In addition to attending veterinary college, a critical care specialist has completed an internship and residency focusing on patients, techniques, and procedures involving emergency and critical care medicine. Once their training is complete, each resident must pass an examination administered by the American College of Veterinary Emergency & Critical Care (ACVECC). Only after the examination has been passed can they be called a board-certified Critical Care specialist.

Patients who are in a life-threatening situation deserve the benefit of being seen by veterinary Critical Care specialists, who are able to use their day-to-day experience and training to provide the highest level of care for ill and wounded patients. Critical Care specialists handle a variety of emergencies and illnesses, and oversee their recovery in an intensive-care setting.

The criticalist will have already reviewed the past and present history provided by your family veterinarian prior to your arrival if we have received it ahead of time. Upon your arrival at our facility, your pet’s condition will be assessed by a member of our Critical Care team. If your pet is deemed stable, he/she will be brought back to you in the exam room. During your appointment, a complete physical will be performed by the criticalist to assess your pet’s condition and retrieve a current set of vitals such as heart rate, respiratory rate, weight, temperature and blood pressure.

If emergent medical concerns are detected, your pet will remain in ICU for interventional treatment until they are stabilized, at which time the doctor will come in to review their findings and discuss the potential treatment plan for your pet. Further testing or treatment will be made based on the doctor’s assessment of your pet’s condition and his/her history. A detailed estimate will be presented to you and your consent received prior to starting any further diagnostics or treatments.

Our Critical Care Department is always staffed with an experienced team of doctors and experienced patient care technicians who provide around-the-clock care, seven days a week for our patients.

The doctor’s assistant will call you in the morning following your pet’s overnight stay in order to give you an update on your pet’s progress. At that time, they may recommend further treatment or testing on the doctor’s behalf. Your doctor will contact you in the afternoon to provide another detailed update along with any additional test results received, or in order to discuss further treatment. In addition to your health update, we will also provide you with a financial update.

If there are any concerns or changes in your pet’s condition, the on-duty doctor will call to inform you.

Gastric dilatation and volvulus (GDV) is a condition affecting primarily the large breed dogs (although it can occur in small breed dogs) in which the stomach fills with air and liquid and rotates within the abdomen. Common breeds affected by this condition include Great Danes, Labrador Retrievers, Golden Retrievers, Irish Setters, and German Shepherds.

The cause of this condition is not fully understood. Symptoms of gastric dilation or GDV include lethargy, discomfort and restlessness, non-productive retching/vomiting, and a distended stomach.

What to expect when you arrive at the emergency hospital?

After an initial evaluation of your pet’s vitals (temperature, heart rate, respiratory rate, mucous membrane color, and pulse quality), the veterinarian will likely request permission to take an abdominal x-ray. Abdominal x-rays help confirm the diagnosis of a GDV.

If your pet is definitely diagnosed with a GDV, immediate treatment is necessary because unfortunately, this condition is life-threatening.

Treatment for GDV:

Your pet will immediately be treated with pain medication and intravenous fluid therapy. A stomach tube will potentially be passed through their mouth and into their stomach (if possible) to relief some of the stomach distension. After initial stabilization, surgery will be required to de-rotate the stomach and to evaluate the abdomen for any complications associated with the condition. During the surgical procedure, a gastropexy will be performed to adhere the stomach to the body wall in the hopes of preventing a future torsion.

Your pet will need to be monitored in the hospital for at least 48 hours after the surgical procedure to monitor for common complications, including abnormal heart rhythms, electrolyte disturbances, abdominal discomfort, etc.

Prognosis:

Survival rate depends on the severity of distention, the amount of time before treatment, and degree of shock present. Approximately 60-70 percent have dogs will survive when very aggressive therapy is initiated quickly.

Contact us now if your pet is experiencing any of these symptoms.

