C10032581 / invoice 10000

Reason: Salivating - Pest Spray YesterdayHISTORY:The owners had standard pest control treatment performed at their home yesterday. The dogs were removed from the house during spraying and remained out for seven hours after completion. They were returned home last night and placed in their usual sleeping area in the laundry room with water bottles. This morning, Twiglet was found to be hypersalivating excessively. The other dog had a single vomit episode but this can be normal for him, and he otherwise appears clinically well. Twiglet escaped into the garden yesterday morning and was amongst weeds. Twiglet appears otherwise well apart from the excessive hypersalivation.Current medications: Recently changed from Simparica Trio to annual injection for fleas and ticks (received approximately three months ago in July)TRIAGE:HR: 160RR: 30Temp: 38.0 MM: pinkCRT: <2Mentation: BAR Pain Scale (MGCS) : 0 Hydration status (%): euhydratedEXAMINATION:Body Condition5/9 Score: Cardiovascular: Cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Neurologically no significant findings, no cranial nerve or proprioceptive deficits/gait, full neurological exam not performedMusculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performedGastrointestinal:- Oral: NSF- Abdominal: NSF- Rectal: not performedUrinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: no obvious wounds or ectoparasitesLymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:- Marked HypersalivationDIFFERENTIAL DIAGNOSIS: Toxicity from pest control chemicals causing gastrointestinal irritation or nausea. Oral irritation from licking caustic substances. Tick paralysis. Other causes of nausea or hypersalivation.DIAGNOSTICS/MANAGEMENT PLAN- Intravenous fluid therapy for hydration support- Blood gas analysis to check electrolytes- Maropitant- Monitor clinical progress over 12 hours- Wash feet to remove potential contaminants- Tick search - Further diagnostic investigation if hypersalivation persists or worsensIV catheter placedBlood gasMild metabolic acidosis, moderate respiratory alkalosis, mild hypocalcamemiaREVISED ASSESSMENT:- Hypersalivation of unknown aetiology, possibly related to pest control chemical exposure although can not rule out other causes. PATIENT UPDATE:Hypersalivation resolved. TREATMENT SUMMARY:Intravenous fluid therapy Hartmanns @ mainteneance rateMaropitant 1mg/kg IV OWNER COMMUNICATION:Discussed potential causes of hypersalivation including pest control chemical toxicity, oral irritation, and tick paralysis. Explained that most dogs do not develop signs from standard pest control treatments but gastrointestinal signs can occur. Discussed monitoring plan over 12 hours with supportive care. Advised that if hypersalivation resolves, likely attributable to pest control exposure. If signs persist or worsen, further investigation for other causes will be pursued. Discussed tick prevention status and low likelihood of tick paralysis at this time of year. Obtained consent for CPR if required.FINANCIAL UPDATE: $1200-1300For last medications given please refer to the attachment "Hospital Flow Sheet" accompanying the history.Smartflow Sheet Checked by If you have any questions regarding the case between 9am and 6pm (Mon-Fri) please call the Underwood and Jindalee Clinical Support Line on 07 3147 8746 otherwise our hospitals during after hours.---------------------------------------------------------------------------------------------------------CLIENT DISCHARGE NOTESPRESENTING CONCERNS:The owners had standard pest control treatment performed at their home yesterday. The dogs were removed from the house during spraying and remained out for seven hours after completion. They were returned home last night and placed in their usual sleeping area in the laundry room with water bottles. This morning, Twiglet was found to be hypersalivating excessively. The other dog had a single vomit episode but this can be normal for him, and he otherwise appears clinically well. Twiglet escaped into the garden yesterday morning and was amongst weeds. Twiglet appears otherwise well apart from the excessive hypersalivation.PROBLEM LIST FROM PHYSICAL EXAMINATION AND HISTORY:- Marked HypersalivationASSESSMENT:- Hypersalivation of unknown aetiology, possibly related to pest control chemical exposure although can not rule out other causes. She is eating well for her owners so is ok to be dicsharged hoem for monitoring. DIAGNOSTICS/MANAGEMENT:- Intravenous fluid therapy for hydration support- Blood gas analysis to check electrolytes- Maropitant- Monitor clinical progress over 12 hours- Wash feet to remove potential contaminants- Tick search - Further diagnostic investigation if hypersalivation persists or worsensPLAN:DC home fro close monitoringRecheck immediately if any vomting, inappetance or other concerns overnight. Particularyl when her Maroptiant (antinausea medication) wears off in 24hrs. If signs return she should be worked up for a separate disease process. Medications for Administration at Home:Name          Dose              Frequency   number dispensed    Next DueNilSPECIFIC HOME CARE INSTRUCTIONS:The Animal Emergency Service advises a reassessment with your regular vet within 48 hours to monitor your pets progress.  If your pet's condition deteriorates or they become flat or lethargic, go off their food and water, develop vomiting or diarrhoea or if you have any concerns please contact the Animal Emergency Service or your primary vet immediately.If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital.Thank you for trusting the Animal Emergency Service with the care of your pet.    Vital Signs    

