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602 Cards in this Set

  • Front
  • Back
In Washinton, who is able to be a vet?
Anyone who is authorized by the state. Must meet certain requirements.
Who can be a vet tech?
Anyone who meets wa state requirement. Must pass state exam as well as national board.
Who is the unregistered vet assistant?
Someone without paper proof of qualifications. Anyone not a dvm or lvt.
Who is a supervisor?
DVM or LVT, based on the situation.
Immediate supervision is what?
If the DVM or LVT is within audible or visual range of the patient while vet asst is working on patient.
Direct supervision is what?
The DVM has performed exam and is in the building.
Indirect supervision is what?
DVM has examined the pet and given orders but is no longer in building.
Things vet asst can NEVER do?
Anesthesia!!
Things that vet assts can do under immediate supervision?
Tissue handling and prep; Instrument handling in aseptic technique.
Things that vet assts can do under immediate supervision of LVT?
Handle blood; lab stuff-- hematology, skin scrapings, microbiology, serology.
Things that vet assts can do under direct supervision of the DVM?
Monitor vitals of anesthesized patient; euthanasia, suture removal, dental cleaning, Provide immunological agents of vx including rabies; enema; remove fox tails or porcupine quills.
Things that vet assts can do under direct supervision of DVM or LVT?
Apply bandages; ear flush; EKG; IM and SQ injections; test prep and interpretation like snap tests. Radiology; rectal contrasts- barium
Things that vet assts can do with indirect supervision?
Give oral meds; topical meds; urine and fecal collection; oxygen therapy, behavior consult; dietary consult
What can a vet asst do when in an emergency?
1. Apply tourniquet or pressue wrap.
2. Administer resuscitating oxygen
3. Open airways, including intubation, but no trachs.
4. Apply external supportive treatment to stabilize body temp.
How to react to the aggressive/ threatening dog:
Stop!
get help so that situation doesn't deteriorate.
Restraining the dog involves what?
Respecting the dog's relatively high IQ and the dog itself
Describe the happy dog:
Wagging tail; tongue out; loosely back ears; licking; jumping
How to react to the happy dog:
Relax-- chill out.
Soothe dog by talking to it.
Describe the neutral dog:
Benevolent; relaxed body; ears are high on head and alert; head is high; tail may hang loosely; watches you.
Handling the neutral dog:
Stay calm; confident; moderate tone of voice; keep watching.
Describe the aggressive/ threatening dogs:
Erect forward ears; tail standing up straight with brief vibration, raised hackles, lip curling, baring teeth; may or may not growl, may drop head and lower body and make eye contact.
Describe the defensive/ submissive dog:
Ears laid back flat; tail between the legs; may or may not bare teeth; may not whine; nervous lip licking or salivating; fight or flight stance; anal glands can release; urination; unpredictable.
How to handle the defensive/ submissive dog:
Remove the dog from the chaos; ask the owner for the leash; take to a quiet room; kneeling to be a dog's lever without making eye contact; use a soft voice; allow dog to sniff you.
What to know about cats prior to handling them?
Tend to be nocturnal; do not have personalities that are not easily defined.
Describe the happy cat:
Purrs;
Eyes are normal (unless cat is sick);
Whiskers tend to be relaxed;
Rubbing face-- marking.
Describe the angry cat:
Ears flat back;
big eyes;
vocalizing;
wants to hurt you;
hair stands on end.
Describe the frightened cat:
Want to "flight";
wide eyes;
twitchy ears (use ears to judge what is going on);
Handling the frightened cat:
Care for it in a quiet room.
Describe the Hunting/ Playful cat:
Between the angry and frightened cat.
Tails of the cat
Happy: swaggering tail
Angry: twitching, tapping, bristling
Frightened: tucked, curled and kind of flattened
Hunting: all the above behaviors, or maybe none at all.
How to lift a small dog?
1. Squat beside the dog
2. Place 1st arm under neck.
3. Place 2nd arm under abdomen-- as far caudal as possible.
4. With a straight back, stand up.
Lifting/restraining a large dog:
Forklift method:
1st arm goes under as far cranial as possible.
2nd arm goes as far caudal as possible.
Lift with knees.
40-60# dogs
How to restrain a larger dog:
Use 2 people. One person takes the front, the second takes the back.
3 types of canine restraint:
1. Oral restraint
2. Physical restraint
3. Chemical restraint
Oral restraint: canine
Not very effective.
Speaking to the animal, used to get dog's attention. EG NO!! or Ask the dog to sit down.
Physical restraint: canine:
Lateral, ventral or dorsal recumbancy
Chemical restraint: canine:
When physical restraint is not enough:
behavior
rads
health/pain of animals
reduce stress if stress will be detrimental.
Drugs used for chemical restraint of dogs:
Ketamine
Acepromazine
Ketamine
Injectable,
stings if given IM
Works well
Acepromazine
Cheap
therapeutic margin
pill or injectable
works well
How to approach a submissive dog and restrain:
1. Give verbal command to establish relationship: use oral restraint. Dog may sit and seem happier
2. Squat and allow dog to sniff you. If dog growls:
3. Have dog and owner reenter room OR allow a break. If dog is still unhappy:
4. Ask owner to muzzle dog.
How to identify a "bad" dog:
It wants to eat tech as tech enters room.
What considerations should be given to older dogs while restraining?
Treat special- can be fragile.
Use non skid mats
May not be able to use chemical means. If dog becomes upset, exam may be over.
Table Restraint: Sternal Recumbancy
Dog sits, stands or lays down sternally.
1st arm goes around neck.
2nd arm holds the body.
Table Restraint: Lateral recumbancy
"siding"
Dog is on side or on ground.
front arm is laying over neck (gently) and holding bottom paw, holding top paw forward by crossing with bottom leg.
Tech applies pressure with body and uses other leg to hold back, bottom leg. Again- use bottom leg to hold top leg still.
Restraining aid: Gauze muzzle
Use only as an interim muzzle. Useful when dealing with aggressive dogs to initially muzzle. Change to leather or basket after.
Restraining aid: Muzzles
Leather or basket style.
Don't break.
DON'T LEAVE MUZZLED PET UNATTENDED
Dangers of muzzles
Breathing- or not being able to breath.
Overheating
Vomitting
What restraint is used for jugular stick
Sternal recumbancy-- by laying on side the increases from the heart into the vein.
What restraint is used for the saphenous vein
Lateral recumbancy is bast choice
What restraint us used for the cephalic vein?
Sternal is most common, but any way can be done
2 types of feline restraint
1. Physical
2. Chemical

Verbal will never work on a cat!!
Cat restraint aids
1. May anger cats even more!!
2. Cat Bags
3. Towels
4. Scruffing
Cat bags:
Canvas bag, enclosed with velcro or zippers.
Can be used with rhythmic pressure to calm cat.
Cephalic restraint of cat:
Used mostly for catheters.
Scruff cat.
Hold front leg and roll the vein on the sternal recumbancy.
How to hold for femoral vein stick?
Lateral recumbancy
How to do a jugular on a cat?
See p 67 of mccurnins
Stretch the front legs over the table edge.
For the head: palm over face, and wrap fingers around and grab jaw or cheekbones.
Lateral Recumbancy
aka STRETCH-- if you know how to do this, you're valuable.
Scruff cat.
Grab hock with other hand and do finger lock.
Lay on side and then stretch around body.
Chemical restraint of cats:
Ketamnine
Acepromazine
What is the SOAP method?
Charting technique used to organize the file.
S of SOAP
Subjective
What the owner says, reports.
O of SOAP
Objective:
Quantifiable measurement: TPR, weight, etc
A of SOAP
Assessment:
Lab results, exam results,
P of SOAP
Plan/ Prognosis: Outcomes.
Bed rest, Rx, etc
Dog Nail Trim
Goal: not to trim quick.
Trim tip of nail, then look from the end to tell how close to the quick you are.
What does the dog toe nail look like?
The further away from the quick, the nail looks flaky. The closer to the quick, it looks waxier and shows a needle size point at the start of the quick
What is the quick?
The inner cavity of the toe nail, which includes the nerve and blood vessel.
How do cat toe nails grow?
They grow in sheets. The outer layer can come off, revealing a new, sharper nail.
The quick is much shorter on a cat.
What are anal glands?
Reserve for secretions used to scent and lubricate fecal matter. They are located in the 4 and 8 O'clock positions in the anus, just inside the anus.
What's the easiest way to tell when a dog needs it's anal glands expressed?
It sits down and scoots on it's rear end.
What happens when the anal glands become full?
Full anal glands need expressing. If not done, they can become impacted. This can lead to infection. This leads to abcess.