How do I know if my pet is suffering from heat stroke? Heat stroke can be a life-threatening condition. Heat stroke occurs when an animal’s core body temperature rises to dangerously high levels. The degree of body temperature elevation is directly related to the severity of secondary organ damage. Various factors can predispose an animal to heat stroke, such as obesity, thick hair coat, brachycephalic conformation (“smush-faced” dogs such as bulldogs, pugs, boxers, etc.), strenuous exercise, water deprivation, or exposure to hot/humid weather. A common heat stroke scenario involves a dog being left in a car “for just a second.” In ambient temperatures (86 degrees Fahrenheit), a car with windows partially rolled down can reach an internal temperature of 104 degrees Fahrenheit within 16 minutes. These 16 minutes can be fatal to your pet.

Common heat stroke symptoms:

• Lethargy
• Weakness
• Excessive panting
• Drooling
• Glassy/glazed eyes
• Dark red gums
• Vomiting
• Diarrhea
• Collapse
• Unresponsiveness to commands

Heat stroke is a medical emergency, therefore treatment should begin as soon as possible. Active cooling is recommended prior to transport but should not delay arrival to the hospital. Use a cool water source such as a hose to completely wet the animal’s hair coat. Due to the risk of drowning, it is not recommended to submerge the pet in a cold-water bath. Transport the pet to the hospital in an air-conditioned car while simultaneously cooling, if possible. If the car lacks air-conditioning or if the internal temperature of the car cannot be decreased rapidly, it is recommended to drive with the windows down.

After arriving at the veterinary clinic, the animal will be evaluated and, if necessary, additional cooling measures will be instituted. Baseline blood work is typically performed to evaluate the animals underlying health status. Depending on the severity of the patient’s symptoms and blood work abnormalities, they may require multiple days of intensive care with aggressive medical management. Heat stroke patients require intravenous fluid therapy support, stomach protectants, antibiotics, and sometimes blood component therapy (plasma transfusions). Serial blood work evaluation is recommended to detect the systemic side effects of heat stroke including abnormal heart rhythms, liver damage, kidney failure, neurologic derangements, and abnormal blood clotting ability.

The prognosis for patients with heat stroke depends on the animal’s prior medical condition, the degree and duration of heat insult, and the response to medical therapy. Overall, mortality in dogs with heat stroke is approximately 50 percent. As heat stroke is a preventable condition, it is important to ensure that your pet has free access to both water and shade during the hot summer months.

Head trauma can occur from a variety of causes, including falling from an elevated level, hit by car incidents, and dog fights. Injury to the head can cause skull fractures, trauma to the brain tissue, or bleeding within the skull causing pressure on the brain. Head trauma is considered a medical emergency and can cause death in your pet.

Signs of a head trauma may include bleeding from the head or ear canals, erratic eye movements, weakness, uncoordinated walking, dilated or constricted pupils, dizziness, nausea, vomiting, disorientation, seizures, or coma.

If you feel that your pet has suffered  a head trauma, seek veterinary care immediately. Remove all restricted collars from around the neck and avoid kinking the pet’s neck during transport. It is best to keep your pets head elevated above the remainder of their body during transport.

Your pet will need immediate diagnostics and supportive care to determine the extent of their medical condition and to stabilize your pet. Unfortunately, it is difficult to predict if there will be permanent brain damage during initial evaluation. Your pet will need to stay in the hospital for possible oxygen support and to monitor for progressive brain swelling.

The final outcome of a head injury that results in a concussion depends on the severity of the injury and the duration of clinical signs. Prognosis is best predicted based on the pet’s response to therapy within the first 24-48 hours. Unfortunately, some pets that suffer from head trauma will have persistent symptoms despite aggressive care.

Contact us now if your pet is experiencing any of these symptoms.

Congestive heart failure can occur secondary to a variety of underlying heart conditions including valvular disease, hypertrophic cardiomyopathy, and dilated cardiomyopathy. Often pet’s will develop congestive heart failure without a previous diagnosis of heart disease. Congestive heart failure can result from the lack of effective pumping of the heart muscles leading to fluid backing up into the lungs (pulmonary edema).

