C10029768 / invoice 10000

**Discharge Summary for Basil****Reason for Hospitalisation:**Basil was presented on an emergency basis for suspected cane toad toxicity. He was exhibiting severe neurological signs, including generalised seizures.**Summary of Hospital Stay:**Upon presentation, he was in a post-ictal state. Initial treatment involved administration of diazepam to control seizure activity, gum cleaning, and placement of an intravenous catheter. He was hospitalised for several hours for close monitoring and supportive care.He recovered well throughout the evening with no further seizure activity noted. His demeanour returned to normal, and he was bright and alert prior to discharge.**Medications to Go Home With:**- No medications have been dispensed at this time.**Discharge Instructions:**- **Monitoring:** Please monitor closely for the next 24-48 hours.- **Diet:** You can offer a small, bland meal this evening. Do not be concerned if his appetite is not fully back to normal straight away.- **Activity:** Restrict activity for the next 24 hours. Short, leashed toilet walks only.- **Prevention:** To prevent future episodes, we strongly recommend supervising him while outdoors, especially during dawn and dusk when toads are most active. Restricting access to areas where toads are commonly found is advised.Please do not hesitate to contact us if you have any concerns.Dr Keanje Van ZylVeterinarian    Vital Signs    

Consult and Notes by KVZIV & Fluid Therapy: a (   ) gauge catheter was placed in the (               ) vein.ECG Interpretation:    Vital Signs    

Reason: L3 ToadHISTORY:Presenting Concerns: Acute collapse at home following suspected toad ingestion.    Basil presented after an acute abnormal episode at home. The owner reports that tonight Basil was found with white foam around his mouth and seemed agitated. He then passed several faecal motions, including some diarrhoea. The owner attempted to clean his mouth with a wet cloth suspecting a toad envenomation (had same symptoms in the past). When placed on the floor, he lay onto his side and seemed unable to stand.EXAMINATION:Mentation: BAR  BCS: 5/9  Wt:  6kgHR:  108RR:  26MM: pink/sl injected  CRT: 1-2s  Pulses: SSFP  Temp:  38.6  CVS: Normal cardiac rate and rhythm, no murmur or arrhythmia detected  RESP: Normal respiratory rate and effort, clear bronchovesicular lung sounds  ABDO: Soft and comfortable  MSK: Able to right, rise and ambulate without lameness, no neck or spinal pain noted on palpation  EENT: Marked ptyalism on presentation. Strong gag reflex.  NEURO: Mentation and gait appropriate  LNs: Submandibular, prescapular and popliteal LN WNL  INTEG: Normal  UROGEN:  NADRECTAL: DiarrheaPROBLEM LIST: 1.  Acute collapse2.  Ptyalism3.  DiarrhoeaDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS: 1.  Toad toxicity2.  Snake envenomation3.  Anaphylactic reaction4.  OtherOwner communication:The differential diagnoses for Basil's signs, including toad toxicity, snake envenomation, and an anaphylactic reaction, were discussed with the owner. It was explained that while some of the signs are consistent with toad toxicity, the acute collapse is also a significant concern for snake bite. The potential for a patient to collapse, temporarily recover, and then decline again with lethal envenomations was highlighted. A clotting time test was recommended to help rule out snake envenomation, but declined by ownerTreatment:-   Oral lavage was performed upon admission, resulting in the resolution of ptyalism  Plan:-   The owner elected to take Basil home for monitoring as seems back to his normal self now-   The owner was advised on signs to monitor for at home and to seek immediate veterinary attention if any concerns arise.    Vital Signs