Critical Care

Most of our critical patients are getting IV fluids of some sort. Many are getting multiple types of fluids and often get IV medication on a pump as well. This sometimes means having 3 or 4 pumps running at one time to ensure the proper amount of medication and fluids are provided. The pumps ensure accurate and steady fluid administration. The pumps will alarm if they are not functioning properly such as if the pet has pinched the line or if air gets into the line from the IV bag. These pumps ensure that the fluids continue to flow and prevent injury from air in the line or overhydration from too much fluids being administered.

Mild to moderate hypothermia is common in heart patients, geriatric and pediatric patients, post anesthesia and in conjunction with low blood sugar. Additional heat support is often needed to keep pets warm. Sometimes this can be performed by putting a blanket in the dryer and adding warm water bottles to snuggle with. Often this is not enough and we need to use technology to maintain temperature. We have 3 incubators and 2 “Bair Hugger” thermal warming systems to help maintain temperature in pets. The incubators also act as oxygen chambers where we can increase the inspired oxygen level from 18% to 40%. This helps small animals having trouble breathing to relax and breathe easier.

We have ordered a Snyder ICU unit and it should be here in October of 2022. It will have heat support, air conditioning, dehumidifier, and provide oxygen therapy. This can be used for larger dogs that have suffered heat stroke to help cool them down and it can be used for short faced (brachiocephalic) dogs having respiratory distress. One problem with providing chamber oxygen in dogs is they pant and make the chamber very humid which increases heat and prevents heat dispersement from the dog. They can then get a fever and breathing becomes more difficult due to the humidity. This ICU unit will actively cool the air and dehumidify the air to maintain a good environment for them to recover.

Fluid or air can build up in the chest for many reasons. When this happens the lungs can not expand properly and the body can not get enough oxygen or get rid of enough carbon dioxide. To help relieve this, the air or fluid must be removed. This can be done by inserting a needle and removing the air or fluid, however, just removing it once may not be enough. Sometimes a tube needs to be placed to continuously remove the air or fluid being built up. This procedure requires heavy sedation or full anesthesia depending on the temperament of the pet. Special monitoring is required to prevent complications.

Abdominal wounds or perforation of the intestines often require the placement of drains to help remove the fluids that will be created due to inflammation. This type of drain must be placed while under anesthesia and once placed can be left in the body for a long time. The suction part is due to having a “suction grenade” on the end of it which is a plastic bulb that is used to create suction through the tube. Once an animal is stable post surgery, they may be sent home with this type of drain for typically less than 5-7 days.

Oxygen can be provided as flow-by or having an oxygen tube blowing oxygen at a pet, via a nasal canula, or by pumping oxygen into an incubator. All these increase the oxygen amount that can be used by a pet. This often makes the difference in how well an animal can breathe. Improving breathing reduces pain and stress as well as increasing oxygen to the body.

When a pet will not eat we have several options to help get nutrition. The easiest way is to use a syringe and squirt food into the mouth. Other ways to help get nutrition are by placement of nasogastric or esophagostomy feeding tubes. We commonly will supplement nutrition with feeding tubes when pets are not eating well on their own.

Having a pet with fluid building up in the thorax or abdomen is very scary to owners. We see pleural effusion (fluid in the chest) and abdominal effusion (fluid in the abdomen) commonly. Our staff is well trained to perform procedures to remove the fluid by using a needle and syringe to help aspirate the fluid.

When fluid or air continues to build up and an aspirate is not enough, then a tube may need to be placed to allow for continuous removal. We have special tubes and continuous suction machines should they be needed.

We have had a blood bank since 2007 which allows us to collect blood, process it and have safe blood products to administer to our patients. The fact that we process the blood on site and have volunteer donors to obtain the blood from means we get to provide the blood products at a lower price than purchasing it from a commercial veterinary blood bank. The centrifuge used to process the blood is an amazing $14,000 refrigerated centrifuge. The investment into this technology was an easy decision because it allows us to provide blood rapidly and reduces supply chain issues which means we can always have the blood we need on hand. Currently we stock canine and feline packed red blood cells and fresh frozen plasma.