C10016725 / invoice 10000

Weight: 2.83 kgSubjective- Presented for potential toxin ingestion this morning.- The kitten pierced the owner's Vyvanse (lisdexamfetamine) 40 mg capsules. The capsule was pierced, not swallowed, but he may have ingested some powder.- Owner brought the kitten in for prophylactic treatment due to the high toxicity of dextroamphetamine in felines.Objective- Temperature: 38.7°C- Pulse: 156 bpm- Respiration: 35 bpm- Mucous membranes: Pink and moist- Capillary refill time: <2 seconds- Demeanour: Bright, alert, responsive. H 4+.- BCS: 5/9, Hydration: Clinically adequate.- Exam:  - Cardiovascular: Normal auscultation, no murmur or arrhythmia.  - Respiratory: Thoracic auscultation clear bilaterally, normal respiratory effort.  - Oral: No cleft palate, otherwise unremarkable.  - Abdominal: Non-painful on palpation. NAD.  - Musculoskeletal: Ambulating normally, no pain on palpation.  - Integument/Ears: Ears clean, skin unremarkable.  - Other systems: Neurologically, lymph nodes, eyes all NSF.Assessment- Suspected dextroamphetamine toxicity.Plan- Hospitalisation: Admitted for day-stay for monitoring and management.- Intravenous Fluids: Hartmann's solution administered intravenously at a rate of 8.4 ml/hr.- Decontamination: Activated charcoal administered orally (2 g/kg dose, 5 g total). Three doses were administered in hospital, one dose was sent home with the owners to administer at night.- Monitoring: Closely monitored for signs of toxicity throughout the day, including CNS, cardiovascular, and gastrointestinal signs. None evident.Discharge Instructions: - Counselled owner on potential toxic effects and clinical signs to monitor for at home. - Signs include: agitation, hyperactivity, restlessness, tremors, seizures, confusion, head bobbing, stereotypic behaviours, tachycardia, panting, drooling, vomiting, hypersalivation, diarrhoea, mydriasis, hyperthermia, aggression, vocalisation, or paradoxical sedation. - Instructed owner to administer one further dose of activated charcoal at home. - Advised owner to seek immediate veterinary attention if any clinical signs develop.    Vital Signs