White Cat with Blue Eyes Lying Down Outside

Critical Care

Overview

The Critical Care service at CVRC works to stabilize and treat critically ill patients requiring ICU level care. This team is responsible for managing the sickest patients in the hospital.

The Critical Care team works very closely with the Emergency service to ensure that the highest level of care is provided from the moment the animal presents to CVRC.

CVRC’s Critical Care service is in the hospital providing care every day, including weekends and holidays.

What is a veterinary Criticalist?

A Criticalist has obtained intensive additional training for specialization in Emergency and Critical Care medicine. The advanced training and education includes a veterinary degree (3 or 5 years of undergraduate university, followed by 4 years of veterinary school), a rotating internship (1 year), and an ECC residency (3 years), followed by a series of rigorous examinations covering all aspects of emergency and critical care medicine for completion of certification by the American College of Veterinary Emergency and Critical Care (DACVECC).

What diseases does the Critical Care service treat?

Trauma
- Hit by car
- Gunshot wound
- Post-operative care
Post-operative care
Sepsis
- Abdominal infection (peritonitis)
- Chest cavity infection
Respiratory
- Labored breathing, respiratory distress
  - Pneumonia
  - Congestive heart failure
  - Acute respiratory distress syndrome
  - Bronchitis
  - Asthma
  - Pulmonary thrombosis
Gastrointestinal
- Vomiting, regurgitation
- Diarrhea
- Esophageal or gastric foreign body
Pancreas
- Pancreatitis
Urogenital
- Urinary blockage
- Urinary tract infection
- Bladder stones
- Kidney disease
- Kidney failure
- Prostatic disease
Liver/gall bladder
- Inflammation of the liver or gall bladder
- Gallbaldder stones
- Liver shunt
Blood disorders
- Anemia
- Low platelets (thrombocytopenia)
- Low white blood cells (neutropenia)
- Immune mediated anemia or polycythemia (IMHA, ITP)
- Coagulation abnormalities
- High red blood cell count (polycythemia)
Endocrine disease
- Hyperthyroidism
- Addison’s disease
- Diabetes mellitus
- Diabetic ketoacidosis
- Hyperparathyroidism
- Hypercalcemia
- Insulinoma
Immune mediated disease
- Immune mediated hemolytic anemia (IMHA)
- Immune mediated thrombocytopenia (ITP)
- Immune mediated polyarthropathy (IMPA)
Infectious disease
- Feline immunodeficiency virus (FIV)
- Feline leukemia virus (FeLV)
- Feline infectious peritonitis (FIP)
- Fungal disease
  - Cryptococcus
  - Blastomycosis
  - Histoplasmosis
  - Aspergillosis
- Mycobacterial infection
- Bartonella infection
- Ehrlichia infection
- Anaplasma infection
- Lyme disease
- Leptospira infection
- Parasites
  - Giardia
  - Coccidia
  - Roundworms
  - Hookworms

What diagnostics does the Critical Care team offer?

Physical exam
Full in-house laboratory
- Hematology
- Blood chemistry
- Urinalysis
- Coagulation profile
- Cytology
- BNP
Full complement of external laboratories for advanced testing
Diagnostic imaging
- Digital radiography
- Ultrasound
- Echocardiography
- Fluoroscopy
- CT
- MRI
Flexible and rigid endoscopy
- Upper and lower GI scoping
- Airway scoping
- Urogenital scoping
Bone marrow aspirates and biopsies
Fine needle aspirates
Ultrasound guided biopsies
Infectious disease investigation – titers, antigens, cultures, e.g.

What treatments does the Critical Care team offer?

In-house pharmacy with full complement of oral and injectable medications to treat disease or symptoms
Dedicated Intensive Care Unit staffed 24/7/365
- Oxygen support
- Advanced fluid therapy
- Continuous patient monitoring
  - ECG
  - Blood pressure: indirect and direct arterial
  - Oxygen saturation
  - Temperature
  - Capnography - CO2 monitoring
Pain Management - multimodal protocols
Nutrition
- Advanced diets
- Feeding tubes
- IV nutrition
Transfusion medicine
- Blood typing and cross matching
- Blood transfusions
  - Whole blood
  - Packed red blood cells
  - Fresh frozen plasma
  - Cryoprecipitate and platelet rich plasma
- On site blood bank and pet donation program
Dialysis services for acute kidney injury (acute renal failure)
- Peritoneal dialysis
Mechanical ventilation