Emergency/Critical Care
What Is An Emergency and Critical Care Specialist?
A board certified specialist in emergency and critical care is a veterinarian who has obtained intensive, additional training in treating life-threatening conditions.
An emergency and critical care specialist can help in the following kinds of cases, among others:
- Traumatic injury (including fractures, bite wounds, burns, lacerations)
- Respiratory emergencies (including cases in which the use of ventilators is needed) Animals in need of blood transfusions Animals that are in shock
- Animals with life threatening neurologic disease, such as coma or severe seizures
While your general practitioner veterinarian can diagnose and treat many health problems and handle many routine emergencies, certain situations may require the care of a doctor who has had specialized, intensive training in handling emergency and critical care for your pet. An emergency and critical care specialist typically works in tandem with your general practitioner veterinarian on a referral basis, as well as with any other needed specialists, until the emergency is resolved.
How Can I Find A Specialist in Emergency and Critical Care for My Pet?
If your veterinarian does not handle after hours emergencies, then he or she probably already has a referral relationship in place with a local or regional emergency hospital. You can also look for emergency specialists in your area on the the American College of Veterinary Emergency and Critical Care (ACVECC) website. In addition, you can also check with any veterinary schools in your area to see if they have a fully staffed and equipped emergency room. You can be assured that a veterinarian who knows when and where to refer you and your pet for emergency or critical care is one that is caring and committed to ensuring that your pet receives the highest standard of care for his or her problem.
When Does My Pet Need Emergency Care?
Any of the following situations can be considered an emergency:
- Difficulty breathing
- Ingestion of a foreign object or unknown substance
- Bleeding
- Vomiting blood
- Blood in the feces or urine
- Swollen, hard abdomen that is painful to the touch
- Serious wound
- Suspected broken limb
- Any injury to the eye
- Loss of consciousness
- Seizures
- Inability to move or sudden weakness
- Unusual or erratic behavior
- Signs of extreme pain, such as whining or shaking
- Straining to urinate (especially a male cat)
- Labor that does not progress
- Signs of heatstroke
What Is Critical Care?
While an emergency is unfolding, or throughout recovery from a serious illness or accident, ongoing diagnostic and therapeutic care and constant monitoring of your pet's condition may be required. Many emergency and critical care facilities offer 24-hour supervision of critically ill pets and, just as in human hospitals, may have dedicated Intensive Care and Critical Care Units (ICU/CCU). Such facilities are equipped to provide oxygen therapy, cardiac monitoring, blood transfusions, and nutritional support. Such facilities also typically have advanced diagnostic capabilities onsite, such as ultrasound and echocardiography.
Will My Regular Veterinarian Still Be Involved?
Many emergency hospitals work on a referral basis with general practitioners. In some cases, your pet will only be referred to the emergency service for after hours care. In other cases, your pet may be in the care of the emergency and critical care specialist for the duration of the emergency and recovery, but then referred back to your general practitioner veterinarian for follow up and routine care.
Did You Know?
There are more than 125 board-certified veterinary emergency and critical care specialists in the U.S. today and it is the fastest growing specialty in the profession.
Frequently Asked Questions
- What Additional Training Does An Emergency and Critical Care Specialist Have?
Veterinarians who want to become board certified in emergency and critical care medicine must seek additional training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Emergency and Critical Care (ACVECC). A veterinarian who has received this specialty status will list the initials, 'DACVECC,' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVECC. The word 'Diplomate' typically means the specialist has achieved the following:
• Obtained a veterinary degree (three to four years of college plus four years of veterinary school).
• Completed a one-year internship at a referral private practice or veterinary teaching hospital.
• Completed an additional three years of advanced training in emergency medicine, surgery, and critical care through a residency at a veterinary teaching hospital where the veterinarian will have trained with some of the best specialists in the field and obtained hands on experience. This training focuses on the most up to date techniques for the diagnosis and treatment of life threatening disease processes or injuries, not only for the duration of the emergency but throughout the critical care period right after.
• Passed a rigorous examination.
After completing and passing all of these requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary emergency and critical care. When your pet faces an emergency, years of additional training and education will be focused on helping him or her to recover from injury or illness and enjoy the highest quality of life possible.
- How Can I Plan For An Emergency?
Make sure you know ahead of time what your veterinarian's policy is regarding emergency care, both during regular practice hours and after hours. If your veterinarian does not have a referral relationship in place, then make sure you know the location of the closest emergency referral center for your area.
If your pet has an ongoing medical problem that could result in a sudden emergency, make sure you keep any pertinent medical records in a handy place so that you can quickly locate them and bring them with you to the emergency service or hospital in the event of a crisis.
