C10017942 / invoice 10000

Reason: Blood TestAppointment Notes: Paws App Details:Booking Type: Consultation Senior Pet (7+ yrs)Booking Vet: - Any -Booking Notes: Blood Test consulting Pet Insured: YesHistory: Ate upto 160mg of apoquel 2 days ago Shaking that night but has since setlles EDUD all normalStill happy to play O feels is back to normal    Vital Signs    Weight: 32.9;       

Reason: How Is Post Toxicity?Hi Bebe! Just checking in to see how Tobey is going today? Any issues overnight? We are keen to hear how he is so please respond to this text when you can with an update, or ring us back on 02 9516 1466 to chat. Kind regards, Sydney Animal Hospitals Innerwest______________________Hi, he’s feeling much better now. He was shaking on and off all night, but it stopped this morning and he ate all his breakfast. When would be the best time to schedule a follow-up appointment and blood test after yesterday’s procedure? Thank you    Vital Signs    

Appointment Notes: Overdue remindersHX Owner has been at work all day and has come home to find the bottle of apoquel dispensed at previous visit chewed up and about 10 tablets missing (16 mg) This is 5 mg/kg Vin research shows that above 10 mg/kg should have aggressive detoxification, renal and hepatic injury and death have occured. In the drug leaflet - doses of 3 mg/kg were given daily for weeks with only advese effects on skin. Elected to come down and induce emesis. Also spoke to emergency vet at medipaws to see if overnight monitoring likely necessary - they thought probably not if decontamination is done - likely more severe advese effects are seen with doses closer to 40 mg/kg./  TX - 4 mls of solution (1 tablet in 20 mls) administered IV Vomited quickly. Reversed with 3.2 mls crenia IV(was quite sedate) Gave 160 mls activated charcoal. Owner will come back for follow up - consider renal/hepatic monitoring in 48 hours    Vital Signs