What happens with abcessed anal glands?
If not treated, they rupture. Usually the rupture goes towards the outside of the anus, since it's designed to release out the anus normally.
Internal Anal Gland Expression
Glove hand and lubricate fingers. Place index finger into anus and palpate and 4 and 8 o'clock. Use thumb as counterweight, apply pressure and milk outwards. Then switch, use thumb internally and finger externally to get to other side.
External Anal Gland Expression
Squeeze the bums together.
Not very efficient.
One handed pinch method.
Rules of ear cleaning:
1. Must examine prior to cleaning.
2. If tympanic membrane is ruptured- very limited cleaning.
3. Never use Qtips in ears
Ear flush or lavage: Tools
Ear bulb
syringe
Bottle
How to clean ears?
Open ear flaps, if needed.
Insert syringe (ear bulb, bottle) and point downward. Instill cleaner. If you hear squishing in ear, it went far enough. Rub ears. Allow pet to shake head- this gets big debris out of the ear.
Why pluck ears?
Hairy ears trap debris.
Ear plucking is therapeutic: allows oxygen in, allows debris out.
ADR
Ain't doing right:
usually acceptable when pet is not doing well overall.
A new client comes in because cat is vomiting, having diarrhea and circling. What's the first step for LVT?
S: V, D, circling
then :Start a conversation:
hx of sx
Records
diet
indoor/outdoor
change of behavior
How many other pets and how are they doing?
New changes in cat's life?
What is involved in the O stage of appointment with the v, d, circling cat?
O: objectives
TPR
MM
Mentation
TPR
Temperature,
Pulse
Respiration
MM
Mucus membrane:
prepuce, vulva, anus, eyes, most commonly the gums.
Pink is ideal; blue is bad!!
Mentation
mental state (attitude)
B vs Q
A vs L
R vs N
B vs Q
animal is Bright or Quiet
A vs L
animal is Alert or Lethargic
R vs N
Animal is Responsive or Non- Responsive. Can be C (comatose)
BAR
Bright, alert and responsive
Taking Temperature
Usually rectal.
Problems: May cause bm.
Feces may change temp
Thermometer needs to pass both anal sphincters.
Why is feces a concern when taking temperature?
If the thermometer is inserted in feces, the feces can cause a lower reading. Feces can be cooler than the body. Need to evacuate colon and retry.
How to determine the respiration rate of a pet in the exam room?
Listen to chest if possible, using stethascope.
Can count visible respirations from across the room.
How to figure the respiration rate?
Count the respirations for 15 seconds, then take that amount and multiply by 4.
How do you count rr of dog that is panting?
You don't, just write panting in the file.
How to listen for RR of hospitalized pets with iv fluids?
Must auscult with a stethascope.
Pulse
HR (heart rate)
Where does the pulse get taken?
On the femoral artery, on the back leg. Feel for artery on inside of back leg, by feeling for a dent between 2 muscles.
How does the HR get counted?
Same as the pulse.
count for 15 sec then multiply by 4
Order of operations for objectives:
1. respiration
2. Pulse/hr
3. Temp
MM
Mentation
What is the lacrimal duct?
The opening that allows tears out.
What is the lacrimal gland?
The lacrimal gland produces tears.
What is a lacrimal gland flush?
It is when you flush out the lacrimal gland with a syringe and catherter.
What is the Schirmer tear test?
It tests the lacrimal gland and tear production.
Checks for dry eye.
Who gets dry eye a lot?
Cocker spaniels
Explain the Schirmer test.
It is a piece of paper that is placed in the eye. It's tab is folded down and sits between the eyeball and eyelid. It wicks up moisture.
Time it for 30s. then read results. DO NOT PLACE EYEDROPS PRIOR TO TEST
What is the fluoresence test and what does it do?
The fluorescence test consists of an eye stain that checks for corneal ulcers.
How do you perform a fluoresence test?
Place a drop of saline on the dye portion of the test strip. Then place on eye briefly. Flush eye then examine under woods lamp. Injuries glow.
How do you perform a flourescence test?
Place dye strip into syringe then instill drops in eye. Flush eye to make sure dye uptake is real, then use woods lamp to look for glowing ulcers.
Why would the nose glow?
If the duct between the eye and the nose is healthy, then nose should have glowing fluid escape nose.
What is Schiotz tonometry?
A tono pen that is used to test interoccular pressure (dx glaucome)
What is a concern when testing with a tono pen?
Requires gentle restraint, otherwise artificial highs can occur. Careful of jugular restraints.
How to perform schiotz tonometry?
1. Calibrate pen
2. Bounce tip against the eye, towards the iris (not on cornea or sclera) several times until pen tells you to stop. Will give pressure reading and %error reading.
How to instill eye drops?
Muzzle may be warranted.
Don't let dog see the bottle, bring in from behind.
-with available hand, hold eye lid open.
-with 2nd hand, from a distance, drop meds in eye.
Does the tip of the bottle ever go near the eye?
NEVER!!!
How to instill eye ointment.
Restrain animals like you would for eye drops.
Squeeze out ribbon. Drag over and from behind behind. Touch ribbon to eye. Never the bottle.
sample history ? for general body system
How is your pet's attitude? Is it interested in the family? Is you pet playfule?
Sample history ? for integumentary system:
Is your pet scratching, licking, or biting excessively? What do you think of your pet's hair coat?
Sample history ? for respiratory system:
Is you pet coughing or sneezing? is there any nasal discharge?
Sample history ? for cardiovascular system:
has there been a change in your pet's activity level? do you exercise your pet reagularly, and if so, have there been any changes in the amount of exercise your pet will tolerate? Does your pet cough?
Sample history ? of the gi system.
Has there been any vomiting? How is your pet's appetite? Have there been any changes in the stool character?
Sample history ? of the urinary system.
Has there been a change in the urinating habits of your pet? Do you think your pet drinks the same amount of water as before this problem started.
Sample history ? of the musculoskeletal neurologic system
Have you noticed any lameness?
Sample history ? of the neurologic system
Does your pet seem alert and aware of its surroundings? Is your pet weak or unable to support weight?
Sample history ? of the special senses?
Does you pet see sufficiently well? Does your pet hear normally?
T or F: Under "emergency situation" an unregistered assistant may legally tourniquets and/or pressure bandanges to control hemorrhage (bleeding)
True
T or F: It is safe to reach for, grab or pet a dog in a threatening posture.
False
T or F: Cats respond well to verbal commands like "NO"
False
T or F: Tail wagging can indicate either a happy dog or an aggressive dog, and therefore tail wagging is not always a safe indicator of a friendly dog.
True
T or F: A happy cat will always wag its tail.
False
T or F: It is never lawful for an unregistered assisstant to perform surgery.
True
T or F: A muzzle should be removed innediately if an animal has difficulty breathing or starts to vomit.
True
T or F: A poorly made muzzle leads to a false sense of security and the possibility of one's being bitten by the dog
True
T or F: Unfamiliar surroundings may startle cats; they may feel more secure if they can't see whats going on.
True
T or F: According to Wa State law "immediate suprevision" means the supervisor (DVM) is in audible and visual range of the animal patient and the person treating the patient.
True
T or F: As long as an animal has had an exam by a DVM and orders have been written or verbally communicated, unregistered vet assts can lawfully perform some treatments, like giving oral meds, without a DVM in the building.
True
T or F: Sheep are easily separated from the herd.
False
T or F: Guinea pigs are not known for being mean.
True
T or F: Rabbits do not stress easily.
False
T or F: Under the correct supervision an unregistered assistant is allowed to administer Immunological agents including Rabies vaccine.
Ttue
Who has horns and know how to use them, causing injury by head butting?
Goats
How should a Vet Asst should remove a calm feline patient from its carrier?
Tilt the carrier with the door open until gravity helps the animal slide out, or take the top off the carrier and lift the cat out, or place a large towel near the front of the carrier to catch the cat as he is encouraged to exit.
Are unregistered assistants allowed to induce anesthesia?
No.
Dogs displaying a threatening posture would be best restained by which method?
Chemical restraint
Why is it improtant to support a rabbits hind legs when retraining?
The rabbit might kick it's rear legs and cause severe injury to it's spine.
What is the primary information the vet tech attains in the exam room?
History and Temp
What is the primary information the vet tech attains (and tracks) in the treatment room?
TPR
Mentation
MM
CRT
How is mentation charted?
BAR--> great
QAR--> okay
QLR--> Document and verbally inform doctor
QLN--> Becoming an emergency, also describe behavior
How are MMs charted?
Pink--> ideal
Blue--> cyanosis
White--> shock, anemia
Yellow--> Jaundice
How is the CRT charted?
