The changing landscape of veterinary medicine


Tuesday, August 5, 2014 - 08:45

By Alan Green with David Sachs

It gives me great pleasure and enormous pride to introduce this month’s guest writer, Dr. David Sachs. Dr. Sachs is my partner at CVRC. He is also the medical director and the driving force in implementing the many accomplishments in the Center’s never-ending quest for excellence. As you will read about, CVRC has achieved an extraordinary recognition by the Veterinary Emergency and Critical Care Society (VECCS) as one of only six Level 1 centers in the entire country and the only center of its kind in the region. Dr. Sachs and his team deserve kudos for this impressive accomplishment.

Like most professions, the medical field — specifically veterinary medicine — is an ever-changing environment where we have seen significant transformation in the expectations of pet owners and the practice of veterinarians. Although many aspects of veterinary small-animal medicine have changed and progressed through the years, the most significant changes have occurred within the discipline of emergency medicine and emergency facilities themselves.

The past 25 years of these changes have given pets the very best opportunities for favorable outcomes in emergency situations. Much of this progress is due to improved medical technology, advanced research in emergency medicine, increased educational opportunities for veterinarians and the building of veterinary hospitals, which rival many human facilities. A huge catalyst for many of these improvements is the pet-owning public, as their desire to care for their pets in a similar fashion to themselves or loved ones has driven the advance of our entire profession.

Emergency and critical care medicine addresses acute illness or injury. Although many conditions are considered emergencies, some of the more common conditions we see are trauma, respiratory distress, gastrointestinal disturbances, urinary obstructions, neurologic disease, weakness and collapse.

These types of emergencies among our four-legged family members are not a new phenomenon. For as long as people have had domesticated pets, there have been veterinary emergencies. What has changed dramatically is our knowledge of diagnosing and treating emergency conditions. Prior to 1989, specialized training in veterinary emergency and critical care medicine did not exist. Most veterinarians dealt with whatever was presented to them as best they could, but the profession lacked both research in this field and proper facilities to address many conditions.

To improve the care needed for these pets, several veterinary pioneers began a process that culminated in the formation of the American College of Veterinary Emergency and Critical Care (ACVECC). While not a physical college, ACVECC is an organization with an advanced training program, known as a residency, at several veterinary colleges and private practices designed to ensure the information being presented to vets was the most up to date. This information would arm these specialized veterinarians with the diagnostic and therapeutic abilities to take on the most severe and challenging cases.

Around the same time veterinarians were being trained to address these types of emergencies, improved facilities to care for these animals began popping up around the country. These facilities were the first emergency hospitals for pets, and several are still in existence today. Facilities were staffed, and often owned, by local veterinarians who would cover each other’s emergency caseload on a rotating basis. Generally, these facilities were open only when primary veterinary clinics were closed. Restricted hours often presented problems for pets that needed prolonged emergency care.

By the mid-1990s, these facilities began to give way to the larger and better-equipped veterinary centers that we know today. These emergency and specialty facilities are able to offer far more in the way of diagnostics and therapeutics and many are open 24 hours a day, seven days a week. It is not uncommon for these facilities to have specialized equipment such as ultrasound, CT scanners, MRIs, ventilatory support and endoscopic equipment, all in an effort to provide a level of quality rivaling many human facilities.

This past year, The Veterinary Emergency and Critical Care Society (VECCS) took another step in advancing emergency veterinary care. They began a process of facility certification to ensure that extremely rigorous standards were being met. The purpose of this certification is to recognize those hospitals that meet and exceed the Society’s minimum standards and guidelines. The VECCS does this in the hopes of raising the standard of care while also increasing public and professional awareness in the area of veterinary emergency and critical patient care.

To date, only six hospitals across the country have been given Level I certification — the highest level a facility can receive. This includes facilities located in California, Rhode Island and Wisconsin, as well as the world-renowned Matthew J Ryan Veterinary Hospital at the University of Pennsylvania. The Lowcountry can be proud — and rest a bit easier — knowing that Charleston Veterinary Referral Center is one of these six facilities, and the only one in the region.