Basic triage in dogs and cats: Part III

Abstract

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if the ultimate goal is to refer the animal to another facility.

Objective and procedure: The third and final part of this 3-part review article series discusses arrhythmias typical in emergency cases and the approach to animals that are presented with an inability to stand up and walk normally. A stepwise method to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated.

Results: Recognizing and knowing how to treat tachy- and bradyarrhythmias is important in stabilizing a dog's or cat's condition. Understanding how to differentiate the various reasons that a dog or cat is unable to stand on its own allows a veterinarian to both treat and communicate outcome expectations for those animals.

Conclusion and clinical relevance: Do not refer emergent cases before basic stabilization is completed. Many emergency cases can either be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Figure 1

Approach to tachyarrhythmias. CRI — Constant rate infusion; SVT — Supraventricular tachycardia.

Figure 2

Approach to bradyarrhythmias. AVB — Atrioventricular block; UTO — Urinary tract obstruction.

Figure 3

A — Atrial fibrillation. An ECG from a 12-year-old wolfhound dog with atrial fibrillation and dilated cardiomyopathy. Note the tall, upright QRS complexes, irregularly irregular rhythm, and absence of P waves. B — Ventricular tachycardia. An ECG from a 10-year-old golden retriever with ventricular tachycardia. Note the wide and bizarre QRS complexes. C — Third-degree atrioventricular block. A 6-lead ECG from a 12-year-old dog with 3rd-degree atrioventricular block. Note the slow heart rate and P waves not associated with QRS complexes. D — Sick sinus syndrome. A 14-year-old West Highland white terrier dog was presented due to collapsing events at home. Note the tachycardia followed by severe bradycardia with pauses. Images courtesy of T. Gerlach, DACVIM — Cardiology.

Figure 4

Approach to an animal unable to stand or walk.