lethargy, inappetence, or true vomiting. Advised to obtain video footage of the abnormal sounds if they recur. Explained the next diagnostic steps if Frankie does not improve. Owner educated on normal gum colour. Advised to contact the clinic if any concerns. No charge for today's revisit.    Vital Signs    Weight: 6.4;