C10032313 / invoice 10000

Reason: Ate ADHD Meds And Antidepressants SGGAP ONLY HISTORYFirst clinical signs -  in the past 2 hoursSummary - ingestion offlouxetine & lisdexamfetamine dimesylate mediationDiagnosis - ingestion offlouxetine & lisdexamfetamine dimesylate mediationTreatment - management of toxicity and referral to ARH for othernight monitoring and continues careHISTORY:O's presenting complaint(s): possible ingestion of family member's medication1x 20mg flouxetine tabletsLisdexamfetamine dimesylate 50mg tablets - chews up but does not look to be ingestedIron tablets but most unlikely to be chewed upO saw Hazel chew it? Cat played with it, other dog did not try to ingest itExamine:PHYSICAL EXAMINATION: BCS: 5/ 9MCS: normal muscle mass Mentation: alert and responsiveEYES: NAD - clear, no noted discharge *bilaterally dilated pupilsEARS: NAD - clear, no discharge, odour, erythemaNOSE: NAD - clear, no discharge, symmetrical, no lesions ORAL: NAD - normal pink and moist mm, normal CRT, healthy teeth & gumsCARDIOVASCULAR - NAD - no murmur or arrhythmia auscultated, pulse pressures normal and synchronousRESPIRATORY: NAD - thoracic auscultation clear sounds bilaterally, respiratory effort normalABDOMINAL: NAD - soft pliable, no detectable pain or palpable abnormalitiesNEURO: NAD - neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMUSCULOSKELETAL: NAD - ambulating with normal gait & posture, no pain on palpation of joints, appropriate ROM#RECTAL: not performedREPRODUCTIVE: externally normal INTEGUMENT: NAD - clear coat and skin LYMPH NODES: NAD - peripheral nodes palpate normal Assessment:HyperthermiaHyperesthesiaCircling to the right? But can walk striaght and turn in the other direction - noted in cageSuspect ingestion of medication (flouxetine tablets &Lisdexamfetamine dimesylate 50mg tablets) againTreatment:1. Admit for IVFT and sedation 2. Butorphanol 0.2ml IM on admit 1130am - mild sedation, enought to place iv cath3. Pamlin 0.5mg/kg IV at 1145 and 1200 - mild sedation only, temp back to 37.84. 0.05mg/kg acp IV at 1245, another another 0.05mg/kg IV at 1330 - settling better in cage, but hyperesthesia still presentPlan:1. Referral to ARH for overnight moniotr and care 2. Advised likely needs further medication +/- repeat bloods    Vital Signs    Weight: 6.5;       MMColour: pink;       Temperature: 40.1;       HeartRate: 100;       RespirationRate: panting;       BodyScore: 5;       DentalGrade: 2;