C10013157 / invoice 10000

(THC toxicity)

History: (sudden onset weakness/lethargy, dribbling uine; down here on holidays, completely fine for most of the day - went to the back beach this morning, went to the pier - may have stolen a bit of bait, this afternoon have been at the pelican feeding & resting at the kids park & beach; does snuffle about but nothing obvious seen; no snakes seen)
Maybe drinking & urinating a bit more than normal the last few days.  No previous medical concerns, not on any medications


Examination: QAR/floppy but can be roused, HR=PR=72, no murmur/arrhythmia, pulses equal & synchronous, resp WNL, mm pink & moist, crt 1sec, T 39.2, BCS 4/9, LNs WNL, NAD on abdominal palpation; normal ROM in all legs
Dribbling urine
Proprioception WNL, head bobble, sudden jolts; PLR/menace/palpebral bilaterally WNL

Assessment: (acute event - insect bite/anaphylaxis, snake less likely, toxin exposure (THC, benzo...), hypoglycaemic event (DM, DKA)...)

Gallbladder halo not present
BP - cuff 3 front left - avg 120mmHg

Discussed bloods & urine drug testing. O happy to keep investigating in stepwise fashion.
Urine drug test: positive for THC

Discussed with O - recommend admission for IVFT, usually for 12-24hr or until clinically better.  However, eve of public holiday so can have her here on fluids for 3 hours then would need to be transferred to either Leongatha or a 24hr hospital in Melbourne.
O elect to keep her here for fluids for a few hours then take her home.

IVC placed - hartmanns @ 37ml/hr -- fluids running for approx 3 hours.

On discharge Momo sitting up in sternal, more alert but not 100% yet
O happy to continue monitoring at home.  Aware of overnight options