Less than 2 seconds, WNL
More than 2 seconds.
What is the normal range of respiratory rate of dogs?
16-24 BPM
What is the normal range of respiratory rate of cats?
16-30 BPM
What is the normal range of heart rate/ pulse in dogs?
70-180 BPM
Smaller dogs can go up to 200 BPM
What is the normal range of heart rate/ pulse in cats?
160-240 BPM
What is the normal temperature range in dogs?
99.0-102.0
What is the normal temperature range in cats?
99.0-102.5
When giving an injection, the bevel side should face which direction?
Up.
How and when should oral meds be given?
Meds go through the gi tract.
Do not give to animals that are vomitting.
What is parental administration of drugs?
Any injection method.
Describe subcutaneous injection method.
SQ or SC. Given with 22/25 guage needle.
Injection under skin, commonly between shoulder blades (dorsal l or r). Bulk fluid admin.
How much fluid can be given SQ?
Up to a liter in large dogs, although it requires an 18 guage needle.
How fast do sq fluids absorb?
Usually within 6-8 hours.
Explain the intramuscular injection.
IM, given in the lumbar muscle pads only-- wings of the pelvis; or biceps femoralis watch for sciatic nerves. Inject cranially in muscle. Use 22-24 guage needles.
Give on 2mL in the site. Pick 2 sites if more needed.
How do we give IM injection?
Stick in injection, then aspirate back to check for blood flash prior to pushing drugs.
Use 22-24 guage needles. Hold cranially.
What is the intravenous injection?
An injection given through the IV catheter.
IV
How do we give IV injections?
Wipe hub of catheter with alcohol.
Treat sterily.
Insert needle into port.
Draw back- check for flash of blood.
Must inject slowly
Where is the best place to find a good pulse on a horse?
On the facial artery.
What is colic in horses, and other animals?
General term for stomach pain.
Reasons: Dehydration, twisted stomach, intestinal rupture.
Don't allow animal to roll over.
What are intraperitoneal injections?
Used on pocket pets and rats.
Given between the muscle wall and the intestines.
IP
What are intracardiac injections?
Goes into the heart. Used in research, euthanasia, emergency situations.
IC
What are intratracheal injections?
Go through the intubation tube. Used in emergency situations.
What are Intraocceous injections?
Go directly into the end of long bones, delivering meds to bone marrow. Used in neonates. High urgency aseptic technique. IO
What bones are used for IO injections?
Femur, tibia, humerus
What are intranasal injections?
IN.
Given nasally.
Bordetella is most common.
What are intra arterial injections?
IA
Goes into the artery.
Not common.
What are intradermal injections?
ID.
into the skin.
Used for local anesthesia (ring block)-Lidacaine used.
Allergy testing.
How do we know that the ID injection is in the right place?
It forms localized blisters. Will have resistance when injecting stuff.
What causes abnormal fluid loss?
Vomitting
Diarrhea
Bleeding
Disease accompany pu (kidney failure, diabetes, etc)
Chronic or acute illnesses that cause fluid loss.
How do you quantify dehydration?
Weight loss within span of a few hours or a day.
Skin turgor; skin elasticity.
Moistness of MM.
HR; CRT
What is skin turgor?
Dehydration test. Grab a patch of skin and see how long it takes for it to go back down.
What is tenting?
When an animal is dehydrated, the skin doesn't go down easily when skin turgor is tested.
What are the approximate degrees of dehydration?
Less than 5%
5-6%
7-8%
10-11%
12-15%
Describe 5% or less dehydration.
Virtually undetected on exam.
Describe 5-6% dehydration.
Mild turgor, slight dehydration.
Describe 7-8% dehydration.
Definate increase of skin turgor.
CRT: time increases between 3-5s.
Dry mucus membranes.
Describe 10-11% dehydration.
Definate skin turgor.
Eyes sunk in and look gaunt.
Increased CRT.
Dry MM
HR and RR increases.
Cold limbs.
Possible sign of shock
Describe 12-15% dehydration.
Death is coming.
Shock.
Lethargic.
PCV will be increased since there are the same number of cells but not as much volume.
What are contraindications of fluid therapy?
Pulmonary contusions.
Existing pulmonary edema.
Brain injury.
Congestive Heart failure.
What are signs of overhydration or "fluid overload"?
Reslessness; increases respiratory rate; increased lung sounds; increased blood pressure; pitting edema; increase in urination; increased weight.
What are the routes of hydration?
1. Oral
2. Subcutaneous fluids.
3. IV fluids
Describe oral rehydration.
Used for less than 5% dehydrated.
Leave a bowl out.
Use a syringe.
Nasogastric tube or nasoesophogeal
What is the contraindication of oral rehydration?
Vomitting.
Describe using subcutaneous fluids for rehydration.
Only for 5-6% dehydrated.
not adequate for higher % of dehydration.
What kind of fluids for SQ fluids used in rehydration?
Isotonic only. Balanced with the body for sq fluids.
Dextrose and other ions go sq.
Why can't hypotonic fluid be used to rehydrate?
Body loses ions into the fluid, since fluid isn't balanced. Has too few ions.
Why can't hypertonic fluid be used to rehydrate?
Ions inside the fluid are greater than the ions outside. Bad.
What temperature should the isotonic sq fluid bags be?
About body temperature.
Describe using IV fluids for rehydration?
Preferred method for dehydrated pets (7%+).
Goes in through the IV catheter.
Extremely improtant to follow aseptic technique.
IVs are good for 3 days.
What are the fluid types?
Crystalliods and Colloids.
Describe Crystalloid fluids.
Isotonic, electrolyte solutions.
Most commonly used by rDVM.
Lactated Ringers, Normasol.
Given IV or SQ.
What are lactated ringers?
LRS.
0.9% saline
"normal" saline.
physiological saline.
What is Normasol?
Norm-R
Similar to LRS, but with different electrolytes.
Describe Colloid fluids:
Contain proteins or starches that can be used for Metabolic purposes.
stay within vascular spaces
Only IV
Can be used on animals with pulmonary adema.
Good for hypoproteinemia patients.
What are 2 Colloid fluids?
1. Plasma
2. Hetastarch: comon for rDVM to keep since it has a long shelf life.
What is the most common reason to perform an enema?
Flushes feces when animal is unable to.
Most common: feces are too hard.
How is an enema performed?
A red rubber catheter is attached to a large bore tip syringe. Catheter is well lubed and inserted well into colon and discharged.
Why would x-rays require an enema?
If colon is full during an xray, then the feces can block the view of organs and bones.
Describe a nasogastric tube:
small gauge red rubber tube.
Placed at start of nares.
Goes into distal esophagus.
Must follow aseptic technique with sterile technique..
Done to dogs and cats.
AKA: nasal esophogeal
What size red rubber tubes are used in nasal gastric feeding tube?
3.5 French (most common) to
8 fr (bigger). 18 is huge.
What are some pros of the nasal gastric tube?
Inexpensive
Non invasive
quick
readily available equipment
What are some cons of the nasal gastric tube?
Often poorly tolerated.
Tubes are so small that food gets stuck or is hard to push through.
Can cause vomitting- tube can become dislodged. Also, Nauseaus pets will V more.
Can cause aspiration.
Describe an oragastric tube:
-Typically used in neonate and GDV (bloat) decompression.
-goes from mouth into esophagus.
-Can be used on small animals.
-short term administration.
-while a good idea, aseptic not required.
-use large tube: will be less likely to enter lungs.
What are the pros of using an oragastric tube?
1 time ER use.
What are the cons of using an oragastric tube?
Chance of aspiration is high. The tube will be full when removed.
Describe the esophagastronomy tube:
Surgical procedure.
Goes from outside of body into the esophagus. Use 16fr on cats, 20fr on dogs.
What are the pros of using an esophagastronomy tube?
Relatively inexpensive.
Large tube.
Tolerated well.
Aseptic technique.
What are the cons of using an esophagastronomy tube?
Invasive.
Can cause chronic changes to the esophagus.
May cause V
Describe the gastronomy tube:
Invasive, sx procedure.
goes from outside the abdomen into the stomach.
What are the pros of a gastric tube?
Large size tube.
Typically well tolerated.
What are the cons of a gastric tube?
Expensive.
Needs special equipment.
Invasive.
Peritonitis (infection between stomach and lining)
Feeding tube care for indwelling tube:
Not for orogastric tubes.
Relatively low maintenance
SX site: keep clean and dry.
How to use a feeding tube to feed?
Always verify tube is in.
Start by inserting 1-2mL of water in tube. If coughing/choking- get doctor. If no coughing/choking then add food. If food stops moving, thenk stop and unclog.
