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Read This Now or You Could Be Kicking Yourself for the Next Decade

June 30, 2010 | 17,287 views
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In the second half of this two-part series, Dr. Karen Becker discusses how to decide if you should take your pet to an emergency clinic immediately, or whether the situation is less critical.

Dr. Becker's Comments:

Last week in part one, I discussed a six-step process to help you prepare well in advance in the event you ever need to take a pet to an emergency veterinary clinic.

Those six steps include:

  1. Deciding which emergency clinic to use.
  2. Visiting the clinic, or if that’s not possible, making a phone call to gather specific information.
  3. Deciding how you’ll pay for emergency services.
  4. Learning about any special policies or procedures the clinic has in place.
  5. Creating an emergency file to keep on hand.
  6. Deciding ahead of time how you feel about difficult subjects like invasive procedures, resuscitation, and euthanasia.

In today’s session, I’ll help you decide whether your pet is truly in crisis (needs emergency care) or can be seen by a veterinarian the following day (needs urgent care). I’ll also offer some tips for how to get the most from a trip to the ER.

There are effectively three different scenarios you might find yourself in with a sick or injured pet:

  • Life threatening
  • Life altering
  • Non-life threatening

Emergency Situation #1: Life Threatening

Life threatening emergencies are those with a very grave prognosis. They can often require a decision about euthanasia.

These situations involve, for example, a full body meltdown – perhaps a rapidly failing organ or one that has stopped working completely. Examples might include:

  • Sepsis -- a full body infection
  • DIC (disseminated intravascular coagulopathy) – a bleeding disorder resulting from an infection or autoimmune disease
  • Bloat – a condition in which a dog’s stomach becomes distended and twists around on itself

When you’re at the emergency clinic with your pet, it’s important to learn what’s really going on and what the prognosis is for your animal.

In frightening, emotional situations, your mind may not fully comprehend what’s happening. You may not understand the true seriousness of the situation, or conversely, you may think the problem is much worse than it actually is.

Emergency Situation #2: Life Altering

These are situations in which your pet’s life, and often yours, will be changed in some significant way after recovery.

Your dog might develop intervertebral disc disease. This means one of the discs in his back has ruptured and his hindquarters are now paralyzed. He’ll survive the injury, but he may never walk again.

In this instance full recovery is not possible, and while your dog is still alive, his life going forward will be very different.

Or suppose your male cat develops a blockage that prevents him from urinating. His vet finds a crystallized stone at the tip of his urethra, and the situation requires major surgery to reroute the urethra out the back of the body.

The re-routing has side effects – your cat is now incontinent and will have urinary issues for the rest of his life. This is another example of a life-altering medical situation. You still have your kitty with you, but his life and yours will be quite different from now on.

In these situations, it’s a good idea to ask the emergency veterinary staff working on your pet about all possible outcomes, from best to worst case.

Emergency Situation #3: Non-life Threatening

These situations can be frightening for both you and your pet, even if they’re not life-or-death.

Example: your dog gets loose and into the path of a car. He’s grazed by the vehicle, but after careful inspection, you confirm he has no broken bones. He may have a bit of road rash from the encounter, but he’s up and moving around.

Or maybe your pooch slips, trips or falls during play. She gets a cut or laceration on one of her legs. You wrap the wound and it stops bleeding in short order.

These are examples of non-life threatening situations which require professional care as soon as you can get in to see your veterinarian, but they are not life-threatening.

With proper treatment, your pet will make a full recovery.

Urgent vs. Emergency Care

If your pet needs critical or emergency care, it means you need to get her to an emergency facility immediately in order to save her life.

If she needs help from a veterinarian quickly -- say, within the next 12 hours -- but not right this burning minute, she’s in need of urgent care.

A non-life threatening situation may still require urgent care.

For example, in part one I mentioned Liz, my videographer, and a recent urgent situation with her cat.

Liz’s kitty was having trouble passing urine. She went in and out of her litter box repeatedly. She was in there pushing, straining and crying out. When she emerged from the box, Liz could see she was irritated and uncomfortable.

She was passing some urine, but not much, so there was clearly an urgent-type problem. But there wasn’t a complete blockage, which would qualify as a true emergency requiring immediate attention by a veterinarian.

Liz didn’t need to take her kitty to the emergency clinic that very moment, but she did need to watch her pet very closely overnight and then get to her veterinarian as soon as the office opened the next morning. Liz opted to take her cat in, just to make sure everything was ok.

