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Case #6

Case of the Week: Case #6

Signalment: 5y MN Pomeranian

CC: Lethargic, not eating well

Original presentation: 6/5/18

  • Client had been out of town and a friend had been watching Case #6, there as a string hanging out of his mouth
  • PE: WNL
  • String removed from lower 4th premolar on the right side
  • Discussed with client that he may have more fabric material in his GI system, recommended abdominal rads, bloodwork, Cerenia and SQ fluids, Client wanted to take him home and see how he did
  • Cerenia injection in house
  • TGH on bland diet

Update: Case #2 pooped out a string the next day!

Recheck: 6/12/18

  • Case #6 still isn’t eating well and has been vomiting
  • PE: Elevated HR and delayed CRT – clinically dehydrated, the rest WNL
  • Diagnostics
    • Bloodwork: Elevated WBC and Neutrophils, Elevated HCT (60), Elevated BUN (37)
    • Radiographs: Gas visible in loops of small intestine, possible FB but not definite
    • cPLI: Abnormal
  • Treatment – Recommended hospitalization and IV fluids, client opted for outpatient therapy today
    • 150mL NaCl SQ
    • Enrofloxacin SQ
    • Cerenia SQ
    • TGH on Cerenia and Metronidazole, continue bland diet
    • Recheck the following day
      • Client didn’t make it to this appt

Recheck: 6/15/18

  • Case #6 still isn’t eating well, client has difficulties pilling him
  • He drank some water this morning but then threw it up
  • No BM in 4 days
  • PE: Gums tacky and CRT slow – clinically dehydrated, the rest WNL
  • Treatment – Client okayed hospitalization for the day and IV fluids
    • IV catheter placed and started on fluids
    • Cerenia SQ
  • Called client after a few hours and recommended repeat abdominal films because Case #6’s hydration status had improved, but otherwise no change
    • Radiographs: Gas dilated colon, no sign of FB, stomach looks thickened
    • Administered Famotidine SQ to decreased gastric acid production
  • Case #6 was brighter by the end of the day, sent home the following day after more fluids, plan to recheck in 3 days
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Tennessee Avenue Animal Hospital

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