C10007773 / invoice 10000

Reason: Poss Ingestion Of Rat Bait - 1hr AgoHistoryThe patient presented following a suspected ingestion of a rodenticide bait. The owner reports that the dog may have accessed rat bait, although the exact quantity ingested and the precise timing of ingestion are unknown. The exposure is suspected to have occurred recently.Since the potential ingestion, the patient has remained clinically normal at home. The owner has not observed vomiting, diarrhea, coughing, sneezing, lethargy, or any other abnormal clinical signs. Appetite and demeanor have remained normal. There have been no signs suggestive of bleeding such as bruising, epistaxis, melena, haematuria, or weakness.The patient is not currently receiving any medications and has no reported concurrent medical conditions.There is no known access to other toxins or foreign materials, and no other recent environmental exposures were identified apart from the suspected rat bait.The owner presented the patient for assessment and management following the potential toxin exposure.ExamDemeanor: BAR/ very happyTemp: NPHydration: <5%CVS: HR 140 SSFP, nil arrythmias or murmurs detected, mm Pink and moist, CRT <2s. Resp: strong bronchovesicular sounds bilaterally, nil adventitious sounds Abdo: comfortable on deep palpation, bladder small and softIntegument: NSFNeuro: CN in tact, nil deficits, gait unremarkable. Full neruo exam not performedMSK: NSFRectal: NPProblem list1. Possible ingestion of rat baitAssessment: Due to the acute possible ingestion of rat bait, and as the patient is cardiovascuarly stable, the patient should be induced for emesis for gastric decontamination. Protocol- Apo-morphine 0.5 tab SMSuccessful induction of emesis. Px had multiple large vomits and finished with several serous vomits. Vomitus contained carrot and some partially digested food. There was no evidence of any ratbait or discolouration from dye containing products. Reversal- Maropitant 1mg/kg SQPlanOption 1 — Monitoring approach- Perform a baseline coagulation profile (PT).- Repeat coagulation testing in 3–5 days to assess for delayed anticoagulant effects.Option 2 — Prophylactic treatment- Begin Vitamin K1 therapy immediately for a 6-week course.- Recheck coagulation profile 48 hours after completion of Vitamin K therapy to ensure normal clotting function.The O elected option two as she is worried that the patient would require sedation to obtain a clean venous stick, and therefore less invasive to undertake medical management. Medication- Vitamin K1 2.1mg/kg PO q12h 42 daysTo be consumed with a moderately fatty meal (avoiding high fats that would induce pancreatitis)The owner was informed that rodenticide toxicity can cause delayed coagulopathy, and therefore monitoring or preventative treatment is recommended even if the patient is currently asymptomatic.    Vital Signs