A Night in the Life of an Emergency Pet Hospital Vet

TV shows often chronicle the dramatic goings-on in the emergency room of hospitals, but what about emergency pet hospitals? Here, Dr. Katy Nelson, an associate emergency veterinarian and a certified veterinary journalist in Alexandria, Va., describes what goes on at such hospitals from her perspective.

How an ER Shift Starts
Nelson says a typical shift in an ER starts and ends the same way: with rounds. “Vets, just like doctors, have to turn over their patients so that the incoming doctor knows all the ins and outs of each case, knows what to watch for, and what the plan is.”

After this work comes what she and some other ER vets call “SOAP.” This stands for “Subjective, Objective, Assessment and Plan.” The acronym refers to many different activities, from fielding owner questions, to communicating with other veterinary hospitals, to handling all of the emergency cases that come through the front door. Some nights, this process goes very quickly; other nights, it goes on and on. “The reality of emergency medicine is that it’s like Forrest Gump’s box of chocolates -- you never know what you’re going to get,” says Nelson. But she says most “emergency types” thrive on the uncertainty.

Cat ER Patients
Nelson says that most cats come into the emergency room for the following health problems: vomiting, diarrhea, urinary problems, respiratory issues and lack of appetite.

“Cats can be very vocal and very physical, so you’ve got to use caution when dealing with them,” says Nelson. “For the most part, they’re just scared, so by dealing with them slowly and with patience, you often can achieve what you need to get done by simply assuring them that you’re not out to hurt them.”

How ER Pet Hospitals Differ From Others
As opposed to a regular veterinary office, most ER facilities stay open for 24 hours, or handle cases after normal working hours. Emergency hospitals are typically more expensive, with care costing about 20 percent to 30 percent more due to higher overhead and higher liability, as well as what Nelson calls “the convenience factor.” As opposed to other care facilities, some ER hospitals would rather that the owner not be in the treatment area at the time of the emergency. This is much like a human hospital, where the family is frequently kept outside in the waiting room.

Reasons to Visit an ER
Because of the ER cost and the often late-night hours, some cat owners try to wait out their pets’ health problems until the morning, figuring that their cats’ usual veterinarians can handle the issues then. Nelson, however, says you should never wait until morning if the following symptoms surface:

  • Respiratory distress. It could be tied to asthma, congestive heart failure or a clot in the lungs, all of which can be fatal.
  • Nonproductive urination. A urinary obstruction can be life-threatening.
  • Vomiting/diarrhea/lack of appetite for more than 48 hours. This can lead to severe and life-threatening liver damage among cats.
  • Ingestion of string or a possible toxin. It’s better to be safe than sorry in such cases.

What to Do Before Going to the ER With Your Cat

Nelson offers the following three tips:

1. Try to bring a copy of the medical records with you (and not just a receipt) so that your ER doctor can have a complete picture of your cat’s history rather than just having to go on your memory alone, which is not always that great during an emergency.

2. Always bring your cat in a carrier. Remember that there will be other pets in the hospital. For your own pet’s safety, having it in a carrier is key.

3. If you know your cat gets aggressive or has required sedation during prior visits, please tell your veterinarian or technician immediately so that no one gets hurt.

Nerves and emotions run high at ER hospitals, so by following such advice, you can eliminate additional hassle. You might also help to save your pet’s life.

Can a Pain Management Center Help Your Cat?

From dealing with bad knees to recovering from a recent surgery, cats nationwide are benefiting from new interest in animal pain management treatments. These veterinary practices specializing in pain alleviation are now available to help you and your cat, no matter the situation, whether you have an elderly cat or one suffering from a more chronic condition.

How the Process Starts
All veterinarians offer pain medications, but you might want a specialist in pain management. If so, and depending on where you live, you might wind up at places like the Animal Pain Management Center in Snyder, N.Y.; The Downing Center for Animal Pain Management in Windsor, Colo.; or at Mountain Ridge Animal Hospital & Pain Management Center in Lafayette, Colo.