After done feeding, clean with 2-5mLs of water.
What kind of food should be used in feeding tubes?
Should be a blended, watered down food.
Often A/D
What cleans out a feeding tube nicely?
Coke. Check with hospital protocol.
Often used for daily cleaning and to prevent blockages.
What is a canine male urinary catheter?
Used to collect urine.
A tube is placed to allow urine to escape.
Used on immobile dogs.
What do you need to perform a canine male urinary catheterization?
Sterile catheter: 3.5-10 fr.
Sterile lube
Sterile syringe for urine collection.
What is the procedure for canine male urinary catheterization?
Modified lateral recumbancy: with top leg pulled back out of the way.
Retract the prepuce to find the glandular penis exposed.
Catheter is inserted into urethra.
What is the procedure for feline male urinary catheterization?
Modified stretch postiion: will hold top rear leg up and out.
Use special short tomcate catheters (6") and usually 3.5fr.
Expose penis and insert catheter into bladder via urethra. Aseptically
Describe manual expression of urinary bladder:
ID Bladder location by palpating from the ribs- back and up.
Apply gentle, constant, steady pressure anound the more cranial end and press up and back a little.
Bladders can rupture- be careful!!
Describe a cystocentesis:
Needle in to the bladder to collect urine.
Describe the procedure of a cystocentesis:
Dorsal recumbancy, often with 2 people in a vee tray.
Large syringe (6mL)and large (1.5") needle.
Tech applies alcohol to clean abdomen, cysto is performed.
How to prep skin sterilely:
Animal is under anesthesia.
Prep outside surgery site.
Use 40 blade on clippers.
Vaccuum afterwards.
How to clip hair for surgery?
40 Blade clippers:
-take hair down to skin.
-can cause razor burn
-anything that cuts hair will also cut skin: careful.
What is "dirty scrub"?
Scrub until gauze is white with no sign of dirt.
Rotation Scrub.
Move animal into surgical suite.
Repeat rotation scrub.
Finish with antiseptic spray.
What is the rotation scrub?
-Start with "soap" based cleaner. Scrub and scrub from center out. Work up good lather.
Scrub with water based scrub or alcohol: scrub to remove soap from center out.
Repeat 2 more times.
What are the antiseptic sprays?
Iodine, betadine, or chlorhex solution.
Contaminated wound: describe what it is.
Every wound, initially.
Elicits no response from the immune system.
Contains microbes.
Non pathogenic
Infected wound: describe what it is.
Microorganisms invading tissue causing immune system response.
Will present about 12 hours after injury occurs.
What are the signs of an infected wound?
Swelling
Redness
Discharge
Heat
Fever
Pus
Pain
Odor
Neutrophilials
Necrosis
What are the 4 phases of wound healing?
1. Inflammatory phase
2. Debridement phase
3. Repair phase
4. Maturation phase
Describe the inflammatory phase of wound healing.
Begins right after woulnd occurs.
-Vasoconstriction
-Vasodialation
-clot dries out, leaving a scab.
What is vasoconstriction?
Occurs immediately.
Minimizes bleeding.
What is vasodilation?
Occurs within minutes after injury.
Cells adhere to vascular endothelium.
Within 30 minutes: WBC arrive.
Monocytes are key for healing.
Neutrophils die off and monocytes take control.
Describe the debridement phase of wound healing.
Starts about 6 hours after inflammation occurs.
Neutrophils and monocytes start working.
WBC create exudate (pus)
What do the neutrophils and monocytes do during debridement?
Start breaking down:
Foreign matter
Necrotic tissue
Bacteria
Describe the repair phase of wound healing.
Delicate stage when wound is most delicate.
Occurs 3-5 days post injury.
If debridement goes well, then this phase arrives earlier.
Fibroblasts produce collagen.
What do fibroblasts do in repair phase of healing?
Lays down granular tissue.
Lays down collagen strands which act like a framework for later cell migration.
What do capillaries do in the repair phase of healing?
Migration of capillaries deliver blood supply to wound.
Fibroblasts need O2 which is supplied by caps.
What do the epithelials do in the repair phase of healing?
Within a few hours "epithelialization" occurs: epithelial migration.
Explain epithelial migration:
Epithelials migrate across wound: Can close a sx site within 48 hours.
Describe the maturation ( and final) phase of healing:
Non functional or misoriented fibers are replaced by the body.
Slowly increases wound strength.
Can take up to 2 years.
What are the 3 types of wound healing?
1.1st intention healing
2.2nd intention healing
3. 3rd intention healing.
Decribe 1st intention healing:
Characterized by non-complicated healing:
No abscess or complication of wound.
Minor Lacerations
Clean wounds
Describe 2nd intention healing:
Wounds are left open to heal.
Wounds will "granulate"
Examples: large wounds
infected wounds
Describe 3rd intention healing:
Start as a 2nd intention.
Quickly followed by Sx intervention.
EX: Severly infected animals.
Very large wounds.
Describe Wound TX: under anesthesia.
1. Control bleeding followed by wound evaluation.
2. Take a good history!
3. Clippering
4. Debridement
5. Drainage (if needed)
6. Bandaging.
Describe how to prepare to clip for sx repair of wound
1. Fill wound with sterile lube before clipping to catch hairs that fall in.
2. Clip area.
What kind of sterile lube is used in preparing to clip a sx site?
Water based.
Is easily flushed later.
Wounds near eyes must have ointment.
Describe how to scrub a wound site.
1.Outer edges of wound are gently scrubbed: as close to the wound, without going in.
2. Lavage
What is lavage?
Flush out wound with fluids.
Optimally 7PSI
Best syringe: 35-60 mL with an 18 guage needle.
Sometimes can use spray bottle.
What fluids are used for lavage?
1. Providine/Iodine
2. Chlorhex Solution
3. Isotonic saline
4. Isotonic LRS, etc..
Describe Provodine/Iodine:
Antimicrobial effect for about 4-6 hours.
Inactivated by: blood, exudates, organic matter
Typically not in detergent form.
Can be irritating.
Describe Chlorhex Solution:
Most popular.
Broad spectrum antimicrobial.
Starts working right away and lasting residue.
Not inactivated by organic matter.
Is hydrogen peroxide recommended as lavage fluid?
No. In has no antimicrobial properties.
Has some antisporicidal.
Describe Debridement as a surgical wound treatment:
1. Removal of necrotic tissue by trimming around the edges.
2. Tissues will be debrided.
3.Degree of sx intervention varies.
What influences the degree of SX intervention?
Age of wound
Severity of wound
What are two types of mechanical debridement?
Surgery
Bandages
What would be a type of non mechanical debridement?
Enzymatic and chemical agents.
What is used to cause drainage after surgery and why?
A penrose drain is used to promote wound health. Allows fluid to escape a wound instead of building up under the tissue.
What are the goals of bandaging?
Limit bleeding.
Immobilize area.
prevent contamination to a wound.
Prevent traumatizing a wound.
Prevent wound desiccation (drying)
Absorbing exudates.
Aiding in mechanical debridement.
How many layers of principal bandaging are there?
3
Describe the Primary layer of bandaging.
It is the 1st layer. Either Adherent or non adherent.
What are the 4 types of adherent layers.
1. Wide Mesh
2. Dry to Dry
3. Wet to Dry
4. Wet to Wet
Describe Wide Mesh:
Allows tissues to become incorporated with gauze.
Describe Dry-to-Dry:
Tends to do mechanical damage, not used much these days.
Describe Wet-to-Dry:
Start with wet material and wrap with dry.
Will be almost dry when you remove.
Will resoak bandage before removing.
Describe Wet-to-Wet:
Super wet and stays wet.
Describe Non Adherent layers
Similar to Band-Aids:
non-stick
doesn't allow bady to form adhesions
Prevents desiccation.
Causes minimal trauma to granular tissue.
Describe the 2nd layer of bandaging:
Absorbs tissue fluid.
Pads the wound.
supports or immobilizes the limb.
Most commonly made out of cast padding and rolled gauze.
Describe the 3rd layer of bandaging:
Tape (elasticon)
Self adhesive tape.
Describe the Robert Jones Bandage (RJB)
Commonly used for temporary stabilization of fractures of distal limps. Bandage must extend past the joint abouve and joint below. Contraindicatied in femoral and humoral fractures.
What does a RJB do?
Compression bandage.
Stabilizes fractures prior to sx.
Edema control after sx.
How long is the RJB good for?
Good for a few hours, maybe a couple days at most. The cotton loosens. If needed longer, must be reinforced with a rigid splint.
