C10008347 / invoice 10000

Reason: Chewed On A BatteryAppointment Notes: chewed on AAA battery unsure if ingestedConsultation Time:0000History: This evening was noted to vomit 3 times, owner saw dark material in vomit and food Then noticed shortly after a AAA battery that had been chewed possibly open but not ingested Subjective: BAR Objective: Temp  39.4     MM    pink moist   CRT  <2      HR     160  =  FPBCS:   5/9                       Wt:   8.2kgCV:  NAD     BP 117/88 MAP 96mmhg   RESP:   NAD           RR  28GIT: abdo palp comfortable U/G:  NADNeuro:  NADM/S:  NADInteg:  NADOphth:  NADLNs: NADProblem List:Vomiting Possible battery exposure - alkali Assessment: Owner contacted poisons line - recommended treating symptomatically and providing gastric protectants GI ulceration is main concern Currently Knox is bright, well hydrated and no longer vomiting - has eaten chicken late evening and kept down Elect to treat as outpatient with ongoing monitoring at home and revisit if deterioration Treatment:Maropitant citrate 1mg/kg sc Omeprazole 10mg PO SID Sucralfate 500mg PO TID in slurry Plan: PCP in 24-48 hours Revisit here or PCP sooner if any ongoing vomiting, lethargy, dark stools or any other concerns    Vital Signs    

Reason: Dribbling Wee & LethargicConsultation Time:2000History: Normal today but the last fe w hours became lethargic and dazed, seeming vague at times. Had one voit in the last few hours before presentation. Had dilated pupils and seemed wobbly to walk. Was dribbling urine, small amount. O believes is improving since intially became dull and lethargic and not urinating as much. No diarrhoea, utd with prophylaxis and eating well since vomited. Access to THC but no other toxins/drugs/poisons No known exposures but possible Subjective:  quiet. Objective: Temp       38.8     MM    Pink          CRT       2      HR     120        FP YesBCS:  4 /9                       Wt 8.0:   kgPain Score (CSU): NA  /4CV:  NAD       RESP:   NAD           RR 36GIT:   NAD soft and comfortable U/G:  not constanty dribbling but did dribble small amount in waiting room. Neuro:  Gag normal, pupils dilated, no ataxia noted. Not head shy or flincy. M/S:  NADInteg:  NADOphth:  NADLNs: NADProblem List:Assessment: Mild TCH ingestion likely. Currently clinically stable. Options Offered to Client:Treatment:1mg/kg maropitant sc Plan:Monitor closely and return if concerned.    Vital Signs