C10003629 / invoice 10000

Reason: Bright Green Feces (Notes) TRARRIVAL TIME:SIGNALMENT: 9-year-old, Male Neutered, LabradoodleHistory Summary:Presented for bright green faeces. The owner is concerned about potential ingestion of rat bait over the last 24-48hrs, as Yoshi has a history of eating inappropriate items and was observed eating from the bin yesterday afternoon. The owner's mother has rat bait on her property, and while she is careful, it is possible Yoshi gained access. Other potential ingestions include iridescent green paint sticks or blue kids' paint that was discarded in the bin. There has been no vomiting or diarrhoea. A recent heart murmur and enlarged heart were diagnosed within the last six weeks, and Yoshi has been experiencing some lethargy and a resting respiratory rate of approximately 80 breaths per minute, which is being monitored. There is a history of recurrent UTIs, managed with a specific kibble, and a previous episode of haemorrhagic gastroenteritis after ingesting an unknown item.TRIAGE:HR: 116 bpmRR: Panting, normal effortTemp: 39.1°CMM: Pink & moistCRT: < 2 secondsMentation: BAR, anxiousPain Scale (MGCS): 0/4Hydration status (%): Clinically hydratedEXAMINATION:Body Condition Score: 5/9Cardiovascular: grade 3/6 heart murmur detected on auscultation. Pulses are strong and synchronous. Normal rhythm Respiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge.Neurological: Neurologically no significant findings, no cranial nerve or proprioceptive deficits/gait, full neurological exam not performed.Musculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performed.Gastrointestinal:Oral: pink and moist gums, no mouth pain, dental score: 1/4Abdominal: Soft and non-painful on palpation.Rectal: not performed. O brought in sample of bright green faeces Urinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: NSF. ectoparasite negative Lymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:1. Bright green faeces - suspected Rat bait toxicity2. Grade 3/6 heart murmurDIFFERENTIAL DIAGNOSIS:For the green faeces:1. Anticoagulant rodenticide (rat bait) toxicity: Consistent with the colour of the faeces and potential access.2. Ingestion of foreign material: Such as green or blue paint/paint sticks.3. vs. other DIAGNOSTICS/MANAGEMENT PLANA coagulation panel (PT/APTT) was recommended to assess for anticoagulant effects of potential rat bait ingestion. Regardless of the results, initiating vitamin K1 therapy was advised as a precaution due to the high suspicion and potential access to rodenticide. The plan is to start treatment and recheck clotting times 24-48 hours after the four-week course is completed.A blood sample was collected for a coagulation analysisPT (14-19 sec): 21 secAPTT (75-105 sec): 89 secResults: PT is slightly prolonged.REVISED ASSESSMENT:Suspected anticoagulant rodenticide toxicity based on clinical signs and prolonged prothrombin time (PT).TREATMENT SUMMARY:Vitamin K1 50mg tablets. Dose: 1 tablet orally twice daily for four weeks. This is approximately a 2mg/kg dose. Advised to administer with a small amount of high-fat food, such as the wet version of his current urinary diet.OWNER COMMUNICATION:Discussed the concern for rat bait toxicity given the green faeces and potential access. Explained that rat bait affects the blood's ability to clot, leading to bleeding disorders. The plan to perform a clotting time test was discussed and consented to. Following the results which showed a prolonged PT, the diagnosis of likely rat bait toxicity was confirmed. The treatment plan involving a four-week course of Vitamin K1 was explained, including the dosing schedule and the need to give the medication with food. The owner was advised to monitor for any signs of bleeding, such as pale gums, lethargy, weakness, or changes in breathing, and to seek immediate veterinary attention if these occur. The importance of a follow-up blood test to recheck clotting times 24-48 hours after the final dose of Vitamin K1 was also stressed. The owner consented to the plan.PLAN:Discharge home with Vitamin K1 therapy. The owner is to monitor closely for any adverse signs. Recheck coagulation profile at their primary veterinarian 24-48 hours after the completion of the four-week Vitamin K1 course. Continue monitoring respiratory rate at rest in relation to the cardiac condition and proceed with the planned chest radiographs with their regular vet.For any questions regarding the case, please contact the Underwood and Jindalee Clinical Support Line at 07 3147 8746 (Mon-Fri, 9am-6pm), or our hospitals during after hours.    Vital Signs