C10014148 / invoice 10000

Reason: L3 - Hives, Facial SwellingHISTORY:- Acute presentation of hives and face swelling- Has had allergic reactions previously but never presented with hives Current meds: nil Prophylaxis: not discussedPre-existing conditions: not discussedAccess to toxins eg. Rodenticide: not discussedTRIAGE:HR: 120RR: panting Temp:Mm: pinkCrt: <2sMentation: BARPain Scale (0-4): 0Hydration status (%): adequately hydrated  EXAMINATION:Body Condition Score: 6/9Cardiovascular: 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: NSF- Abdominal: no detectable pain on abdominal palpation, normal gut sounds- Rectal: not performed, small amt diarrhoea passed Urinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: angioedema around eyes and muzzle, urticaria ventral abdomen/flanks Lymph Nodes: peripheral lymph nodes normalEyes: NSFPROBLEM LIST:Acute onset facial angioedema Diarrhoea DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Hypersensitivity reaction - likely insect bite/sting ASSESSMENT:Charlie presented to PVE with clinical signs consistent with a hypersensitivity reaction. He is cardiovascularly stable and suitable for outpatient treatment/management. TREATMENT:> Allergy Medication - Chlorpheniramine 14mg IM - Dexamethasone 4mg IMPLAN:- Home for monitoring of delayed signs of anaphylaxis (vomiting, lethargy/collapse)- Recheck with regular vet in 3 daysCLIENT COMMUNICATION: Advised oral dose of 0.5-1 tablet 180mg telfast can be given orally in the event of a future similar reaction, however not always effective if vomiting and if severe signs then should always seek veterinary attention.    Vital Signs