Describe the primary layer of the RJB:
Use white bandage tape to make stirrups. Apply to distal 1/3 of the limb. Extend it an equal amt from the end of the leg. Be sure to tab the tape ends. Use a tongu depressor to prevent tape from sticking from itself.
Describe the secondary layer of the RJB:
A full pound of cotton is wrapped around the leg. Moving proximally from the toes. Create a cylinder. Can be 1/2 to 2 pounds depending on the size of the pet.
How are the bandages applied in the RJB?
Overlap the wrap (cotton, gauze, etc) 50% as you wrap.
2 middle toes must show the whole time.
Describe the construction gauze layer of the RJB:
Start tightly wrapping the leg with a conforming bandage (rolled gauze) starting at the toes and moving proximally. Create compression. Overlap the bandage. When finished with this phase, the bandage should appear markedly thinner then it did when you started.
Explain how to use the stirrups after the construction layer of the RJB:
Separate the tape.
Rotate them proximally, sticky side out.
Secure them to the compression bandage thus creating a barrier and preventing the bandage from slipping down.
Describe the terciary (3rd) layer of the RJB:
Wrap with vet wrap or elasticon.
When complete, the leg should make a sound when tapped with a finger mimicking a ripe watermelon sound along the length of the limb.
Is vet wrap okay to use during the terciary layer of the RJB?
Some questions about this. It's thought to increase pressure even more after applied. It's suggested to stretch before applying.
What is the function of the Modified Robert Jones ?
Used for temporary compression of the limb.
Protects the incision site.
Decrease swelling.
Aid in healing.
Used by RDVMs regularly.
What are the differences of applying the MRJ than the RJB?
1. The secondary layer consists of cast padding (rolled cotton, thin), applied only 2 layers thick, following shape of leg.
2.Don't compress as much during the compression phase.
How does the final wrap, during the terciary, get done?
Start at the toes at an angle*** to cover the distal ends of the bandage.
What are the shapes of the RJB vs. the MRJ?
The RJB is cylindrical.
The modified is tapered.
Describe the paw bandage:
Toes are not exposed.
Incorporates the whole foot or else the toes will swell.
Place padding between the toes
Overlap MORE than 50%
When are paw bandages used?
Feline declaws,
torn nails.
What is EMR?
Electromagnetic radiation.
What is the wavelength?
The length between wavecrests.
What is frequency?
How many waves that occur during a unit of time.
Higher Frequency=Higher Energy
What is energy?
Electromagnetic frequency. It's a relation between wavelength and frequency.
What is electromagnetic radiation?
A massless disturbance in space. Both a wave and a discrete unit of energy.
Put in order from lowest energy to highest energy:
ultraviolet, Infrared, X rays, Microwaves, visual light, gamma rays, radiowaves
Radiowaves--> Microwave--> Infrared--> Visual light--> Ultraviolet--> X Rays--> Gamma Rays
Describe frequency and wavelength of Radiowaves:
Low frequency, long wave lengths
Describe frequency and wavelength of Microwaves:
Low frequency
Long wave length
Where are infrared rays in comparison to visual light?
Just below the visual light.
Ultraviolet rays are the first rays in the spectrum to do what?
Cause tissue damage.
How do X rays get produced?
Machine made.
Describe wavelenth and frequency of gamma rays:
Highest frequency
Shortest wavelength
Describe Alpha Radiation:
Low energy.
Usually only causes damage if breathed and on injuries.
Does not penetrate human skin.
Describe Beta Radiation:
Light, short ranged particle.
More pathogenic than alpha.
Produced when an atom ejects an electron.
Penetrates human skin
Travels several feet in air.
Describe Gamma and Xray Radiation:
Highly penetrating.
Travels many feet in air and inches into human tissue.
Readily penetrating and will go inches into tissue.
What is ionizing a molecule?
When a happy normal molecule changes by losing or gaining electrons and becoming charged
Which get ionized more:
radiowaves or gamma rays?
Gamma Rays.
The higher the ray, the more ionizing they are.
What is #1?
Anode
What is #2?
Glass Envelope
What is #4?
Tungsten Filament
What is #7?
Tungsten target: target area where the tungsten filament directs electrons.
What is #3?
Cathode.
What is #7?
Tungsten target: target area where the tungsten filament directs electrons.
What is #a?
Focusing cup.
How are Xrays produced?
Made from fast moving electrons or particles that collide with matter.
Where are Xrays produced?
In a glass tube that has a vaccuum inside.
What is a cathode?
The negatively charged end of the xray tube.
What is an anode?
The positively charged end of the xray tube.
How is 99% of energy lost when making xrays?
As heat. Only 1% turn into Xrays.
What is the Tungsten Filament:
A piece of metal inside the xray tube on the cathode end.
How does the Tungsten filament work?
It's metal. Usually metal has lots of electrons to lose. The metal is heated, and electrons fly off the filament and hits the anode.
What is mA?
Milliamperage:the number of electrons produced by the tungston filament.
Where does the Tungsten filament sit in the Xray Tube?
It is on the cathode end in the focusing cone.
What is the focal spot or target?
The area on the anode target that the electrons hit.
What factors are affected by the focal spot?
Size of the spot affects the xray image.
Size is determined by the filament chosen.
The ray concentration is higher on the anode side.
What is kVp?
Potential of the Xray: how much work it can do:
Increased potential--> more energy--> higher acceleration
mA + time = ?
Quantity of X ray particles.

***test question**
What is the "Quality of X-ray particles"
the kVp
Machines will usually allow one of three control variables. What are they?
kVp + mA + time Or
kVp + (mA*s) or
kVp only
What is collimation?
Device that restricts the size of the beam by narrowing the area of exposure.
How does collimation affect the radiograph?
The smaller the area exposed, the better the radiograph.
What reduces skatter **?
Collimation reduces scatter by lowering the amount of area secondary radiation affects. Makes it safer for us too.
On the xray machine, what is the grid?
Reduces scatter from exposing film. It improves the images.
The angle gets sharper as it gets towards the peripheral. Lead grids.
How does the grid work for the films?
Only lets energy with the correct angulation through to expose film.
Where is the bucky?
Under the grids, where the cassettes are placed.
What are the image receptors?
cassettes that hold film and keeps them safe from light.
What are cassettes made of?
Top:plastic or light metal
Bottom: Made of steel usually.
What condition should cassettes be kept in?
Clean
Dry
Don't drop
What are intesifying screens made of?
Layer of luminescent crystals that are bound together in plastic.
How do luminescent crystals work?
They emit light when exposed to xrays.
What are the functions of Intensifying screen?
Reduces radiation needed to make an image.
95% of exposure to film is due to this light emitted by the crystals.
What are Calcium Tungstate Phosphor crystal?
Blue light emitting,larger sized, with less image definition.
Absorbs radiation, but doesn't emit as much light.
What are Rare earth Crystals?
Green light emitters.
Superior light convertors from xrays= superior images.
Finer crystal sizes.
Who owns the xrays?
The clinic: they are part of the legal record which is owned by the clinic.
What is the owner paying for when radiographs are performed on their pet?
The service and a diagnostic.
How should X-Rays be cared for prior to exposure?
Kept in film box, Horizontally ***
Within a light proof cabinet inside dark room.
Cool (50-59F), low humidity (40-60%)
How must Xrays be labeled?
Must be properly ID'd to be legal: must include:
Patient ID, Owner ID, Date of exam***, hospital names.
How should radiographs be labeled?
Use a card, insert into an imprinting plate and place under the xray when developing the xrays.
What type of markers are used when taking radiographs?
Before taking the film: take a metal marker and set up to show the direction the pet is laying to help ID orientation on the xray.
How is the placement of the markers determined?
If pet is laying laterally, then ID the side that's touching.
When do radiographs need times labeled?
With Barium series.
Describe the barium series:
Radio contrast is given orally. Metal Barium shows white on rads, allowing vet to track it's progress. Time must be tracked.
What are some machine factors that can cause decreased film density?
Underexposed--> too low kVp/mA.
Drop in voltage coming into machine.
What are some machine factors that can cause increased film density?
Overexposure--> too high kVp/mA.
Surge of voltage.
What causes radiographic films to be too light?
Decreased film density.
What causes radiographic films to be too dark?
Increased film density.
What is radiographic contrast?
The visible difference between two adjacent radiographic densities.
How much does the kVp have to be changed in order to see a contrast difference on a radiograph?
Rarely can we see a difference if kVp change isn't more than 10%.
What is the first physical factor that cause decreased film density?
Poorly measured.
What is a caliper?
L shaped bar with a moving piece that measures the widths of the animal to calibrate the xrays.
