Changes

==Treatment==

==Treatment==

'''Of dogs presenting with clinical signs'''

'''Of dogs presenting with clinical signs'''

**'''Inital stabilisation of Cardiorespiratory System:'''

*'''Inital stabilisation of Cardiorespiratory System:'''

***Tachycardia: beta-blockers, eg orally administered metoprolol at a dose of 0.5mg to 1mg per kg every 8 hours <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**Tachycardia: beta-blockers, eg orally administered metoprolol at a dose of 0.5mg to 1mg per kg every 8 hours <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

***Premature Ventricluar Contractions: lidocaine; iv bolus of 2mg to 6mg per kg administered slowly, after which a constant rate infusion of 20ug to 70ug per kg per minute should be given <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**Premature Ventricluar Contractions: lidocaine; iv bolus of 2mg to 6mg per kg administered slowly, after which a constant rate infusion of 20ug to 70ug per kg per minute should be given <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

***Bradycardia: Atropine at a dose of 0.01mg to 0.02mg per kg <ref name="multiples">'''http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/211104.htm''', accessed on 07.11.2010 </ref>

**Bradycardia: Atropine at a dose of 0.01mg to 0.02mg per kg <ref name="multiples">'''http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/211104.htm''', accessed on 07.11.2010 </ref>

**'''Treatment of seizures and hyperactivity'''

*'''Treatment of seizures and hyperactivity'''

***IV Diazepam at a dose of 0.5 to 2 mg/kg <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**IV Diazepam at a dose of 0.5 to 2 mg/kg <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

***Alternative to diazepam is barbiturates <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**Alternative to diazepam is barbiturates <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

***Treating the seizures and hyperactivity should help restore normal body temperature. If animal still hyperthermic then this should be treated directly <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**Treating the seizures and hyperactivity should help restore normal body temperature. If animal still hyperthermic then this should be treated directly <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**'''Correction of acid/base and electrolyte inbalances''' ref merck

*'''Correction of acid/base and electrolyte inbalances''' ref merck

**'''Insertion of urinary catheter'''

*'''Insertion of urinary catheter'''

***Helps prevent further absorption of theobromine and caffeine across bladder wall <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

**Helps prevent further absorption of theobromine and caffeine across bladder wall <ref name="multiples"> King, LG, Boag, A (2007) '''BSAVA Manual of Canine and Feline Emergency and Critical Care(2nd Edition)''' ''BSAVA''</ref>.  

'''Of dogs with a known history of recent chocolate ingestion but who have not yet developed clinical signs'''

'''Of dogs with a known history of recent chocolate ingestion but who have not yet developed clinical signs'''

**Administration of apomorphine (0.03mg/kg IV) or hydrogen peroxide (1-5 ml/kg PO) ref 5 min vet consult in order to induce emesis and/or of activated charcoal in order to minimise further absorption of methylxanthines re 5 min vet consult

*Administration of apomorphine (0.03mg/kg IV) or hydrogen peroxide (1-5 ml/kg PO) ref 5 min vet consult in order to induce emesis and/or of activated charcoal in order to minimise further absorption of methylxanthines re 5 min vet consult

==Prognosis==

==Prognosis==