Preparing for a Visit to a Veterinary Emergency Facility

A veterinary emergency facility is a hospital that provides 24-hour emergency veterinary services and care to critically ill patients. These facilities are staffed with a highly trained team--including veterinary specialists, emergency veterinarians, licensed veterinary technicians, trained animal care attendants, and a dedicated receptionist staff--who are available when you need them to assist you during your pet's medical emergency.Veterinary emergency clinics are typically open all day, every day (even on the holidays).

A visit to a veterinary emergency facility differs from a routine trip to your local veterinarian for many reasons; there are no scheduled appointments, wait times can be long, situations are emergent, and costs tend to be higher. Think of it as the veterinary medicine equivalent to a human emergency room. It can be a stressful and emotional time for pet owners (and pets alike), especially if you don't know what to expect. Here are some tips to help you during that stressful time if you decide to bring your pet to a veterinary emergency facility.

What is considered a medical emergency?
It can be hard to judge whether or not your pet is having a medical emergency. Some conditions are not emergencies and can wait to be seen by your veterinarian during regular working hours. The emergency veterinary facility will be happy to see your pet regardless of the condition, but with non-emergent causes you can expect longer wait times as well as a larger expense compared to what it would cost at your regular veterinarian. If your pet is not in critical condition, you can always call your veterinary emergency facility to see if they recommend bringing the animal in for treatment. Keep in mind, if your pet is experiencing any of the following true emergencies, they should be brought in immediately:

• Severe bleeding, or bleeding that doesn't stop within 5 minutes
• Choking, difficulty breathing, or nonstop coughing and gagging
• Bleeding from nose, mouth, rectum, coughing up blood, or blood in urine
• Inability to urinate or pass feces (stool), or obvious pain associated with urinating or passing stool
• Injuries to the eye(s)
• You suspect or know that your pet has eaten something toxic (such as antifreeze, xylitol, chocolate, rodent poison, etc.)
• Seizures and/or staggering
• Fractured bones, severe lameness or inability to move leg(s)
• Obvious signs of pain or extreme anxiety
• Heat stress or heatstroke
• Severe vomiting or diarrhea--more than 2 episodes in a 24-hour period, or either of these combined with any of the other problems listed here
• Refusal to eat or drink for 24 hours or more
• Unconsciousness

An emergency facility will focus on your pet's most life threatening medical conditions. The goal of the doctors and staff is to stabilize the patient, control the ailment and return your pet to a point where they are stable enough to return home and visit your regular veterinarian for further treatment and monitoring. Remember, emergency veterinary facilities do not typically deal with routine vaccinations or stable long-term conditions that are being monitored by your usual veterinarian. Don't worry, your emergency veterinary hospital will send any records from your visit to your usual veterinarian so that they can seamlessly take over case management when your pet has been discharged.


Where does my pet go after they have been triaged?

If your pet is truly having an emergency, the veterinarians will want to stabilize it as quickly as possible. Taking your pet into the treatment room, where all the equipment is located, will be the quickest and most efficient way of ensuring your pet gets the medical attention it needs.

Your veterinary emergency facility has staff that are trained specifically to hold and restrain animals so that procedures can be performed quickly and easily with minimal stress to your animal. This also makes it easier for the veterinarians to examine the patient. You may be wondering why you cannot follow your patient back to the treatment area. Well, interestingly enough, many animals are more cooperative and less anxious when they are not in the presence of their owners; it is for their safety, as well as your own.

Your veterinary emergency facility is filled with employees who are pet owners just like you--many of which have been sitting in the waiting room themselves at one point or another. They understand how stressful it can be to be away from your pet, waiting to hear from a doctor about your pet's condition. Please know that veterinary staff treat your pet like one of their own and your pet is in the best hands when you bring them to a veterinary emergency clinic.

Should I schedule an appointment?
Emergency facilities are open 24/7/365 and are prepared for truly emergent situations that need immediate care from the moment they walk through the doors. As most of these situations are unpredictable, making an appointment ahead of time is not expected or required. However, it can be beneficial to you and the hospital staff if you can call ahead to provide a "heads up" so that the hospital can be optimally prepared when you arrive.

Why do I have to wait?Similar to the happenings of a human emergency room, wait time varies between patients depending on the severity of your pet's illness. On arrival, each animal is triaged by a trained professional who will determine how soon your pet may need to be seen by the doctor. You can imagine that a pet who appears stable may be waiting longer than a pet who comes in that is unstable.