Symptoms of congestive heart failure:

• Exercise intolerance
• Coughing
• Difficulty breathing
• Discoloration of the tongue and gums (cyanosis)
• Collapse episodes

In the event that your pet is experiencing the following symptoms, seek veterinary care immediately. Congestive heart failure can be fatal resulting in the death of your pet.

Upon arrival at the hospital, you pet will immediately receive oxygen therapy, a mild sedative to decrease their anxiety, and a diuretic injection in an attempt to decrease fluid within the lungs. The veterinarian will request chest x-rays to confirm the diagnosis of congestive heart failure. X-rays typically will reveal an enlarged heart, fluid within the lungs, or fluid around the lungs.

Your pet will likely need to stay in the hospital for a minimum of 24–48 hours. Often they will require blood work, blood pressure evaluation, oxygen therapy, and heart medications. After initial emergency stabilization and hopeful resolution of heart failure, a referral to a veterinary cardiologist will likely be recommended for a full evaluation of their heart.

Your pet’s prognosis is based on the cause of the heart failure, degree of heart disease, and response to treatment.
Contact us now if your pet is experiencing any of these symptoms.

Feline Lower Urinary Tract Disease (FLUTD) is a condition that commonly occurs to male cats resulting in inability to urinate. FLUTD is characterized by bladder wall inflammation secondary to infections, bladder stones, urinary crystals, or it can be idiopathic (unknown cause). Often cats with FLUTD develop a urethral obstruction, which is considered a medical emergency.

Symptoms of a urethral obstruction include:

• Straining to urinate with little to no urine production
• Frequent trips to the litterbox
• Restlessness and a painful belly
• Vomiting

If you feel that your pet potentially has a urethral obstruction, seek veterinary care immediately. If your pet is diagnosed with a urethral obstruction, immediate urethral catheterization to relieve the obstruction is required. Without appropriate care, a urethral obstruction can be fatal.

Typically, your cat would be placed under heavy sedation or general anesthesia. A urinary catheter would then be utilized to alleviate the urethral obstruction and remove urine from the bladder. It is recommended to keep the urinary catheter in place for approximately 36 hours while providing your cat with intravenous fluid therapy. Urine production and serial blood work evaluation is typically monitored while your pet remains in the hospital. Unfortunately, cats can reobstruct at any time after removing the urinary catheter.

Often, environmental modifications are recommended in an attempt to prevent recurrence of the urethral obstruction. Environmental modifications include feeding exclusively a wet diet (urinary formula), increasing water consumption, adding another litter box, and decreasing environmental stress.

Contact us now if your pet is experiencing any of these symptoms.

We ask that you provide a DNR status only to respect your wishes regarding treatment for your pet's continued care should their condition warrant life saving measures

Yes! Grapes (and raisins) can be toxic to pets, causing symptoms from vomiting and diarrhea to acute (sudden) kidney failure in some patients. If your pet has ingested grapes or raisins, seek veterinary treatment immediately, as grape and raisin toxicity can be fatal.

 

Many foods that we humans eat regularly can be harmful to our pets.

• Chocolate (dark chocolate is more dangerous than milk chocolate)
• Grapes/raisins
• Alcohol
• Coffee (caffeine)
• Macadamia nuts
• Onion/garlic/chives (more toxic to cats, but dogs are also at risk)
• Salt or overly salty food
• Xylitol (found in many gums, candies and some baked goods)
• The seeds or pits of many fruits (apples, apricots, cherries, peaches)
• Yeast dough

For more information on toxins, please visit the ASPCA.

If your pet ingests any form of chocolate, contact a veterinarian immediately. In general, the darker, more bitter the chocolate, the more toxic it is to your pet. Chocolate ingestion causes toxic effects to the heart and can result in seizures.

