C10027367 / invoice 10000

Reason: Lethargic, Recheck PCV & LimpingHistory: After his visit here on 5/3 he was very lethargic so took him to Port City Vets that evening and they discovered a quite severe anaemia - see attached report. He was in hospital for a couple of nights having PCV closely watched (lowest reading was around 21%) and treated for presumptive git haemorrhage. PA-US abdo scan on 9/3/26 didn't show any deep gastric ulcers but there was suspicion of superficial ulcers. Has been treated with sucralfate and Losec. A Vetpath full bloods at Port City on 6/3/26 had PCV on 26% with no regeneration present consistent with acute haemorrhage, TP of 36 (56-80) with low albumin (19) and globulins (17), CRP 42, but otherwise normal biochem and CBC.Since then he is eating well, no black stools or signs of visible haemorrhage, but is still quieter than normal.2) Acutely lame on LF limb noticed today. Gemma says he sometimes does seem stiff getting up, she thinks in back legs but never limped before and unaware of any injury to the limb. Hasnt seen him licking at the limb.Examine: Gums pink, no petechiae, anaemia looks to be recovering well. Brightish but a little less than I'd expect a young Labrador to be.No abdominal pain. Temp normal. Chest all clear.2) Clear LFL lameness on walk with head bob etc. No obvious source of the lameness detected although consistent reaction to full left elbow extension which he doesnt have in the RFL. Both cephalic areas have been clipped for IV access but no evidence of infection in the local area and no forelimb joints feel hot or swollen to be consistent with septic arthritis. Assessment: 1) Anaemia from suspected upper git haemorrhage presumed secondary to oral peroxide administration for emesis purposes on 5/3/26, but does seem to be resolving given the healthy pink MM colour today.2) Acute LF lameness. I'm unsure how this relates to 1). It could be separate issue such as sprain, he may have elbow dysplasia that is showing up now with muscle fatigue leading to increased load through the bones, reactive IM joint arthritis etc all possible.Plan: Bloods for full profile to reassess CBC and protein levels especially, but also CRP and any other changes. Gemma will call tomorrow for the results.Give paracetamol 500mg bid for limb pain in interim.Continue Losec as prescribed by Port City Vets for minimum 1 month whilst any severe gut ulceration recovers, but I'd think even 3 months would be sensible, reducing dose to 20mg sid once initial course of 40mg sid from Port City is finished. Owner says she has lots of this at home for now.    Vital Signs    Weight: 34.1;       

Reason: All The ToxicitiesAppointment Notes: ate a whole block of dark chocolate, a wole loaf of raisin bread + other stuff. O given hydrogen peroxide to induce vomiting. Is now unwell, V+++. At 5.30am dog ate all this, so owner found on Chat GPT to use peroxide, she had 6% pharmaceutical grade peroxide that she diluted to 3% and gave appropriate doses. Dog vomited but has continued vomiting through the day. On exam, this guy could win best in show. He's bright and happy and would probably eat another loaf of raisin bread if given the chance.Abdominal palpation NAD, no pain, no nausea induced. Gums healthy pink, CRT 1 sec, hydration normal. Temp 38.6. Lung auscultation normal.Chocolate was about 180g of 85% cocoa so according to VIN calculator likely to result in death. I think owner has clearly saved this dogs life, and she's feeling guilty about it.Treat with prevomax injection followed by Losec for 5 days. Research on VIN suggests peroxide is a valid way to induce emesis and she's followed standard protocols to the letter. Touch base if goes downhill, gave my mobile for overnight and over the weekend    Vital Signs