What is this device?
Caliper
What is the first physical factor that increases film density?
Poorly measured: overweight pet.
What is the 2nd physical factor that decreases film density?
SID is too great
(source-image distance)
Xray arm was raised.
How does the SID change?
The xray arm can raise and lower depending on need.
What is the 2nd physical factor that increases film density?
SID too small.
What are other physical factors affecting film density?
Wrong film, no grid, cassette not used properly.
What are processing factors that can cause decreased film density?
1. Underdeveloped
2. Poorly mixed solution.
What are processing factors that can cause increased film density?
1. Overdeveloped.
2. Light pollution.
3. Leakage of ambient light into the xray processor.
How can you tell if xray is underdeveloped?
Gas won't show on the film.
Can see roller marks on films.
How can you tell if xray is overdeveloped?
Shows a dark band on the xray.
How does one test for light pollution in the dark room?
Turn off all the lights, then place hand on top of an xray for ten minutes. Develop, will show clear hand with the rest is dark- then light is in the darkroom.
How can you tell if ambiant light is leaking into the processor machine?
The top usually pops up.
What is RAD?
Radiation Absorbed Dose.
Quantifies amount of exposure absorbed
What is REM?
Xrays produced.
Why is ionizing radiation a concern to tissues?
1. All tissues are sensitive.
2. Exposure causes long term issues with late manifestation.
How does ionizing radiation affect DNA?
gaps in DNA leads to problems.
No way to predict manifestations.
Radiation safety:
1. Never in primary beam.
2. Primary Beam will penetrate lead.
What other tissues are affected by ionizing radiation?
Dermis, thyroid, eyes, lymphatic system, blood-forming tissues, bone, and gonads.
Which layer of dermis is most affected by ionizing radiation?
Germal epithelial cells.
How is ionizing radiation a problem for somatic cells?
Somatic cells (stem cells) are precursers to funtional cells. Exposure can cause function loss or cause cancer.
What is ionizing radiation?
The excitement of orbital electrons in an atom so that the atoms are separated into charged particles.
What are the hospital owners responsibility to staff regarding radiology?
1. Make sure proper safety measures are followed.
2. Meet state or provincial requirements.
3. Instruct personnel in proper radiation safety and use.
What are some concerns regarding secondary radiation?
-Higher kVp = more scatter.
-Leaky xray machine.
Should pregnant women perform xrays?
No, never.
What should we wear performing xrays?
Lead apron, lead thryoid guard, lead gloves, protective goggles, collimate
Dosimeter
Where should the dosimeter be located?
Outside lead near collar.
Can people under 18 be in the radiation room?
No. Must be over 18.
When performing xrays, what should be used on the animal to protect the technician?
Chemical restraint
Sand bags
Foam/sponges
Tape
What are the 3 major ways to avoid radiation?****
1. Do it right the first time!
2. Distance yourself as far from primary beam as possible.
3. Use sheilds.
What does M mean with rads?
Medial. regarding limbs. Towards the body
What does L mean with rads?
Lateral, regarding limbs.
Away from the body.
What does Cr mean with rads?
Cranial. Towards the head.
What does Cd mean with rads?
Caudal. Towards the tail.
What does D mean with rads?
Dorsal, closer to the backbone.
What does V mean with rads?
Ventral, closer to the belly/nipples on the abdomen.
What does O mean with rads?
Oblique view, a rotation less than 90degrees to the axis.
Most often used to perform dental xrays.
How is beam direction defined?
The first direction is where the beam goes into the body, then the second direction is where the beam goes out.
How to mark a lateral rad?
The side touching the table is marked.
How to take a VD rad?
Ventrodorsal. The beam enters the ventral aspect of the animal while the film is against the dorsal aspect.
What is the problem with DV rads?
The limbs affect how the animal lays. Spine might not be straight, view torqued.
What are postitions that are used to check cancer?
R and L Lateral
VD and DV
All focused on the same organ/bone.
What is the first step in taking an xray?
Set machine!!
What are the steps in taking an xray?
1. go slow and be gentle
2. minimal restraint.
Where should you measure in thoracic rads?
At diaphragm-- the widest point of the ribcage.
Where should you measure in abdominal rads?
Measure widest part of ribs.
*Pay special attention to structures of interest and adjust PRN.
What is positive contrast?
Absorbs most radiation.
Appears white.
Is Radiopaque.
Barium and Iodine
How is barium used when making positive contrast rads?
GI tract only- usually oral, sometimes rectally.
Used for GI studies.
Can relieve gi upset.
How is iodine used when making positive contrast rads?
Injection only!
Comes as a sterile solution- intravenous use.
Look at kidneys, bladder, etc.
What is negative contrast?
Is radiolucent.
Such as air or co2 (maybe)
No xrays are absorbed, appears black.
How are negative contast rads used?
Doubled up with positive contrast rad to create double contrast.
Explain double contrast on urinary bladder:
Via urinary cath, inj positive contrast. Then inject air into same catheter. Inflate bladder. Positive contrast will coat lining and show tumors.
How to calculate kVp?
square the width and multiply by SID
Measurement squared (of caliper) X SID
What is another name for ultrasound?
Sonography
What is ultrasound?
Using high frequency sound waves to make a topographic map based on waves being returned to the machine.
Do ultrasounds use iodizing radiation?
No. No need to wear lead.
How are ultrasound pictures displayed?
In thin flat sections in real time.
What do ultrasounds compare?
Compares tissue densities.
What is a doppler?
Utilizes sound to specify blood flow. Used to check blood pressure.
Anesthesia monitoring.
When is a doppler used on cats?
When a cat throws a saddle thrombus, the doppler is used to track blood flow.
What does radiographic contrast mean?
Refers to the various shades of black, gray and white on a radiographic film and the differences between them.
What is a high contrast film?
Very black and white film with few grays.
High mA and kPv.
Have a short latitiude or scale of contrast.
Fewer but bigger steps on the scale.
What is a low contrast film?
Has more shades of gray but few differences or contrasts between them.
More but smaller steps.
Preferred for soft tissue.
What is the kVp setting on low contrast films?
Low.
What has the greatest influence on radiographic contrast?
Kilovoltage (kVp)
How does low kVp affect radiographs?
There are more lower energy photons and a greater difference in energy levels, leading to more shades of gray.
How does high kVp affect radiographs?
As kVp increases, the difference between the energy levels lessens, allowing greater penetration of the Xray through the tissue.
What is radiographic quality?
Describes to what degree the shadows identified on the film clearly depict the anatomical features under investigation.
What should a film with good diagnostic quality have?
Optimal density,
correct scale of contrast
Excellent detail with minimal magnification and distortion.
What is radiographic density?
The degree of darkness or blackness on the film.
How is radiographic density determined?
By the number of photons that have affected the film. The greater the number, the darker the film.
Radiographic density is influenced by what factors?
1. Quantity of x rays that reach the film
2. Quality of penetrating power of the xrays (kVp)
3. developing time and temp
4. Filters and grids used.
5. Tissue density
What is the most commonly adjusted parameter to increase film quality?
kVp.
What is the 1st option for transferring/catching mice?
1. Can be lifted by tail as close as possible to the base and quickly transfer to a hard surface.
What is the 2nd option for transferring/catching mice?
Scoop mouse and transfer to a hard surface.
Should mice be swung by the tail?
No, do not swing mouse by tail or hold by tail for long.
What is the best method for restraining a mouse?
1. Scruff with thimb and index finger
2. Hold back legs with other hand.
What is the best method for lifting/moving a rat?
Grab rat around thorax with thumb and forefinger, between front legs.
Is it ever okay to pick up a rat by the tail?
If it's aggressive, it may be ok, but try covering with a towel and then lifting.
Quickly transfer to hard surface.
What is the best method for restraining a rat?
Scruff rat and then extend rear legs like mice.
Less restraint can be used on a rat.
What is the towel toss?
Toss the towel over the body. Grasp thorax with claw method, then pick up.
What is the best method to lift a guinea pig?
Utilize the claw method.
How do you catch a guinea pig?
Try to corner it and then use a claw technique and support body with other hand.
What is the best way to restrain guinea pigs?
Scruff, then extend rear legs.
Place into lateral recumbancy. Don't lift by scruff!!!
How do you capture a hamster?
Scoop with hand or cup.
USE CAUTION
How to you restrain a hamster?
Scruff and stretch--- lateral recumbancy
How do you catch a gerbil?
You grab it.
How do you restrain a gerbil?
Scruff and stretch--- lateral recumbancy
how do sheep act if you are trying to catch one?
Instinctually herd animals.
Will have tremendous fear reaction, but will follow leader.