Coughing in dogs can be an indicator for quite a few conditions including, but not limited to, kennel cough, pneumonia, and heart failure. Kennel cough (tracheobronchitis) is a highly contagious respiratory disease caused by a virus. Treatment usually involves supportive care and, in some cases, cough suppressants and an antibiotic (if a secondary bacterial infection is present). Pets with viral infections must be isolated from other animals and avoid areas where other pets frequent (dog parks, pet stores, groomers, etc.). Coughing caused by more serious diseases, such as heart failure and pneumonia, will require more aggressive care. If these conditions are left untreated, they can be life-threatening.

Consistent gagging and choking in pets can be indicative of several medical conditions ranging from issues that need immediate medical attention (such as a foreign object in the trachea or esophagus), to more chronic problems like laryngeal paralysis or collapsing trachea. In any of these cases, veterinary evaluation and treatment should be sought.

 

There are many reasons why a dog might experience vomiting or diarrhea. Vomiting and diarrhea could be secondary to something as simple a dietary indiscretion but could be a symptoms associated with a more serious medical conditions, such as a toxin ingestion, inflammation of the pancreas (pancreatitis), an intestinal blockage, or parvovirus. These medical conditions can result in fatality if left untreated.

Animals who have not urinated in 18-24 hours are considered a medical emergency and should be seen by a veterinarian immediately. Urinary blockage (urethral obstruction) is particularly common in male cats, but can be experienced by any animal. Urethral obstructions are life-threatening if they are not treated immediately.

For pets that have not defecated, contact your veterinarian for further instruction. Some cases may be simple constipation; but if your pet has not defecated because they are not eating, for example, evaluation may be warranted.

Paw-chewing can be an indicator of allergies. Just like humans, pets can be allergic to environmental allergens (pollen, grass) and even certain types of foods. A visit to a veterinarian or veterinary dermatologist is likely warranted.

Lethargy is a common symptom of a vast number of medical conditions, ranging from cancer to a simple upper respiratory infection to cancer. If your pet is lethargic, they should be evaluated by a veterinarian to ensure they do not have a serious underlying medical condition.

Pungent odor can absolutely be an indicator of infection, especially in the ear. Certain types of bacteria and yeast produce the odor. Other indications of an ear infection include pawing or rubbing at the ears, head shaking, or discharge from the ears. Ear infections can be extremely uncomfortable. If you feel that your pet has an ear infection, contact a veterinarian as soon as possible to have their ears evaluated.

Allergic reactions typically occur secondary to exposure to an environmental allergen or a bug bite/sting. Mild allergic reactions can results in watery eyes and raised areas of skin (hives). Some allergic reactions can progress to facial swelling, swelling around the airway and difficulty breathing. In the most severe cases, pets can develop a sudden onset of lethargy, vomiting, collapse, and even death, which is known as an anaphylactic reaction. If you think your pet is having an allergic reaction, seek veterinary care immediately as symptoms can progress rapidly.

Excessive drooling can be caused by many underlying conditions such as nausea, an issue with your pet’s teeth, or foreign material stuck in your pet’s mouth or esophagus. If your pet is drooling, they should be evaluated by a veterinarian as soon as possible.

Yes! A large, distended abdomen is one of the most common indicators of GDV, or Gastric Dilation and Volvulus Syndrome. GDV occurs when a dog’s stomach becomes bloated and twists. This results in various types of shock and can lead to stomach necrosis and, ultimately, the death of the patient. GDV is typically characterized by a large, distended and hard abdomen, dry heaving, panting, inability to get comfortable, stretching, drooling, and weakness. Although any dog breed can experience GDV, it is most commonly seen in larger breeds, such as Great Danes, Retrievers (Labradors, Goldens), Standard Poodles, Rottweilers, and Doberman Pinscher.

Dogs that are bloated or experiencing GDV should be seen by a veterinarian immediately. This condition is life-threatening and affected animals can very quickly go from stable to critical. Surgical intervention is necessary for an animal with GDV as soon as possible. Early recognition and intervention has resulted in a positive outcome for a majority of affected pets.

