C10007842 / invoice 10000

History: Os partner called ~6pm. 40min ago Pippa drank an unknown amount of diesel from an open container. Has vomited 5x, and started having diarrhoea, will drink some water and was fed some food before vomiting the first time, has kept drinking but keeps vomiting it back up. Is happy enough in herself, perhaps a bit more clingy, but still running around. Expl v+ creates risk of aspiration pneumoia which is the largest issue for ingestion of hydrocarbons such as diesel. Recc bringing to the clinic for anti-emetic and gastroprotectants. Examine: BAR, friendly. No vomiting in consult. Plan: Antiemetic to reduce risk of aspiration pneumonia = 1.7mL prevomax SQ ~6:20pm. Give 1hr for effect then feed and give sucralfate and activated charcoal.Activated charcoal - 40mL PO w/ food BID. Expl that for diesel specificially it's function is limited, but it can help bind some of the contaminants in diesel preventing them from circulating further around the body and ac should not be harmful so worth giving some. Start tonight. Sucralfate 1000mg dissovled in ~4ml water - gastroprotectant to reduce gi irritation. Demostrated to O how to dissolve. To be given 3 times daily, starting tonight. Research - gastric lavage contraindicated due to aspiration pneumonia risk, and given she will have already v+ hopefully most of what was in stomach, not opting for this at this time. O to monitor at home. Discussed signs of aspiration pneumonia - feeling unwell, off food, breathing fast, +/- coughing. Rarer but also possibly neurological signs - wobbliness, lack of awareness, unconsciousness. V+ should not recur in the next 24hrs, d+ to be expected. If any new symptoms esp resp or neuro - instructed O to call a/h number, may need further tx. Os informed consent (a/h exam + antiemetic + gastroprotectant + activated charcoal) -yes - verbalOs informed consent (financial - insurance) -yes --to be sorted Tuesday.    Vital Signs    Weight: 17.5;       

Reason: 2nd VaccBiop 6-7 weeks.  Had C3 on 1.11.23. No health concerns at home.  Has been worming.  Being fed chicken mince, brocolli, carrots, greek yoghurt, pigs ears etc.Examine: Clin exam ok. Assessment: Discussed feeding. Advised puppy food.  Discuss need for correct balance of nutrients, and that there is a risk of getting that wrong with home-made diets.  Discuss potential for developmental issues. Owner says Pippa has turned her nose up at puppy food and is fine.  Went to give C5 vacc.  Owner says she just wants to give what Pippa needs, but also just wanted to give what was given at last vacc. Advised C5. Owner just wants C3. We only have C4 at Penguin.  I think we have C3 at Ulverstone. Owner will book in there, but advise ask reception to check we have C3 before making booking.  Advise I think we have it, but don't use it often, so best to check.    Vital Signs