Do you ever grab a sheep by the wool?
No! it hurts!
How do goats act if you are trying to catch one?
Again- herd animals, but these will scatter when approached.
Watch for hoofs/horns.
How do you capture a rabbit?
**Delicate spine/Stresses easy
Arm 1 is under the thorax and front line.
2nd arm holds rump
Cradle toward body.
How do you restrain a rabbit?
Keep rabbits feet on surface (much happier rabbit).
Use non skid surface.
Scruff and stretch.
When working with exotics, what should we remember?
What weapons does it have.
What are considerations when working with birds and reptiles?
Very delicate.
Different respiratory systems.
They don't have diaphragms.
How should lizards be grabbed?
1. not by the tail!!
2. 1st hand should grasp between jawbone and shoulder.
3. 2nd hand holds pelvis/caudal abdomen
How should a snake be captured?
Pinch neck laterally with one hand.
Grab midway down body to spread out weight.
Who should catch crocs/alligators and caymans?
Experts only.
If you were to try to catch a crocodile, what should you have?
Depending on the size:
duct tape, rubber bands.
Goats with horns are dangerous because?
They know how to use them and can cause injury by head-butting.
A feline patient appears calm but doesn't want to leave the carrier. What is one thing a VTA should try to do? 1
1. Tilt the carrier with the door open until gravity helps the animal slide out.
A feline patient appears calm but doesn't want to leave the carrier. What is something (#2) the VTA should try?
Take the top off the carrier and lift the cat out.
A feline patient appears calm but doesn't want to leave the carrier. What is something (#3) the VTA should try?
Place a large towel near the front of the carrier to catch the cat as he is encouraged to exit.
Are VTAs allowed to induce anesthesia?
No, a VTA is not permitted to induce anesthesia.
Dogs displaying a threatening posture would be best restrained by which method?
Chemical.
Why is it important to support a rabbit's hind legs when restraining?
The rabbit might kick it's rear legs and cause severe injury to it's spine.
Which injection method would be outside the leagal scope of a VTA?
IC (intracardial)
When may chemical restraint not be appropriate?
When it's on old dogs or dogs with underlying health issues.
Which recumbency would expect to be utilized for the restraint of a cephalic blood draw of a dog?
Sternal recumbency.
Which of the following can safely be lifted by the tail?
Cat, Goat, Reptile, Mouse
Mouse.
What term best describes the correct method for lifting a large dog?
Fork lift.
Why is it not appropriate to catch sheep by the wool?
Catching sheep by the wool is extremely painful to the sheep.
What are the 3 types of restraints for dogs?
Oral
Physical
Chemical
Why is it dangerous to restrain a reptile by rasping and constricting around the thorax?
Reptiles are not able to reinflate their thorax if it is squeezed too hard. It would be unable to breathe.
Why is it dangerouse to leave a muzzled patient unattended?
It is dangerous because muzzles can cause an inability to breathe, overheating or vomitting.
What methods can be used for restraining a dog for a jugular blood draw?
Sternal recumbency: sitting or laying.
Elbow around throax.
What methods can be used for restraining a cat for a jugular blood draw?
Modified sternal recumbency, laying down. Must scruff cat and extend/pull legs over edge of table.
What does triage mean?
The initial assessment of the emergency patient.
What is the first step of triage?
Telephone contact.
Can you give diagnosis over phone?
No
List of questions to be asked during telephone triage:
1.How is he breathing?
2.What color are MMs?
3.Level of consciousness (LOC) or mentation?
4. Vomitting or Diarrhea?
5. Is there any abdominal distension (bloat)
6. Urination
7. Medications
What info does "how is he breathing?' elicit during telephone triage?
covers cardiovascular and respiration.
What info does "what color are MMs" elicit during telephone triage?
Circulatory
What are some LOC questions for telephone triage?
How is he acting?: hyper, lethargic, etc...
Doesn't come for biscuit- QAR per owner.
If pet has Vomitting and diarrhea, what questions should follow? (during telephone triage)
Smell, consistancy, blood present, etc...
How long has it been going on?
Has he gotten into anything?
Narrow down the source.
What should be asked about urination during telephone triage?
Are the ins and outs normal?
When telephone triaging an emergency like hit by car, what should be addressed? (trauma related injury)
1. Nature of injury
2. How is it breathing?
3. Mucus membranes?
4. Bleeding? if so source..
5. Mentation? LOC?
6. Able to walk?
7. Obvious fracture/wounds?
What should be asked if pet unable to walk?
Is he limping? Or is it more dizzy, head tilted, etc..?
The inability to walk can indicate what?
Orthopedic injuries.
Central Nervous System injuries.
On the telephone trauma triage, when should you stop asking questions?
When one of the questions is answered with a red flag answer. If it isn't breathing, stop asking questions- bring in immediately.
How should the owner usually bring in pet from emergency?
In a carrier, unless spinal injury: then on board.
What are considered true emergencies where you get doctor immediately?
1. Respiratory distress
2. Bleeding from any orafice.
3. Pale mucus membranes
4. Weakness
5. Neurological Abnormality
6. Rapid abdominal distension
7. Protracted Vomitting
8. Inability to Urinate
9. Severe coughing
10. Ingestion of toxins
Why do pale MM get considered a true emergency?
Considered to be in shock until found otherwise.
If blue: oxygen immediately while someone else gets DVM.
What do we mean by weakness as a true emergency?
Objective, this dog is not standing up. May be in conjunction with pale MM, Bleeding, resp distress.
What are some terms used for Rapid abdominal distension?
Bloat.
GDV
What is protracted vomitting?
Occurs over days and weeks. Causes electrolyte imbalance.
Can be caused by foreign bodies.
Why is the inability to urinate a true emergency?
Urinary blockage can cause rupture.
How can you assist an animal to vomit if ingestion of toxins occur?
Apomorphone- can be stopped.
Hydrogen peroxide.
Walk the pet-- increases gi motility.
What is the priority of emergency based on?
Severity of need. Order of urgency.
When a patient comes in during an emergency, what should be done first? (Initial assessment)
Primary assessment and resucitation as needed.
What's involved during initial assessment regarding resucitation?
A: Airway
B: Breathing
C: Cardio/circulation
D: Drugs (or dysfunction)
E: Exam
What does A stand for in the abc's?
Airway: is it adequate?
How do you assess the airway?
Visualization - look in the mouth
Palpation- obstruction felt?
Auscultation: listen with a stethascope.
What does B stand for in the abc's?
Breathing
What do you assess during Breathing?
Ventilation: chest wall, lungs diaphragm.
Due to apnea, open chest wounds, pneumothorax, hemothorax.
What does C stand for in the abc's?
Circulation or Cardiovascular.
What technizues of assessment are used during Cardio/circulation?
Visualization
Palpation
Auscultation.
Where should you palpate during C?
Thorax and abdomen. Different feels can indicate different problems
What problems could Circulation indicate?
Hemodilution (Dilution of blood)
Hypovolemia- loss of blood
Pump failure (CHF, heart attack)
What do Drugs do during emergencies?
Atropine- increases heart rate
Sodium bicarbonate
epinepherine
lidocaine
What does atropine do?
Increases heart rate.
Crosses the blood brain barrier for faster action.
What is epinepherine?
Stimulates heart beat
Increases Heart rate.
**must be refrigerator**
What is lidocaine?
Corrects arrythmias.
Can cause catastrophic blood pressure crash in humans, pigs and sometimes cat.
What is CPCR?
Cardio Pulmonary Cerebral Recusitation.
When is the animal dead?
Cardiac arrest with cessation of blood flow.
What is death seen with?
Loss of consciousness, collapse, no pulse.
Pale/blue MM.
Respiration stops.
Animal must have which symptoms to qualify for CPCR?
Loss of consciousness, collapse, no pulse, pale/blue MM, respiration stops.
Will die without CPCR.
What are the ABCDEs of animal emergency care?
Airway
Breathing
Circulation
Drugs
Exam
How do you check the airway?
Visually look in, palpate around, ausculate,
If airway is blocked, what is the first thing that should be done?
1. Trach tube
2. Positive pressure face mask
3. Tracheostomy- put tube through the esophagus to assist breathing.
What is breathing in CPCR?
Ventilation. Moving of oxygen into the lungs.
100% Oxygen if using anesthesia machine.
How many breaths per minute should be given to an animal during CPCR?
20-60 BPM. Depends on the size of the animal.
What is respiratory asidosis?
Too much oxygen.
What is circulation during CPCR?
Compressions are used only on an animal without a heartbeat. Doing on live animal will cause heart attack.
How many compressions are expected during CPCR?
