If your pet is facing a life-threatening situation, a board-certified specialist in veterinary emergency and critical care can provide life-saving interventions and therapy. Our team at Animal Care and Emergency Services (ACES) has two critical care specialists on staff to offer their expertise, and we would like to answer some frequently asked questions about veterinary critical care.
Question: What is a veterinary critical care specialist?
Answer: A veterinary critical care specialist is a veterinarian who, after graduating from a recognized veterinary school, undergoes intensive training for four or more years in emergency medicine and critical care. After their training, they must pass a detailed examination that evaluates their skills in the specialty. Once they pass the test, they become a Diplomate of the American College of Veterinary Emergency and Critical Care (DACVECC). These specialists are known as criticalists, because they are dedicated to handling life-threatening emergencies, as well as managing critically ill pets. They provide immediate, essential, and intensive care to severely ill and injured pets.
Q: What treatments do veterinary critical care specialists provide?
A: The veterinary criticalist must manage the pet as a whole, while also knowing about all organ systems and their associated functions, anatomical structure, physiology, and pathophysiology. They frequently must manage multiple disease processes and conditions at once. They specialize in treatments that include:
- Pain management — Most pets experiencing a medical emergency are in pain to some degree. A veterinary criticalist must be able to recognize the pet’s pain, assess their pain level, and treat the pain accordingly, while not exacerbating the pet’s fragile condition. They will also perform ongoing assessments throughout the pet’s hospital stay. Pain management, sedation, and local or general anesthesia may be needed to facilitate diagnostic imaging procedures, and to manage the pet’s primary or secondary problems. The protocols selected must be carefully chosen, based on the pet’s health condition.
- Trauma management — Criticalists can quickly and accurately assess pets who are trauma victims and start the appropriate treatment as soon as possible. With traumatic injuries, immediate intervention is imperative and can mean the difference between survival and the loss of a patient. Criticalist are highly trained to manage cases such as these.
- Resuscitation — Veterinary criticalists are trained to resuscitate pets by cardiopulmonary resuscitation (CPR) and defibrillation. They also provide post-resuscitation care to optimize ventilation and circulation, preserve organ and tissue function, and maintain appropriate blood sugar levels.
- Fluid therapy — Many pets presented as an emergency require fluid therapy to replace lost fluid, and support organ and tissue function. Criticalists must know the required fluid therapy, and the fluid administration rate, so the pet is not overloaded.
- Respiratory support — For pets in respiratory distress, respiratory support, including nasal oxygen, oxygen cages, and mechanical ventilation, is necessary.
- Transfusion medicine — Criticalists are trained to crossmatch and blood-type pets, and to help prevent transfusion reactions in pets suffering from blood loss. They are trained to manage ongoing blood loss and intervene with appropriate measures.
- Coagulation disorder management — Critically ill pets are at high risk for developing coagulation abnormalities, since the inflammation and coagulation processes are intertwined. Criticalists must manage this serious condition while treating the primary disorder.
- Toxicity management — When pets ingest poisonous substances, criticalists must act quickly to counteract the toxin’s effects.
- Antimicrobial use — Many critically ill pets require antibiotics for their primary problem, or for potential secondary infections. Criticalists must choose the appropriate antibiotic that will fight the disease, but have the least impact on the pet’s gut microbiome and organ function. They also must make their choice with consideration for antimicrobial resistance concerns.
- Critical care monitoring — Critically ill pets must be continually monitored to assess their condition, using direct and indirect blood pressure monitoring, pulse oximetry, electrocardiography (ECG), and capnography.
Q: How do I know if my pet needs a veterinary critical care specialist?
A: If your pet is seriously ill, or has experienced a traumatic episode, they can benefit from a criticalist’s care. Conditions include:
- Trauma — Pets who have experienced a significant trauma, such as being hit by a car, falling from a high elevation, bullet wounds, bite wounds, and lacerations
- Burns — Pets who have been burned, or affected by smoke inhalation
- Respiratory distress — Pets who are having trouble breathing, with signs that include open mouthed breathing, exaggerated abdominal movement during breathing, noisy breathing, and pale or blue mucous membranes
- Toxin ingestion — Pets who ingest or are suspected of ingesting a toxin, such as rat bait, snail bait, chocolate, marijuana, illicit drugs, grapes or raisins, or human medications like Ibuprofen, Aspirin, or vitamin D
- Foreign body ingestion — Pets who ingested or are suspected of ingesting a foreign body
- Hemorrhaging — Pets who are bleeding excessively, especially those requiring a blood transfusion
- Organ failure — Pets who are experiencing major organ failure, such as heart, liver, or kidneys
- Vomiting or diarrhea — Pets who are suffering from severe vomiting or diarrhea
- Heatstroke — Pets who are experiencing hyperthermia
- Seizures — Pets who are having severe seizures, especially those not responding to the usual treatments
- Urinary tract obstruction — Pets having difficulty urinating, or who aren’t producing urine
- Surgical recovery — Pets who have had surgery, but are not recovering well from the anesthesia
A veterinary critical care specialist’s knowledge and expertise could save your pet’s life, if they experience a veterinary emergency. If your pet is facing a life-threatening situation, immediately contact our team at Animal Care and Emergency Services, so we can get them the care they need.
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