C10003650 / invoice 10000

Reason: G- Eaten At Least 6 Grapes YesterdayHistory:Ate 6 grapes 24hrs ago Dog presented this evening with hx of mild lethargy and confirmed ingestion of 6 grapes yesterday afternoon.  Dog has been well today EDUD wnl, no v/d., however dog seems distant to O and also a little Q.  Dog is otherwise well - no current medications, no underlying health concerns. Examine:BARHR 128, mm pink crt 1.5, pulses N aus NRR panting slow panting with normal aus effort patternT: 38.4CAbdomen wnl, comfortable EEN wnl Integ: wnl M/S : Ambulatory Neuro wnl Normal stools on rectal examAssessment: Known access to 6 grapes - potential for renal sde fxs - typically not seen for 48hrs post ingestion Plan: Advised client grape toxicity often not evident until 48hrs post ingestion. However as dog is mildly lethargic can run bloodwork today and review but may be wnl, and too early to see teh renal fxs.Advised grape toxicity is variable among patients.  Offered1) Bloodwork today, but then ideally at 48hrs post ingestion and tehn potentially 96hrs post ingestion depending on 2nd set of blood results2) Admit and tx as grape toxicity with renal effects but advsed this is not clearly required ats3) Bloodwork tomororw and review for ptoentail 2nd set bloods after first. Client notes the toxicity of grapes may not be evident on bloods ats but wishes for bloods now and again tomorrorw and then potentially 3rd at 96hrs as required. - Bloodwork Chem 11 panel : SDMA, Creat both wnlBUN 10.5 ( RR2.5-9.6)  - ddx; prerenal >> renal Conclusion: NO clear renal insufficiency ats.  Advised client of bloodworks results - offered for review at 48hrs post ingestion and then again at 96hrs if indicated on tomorrows bloods. Client ok to return tomorrow evening for ideally nurse to collect bloods, run renal panel and status.  Vet to review patient and bloodwork tomorrow evening too please. Client will return sooner if concerned or further cxs develop. .    Vital Signs