Pets experiencing weakness, uncoordinated walking (ataxia) or inability to stand should be evaluated immediately. These symptoms can be secondary to a potential toxin, metabolic disease (liver/kidney disease), neurologic condition such as spinal cord injury (intervertebral disc disease- IVDD), or orthopedic disease. Common orthopedic problems include torn cruciate ligaments, hip dysplasia, and luxating patellas. Surgical intervention is available for many of these issues, so an evaluation by a veterinary surgeon should be considered. If your pet is experiencing any weakness, uncoordinated walking, or inability to stand, seek veterinary care immediately.

If your pet is experiencing seizure activity, understand that they are not aware of their surroundings during the seizure and can bite you in the process. It is important to protect them from their surroundings and transport them to a veterinary hospital after their seizure activity ceases. You can scoop them up with a large blanket to protect yourself from injury. Seizures are a scary and often unpredictable problem that affects both people and pets. Both cats and dogs can have seizure activity of varying severity. Most seizure activity involves the entire body, where pets fall on their side, are unresponsive, paddle their legs, drool excessively, vocalize, and often lose control of their bowels. Some pets can have seizure activity that is localized to one part of their body (facial twitching, twitching of one leg, etc.). Most seizures are generally limited to approximately 30 seconds to a minute and a half. After the active seizure is over, a post-seizure phase (called postictal behavior) can affect the patient for up to a few hours or a day post-seizure, and includes behavior such as confusion, disorientation, pacing, anxiety, panting, and even blindness in some instances. Due to the wide variety of disease process that can cause seizure activity, including low blood sugar (hypoglycemia), toxins, head trauma, metabolic disease (kidney/liver disease), structural brain disease, or infection/inflammation within and around the brain, diagnostics are recommended to determine the underlying cause. Diagnostics often include blood work, liver function testing and a consultation with a veterinary neurologist for an MRI and spinal tap. After performing these diagnostics, your pet may be diagnosed with idiopathic epilepsy (seizures of unknown origin). Pets with a seizure disorder, should be treated with anti-seizure (anti-convulsant) medication to attempt to prevent future seizure activity. Anti-convulsant therapy will not eliminate seizure activity but will hopefully decrease the frequency and severity of seizure activity. Sometimes pets require multiple anti-convulsant medications to control their seizure activity. Some veterinarians have differing opinions on when to begin seizure medication, but in general if your pet is suffering from more than one seizure every two months, or if they are experiencing “cluster” seizures (two or more seizures in a 24-hour period), it is recommended that you begin medical therapy for seizure control. Many seizure medications need to be monitored through frequent blood work in order to maintain an appropriate therapeutic level of the anti-seizure medication in the blood and ensure the body is handling the new medication appropriately. When first beginning medical management, it can take some adjustment in dosage to find the correct dosing schedule for each patient to sustain therapeutic levels of mediation and ensure the seizures are controlled.

Any form of bleeding is considered abnormal. If your pet is bleeding, contact a veterinary professional right away.

Eye issues in animals present in many ways. Many patients with traumatic eye problems (ulcers, scratches, etc.), will squint the affected eye, and the eye will tear. In other situations, such as cataracts, the problem is recognizable by cloudiness in the eye, or the patient’s loss of vision (bumping into things, etc.). Patients with an acute (sudden) onset of symptoms associated with the eyes should be evaluated immediately. Delayed treatment for some eye conditions could lead to altered healing and long-term vision loss. Patients with a sudden onset of squinting, redness of the eye, cloudiness of the clear portion of their eye (cornea), discharge from the eye, or sudden blindness should be evaluated immediately. These sudden symptoms could indicate trauma to the eye (ulcers, scratched, etc.) or glaucoma and require emergency treatment. Patients with chronic (slow progressive) changes to their eye, such as decreased vision and cloudiness of the lens within their eye (cataracts), can be evaluated by your family veterinarian or a veterinary ophthalmologist. You should schedule an appointment for further evaluation.