C10032922 / invoice 10000

Reason: Ingestion Corn CobAppointment Notes: Overdue remindersConsultation Time: 2258History: Scout presented for emergency assessment following suspected ingestion of a whole corn cob approximately 15 minutes prior to arrival. The owner reports that one corn cob went missing from the house and is confident that Scout consumed it, as this has occurred previously. The ingestion was rapid, suggesting the cob may have been swallowed whole without being chewed. A previous incident of corn cob ingestion was also managed by inducing emesis. Scout has a history of a previous OD  enucleation and is currently receiving Trusopt eye drops once daily to manage pressure in OS. There is also an intermittent history of haematochezia, which has been previously assessed by a veterinarian.The owner reported no vomiting or other clinical signs at home prior to presentation. The primary concern is the potential for gastrointestinal obstruction from the ingested corn cob.Subjective: BARObjective: Temp   unable         MM  pink            CRT   <2          HR   150          FP Bilaterally synchronousBCS:   5/9                       Wt:  21.8 kgPain Score (CSU):   0/4CV:  Nil murmur or arrythmia, normal hydration parameters      RESP:   Normal bronchovesicular sounds, nil effort           RR pantGIT:   Abdomen was soft and non-painful on palpation. A rectal examination was performed following an episode of defecation and was unremarkable. Emesis induction - A small piece of cob, corn kernels, and recently administered food were recovered in the vomitus. U/G:  NADNeuro:  Normal mentation, symmetrical pupils M/S:  Able to rise, ambulatex4, nil lamenessInteg:  Normal skin turgor Ophth:  No ocular discharge LNs: Palpably normal Problem List:- Suspected foreign body ingestion (corn cob).- Intermittent haematochezia (historical).Assessment: Scout is clinically stable following the induction of emesis for suspected corn cob ingestion. A small piece of cob, corn kernels, and recently administered food were recovered in the vomitus. Given the short time frame between ingestion and emesis, it is likely that most of the stomach contents were evacuated. However, a significant portion of the corn cob remains unaccounted for, and the risk of a retained foreign body leading to gastrointestinal obstruction persists. All vital signs are within normal limits and the physical examination is unremarkable at this time. The owner reports that the intermittent haematochezia is a recurring issue.Options Offered to Client for Ongoing Care:Two main options for ongoing management were discussed with the owner:1. Hospitalisation for monitoring, intravenous fluid therapy, serial abdominal radiography to check for a retained foreign body, and baseline blood tests. The estimated cost for a 12-hour period of hospitalisation, including diagnostics, is approximately $2,800 to $3,200. An additional 12 hours of hospitalisation would incur an extra cost of approximately $1,000 to $1,500.2. Discharge for close monitoring at home. The owner was counselled on the clinical signs of gastrointestinal obstruction to watch for, including vomiting, diarrhoea, lethargy, inappetence, or abdominal pain. It was explained that these signs would likely develop within 12 to 24 hours if an obstruction were to occur.Owner elects option (2), comfortable monitoring at home and returning to AEC if concerning clinical signs occurTreatment:Apo 1.5 tab buccalMetoclopramide 0.5mg/kg DC > Maropitant would have been preferred to reduce perforation risk Plan:Diagnostic plan:No further diagnostics are planned at this stage. The owner has elected to monitor Scout at home and will return if clinical signs of obstruction develop.Therapeutic plan: No immediate therapeutic interventions are planned. The owner was advised on supportive care measures at home.Discharge plan:Scout was discharged for monitoring at home. The owner was advised to:- Maintain normal hydration by adding water to food.- Feed the usual breakfast meal. Avoid sudden dietary changes.- Consider adding easily digestible fibre, such as pumpkin, to the diet to aid gastrointestinal transit. The owner mentioned using the Hills easily digestible diet, which was approved.- The owner was advised against using slippery elm as its effects are not well-established in this context.- Monitor closely for any clinical signs of illness, particularly over the next 24 hours.- Return for re-assessment immediately if there is any vomiting, lethargy, inappetence, or abdominal pain. The owner was informed about pet-friendly taxi and rideshare services, as they do not have access to a car during the day.    Vital Signs