C10008399 / invoice 10000

Fishing hook in upper thigh?

HX: O was fishing this morning, Kozi grabbed fish and flicked it around and managed to get fish hook caught in HL. O attempted to remove but very uncomfortable. EDDU normally otherwise. O noticed that when he sleeps that seems to have more snuffly breathing, no sneezing coughing noted.

EXAM:
Distant: BAR, uncomfortable and turning to bite at rearend
Oral: pink moist mm, CRT <2s, C1/4
Eyes: corneas clear, sclera white, no discharge bilaterally
Ears: clean
Cardiovascualr: regular rhythm, no murmur
Respiratory: panting, lung sounds clear
Abdomen: soft pliable, no discomfort or masses
Integument: clean coat, skin good condition, fishing lure with at least 1 hook embedded in skin RHL caudal, unable to visualise further as very uncomfortable.
Musculoskeletal: ambulatory and WB on all limbs. 

PLAN
Sedated removal of fish hook + nasal flush with post-procedure medications.

0.5ml Butorphanol + 0.5ml Medetomidine IV - good profound sedation.
Right caudal HL clipped and light prep. 2 hooks embedded in skin, wire cutters used to clip hook as closely to skin and then hook pulled through to minimise drag and trauma to tissues. No other foreign bodies palpated. 

SD did nasal flush - no foreign bodies or discharge observed.

Reversed with atipamezole.
Discharged with e-collar
AMC 12.5mg/kg BID PO
Onisior 1mg/kg SID PO
Trazadone 10mg/kg PO, as highly neurotic dog on wake up and very irritated at site of hook removal. 

D+ see in courtyard first
D+ 3 days, gums range from grey to pink, has recently been travelling, eating very small amounts, lethargic, drinking normally, no V+, eating grass y/day, is fully vacc with usual vet in ACT

Hx: Tuesday ate dog faeces, unwell that night. NQR, diarrhoea that night and since - "pea soup". Since then has eaten entrails at park and dead piwi bird. Ongoing diarrhoea, some vomiting. Lethargic. Has had large long days in the car. Not enthusiastic about getting out of bed and going for a walk

CEx; BAR
MMs pink, moist, crt 1.5s
HR 118bpm, no mrumurs or arrhythmias
RR 20brpm, normal BV sounds
EEMO - NAD
Abdo soft and comfortable
LNs wnl
Temp - not read as highly reactive to thermometer
Faecal staining about back end

Assessment: Gastroenteritis 2o to dietary indiscretion

Tx: 
Pndans 8mg BID until resolved
Prokolin 5ml bid x 3d
Fenben 50mg/kg SID x 4d
Lectade electrolytes
Gastrointestinal food

Plan: INI return for further workup

NEXGARD