Even if you are seeking a second opinion, your cat will likely have to undergo routine blood work and X-rays. “These allow us to see exactly what’s going on,” says Michele Beveridge, practice manager of Mountain Ridge. Cats are notorious for hiding pain and illness. Conversely, some of their behaviors might be misinterpreted as pain. It’s therefore essential to find out the truth behind the symptoms. “We cannot just pass out medications,” says Beveridge. “If medications are prescribed, we also have to run routine blood tests, since each individual handles medications differently.”

Available Treatments
Once a diagnosis is made, one or more pain medications may be prescribed. Alternative treatments are also possible. These could be offered in addition to the prescribed meds. They may include one or more of the following:

  • Acupuncture Small-animal acupuncture care is becoming more common both nationally and internationally. Mark Bianchi, a holistic veterinarian at the White Oaks Veterinary Clinic in Edmond, Okla., is certified to provide veterinarian acupuncture by the International Veterinary Acupuncture Society. “As pets age, natural wear and tear on the joins can lead to pain and reduce a pet’s ability to move comfortably,” says Bianchi. “Pets that have sustained an accident injury may also suffer recurring pain, even after the injury has healed. Pet acupuncture is a natural way to relieve this pain by restoring balance to the nervous system and enhancing a pet’s natural endorphins for pain relief.”
  • Laser Therapy Laser therapy involves a low-light laser that is run over areas of the cat’s body. Doctors now use this kind of therapy on humans too. “It can decrease inflammation, improve blood flow to target areas and may decrease pain,” says Beveridge.
  • Stem Cell Therapy To treat pain and chronic conditions, some veterinarians now also use another carryover from human medicine: stem cell therapy. “It requires a surgical procedure,” says Beveridge. “Fat is removed from the animal’s stomach. Stem cells are harvested from the fat and are then later injected into trouble sites.” Rob Landry, veterinarian and owner of Mountain Ridge, says she has successfully treated both dogs and cats with stem cell therapy.

Cats Can Live a Pain-free Life
Thanks to new therapies and animal pain management specialists, your cat has a very good chance of living a long, healthy and pain-free life. If your cat suffers from a serious illness, sometimes discomfort can hurt the chances for healing. For example, many cat cancer patients suffer from appetite loss after chemotherapy. Bianchi believes acupuncture can help to both relieve pain following cancer treatments and prevent this loss of appetite that often happens. Your cat then has a better chance of eating as usual, keeping your pet’s strength up at a time when fortitude is needed.

Your cat’s behavior might even improve for the better. “Many times, a pet may act out or be aggressive toward other humans or animals because of pain,” says Bianchi. “By relieving the pain, a pet’s natural even temperament emerges, resolving the behavioral problems.”

6 Ways to Keep Your Cat Healthy in 2012

With the turn of every year, countless people resolve to improve their health by losing weight, exercising and more. The vast majority breaks those promises and ends up disappointed. So rather than subject yourself to another year of self-defeat, why not resolve to improve the health of your cat instead? Below are a handful of both timely and timeless ideas to choose from.

1. Assess your choice of cat food. As your cat ages, its nutritional needs will change. “Aging brings with it physiological changes. Some are obvious, others are not,” says Dr. Amy Dicke, a technical services veterinarian for Iams. “Skin and hair coat changes may be obvious, while lean muscle mass loss and digestive or immune system failure may be less evident or hidden.” The science behind today’s cat food has gotten specific enough that there are different blends for almost any situation. Talk to your vet about whether your cat is due for a change.

2. Upgrade your cat’s ID tag. The classic heart-shaped metal collar charm may help your cat get returned if it wanders away, but technology allows for so much more. Dr. Patricia Joyce of New York City Veterinary Specialists says, if possible, to use a GPS tracker that allows you to find your cat wherever it is. Another option is a QR code tag, like those offered by PetQRTag. The tags are the same size as a regular ID tag but are not as constrained by space. They point a person to a Web page that can hold as much information as you’d like to give, from contact info to special medical issues your cat has. As your cat ages and your contact information changes, the tag never needs to be replaced.