---------------------------------------------------------------------------------------------------------CLIENT DISCHARGE NOTESPRESENTING CONCERNS:The owners had standard pest control treatment performed at their home yesterday. The dogs were removed from the house during spraying and remained out for seven hours after completion. They were returned home last night and placed in their usual sleeping area in the laundry room with water bottles. This morning, Twiglet was found to be hypersalivating excessively. The other dog had a single vomit episode but this can be normal for him, and he otherwise appears clinically well. Twiglet escaped into the garden yesterday morning and was amongst weeds. Twiglet appears otherwise well apart from the excessive hypersalivation.PROBLEM LIST FROM PHYSICAL EXAMINATION AND HISTORY:- Marked HypersalivationASSESSMENT:- Hypersalivation of unknown aetiology, possibly related to pest control chemical exposure although can not rule out other causes. She is eating well for her owners so is ok to be dicsharged hoem for monitoring. DIAGNOSTICS/MANAGEMENT:- Intravenous fluid therapy for hydration support- Blood gas analysis to check electrolytes- Maropitant- Monitor clinical progress over 12 hours- Wash feet to remove potential contaminants- Tick search - Further diagnostic investigation if hypersalivation persists or worsensPLAN:DC home fro close monitoringRecheck immediately if any vomting, inappetance or other concerns overnight. Particularyl when her Maroptiant (antinausea medication) wears off in 24hrs. If signs return she should be worked up for a separate disease process. Medications for Administration at Home:Name          Dose              Frequency   number dispensed    Next DueNilSPECIFIC HOME CARE INSTRUCTIONS:The Animal Emergency Service advises a reassessment with your regular vet within 48 hours to monitor your pets progress.  If your pet's condition deteriorates or they become flat or lethargic, go off their food and water, develop vomiting or diarrhoea or if you have any concerns please contact the Animal Emergency Service or your primary vet immediately.If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital.Thank you for trusting the Animal Emergency Service with the care of your pet.    Vital Signs    

CLIENT DISCHARGE NOTESPRESENTING SIGNS: Vomiting ASSESSMENT:Twiglet presented for acute onset of vomiting after access to Round up. After consultation with Animal Poisons, mild gastrointestinal upset such as vomiting, diarrhoea, inappetence can be expected, although clinical signs usually happen soon after ingestion/contact. Other causes of acute vomiting cannot be completely excluded and that would include gastric and intestinal causes (eg. dietary indiscretion, foreign body, infectious, inflammatory, or toxic causes), abdominal disorders (eg pancreatic, hepatobillary, or renal disease or peritonitis) as well as metabolic and endocrine disease. Given she has no further vomiting in the last 2 hours, close monitoring at home is recommended. If she continues to vomiting, experiences inappetence or diarrhoea please recheck with a veterinarian in the morning, or with us overnight if there is any concerns or deteriorations.TREATMENTS ADMINISTERED:Nil SPECIFIC HOME CARE INSTRUCTIONS:The Animal Emergency Service advises a reassessment with your regular vet in 3 days to monitor your pets progress.  If your pet's condition deteriorates or they become flat or lethargic, go off their food and water, develop vomiting or diarrhoea or if you have any concerns please contact the Animal Emergency Service or your regular vet immediately.Thank you for trusting the Animal Emergency Service with the care of Twiglet.    Vital Signs