C10004841 / invoice 10000

Reason: WALK IN -Hx:Presented collapsed in respiratory distress with loud stertorHas been on a 15min walk this morning (quite warm/humid this AM)Otherwise no concerns latelyNo trauma this morningWas on leadNo toxins/rat baits anywhere at homeNo snakes aroundPE:Collapsed, dyspnoeic, loud stertorHR 140, no murmur or arrhythmiaRR panting ++ (120), loud crackles bilat ventrally, louder L sideMM cyanotic, CRT<2sAbdo NAD on palpTemp 41.5LNs WNLAdvised O life threatening emergency, rec GA (advised risk) and est of $1500-1600 for initial diagnostics/tx, still with grave prognosis- O consented. Emergency tx/diagnostics @ 9.30am:Cephalic IVC placed, 1.5ml alfax induction, topped up with 0.5ml + 0.5ml IV7.0mm ETT placed, no FB seen in larynx, O2 3-4L/min + iso 1-2% 9.30am -12.30pmSP02 70 - 99%, only able to maintain >90% with IPPVBG 7.5Active cooling: luke warm water over body and fan on, stopped cooling at 39.7, (continued to reduce to 36 degrees- bare hugger applied then temp stabilised). IVFT 15ml/kg bolus then 48ml/hr3 view thoracic rads and R lat abdo rad: unstructured interstitial pattern and leading in to alveolar pattern (air bronchograms) mainly ventral lung fields, though fairly diffuse/generalised, worse L side. Aerophagia (++gas in eosophagus and stomach. AFAST: no FF, no gall bladder wall oedema (unlikely anaphylaxis)Manniotol soaked swabbed packed in pharynx to reduce pharyngeal oedema, + dexamethasone 0.5ml IVTx: Butorphanol 0.3ml IVDdx:BOAS with secondary heat stroke, pharyngeal swelling, asphyxiation and non-cardiogenic pulmonary oedema, HaemoptysisLikely platelet dysnfunction causing bilateral epistaxis.Acute Respiratory Distress Syndrome (ARDS)PL spoke to emergency vet Dr Alex at WAVES for advice:Grave prognosis given cannot maintain SPO2>90% without IPPVOptions to try and recover from GA, however will likely suffer with URT obstruction/further asphyxiation on recovery and need euth, or reasonable to euthanise especially given cost constraints, as Pt will likely require days of hosp at emergency to try and recover (est $8000-10,000 from WAVES).Long discussion with O, understandably devastated, O considered options and spoke with mum on phone, O Madison opted for euthanasia (which I supported based on conversation with Dr Alex at WAVES), rather than allowing Pt to suffer on recovery. Os in tx room with Pt under GA,Lethabarb 15ml IV, passed peacefully, extubated, O stayed for 45mins to get closure after Pt passed. Os very grateful for efforts today. O requested paw prints, fur, private cremation - organised by JPF/ST. Discount due to longer GA than estimated/signed for. Booking ID:	1692025Service type:	Private Cremation & Return of AshesVet name:	Ascot Veterinary HospitalSubmitted by:	Sarah Tedder--- 09/03/2026 09:11:14 BA:Bereavement - Resolved -    Vital Signs