3. Hop on the social media bandwagon. Social media sites like Facebook and Twitter can help you diagnose and work through potential health problems. A standout is PetPop.com, where pet owners create profiles and link up. In the PetPop Healthy section, a panel of veterinary experts fields questions from site members and provides advice.

4. Enrich your cat’s environment. Scientific evidence continues to show that when a cat is stressed, it can get sick. The good news is that the same scientific data has now shown that an enriched environment can help prevent illness. “Happy cats are healthy cats, and their environment plays a role in that,” says Dr. Tony Buffington, a professor of veterinary clinical sciences at Ohio State University. “There’s now good evidence for this.”

5. Don’t ignore dental health. According to the American Veterinary Medical Association, periodontal disease is the most diagnosed problem in cats. But it doesn’t have to be that way. “Dental disease is one of the most preventable conditions in veterinary medicine,” says Dr. Katy Johnson Nelson, a veterinarian in Arlington, Va., who is a member of the Iams Pet Wellness Council. Schedule an appointment with your cat’s doctor for a teeth cleaning, and start doing brushing on your own as well.

6. Get pet health insurance. Sometimes even the best prevention can’t stop disease or an accident, and veterinary bills can add up quickly. It can put pet owners in the most difficult of positions: You either set yourself up for extreme financial hardship, or consent to putting your cat down. Health insurance allows an alternative. Thanks to more modest monthly premium payments, decisions to undergo costly procedures are easier to make.

So this New Year’s, let yourself off the hook and make a resolution for your cat. Whether you opt for the tried-and-true or the timely and trendy, following through with just a few of these tips can make a world of difference.

Pregnant Cat Care

Virginia-based veterinarian Dr. Katy Nelson has three words of advice for cat owners thinking about breeding their cats: Don’t do it. “Just because your cat is cute and your neighbor’s cat is cute does not mean they should get together to make kittens,” says Nelson. “You need experience and know-how to breed. It’s not something to be taken lightly.”

Nelson suggests spaying and neutering to avoid unplanned pregnancies. If you do find yourself tasked with the care of a pregnant kitty -- known in the cat world as a queen -- there are important steps you can take to ensure a healthy pregnancy and delivery. Below, Nelson weighs in on how to provide the best prenatal and postnatal care for your pet.

Veterinary Visits

When you first suspect your cat is expecting, it is important that her veterinarian examine her in order to confirm the diagnosis. “Infections to the uterus can mimic pregnancy, with an enlarged midsection and discharge,” says Nelson. “These infections can be life-threatening, so it’s important to rule this out.”

Once your vet establishes your cat is indeed pregnant, her vaccination schedule should be checked to make sure she is up-to-date. “Maternal antibodies last 12 weeks in kittens. They benefit from having a fully vaccinated mother,” explains Nelson.

Queens gestate their babies for about nine weeks. Your cat will see her doctor two or three times during this period. The veterinarian can help you anticipate what to expect during labor, including how many kittens may be in her litter.

Nutrition and Exercise

Because her most pressing need during pregnancy is for more calories, a pregnant cat should be fed a nutrient-dense kitten formula immediately after her status as a mother-to-be is confirmed. She should also have access to plenty of water.

Like a pregnant human, a pregnant cat can benefit from regular exercise. “It’s hard to get a cat to exercise, but present her with toys that she enjoys,” says Nelson. Play with her in ways that keep her moving. If her muscles stay toned, she’ll have a safer labor and delivery.”

Labor Day

In advance, prepare a private, quiet place for the birth to occur, and keep the room warm. “Like human females, a female cat doesn’t want 10 people in the room when she’s in labor,” says Nelson. She suggests providing your pet with a birthing area -- a comfortable bed or box filled with newspapers she can shred. Nelson also suggests a room with a tiled floor to make cleanup easier.

Your veterinarian should speak with you about the signs that your cat is going into labor. “She may become very aloof, or on the flip side, very clingy,” says Nelson. Follow your queen’s lead: if she doesn’t want company, don’t force it on her. “Her hormones are raging. She’s very protective of these arriving babies. Read her body language and take it seriously.” Keep the number of a 24-hour veterinary clinic on hand in case there are labor complications, such as strong contractions without a delivery for more than two hours.