Keep your veterinarian's phone number and any emergency phone numbers and directions next to your phone along with all other important emergency information for your family.
Know basic first aid tips for pets. Ask your veterinarian for these ahead of time during a routine wellness exam- How Can I Avoid An Emergency Situation With My Pet?
It goes without saying that the best way to avoid an emergency is to prevent it in the first place. To reduce the chances that you will experience an emergency situation during the lifetime of your pet, consider the following tips:
• Follow your veterinarian's advice regarding all relevant wellness care, including vaccinations, age appropriate health screenings, and parasite prevention.
• Prevent traumatic injury by keeping pets under your control at all times. Keep cats indoors and dogs fenced. When pets venture outdoors, keep them leashed at all times. If you do allow them off leash, limit this privilege to large enclosed areas away from traffic, other potentially aggressive pets, and wildlife.
• Invest the time in training your pet to obey simple commands, such as Come, Sit, Down, Stay, and No.
• Never leave your pet alone or unattended in a car, even with the windows open.
• Pet proof your home, removing all potential hazards from your pet's reach, much the same as you would do with an infant or toddler.
• Supervise your pet as much as possible. Puppies and kittens, just like human babies, like to explore with their mouths. Supervising them during playtime can prevent their ingesting poisonous substances or choking hazards.
• If your pet is coping with a chronic illness, carefully follow all of your veterinarian's recommendations regarding medication administration and check ups.
- What To Do In An Emergency?
• Call your veterinarian immediately. Even if it is after hours, most veterinarians have recordings that explain how to obtain emergency help for a pet when the practice is closed.
• Call your veterinarian rather than attempting to obtain advice online. Do not leave a voicemail. In an emergency, your pet needs help immediately. Keep going until you get a live person on the other end of the phone who can connect you with a veterinarian or direct you to an emergency facility.
• If you are away from home, consult the yellow pages of the local phone book for the closest veterinary emergency facility.
- How do I handle my injured pet?
Handle With Care
Pain, fear, and shock can make animals behave differently. When you are faced with a pet emergency, remember that even the most well trained and loving pet can behave differently when feeling ill or in pain. Also realize that even relatively small animals, such as cats or small dogs, are capable of inflicting serious bite and scratch wounds when they are disoriented and in pain. If this occurs, it is important not to take such actions personally, but to realize that it is an expression of the extreme pain or disorientation your pet may be experiencing at the time.
Approach all injured pets with caution. Despite your natural wish to comfort your ill or wounded pet, do not place your face or hands near his or her head until you can assess your pet's condition. If you feel you cannot safely manage the emergency situation, ask your veterinarian for advice on how to handle and transport your pet when you call to report the emergency. Sometimes wrapping small, injured pets in towels (taking care not to cause further injury or pain) or placing larger pets in crates or carriers for transport may be the safest option for both you and your pet.
- What Type of Equipment Do Emergency and Critical Care Specialists Use?
High Tech Help
Much of the same high tech equipment that human doctors use to help critically ill humans is also available to help save injured or seriously ill pets. Emergency and Critical Care specialists are more likely to have access to the following cutting edge equipment or capabilities to help your pet recover:- Supplemental oxygen delivered via oxygen cages or nasal tubes
- Pulse oximeters
- Blood gas monitoring
- End tidal carbon dioxide measurement
- Colloid oncotic pressure measurement
- Continuous ECG monitoring and telemetry
- Ultrasonography
- Endoscopy
- Blood pressure and central venous pressure measurements
- Blood transfusions
-
Advanced imaging techniques, such as CT scans and MRI
- How is the VCA West Los Angeles Animal Hospital different from other specialty hospitals?
Welcome to VCA West Los Angeles Animal Hospital. If you are new to our hospital, I hope your experience will be as pleasant as possible and we hope that we can live up to your expectations. If you are returning, we are pleased that you have once again chosen our hospital to help meet your pet's health care needs. In order to improve our service, I wanted to take this opportunity to tell you a little about our hospital, how it functions and how we can both work to provide your pet with the best care possible. VCA West Los Angeles Animal Hospital is one of the largest private small animal hospitals in the country. We have referral hospital for veterinarians in Southern California and we are a teaching hospital providing post-graduate education for veterinarians. We have a professional staff of over 25 veterinarians including specialists in such disciplines as internal medicine, surgery, oncology, radiation therapy, dermatology, ophthalmology, radiology, and cardiology. Specialists are available 7-days-a-week on an appointment basis. One advantage of a large hospital like VCA WLA is that all cases receive the benefit of input from a number of veterinarians all of whom lend their special expertise to the problem at hand.We are open 24-hours-a-day, 7-days-a-week, 365 days of the year to provide comprehensive care. However there are instances when waiting times to see a doctor may be long depending on the time of day and the number of emergencies that are being handled. To avoid unnecessary delays, especially if you don't have a medical emergency, you may wish to call ahead to determine if there is a wait to see a doctor or to schedule an appointment with one of our staff doctors at a time convenient to you.
