C10021373 / invoice 10000

SIGNALMENT: 9.2kgHistory:Presented for possible grape/sultana ingestion. Owner is unsure if Bean or the other house dog (Ralphie) is the culprit.Current meds: A tablet for skin allergies.Prophylaxis: UTDPre-existing conditions: Atopic dermatitis, noted on stomach.Access to toxins eg. Rodenticide: Possible access to grapes/sultanas.TRIAGE:HR: 100 bpmRR: 32 bpmTemp: Not performedMM: Pink & moistCRT: < 2 secondsMentation: QARPain Scale : 0/4Hydration status (%): Clinically adequateEXAMINATION:Body Condition Score: 5/9Cardiovascular: Cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronous.Respiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal discharge.Neurological: Neurologically no significant findings, no cranial nerve or proprioceptive deficits/gait, full neurological exam not performed.Musculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performed.Gastrointestinal:- Oral: normal, no mouth pain, dental score (1-4): 2- Abdominal: no detectable pain on abdominal palpation, normal gut sounds- Rectal: not performedUrinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: Evidence of allergic skin disease on the abdomen.Lymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:1. Possible grape/sultana toxicityDIFFERENTIAL DIAGNOSIS:Possible grape/sultana intoxication is the primary concern.DIAGNOSTICS/MANAGEMENT PLANInduce emesis to decontaminate.Sift through vomitus to identify contents.Discussed with owner that emesis removes approximately 80% of stomach contents.Plan to induce emesis in the other dog, Ralphie, for further assessment.ASSESSMENT:Possible grape/sultana intoxication. - No Grapes Visualised in vomitTREATMENT SUMMARY:Apomorphine (half tablet) administered to induce emesis.Metoclopramide 0.5mg/kg SC.Vomitus was produced and subsequently sifted through. No evidence of grapes or sultanas was found. Some papery material was noted in the vomitus.OWNER COMMUNICATION:Discussed with the owner the possibility of either Bean or their other dog, Ralphie, having ingested grapes/sultanas. Explained that after inducing vomiting in Bean, no grapes or sultanas were found in the vomitus. Advised that the next step would be to induce vomiting in Ralphie to assess for ingestion.PLAN:Admit for further assessment and monitoring. Plan to induce emesis in the other dog at home (Ralphie).    Vital Signs