C10012524 / invoice 10000

------------------------------------------------------------------------CLIENT DISCHARGE NOTESPRESENTING CONCERNS:PROBLEM LIST FROM PHYSICAL EXAMINATION AND HISTORY:Ingestion of 5- 20 sultanas approx 2 hours ago ASSESSMENT:Sultana ingestion - unkown quantityPLAN/DISCUSSION:Emesis induction via Apomorphine Findngs:  13 sultanas in the vomit Anti-emetic: Metomide 0.5mg/kg SC @ 1935Medications for Administration at Home:  Activated charcoalYour pet has been administered a medication to induce vomiting (emesis) to try and remove a suspected object or toxin from the stomach.They may have also been administered an anti-nausea medication to reduce the risk of further vomiting.Monitoring at home:* It is possible that your pet may have a further vomit, if this does occur it is likely to occur within 15-30 minutes of discharge.* The medications administered may also cause some sedation for up to an hour and should be closely monitored for the first few hours once at home.* It is not recommended to feed your pet within the first 2 hours after having induced vomiting.* If there is continued vomiting, your pet becomes dull or lethargic or there are any other concerns, please contact the Animal Emergency Service or your primary care veterinarian immediately.Diagnosis:  Raisin/Sultana IngestionTreatment Summary: - Your pet has had had medication to make him/her vomit (decontamination) and remove as much of the toxic material as possible. After this they have had charcoal to absorp any remaining toxin in their gastrointestinal tract. Raisins/Sultanas and grape ingestion can cause kidney toxicity and result in severe disease in dogs. While the results can be life threatening, the number of animals that do acquire severe disease from ingestion is unknown. Signs to monitor at home: - Urination:  Your pet should urinate 2-4x a day, meaning at a minimum, every 12hrs at least. If you dont see him/her urinate within a 12hr period, have him seen by your regular vet as soon as possible, otherwise with us if out of hours.  - Vomiting:  If your pet is seen vomiting, there maybe some blood in the vomitus. Have a close look and if seen, he/she will need to be seen by your regular vet or by us if out of hours. - Diarrhoea:  It is expected your pet will have some charcoal passing through your pets faeces. This should clear up soon enough. However, if you see dark and tarry like diarrhoea coming through continuously and your pet appears flat or  is not eating, then they will need to be seen to as soon as possible by your regular vet or here if out of hours.Recheck:If at any time you are concerned regarding your pets health, please arrange to have a recheck as soon as possible, as these problems can be life threatening.Recheck:The Animal Emergency Service recommends a recheck with your primary care veterinarian within 48 hours to monitor your pets condition. They will perform a biochemistry bloods test to assess for any kidney enzyme increase. Thank you for trusting the Animal Emergency Service with the care of Millie.    Vital Signs    

Reason: Suspected ingested raisins (yoghurt covered)-TRHISTORY:Current meds:Prophylaxis:Pre-existing conditions:Access to toxins eg. Rodenticide:TRIAGE:HR:RR:Temp:Mm: Crt:Mentation:Pain Scale (0-4):Hydration status (%):EXAMINATION:Body Condition Score: Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal, no mouth pain, dental score (1-4):  - Abdominal: no detectable pain on abdominal palpation, normal gut sounds- Rectal: no detectable abnormalities, faeces:  Urinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: peripheral lymph nodes normalEyes: NSFPROBLEM LIST:DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:DIAGNOSTIC/MANAGEMENT PLAN:DIAGNOSTICS:ASSESSMENT:TREATMENT:PLAN:CLIENT COMMUNICATION:------------------------------------------------------------------------CLIENT DISCHARGE NOTESPRESENTING CONCERNS:PROBLEM LIST FROM PHYSICAL EXAMINATION AND HISTORY:ASSESSMENT:PLAN/DISCUSSION:TREATMENTS ADMINISTERED:Medications for Administration at Home:SPECIFIC HOME CARE INSTRUCTIONS:The Animal Emergency Service advises a reassessment with your regular vet within 48 hours to monitor your pets progress.  