These are not the only factors that play into wait time, however; behind the doors there are a variety of patients who are critically ill or undergoing emergent procedures that are being treated while your pet waits up front. Rest assured, that your pet will be seen and treated as soon as possible. Many veterinary emergency facilities have a wonderful front desk staff who are more than willing to update you on the emergency status within the hospital while your pet is waiting. Do not hesitate to ask them questions!


Why is the cost so high?
When your pet becomes injured, or suddenly develops an acute, life threatening disease, he or she will need prompt emergency care. In addition to the initial emergency treatment, many days of intensive care may be needed for recovery.

When you visit a veterinary emergency facility, you can be assured that they have the most advanced equipment to care for your pet's ailments as well as a group of dedicated support staff and highly trained specialists that are are able to diagnose and treat the most critical and life-threatening emergencies. They do this around the clock, 365 days a year, so operation of this type of facility comes at a price.

The benefit to this type of facility is that your pet gets premium, around the clock monitoring and care when they need it the most. Staff at a veterinary emergency facility are always willing to talk with you about the condition of your pet and work with you on the best course of treatment for the well-being of your pet and you, the pet owner!

How can I prepare for a pet emergency?
A veterinary emergency is not something people are usually prepared for. Much like in human medicine, treatment during an emergency is not inexpensive. We, as humans, are lucky to have insurance to help us, but this is not readily available for our furry friends; however, you can be prepared for a pet emergency with a little creative planning:

• Become familiar with your local veterinary emergency clinic. Know their hours, location, and all policies (including their financial policies).
• Keep your pet's veterinary records in an easily accessible place in case you need to rush out the door with them. It is always a good idea to keep a copy of your pet's current vaccine history in the vehicle as well, in case you are traveling with your pet. 
• Make sure to have a leash and and/or a carrier ready for your pet in an easily accessible area to make transporting easy. Keep in mind that in a true emergency, your pet is going to be painful and typically more stressed than usual.
• Have a credit card with an available balance set aside for these types of emergencies or an untouched savings account.
• Look into pet insurance for your pet. You may have to provide the money initially, but you will be reimbursed a percentage later, reducing the long term cost
• Know what your financial limits are and be willing to consider euthanasia as a last option if the level of care you can afford will not permit a humane recovery and reasonable quality of life for your pet.

The bottom line is that every veterinary emergency facility is stocked with highly trained individuals who specialize in serving animals and the people who love them. They provide support to the local veterinary community at any time of the day or night. Even though your visit to an emergency clinic may be emotional and stressful, know that your pet is receiving the highest standard of care when you need it the most.

Written by Jocelyn Wichtel, DVM

What is an LVT?

Veterinary Specialists & Emergency Services is a 24 hour veterinary emergency and specialty referral facility. We are the only hospital like this in our city--the next closet being 100 miles away and over an hour's drive. This means that we are always busy and require staff around the clock! Our staff is like no other. We are so honored to have such devoted, hard working, and compassionate employees in our facility who work hard for the patients every day.

This is why we are finding ways to say thank you to our staff this week during our annual Staff Appreciation week. We're going to be doing all kinds of fun things to show the staff how much we appreciate what they do every day. It just so happens that this week is also National Veterinary Technician Week! Although we value our technicians and the rest of the staff every day of the year, we like to use this week to honor them for the high-quality veterinary care they execute.

You might want to know what a Licensed Veterinary Technician (LVT), or "Vet Tech", does; well, that can vary depending upon the type of hospital and where the hospital is located. We were lucky enough to get some insider information from one of our vet techs at VSES. Jen has 14 years of experience in the field, and has been a technician with VSES for half of those years! We asked her what it is like to be a technician at an emergency/specialty hospital and her is what she had to say!

 Emergency LVTs working on an IV catheter for this patient.

 You never know what the day will bring when you are an LVT in an emergency/specialty practice. Our emergency technicians generally see and care for some of the most severely ill and injured patients in our area. This means that they have some advanced skills that are not seen in general veterinary practices--such as placing jugular catheters, arterial catheters, urinary catheters (in both male adn female dogs), and excellent venipuncture skills. 

Along with these skills, our technicians are typically working during some very sad and stressful situations because of the nature of the cases that come through our front doors. Patients that have been hit by a car, bloat, urinary obstruction, and dog fights are just a few of the types that we see on a regular basis. The LVTs are then expected to perform all of their tasks--such as drawing blood, placing intravenous catheters, administering medications, taking radiographs, and monitoring breathing and patient comfort--during very critical and chaotic situations. Once patients are stabilized, our technicians get to follow up with after care treatments like monitoring vitals, administering medications, blood transfusions, and general husbandry care. 