Some Conditions Requiring Urgent (not ER) Care

  • Limps. Your dog comes in from the backyard and is holding one of his legs off the ground. You try to encourage him to put his foot down, but he can’t or won’t. This is very likely an ACL (anterior cruciate ligament) strain or tear. Your pet needs to see his vet within the next 12 hours, but he’s not going to die from an injury to a ligament. A more pressing issue that may lead you to an ER clinic would be the pain and discomfort your pet has associated with this injury, versus having to have the ligament repaired immediately.
  • Lumps. As you’re giving your dog a massage, you feel a swelling you’ve never noticed before. As long as your pup is breathing fine and behaving normally, there’s no need to rush to an emergency clinic. Make an appointment with your pet’s veterinarian to have the lump checked out.
  • Rashes. A rash that is not progressive – even if it’s an oozing, nasty hot spot on your dog’s belly – doesn’t require a trip to the emergency clinic. Rashes can look angry and just plain gross, and your dog is probably uncomfortable, but you can wait till tomorrow to see the vet.
  • Parasites. One of my Natural Pet clients went to an emergency facility after her dog passed a big ball of tapeworms. It was a disgusting sight, and she was mortified. She didn’t know what to do – she panicked and headed to the ER. The trip wasn’t necessary, as the situation wasn’t critical and could have been easily addressed in a next day appointment at my clinic.
  • Mild diarrhea. If your dog or cat is still active and behaving normally, a case of mild diarrhea is not an emergency requiring immediate attention.
  • Low grade fever. A fever under 104 with some mild malaise or lethargy should be checked out, but a mild fever, with no other symptoms, isn’t critical.

True Medical Emergencies

  • Your pet can’t urinate at all. He’ll probably also be in obvious discomfort and may even start to panic. This means there’s a complete blockage somewhere in the urinary tract and your dog or cat must be seen right away. The inability to pass waste is a life threatening emergency.
  • Unconsciousness/coma.
  • Seizure. Especially if your pet doesn’t come out of it right away.
  • Loss of balance. If your dog or cat can’t right herself or is unable to maintain her balance and is falling over.
  • Changes in respiration. If your pet is gagging, if his mouth or tongue is turning blue, if he collapses and can’t get up, this means he’s not getting enough oxygen.
  • Penetrating wounds to the chest. Deep lacerations or punctures to the chest cavity.
  • Ingestion of known poisons.
  • Uncontrolled vomiting or diarrhea.
  • Uncontrolled bleeding.
  • A fever over 104 and profound lethargy.
  • Bulging eyes and sudden blindness, or any major trauma to the eyes.
  • Burns or injuries in which a bone is exposed.

Neither of these lists is complete, but they should give you a feel for what distinguishes an urgent medical situation from a life-or-death emergency.

If you contemplate possible scenarios before you’re faced with them (and hopefully you never will be), you will almost certainly make better decisions in the heat of the moment.

Tips for Navigating the Emergency Room

For optimum two-way communication, try to remain calm. Think before you speak. Be kind. Realize everyone is stressed – the emergency staff as well as you and your pet, other pets and their owners.

Understand that triage -- the prioritization of patients based on the seriousness of their condition -- is taking place. If your pet has an urgent medical issue but is not in a battle for his life, an animal in crisis will be seen first. This is as it should be.

Once your pet’s condition has been assessed, you may be asked to wait. You are the best person to monitor changes in your pet’s behavior, so ask to wait in the same room with her. Or ask if she’s stable enough to wait in your car with you if the emergency waiting room is chaotic and stressful.

If your pet is crashing or in crisis, the staff will probably take him to another room to stabilize him. This is done because they must focus solely on your pet and cannot answer your questions or concerns at the same time. Again, this is as it should be. Let them get your dog or cat stabilized first.

If it turns out your pet is in need of urgent rather than emergency care, ask what tests and procedures will be needed for a diagnosis. If a diagnosis has already been made, ask what the treatment plan should be. If the diagnostic or treatment plan is lengthy or complex, ask the doctor to rank the various tests and procedures in order of importance.

Other questions you might ask:

  • “If my pet is stable, can we do one test at a time?”
  • “Will the stress of the tests or procedures worsen my pet’s condition in any way?”
  • “Can I care for my pet at home once she’s stable?”

Conclusion

If you find yourself with a sick or injured pet and you believe the problem is serious enough to warrant a trip to the ER, you should follow your instincts.

You know your pet better than anyone else, and if you’re seeing profound or progressive symptoms of a serious illness -- it’s cause for concern. If you left a frisky dog at the door on your way to work, but came home to a lethargic, feverish, vomiting pet – you have cause for concern.

If your cat was fine an hour ago but now has a blue (cyanotic) tongue or mouth and is gasping for air – you should be concerned.

If it turns out your dog or cat is not in any immediate danger, all you’re out is the cost of the visit.

There’s nothing wrong with buying peace of mind, as Liz did, by going to the emergency clinic.

The question to ask is, “Will a visit to the ER dramatically improve my pet’s quality of life?” If your answer is yes, you should take your animal to the emergency clinic.

I hope this series on how to prepare for and handle pet emergencies has empowered you to put a plan in place before you need it.

Remember: preparation is priceless.

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