Emergency Veterinary Care

1. Emergency Veterinary Care LAT Chapter 12

2. LAT Presentations Study Tips • If viewing this in PowerPoint, use the icon to run the show. • Mac users go to “Slide Show > View Show” in menu bar • Click on the Audio icon: when it appears on the left of the slide to hear the narration. • From “File > Print” in the menu bar, choose “notes pages”, “slides 3 per page” or “outline view” for taking notes as you listen and watch the presentation. • Start your own notebook with a 3 ring binder, for later study!

3. Introduction • Laboratory animal technicians will bring the emergency situation to the attention of the veterinarian or supervisor. • They are also the ones who, under the direction of the veterinarian, may carry out the emergency procedures. • The basic steps for dealing with emergency situations should be mastered by laboratory animal technicians.

4. Surgical Emergency Procedures • Anesthetic Emergencies • Cardiac or respiratory arrest => open an airway to facilitate administration of oxygen. • Rabbits and larger, this is often accomplished by inserting endotracheal tube into the trachea. • Placement of an endotracheal tube = intubation. • Laryngoscope is a flat blade with a light on the end. • The blade depresses the tongue and the light illuminates the posterior pharynx and the laryngeal opening. • Antagonist - counteracts the effects of the anesthetic in the event of accidental overdosing or complications during the surgical procedure. • Know which antagonist works best with anesthetic being used, and have antagonist available for emergency.

5. Intubation 1 of 5

6. Intubation 2 of 5

7. Intubation 3 of 5

8. Intubation 4 of 5

9. Intubation 5 of 5

10. Post-Surgical Complications • Monitor closely for > five days. • includes body temperature, appetite, and urination and defecation. • watch for bleeding, dehiscence, redness, swelling or discharge. • observe for self-trauma, licking or chewing the wound or sutures. • record observations in a log book or individual record. • Shock is a life-threatening emergency. • peripheral circulation fails either because of excessive fluid loss or loss of circulatory control. • signs - pale gums, clammy or cold skin, < bp, rapid weak pulse, decreased respiration, restless, anxious, dazed, or unconscious • Treatment of shock varies with severity: 1. Keep the patient quiet and warm (not hot). 2. Administer intravenous fluids. 3. Administer antibiotics.

11. Shock

12. Nonsurgical Emergencies Serious Illness • Bacterial, viral, and parasitic disease can be life-threatening. • Respiratory problem => pneumonia overnight. • Observant animal technicians can detect respiratory problems in their early stages and bring them to the attention of the facility veterinarian before they become more serious problems. • Animal may be treated with antibiotics and supportive therapy, or may be euthanized. • Seriously ill animals may require fluids and supplemental nutrition, heat, or oxygen.

13. Check Heartbeat & Respiration

14. Dystocia • Dystocia: non-productive, painful labor • Large pregnant animals, check at least twice daily near the end of gestation period. • Once in labor, check as often and as quietly as possible. • Have an idea of how long animal has been having contractions. • Most animals deliver at night or early in the morning. • Dystocia or uterine inertia treated with various contraction-stimulating drugs. • Cesarean section performed if drug therapy contraindicated or ineffective. Neonatal mini-pigs under a heat lamp

15. Injuries from Fighting • Separate combatants immediately. • Cats, dogs, pigs and monkeys can inflict severe injuries and on anyone who attempts to intervene. • Place physical barriers between combatants, or splash a bucket of cold water on them to end a severe fight. • Injuries include internal injuries, lacerations, puncture wounds, torn ears, and broken or amputated limbs. • Lacerations should be cleaned, damaged tissue excised (debrided), and the wound sutured. • Puncture wounds probed to remove hair and dirt. • Keep puncture wounds open for drainage, antibiotic therapy should be given at this time. • Amputations require first aid to stop hemorrhaging, followed by debridement and suturing.

16. Trapped Animals A trapped muzzle? • A common mechanical emergency, especially among dogs and monkeys, is a trapped paw. • Rodent limbs or tails become trapped in a cage floor or feeder. • Sometimes the application of some lubricant to the area is all that is necessary to free the animal. • A large screwdriver or crowbar can often be used as a pry bar to aid releasing a trapped appendage. • Cage bars may need to be cut in order to free an animal. • Since most cages are made of heavy gauge stainless steel, a heavy duty bolt cutter may be required. • Animal may be frightened or in pain and difficult to handle => anesthetize in order to be released.

17. Flooded Cages • Due to automatic watering system problems or water bottles leak • Guinea pigs have a tendency to play with their watering valves and stuff food into them => valve leakage. • Problem can be prevented by using cages that have flanges which direct water leakage out of the cage. • If flooding occurs, it must be corrected before the cage fills and drowns the animals. • Soaked animals should be dried, placed in dry bedding, and provided with supplemental heat until they regain a normal appearance.

18. Poisonings • Poisoning rarely occurs in an animal facility but could if animals were subjected to insecticide and disinfectant dips. • Majority of poisoning cases occur in the receiving or quarantine areas of the facility, when newly arrived dogs and cats are dipped or treated for external parasites. • For contact poisons, the first line of treatment is to flush the animal with water or give it a soap and water bath to remove as much of the poison as possible. • Technicians should wear waterproof gloves during this procedure.

19. The Emergency Cart Prepare emergency cart in anticipation of emergencies: • Have drugs, equipment, dosage lists and SOPs possibly needed. • Check supplies and replace with new items to ensure that expired drugs, deteriorated tubing, syringes, or other materials don’t interfere with emergency care. • Cover container of stored equipment with a easily torn tape such as masking tape. • Tape a place for initials along with date of most recent refilling. • In an emergency, tape can be quickly and easily removed. • For a complete list of the equipment, drugs, and supplies needed for an emergency cart see Fundamental Techniques in Veterinary Surgery, listed in the “Additional Reading” section below.

20. The Emergency Cart

21. Facility Emergency Plan • For use during natural disasters such as floods, hurricanes, tornados and earthquakes • A written SOP outlining: • responsibilities of each member of the animal facility staff • location of flashlights, first-aid kits and other emergency equipment • a designated meeting place for all personnel • Review plan annually.

22. Additional Reading 1. Kirk, R.W. and Bistner, S.I. Handbook of Veterinary Procedures and Emergency Treatment, 6th Ed. W.B. Saunders, Philadelphia, PA, 1995. 2. Recognition and Alleviation of Pain and Distress in Laboratory Animals, National Research Council, National Academy Press, 1992. 3. Knecht, C.D. et al. Fundamental Techniques in Veterinary Surgery, 3rd Ed. W.B. Saunders, Philadelphia, PA, 1987.