C10030594 / invoice 10000

HISTORY:Bloated, panting1hr pacing, not lying downGoes to lie down, lifts tail uncomfortable Pushing head out neck downWeird smell from buttEDUD okNo v/d/c/sFormed poo 1 hour agoNo retching/gagging or trying to vomitMaybe got into old dog food but don't think soEats fruit from fruit trees, nectarines, apricotsMeds- noneMedfical hx- noneDiet- dry supermarketWorm/flea- Given last weekAnother dog at home No offleash Barks at peopleSVC is reg vetEXAMINATION: HR: 120 RR: 20 Temp: 38.0 Mm:  pink + moist Crt: 1-2s Mentation: QAR Pain Scale (0-4): 0 Hydration status (%): Euhydrated Body Condition Score: 7/9 Cardiovascular: 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 normal. Placing normal 4/4. Musculoskeletal: ambulating normally 4/4 Oral: normal, no mouth pain, dental score (1-4):  1 Abdominal: soft and comfortable on abdominal palpation, normal gut sounds Rectal: Normal faecesUrinary: small soft bladder Reproductive (incl ext genitalia): NSF Integument/Ears: No obvious dermatitis or lesions Lymph Nodes: No peripheral lymphadenopathy Eyes: Menace, PLR, palpebrals WNL bilaterally. Pupils normal size, no anisocoria. Cornea and lens clear. DIAGNOSTICS:Methadone 0.2mg/kg IM + 0.2mg/kg methadone IMVery mild sedation, enough to get xrays2 view lateral xrays- Large bloated stomach full of food- Some gas in small intestineUnable to get VD as not sedated enoughPROBLEM LIST: Abdominal pain ASSESSMENT: Food bloatTREATMENT: Maropitant 1mg/kg SQ Paracetamol 500mg PO TID to BID PLAN: Monitor at homeDon't feed breakfast tomorrowCOMMS: Discussed GDVMonitor for worsening, RV May have gotten into other dogs food    Vital Signs    Weight: 29.5;       

Visit Vet: Dr Sinead Phillipsnote details from 2022-01-06:REGULAR VET CLINIC: TVHSTIME: 1930VET: S PhillipsREASON FOR PRESENTATION: Ate an airpodHISTORY:Has chewed up an airpodHappened around 5pm - got home 5.15-5.30pm Let her out of her crate and found her chewing the airpod - has eaten the stem with the battery in itPrior to this has been healthy Eats everything Current Medications: NoneEXAMINATION:Mentation - BARBCS - 5/9Temp - 38.5CVS - HR 92bpm, no murmur, pulses normalResp - WNLAbdo - ComfortableMouth - MM pink and moist, CRT <2, no signs of oral ulceration Musculoskeletal - NADNeuro - NADEyes - NADEars - NADSkin - NADUrogenital - NAD Lymph nodes - NADASSESSMENT:Possibly digested a lithium ion batteryClient communication:Discussed risks of GI ulceration with owner.Would like to xray to assess where it is in the GIT. O consented.RADIOGRAPHS:1 x lateral abdomen - metallic opacities throughout the GIT --> in stomach, SI and colon1 x VD abdomen - confirmed above. Discussed with owner that it is hard to say what effect the battery will have, it's potentially already moving through her GIT and unsure how rewarding an ex lap would be? Recommended we take a wait and see approach for the moment as a search of VIN suggests most pass through without issue, but O is to monitor for signs of lethargy, anorexia and vomiting. To monitor faeces for airpod parts, and to represent at TVHS tomorrow perhaps for repeat RADs to see how it's moving through. O happy with this plan.TREATMENT:1. Metoclopramide 2.3ml SQ @1945 (to increase gut transit time)2. Omeprazole 20mg PO SID for 4 days starting tonight3. Sucalfate 1g PO TID for 4 days starting tonightPLAN:Monitor and revisit if concernedIf owner is concerned overnight - to revisit, no consult fee will be charged. Otherwise TVHS may touch base tomorrow. **complete**Visit Vet: Dr Sinead Phillipsnote details from 2022-01-06:REGULAR VET CLINIC: TVHSTIME: 1930VET: S PhillipsREASON FOR PRESENTATION: Ate an airpodHISTORY:Has chewed up an airpodHappened around 5pm - got home 5.15-5.30pm Let her out of her crate and found her chewing the airpod - has eaten the stem with the battery in itPrior to this has been healthy Eats everything Current Medications: NoneEXAMINATION:Mentation - BARBCS - 5/9Temp - 38.5CVS - HR 92bpm, no murmur, pulses normalResp - WNLAbdo - ComfortableMouth - MM pink and moist, CRT <2, no signs of oral ulceration Musculoskeletal - NADNeuro - NADEyes - NADEars - NADSkin - NADUrogenital - NAD Lymph nodes - NADASSESSMENT:Possibly digested a lithium ion batteryClient communication:Discussed risks of GI ulceration with owner.Would like to xray to assess where it is in the GIT. O consented.RADIOGRAPHS:1 x lateral abdomen - metallic opacities throughout the GIT --> in stomach, SI and colon1 x VD abdomen - confirmed above. Discussed with owner that it is hard to say what effect the battery will have, it's potentially already moving through her GIT and unsure how rewarding an ex lap would be? Recommended we take a wait and see approach for the moment as a search of VIN suggests most pass through without issue, but O is to monitor for signs of lethargy, anorexia and vomiting. To monitor faeces for airpod parts, and to represent at TVHS tomorrow perhaps for repeat RADs to see how it's moving through. O happy with this plan.TREATMENT:1. Metoclopramide 2.3ml SQ @1945 (to increase gut transit time)2. Omeprazole 20mg PO SID for 4 days starting tonight3. Sucalfate 1g PO TID for 4 days starting tonightPLAN:Monitor and revisit if concernedIf owner is concerned overnight - to revisit, no consult fee will be charged. Otherwise TVHS may touch base tomorrow. **complete**-------------------- Fees Charged: --------------------Item Code: 835 Item Name: Sucralfate 1g Tablets Qty: 12.000Give ONE TABLET as a slurry THREE TIMES DAILY until finished Item Code: 137494 Item Name: Omeprazole 20mg Tablets Qty: 4.000Give ONE TABLET ONCE DAILY until finished Item Code: 152523 Item Name: Radiographs - Single View Qty: 1.000Item Code: 132158 Item Name: Metoclopramide 5mg/mL Qty: 2.300Concentration:Item Code: 149649 Item Name: Consultation - Weeknights Qty: 1.000    Vital Signs    Weight: 23.2;