C10015356 / invoice 10000

Reason: Possibly Eaten Two Nurofen TabletsRecord Entered by: Olivia Ritchie - DVM 4th year studentRecord Checked by: Dr Isabel Brazier History:Jersey is a 11m FS Cavoodle who presented to UVTHS for potential ingestion of nurofen tablets. - Jersey was seen chewing on a foil strip of advil 200mg tablets approximately 30 minutes prior to presentation- The owner thinks the foil strip may have been empty or there was a maximum of 2 tablets- Jersey has otherwise been well, no other health concerns - Not on any current meds- EDUD normal- Normal diet is chicken lyka- This is the first scavenging event Physical Examination: Demeanour: BARBCS: 5/9EENT: Eyes clear, ears clear no discharge, nose moist, MM pink, CRT 1-2 secondsPeripheral lymph nodes: LNs WNL, symmetrical, normal size and textureIntegument: Coat good quality, NAD Cardiovascular: HR 128, strong synchronous pulses, no murmus or arrhythmias auscultated.Respiratory: RR 32, no increase in respiratory effort, normal bronchovesicular soundsAbdominal: Soft and comfortable on palpation, small soft bladderMusculoskeletal: Ambulatory on all 4 limbs, full MSK exam not performedNeurological: Ambulatory, mentation normal, responds to visual and auditory stimulus, full neuro exam not performedRectal: Not performedUrogenital: External genitalia appear normal Assessment:Stable to induce emesis.If both tablets were ingested total dose is 75mg/kg, dose at which GIT effects are seen is approx 80mg/kg and renal effects >125mg/kg.  Treatment:Apomorphine 0.04mg/kg (0.05ml) SCEmesis induced.Two large vomits containing food was brought up. No sign of any tablets or foil/packaging although tablets may have disintegratedReversed:  Metoclopramide 0.5mg/kg (0.5ml) No further vomiting after reversal was administered. Discussion:Discussed with Ox options - Ox feels it was actually very unlikely that Jersey had actually consumed the advil so she feels is low risk - discussed GI issues (vomiting, diarrhoea and GI ulceration) and renal affects - current dose (if did manage to consume and absorb the total amount) is unlikely to cause renal issues - discussed baseline renal values and using gut protectants - Ox happy to just monitor at homePlan (incl. alternative options): Monitor for any GIT upset such as vomiting or diarrhoea and return if this occurs.Provide extra water to maintain hydration, add extra water to lyka food. Advised of the toxic dose ranges for GIT and renal effects. Advised to monitor for any GIT upset. We offered to start Jersey on omeprazole - warned of potential for diarrhoea with this medication, owner elected to just monitor for now and start on medications later if indicated.    Vital Signs    Weight: 5.4;       MMColour: Pink;       RespirationRate: 32;       HeartRate: 128;       BodyScore: 5;       DentalGrade: 0;       CRT: < 2 sec;