Postpartum

The most important consideration for your new mother is nutrition, specifically a higher caloric intake. She should continue to eat kitten food until her babies have weaned (about eight weeks after birth). “If the litter is more than three kittens, intense nutritional support is in order,” says Nelson. Consult your cat’s veterinarian about how much food she’ll need.

You should also be tuned in to the mother’s overall health. Postpartum cats can develop eclampsia, which results from a calcium imbalance and can be life-threatening. It usually happens within a week of delivery, and signs include shaking, seizures and lethargy. If your cat exhibits these, get her to the vet immediately.

With the right medical and nutritional support, every cat can have a healthy pregnancy and a happy Mother’s Day -- every day.

Who Works at Your Cat’s Veterinary Office?

When you take your cat to the vet, there may be a number of people working there, other than the veterinarian. These individuals can include a veterinary assistant and a veterinary technician, among others. Don’t know the difference? Below, veterinarian Trisha Joyce of New York City Veterinary Specialists explains the roles that these individuals play in the typical office of an animal doctor.

Veterinary Receptionist
There typically is a difference between the receptionist at your veterinarian’s office and the one at your dentist’s, for example. The former likely has a love of animals and some degree of on-the-job training that allows him or her to determine whether your pet needs immediate care. Veterinarians often choose their receptionists carefully, as they are the first to greet every patient that walks in the door. “They are the folks that get your information, find out what’s wrong, and decide if the animal needs immediate care,” says Joyce. They do not need a higher degree, but often use the job as a stepping-stone in order to gain experience and move up in the field.

Veterinary Assistant
Veterinary assistants are trained by veterinarians on the handling and restraint of animals. “Almost anything a veterinarian does with an animal requires two people,” says Joyce. “You can’t place a catheter or draw blood by yourself.” Veterinary assistants help veterinarians and veterinary technicians to keep an animal still during a variety of procedures. They are also often tasked with the housekeeping of the office. “They walk animals, clean cages, do laundry,” says Joyce.

Veterinary assistants receive on-the-job training and are not required to have any particular level of formal education. Some are happy to remain assistants, while others take the job as a means to an end. It can be a good a way to build a resume before applying to veterinary school, admission to which is very competitive.

Veterinary Technician
Veterinary technicians, or vet techs, come in two varieties: licensed and non-licensed. Licensed veterinary technicians spend two years in school and come out with associate’s degrees. After finishing school, they must pass a credentialing exam in order to obtain their license. “It’s very specialized study,” explains Joyce. “They get a good understanding of disease and are trained in doing invasive procedures like inserting catheters.”

Non-licensed veterinary technicians are trained on the job and their skill level varies according to experience. “You can have a fabulous one who’s been working for 25 years and really knows her stuff, or a high school kid who just likes animals,” says Joyce. She acknowledges that the latter can be less than desirable, and notes that it pays to ask your veterinarian whether the techs in her office are licensed, especially if they are assisting in complicated procedures involving anesthesia.

Veterinary Technologist
A veterinary technologist attends a four-year college, graduating with a bachelor’s degree in veterinary technology. Despite this difference in training, they perform the same duties as the technicians in the clinic. “We group technicians and technologists all into one category,” says Joyce. “If you’re going to a four-year college and decide you’re interested in working with animals, it’s a degree you might choose -- though not too many colleges actually offer it. What it really comes down to in the office is still licensed versus non-licensed.”

Veterinarian
After completing a bachelor’s degree, a veterinary student attends four more years of school to earn a degree in veterinary medicine. The fourth year is generally spent working in a hospital or medical practice. Veterinarians are trained in basic science like anatomy and physiology as well as other care like nutrition, diagnostics, surgery and dentistry. It is increasingly common for veterinarians to continue training for at least a year after graduation, and more than that if they want to specialize. “You can spend as long doing your training as you would in med school,” says Joyce.