Veterinary Emergency Clinics

By Roxanne Willems Snopek

Most people first become aware of their local veterinary emergency clinic during a medical crisis. Though they often meet their emergency veterinarian under stressful circumstances, owners soon appreciate the level of expertise and dedication provided. More than just an after-hours facility, the care in many emergency hospitals is equivalent to a veterinary ER.

A Win-Win Solution

In the past, individual veterinarians provided after-hours care to their own clients. Many still do, especially in smaller communities. Phone calls to the clinic after regular business hours are relayed to an answering service, which then pages the doctor on call. The doctor returns the call to the client, determines the degree of urgency and, if necessary, arranges a meeting. Obviously, there can be a considerable time lag between the initial call and actually seeing the doctor.

The toll of being “on-call” 24 hours a day, 7 days a week, and the physical demands of sometimes working day and night is one of the primary causes of veterinary burn-out, so some veterinary communities rotate emergency duties among participating hospitals. Sharing cases between two or more doctors can result in better care, but open lines of communication are essential. It’s easy for vital patient information to be lost in the shuffle. Hospital policies and fee structures differ from one clinic to another, also, which can be a source of frustration for pet owners. The desire to provide the best quality service and medical care has prompted many doctors to find a better solution. The answer, for both pet owners and veterinarians, is the emergency only hospital.

Critical Care Specialists

In addition to highly-trained support staff, emergency hospitals are equipped with greater technology than that needed by most general practice veterinarians. This is some of the technology critical care specialists use:

• Oxygen cages, for animals with breathing difficulties
• Defibrillators, to “restart” the heart
• Telemetric electrocardiograph equipment, to measure and assess cardiac function
• Ventilators, to “breathe” for the animals during surgery
• Pulse oximeters and capnography equipment, to determine if oxygen therapy is required

Of course, this high quality of medicine comes at a price. A veterinary examination during regular office hour is around $40 – 50 in most areas. A typical examination fee at an emergency or critical care facility is around $125.

Exceptional Standards

The Veterinary Emergency and Critical Care Society is made up of almost 2000 members. Seventy-five percent of members are veterinarians; the rest are registered technicians and students. In 1999 The American Animal Hospital Association, in conjunction with VECCS, created guidelines for minimum standards of practice, designed to ensure that critically ill animals receive superlative medical care:

• Staffing – one veterinarian and one registered technician must be on duty at all times during the hours the hospital serves. Most emergency clinics maintain a close association with veterinary specialists in case referral services are needed.
• Medical records – a complete record must be kept on file for each patient. A copy or report is also sent to the primary care veterinarian.
• Library – current textbooks and journals should be on premise for reference.
• Communications – primary care veterinarians and emergency personnel should maintain close communication regarding patient care. Transfer of patient information is vital to maintain high-quality patient care, as well as a good working relationship.

Medical Care

Emergency and critical care facilities are equipped to provide a higher level of emergent care than primary care veterinarians are.

They must be prepared to:

• treat cardiac problems with an electric defibrillator, electrocardiograph, and cardiac monitor,
• treat respiratory problems with oxygen cages, nasal catheters, and ventilators
• provide cross-matched blood transfusions
• provide complete laboratory services
• utilize current anesthetic protocol
• treat shock with intravenous infusion pumps for accurate fluid therapy
• treat hypothermia with incubators and circulating water blankets
• provide access to endoscopic and ultrasonic services.

The Downside

Distance and price are two commonly mentioned disadvantages of emergency hospitals. But the biggest one for many owners is the lack of prior relationship. New doctors can’t always understand issues the regular veterinarian may be familiar with. Because they rarely see the same clients twice, communication is vitally important.

Dedication and Drive

Why do veterinarians choose to work 12 – 15 hour days, nights, weekends and holidays? It’s a challenging, fast-paced environment, full of diversity. Not all veterinarians thrive in such an environment, but the satisfaction of seeing animals go from near-death to walking out the door keeps these determined doctors going.

That and a lot of caffeine!

Article courtesy of Suite101.com.