Surgery LVTs helping a patient recover after surgical repair of wounds from
a dog fight.

The specialty technicians can have their own similar challenges. In many cases, a critical patient may be transferred to a specialty department for a more advanced look into the problem. In these instances, the staff is typically moving quickly to try and coordinate many of the treatments and procedures between departments in the most efficient way possible so that appropriate care can begin immediately. For general specialty patients that come in on appointments, the cases tend to be extremely complex. This is because patients are typically referred to us by their primary care veterinarian when their doctor feels that the pet requires a board-certified specialist with increased knowledge and experience in a specific area such as surgery, internal medicine, diagnostic imaging, ophthalmology, neurology, or dermatology. 


Simply put, any technician at an emergency/specialty hospital has to know their basic LVT skills and knowledge plus the skills and knowledge needed to work with complex and critical cases. One thing remains equal across all veterinary technicians (and all other staff members) in any field of veterinary medicine: no matter where they work, they all have the same goal to care for and keep patients as comfortable as possible. People in veterinary medicine work for animals. At VSES, we do that 24 hours a day, 7 days a week, 365 days a year. So, we thank all of our staff (and all veterinary staff) for all that they do around the clock to provide care to the animals of the world!

Dog Vs. Dog -- Canine Bite Wounds

Even play time can get out of hand. Remember, play time should
be bouncy and loose. If any of the dogs playing becomes
stiff/rigid, you should intervene before a fight begins.

As an emergency veterinarian I see bite wounds in dogs almost on a daily basis. The severity of these wounds can vary from just small lacerations to serious life threatening injuries. Frequently they involve a larger dog biting a smaller dog and/or multiple dogs attacking another dog. The scenarios where bite wounds occur are a myriad, but frequently occur at dog parks or other areas where people bring their pets to walk or run off leash. They can occur while out walking your dog on the street or even in your own yard. They can also occur among your own dogs. What is important is to know what to do in case your pet is bitten by another dog. There are many factors that affect what the best course of action is, but having your pet examined by a veterinarian as soon as possible after the bite is probably the most important.

If dogs are currently fighting do not try and grab or otherwise touch the fighting dogs as this can escalate things and you may be bitten as well. You can try to distract them with a loud noise such as banging pots or garbage can lids together, spraying with a hose, or try to get in between them by opening a large umbrella or folding chair. Once the fight is over, assess the dog(s) and begin first aid.

If the dog is small, it may be best to wrap them up in a towel or use a muzzle to safely restrain them as to prevent them from biting you; when an animal is in pain, they are more likely to bite in response to being touched. If you do not have a muzzle, one may be fastened with some gauze--a leash could work for a larger dog. If there are any bleeding wounds, direct pressure on the wound is the best to stop the bleeding. Avoid the urge to put anything on or in the wound as most over the counter topical medications such as hydrogen peroxide are not meant to go in open wounds and can cause more harm than good.

Remember, what is on the surface is not the entire
injury. Most often, bite wounds are worse than they
appear from the bacteria and crushing force of the bite.

As stated earlier, the best thing to do is to get your dog to your regular veterinarian or veterinary emergency facility as soon as possible. After your dog has been examined, in many cases, wound exploration under sedation or general anesthesia will be recommended by your veterinarian. I am often asked why we are unable to just clean the wound and put some sutures in it. The answer is that what you see on the surface is just the "tip of the iceberg". Bite wounds, by nature, cause crushing injury to the skin and tissue below. They carry hair, debris, skin bacteria, and bacteria from the biting dog's mouth--embedding them into the tissue. These wounds need to be surgically explored to remove damaged and contaminated tissue and flushed with sterile saline to remove bacteria and debris. Many of these bites will cause large pockets under the skin and may need to have drains placed to prevent fluid accumulation after the wound is closed. Antibiotics and pain medications will likely be prescribed and follow up exams will be rquired to remove drains, monitor healing and remove sutures or staples. Some wounds may dehisce (break down) because some crushing injuries damage the blood supply to the skin and this may not be apparent at the time of the initial injury. Repeated surgery and/or open wound management and skin grafts may be required for more severe wounds.

In summary, bite wounds in dogs are one of the more common injuries seen in veterinary practice. They can happen in almost any scenario imagined, have a wide range of severity and often need to be surgically explored to asses/treat the damaged tissue under the skin. Examination by a veterinarian is recommended in almost every case and frequent follow up to monitor healing.

Written by Joseph Wilder, DVM, DABVP