VCA West Los Angeles Animal Hospital has one of the largest graduate teaching programs in the country through our internship and residency programs. Interns and residents are graduate veterinarians who are seeking to obtain additional supervised training and expertise in a facility such as ours where the caseload and the availability of specialists ensures an excellent teaching environment. Competition for these positions is intense and those selected are amongst the brightest in their class.
Having a sick or injured pet can be very stressful and we will work to help alleviate your concerns while we tend to the needs of your pet. In order to help improve our service, we do wish to remind you of a few items that should help. First, if you need to obtain a prescription refill please let us know 24 hours in advance. All prescription refills must be approved by a doctor. We need this time to obtain approval and have your prescription available. Secondly, when your pet is hospitalized, the attending doctor will be calling to give you an update after 11 a.m. in the morning. Prior to 11 a.m., your doctor will be in rounds where all the hospitalized cases are discussed amongst our medical and surgical staff and unless there is an emergency, your doctor will not be able to take your phone calls until this time. This allows us to obtain a wide range of opinions regarding your pet's condition, and obtain the input from all the specialists on duty that day. We work as a team, which helps in providing more complete medical care. Of course, we do have visiting hours every evening from 7 to 8 p.m. so that you can visit with your pet, talk face to face with the attending doctor, and help in the healing process. Lastly, if your pet is being admitted in the morning for an elective procedure (simple mass excisions, endoscopy, etc.) your pet should be able to go home the same evening between the hours of 7-10:30 p.m. This helps us ensure that your pet has completely recovered from anesthesia and is ready to return home after evening rounds have been completed. It is possible that on rare occasions, elective procedures may be performed later in the day or even postponed until the following day if unforeseen emergencies arise which demand our immediate attention. We will always place the medical needs of a patient above those of a schedule and if we need to unexpectedly change you pet's procedure date or time we will be sure to notify you as soon as we are aware of the situation.
We are primarily concerned about your pet's health and will do our best to provide the best health care possible. This of course involves a fee and at times veterinary bills can seem quite expensive. At first this may be hard to understand but the reality is that veterinary medicine is not all that different from human medicine. Veterinarians spend as much time as physicians in school and veterinarians can provide many if not all of the services that would be available to you or I in a human hospital. Our veterinary facility is also unique in many respects. Our hospital is quite large. We employ over 30 doctors and over 150 technicians, front office and housekeeping staff. VCA WLA also has a large specialty staff and a great deal of sophisticated equipment, which helps us to provide the best care possible. Lastly, we are open 24-hours-a-day, with doctors and technicians always available to see any emergencies as they arise and to monitor those pets that are hospitalized. We will do our best to provide you with written initial estimates and to keep you updated on a daily basis on the status of your account when your pet is hospitalized. It is expected that 100 % of the estimate will be left as a deposit when your pet is admitted (not necessary for routine or elective procedures) and that the balance will be paid in full at the time of discharge. While we do not offer payment plans we can offer you a financing plan through CareCredit. Again our front office staff can help you with these arrangements.
Of course, the buck stops here. If you have any comments/suggestions/complaints or praise, I am always available. I can promise that I will listen to all of your concerns and compliments as we are always looking to improve our service and patient care. Feel free to call (310-473-2951) or fax (310-477-7412) and I will get back to you as soon as possible. You may also e-mail me at David.Bruyette@vcamail.com. I would like to thank you again for selecting VCA West Los Angeles Animal Hospital and I hope that both you and your pet have a pleasant experience.
Sincerely, David Bruyette, DVM
Medical Director
Diplomate, American College of Veterinary Internal Medicine
Services Offered in Emergency/Critical Care
- Blood chemistry analyzer
- In-house STAT laboratory
- Abdominal ultrasonography-abdominocentesis and cystocentesis
- Digital radiography
- Transfusion therapy
- Pulse oximetry and end tidal capnography
- Direct blood pressure monitoring
- Central venous pressure monitoring
- Nasal and transtracheal oxygen therapy
- Aggressive analgesia
- Emergency surgery
- Elective and emergency caesarean section
- Transcervical insemination and diagnostics