If your pet's condition deteriorates or they become flat or lethargic, go off their food and water, develop vomiting or diarrhoea or if you have any concerns please contact the Animal Emergency Service or your regular vet immediately.If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital.Thank you for trusting the Animal Emergency Service with the care of your pet.Emesis was induced:Findings:HISTORY:Ingested ...*Current meds: nilARRIVAL TIME: TRIAGE:HR: RR: Mm: Pink*Crt: <2*Mentation: Bright, alert and responsive *Pain Scale (0-4): 0 *Hydration status (%): clinically adequate *EXAMINATION:Cardiovascular:  cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronous *Respiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge *Neurological: bright, alert and responsive *Musculoskeletal: musculoskeletal exam - ambulating normally *Gastrointestinal:- Oral Exam:  No signficiant abnormalities oral exam normal *- Abdominal: comfortable abdomen but does not like abdominal palpation *Urinary: bladder palpation - small *Reproductive (incl ext genitalia): no significant abnormalities *Integument/Ears: no significant abnormalities *Lymph Nodes: no enlargement noted *Eyes: no significant abnormalities *PROBLEM LIST:Foreign body ingestion *Emesis induction:  Apomorphine was administered ... * Findngs: ....Anti-emetic: Metomide 0.5mg/kg SC ASSESSMENT:Gastric foreign body ------------------------------------------------------------------------CLIENT DISCHARGE NOTESPRESENTING CONCERNS:PROBLEM LIST FROM PHYSICAL EXAMINATION AND HISTORY:Ingestion of 5- 20 sultanas approx 2 hours ago ASSESSMENT:Sultana ingestion - unkown quantityPLAN/DISCUSSION:Emesis induction via Apomorphine Findngs:  13 sultanas in the vomit Anti-emetic: Metomide 0.5mg/kg SC @ 1935Medications for Administration at Home:  Activated charcoalYour pet has been administered a medication to induce vomiting (emesis) to try and remove a suspected object or toxin from the stomach.They may have also been administered an anti-nausea medication to reduce the risk of further vomiting.Monitoring at home:* It is possible that your pet may have a further vomit, if this does occur it is likely to occur within 15-30 minutes of discharge.* The medications administered may also cause some sedation for up to an hour and should be closely monitored for the first few hours once at home.* It is not recommended to feed your pet within the first 2 hours after having induced vomiting.* If there is continued vomiting, your pet becomes dull or lethargic or there are any other concerns, please contact the Animal Emergency Service or your primary care veterinarian immediately.Diagnosis:  Raisin/Sultana IngestionTreatment Summary: - Your pet has had had medication to make him/her vomit (decontamination) and remove as much of the toxic material as possible. After this they have had charcoal to absorp any remaining toxin in their gastrointestinal tract. Raisins/Sultanas and grape ingestion can cause kidney toxicity and result in severe disease in dogs. While the results can be life threatening, the number of animals that do acquire severe disease from ingestion is unknown. Signs to monitor at home: - Urination:  Your pet should urinate 2-4x a day, meaning at a minimum, every 12hrs at least. If you dont see him/her urinate within a 12hr period, have him seen by your regular vet as soon as possible, otherwise with us if out of hours.  - Vomiting:  If your pet is seen vomiting, there maybe some blood in the vomitus. Have a close look and if seen, he/she will need to be seen by your regular vet or by us if out of hours. - Diarrhoea:  It is expected your pet will have some charcoal passing through your pets faeces. This should clear up soon enough. However, if you see dark and tarry like diarrhoea coming through continuously and your pet appears flat or  is not eating, then they will need to be seen to as soon as possible by your regular vet or here if out of hours.Recheck:If at any time you are concerned regarding your pets health, please arrange to have a recheck as soon as possible, as these problems can be life threatening.Recheck:The Animal Emergency Service recommends a recheck with your primary care veterinarian within 48 hours to monitor your pets condition. They will perform a biochemistry bloods test to assess for any kidney enzyme increase. Thank you for trusting the Animal Emergency Service with the care of Millie.    Vital Signs