Approximately 80-100 compressions per minute.
At what rate should compressions be given?
Compress 1 sec
Then release 1 sec
When perfoming CPCR, what position will most dogs be in?
Right lateral recumbency
When performing CPCR, what position will cats be in?
Dorsal recumbency
When performing CPCR, how should the compressions be modified for large dogs?
Use palm of hands.
When performing CPCR, how should the compressions be modified for small dogs and cats?
Thumb and fingers.
Why constantly evaluate efforts?
Need to know how you are performing a task and how to do it better.
Don't forget to recheck what during CPCR frequently?
The pulse. No need to do more than is necessary.
What will an animal have if revived?
Arrythmias
What drug should be on hand in case of arrythmias?
Lidocaine.
What is Dopram V used for?
Respiratory resuscitation.
What are the steps used when caring for birds and mammals when they have a pulse but no respiration?
Establish airway.
Ventilate with 100% O2 or ambubag.
Then use drugs to try resuscitation (dopram usually) or atroprine PRN
Continue breathing until on its own.
What machine will animals be used when resucitated?
Keep breathing,
use EKG
Temp, Blood pressure
Bloodwork to check to see why it happened to start with.
What are the steps used when caring for birds and mammals when they have no pulse and no respiration?
Establish airway and vent.
Start chest compressions.
More likely to give dopram.
EKG
What is ventricular fibrulation?
Disorder of the heart where the heart is fluttering because the electrical messages are not in tune.
Electrical stimulation works with difibrulation paddles.
What is Pulseless Electrical Activity?
PEA is a measurement of the EKG. Shows electricity without pulse.
If an animal has PEA, what is done?
Use epinephrine to restart heartbeat.
What is vasopresson?
New drug designed to give the heart something work against. Antidiuretic hormone.
What happens if Asystole occurs?
Epi and Vasopresson
What happens if bradychardia occurs?
Atropine
What should be used on rabbits in cardiac distress?
Glycopine.
What are clinical symptoms of shock?
tachycardia.
Hypotension (low bp)
Cool extremities.
Poor urine production
increased CRT (longer)
Pale MM- gray or muddy color
What is the physiology of hypovolemic shock?
-Decreased vascular volume
-Veinus return to heart decreased.
-decreased preloading of the heart (ventrical loading)
-Decreased stroke volume (amt ejected)
-Heart rate increased
-Decreased profussion and decreased oxygenation.
What is hypovolemic shock?
Not having enough intravascular volume.
How does laryngeal paralysis present?
Presents with noisy breathing and distress on inspiration and postural adaption of dyspnea.
will be blue
How does laryngeal paralysis get treated?
Supply oxygen.
Calm with sedation.
Endotracheal intubation.
+/- surgical intervention.
How does foreign body in larynx present?
Noisy breathing, distress on inspiration, gagging.
With severe cases: postural adaption of dyspnea
How does foreign body in larynx get treated?
Supply oxygen
Remove object
How does soft tissue swelling/allergic reaction present?
Facial swelling
Hives
Noisy breathing
Distress on inspiration +/- postural adaption of dyspnea.
How do soft tissue swelling/ allergic reactions get treated?
Steroids (anti-inflammatory agent)
Diphenhydramine (antihistamine)
+/- surgical intervention
Allergies affect what facial features?
Eyes and nose swell
How does pulmonary edema present?
Tachypnea (rapid, often shallow breathing)
Postural adaption of dyspnea
Cyanosis
Harsh lung sounds
How does Brachycephalic occlusive syndrome present?
Upper airway distress
How does brachycephalic occlusive syndrome get treated?
Supply oxygen
Calm with sedation
+/- intubation
+/- Surgical intervention
Pulmonary edema can be secondary to what problems?
Electrocution
Heart murmur
Over-hydration
How does pulmonary edema get treated?
Supply oxygen
Diuretics
Positive ventilation PRN
How does a pneumothorax present?
Tachypnea
Dyspnea
+/- Cyanosis
Ventrally muffled lund sounds
What actions are taken to treat pneumothorax?
Surgical oxygen
Surgical Correction
How does diaphragmatic rupture/ hernia present?
Tachypnea
Dyspnea
Paradoxical abdominal movement
Cyanosis
+/- evidence of trauma
How should diaphragmatic rupture/hernia be treated?
Supply oxygen
+/- ventilation
Surgical repair
How does pleural effusion present?
Tachypnea
dyspnea
+/- cyanosis
Muffled lung sounds
Fluid will follow gravity
How should pleural effusion be treated?
Supply oxygen
Place chest tube
How does Hypovolemic shock present?
Pale, gray MM
Prolonged CRT
Rapid Pulse
Weak pulse quality
Evidence of fluid loss
How should hypovolemic shock be treated?
Shock fluid therapy (colloids)
Oxygen support
How do seizures/epilepsy present?
Seizures
Low Blood glucose
Nystagmus
Pupilary changes
How does epilepsy get treated?
Diazapam- for control
Dextrose- hypoglycemia
How do head traumas present?
Depression
coma
Pupil changes
Sclera hemorage
Skull/Facial fractures
How are head traumas initially treated?
Corticosteroids
Manitol (warmed sugar solution- hypertonic)
Elevate head
Ventilation PRN
How does acute paralysis present?
Acute paralysis.
Loss of voluntary motor control: involuntary muscle, supervicial pain, deep pain)
What actions are taken to treat acute paralysis?
Corticosteroid
STRICT cage confinement
Surgical Intervention
How do renal system emergencies present?
Vomitting/ Diarrhea
Dehydration
+/- Toxin Exposure (ethylene glycol- antifreeze)
What actions are taken to treat renal system emergencies?
Fluid therapy (FLUSH)
Monitor urine output
Peritoneal Dialysis
How do urethral obstruction present?
Dysuria
Hematura
Vomiting
Vocalizing
Painful Abdoment
+/- Hyperkalemia (high K)
+/- Hypocalcaemia (low Ca)
What actions are taken to treat urethral obstruction?
Unblock/ decompress bladder
Fluid therapy
Stabalize the electrolytes
Surgical intervention
How does hypoglycemia present?
Depressed
Weak
Ataxia (Loss of limb control)
Seizure
What actions are taken to treat hypoglycemia?
Supplement with dextrose.
Most commonly seen with diabetic animals mistreated with insulin
***What should owners be told if animal is hypoglycemic?
Rub sugar solution in mouth-- honey, Karo syrup ...
How does addisonian crisis present?
Hyponatremia, hyperkalemia,
Bradycardia (hyperkalemia)
Hypovolemic shock, hypolglycemia, hypercalcemia, vomiting, pu/pd
What actions are taken to treat addisonian crisis?
Fluid therapy
Normalize electrolytes
Glucocorticoid (dexamethasone)
How does Gastric Dilation and /or Volvulus present?
Destended abdomen
Dry heaving
Gray or muddy MM
Prolonged CRT
Tachycardia
Weak pulse quality
What action is taken to treat GDV?
Fluid therapy
Decompression
Gastric Lavage
Surgical intervention
How do gastrointestinal obstructions present?
V/D
Brick red MM (may or may not have)
Painful Abdomen
Prolonged CRT
What actions should be taken to treat gastrointestinal obstructions?
Radiographs
Fluid therapy
Surgical intervention
How does peritonitis present?
Brick Red MMs
Rapid CRT
TAchycardia
Bounding pulse
Hyperthermia
Abdominal Pain
What actions are taken to treat peritonitis?
Fluid therapy
Heavy ABX
Abdominocentesis
Surgical intervention
How does parvovirus present?
Vomiting
D- often bloody
Pale, gray, or muddy MMs
Dehydration
What actions are taken treat Parvovirus?
Fluid Therapy
ABX- to prevent secondary bacterial infection
Antiemetics
Blood Transfusion PRN
How does liver failure present?
Vomiting, blood occassionally
Diarrhea
Seizures,
Jaundice
Anemia
What actions are taken to treat liver failure?
Fluid therapy
GI protectands.
How does pacreatitis present?
Recent exposure to high fat food
V/D
Anorexia
Very painful abdomen
What actions are taken to treat Pacreatitis?
Fluid therapy
NPO
Antibiotic PRN
Pain meds PRN
How do pyrometra present?
Recent estrus
V
"diarrhea" that is pus
hyperthermia
+/- vaginal discharge
+/- distended abdomen
What actions are taken to treat pyometra?
Fluid therapy
Surgical
How does Dystosia present?
Active contractions for more than 30 minutes --OR-- More than 2 hours between deliveries --OR-- Green discharge with no delivery.
What actions are taken to treat dystosia?
Rule out obstructive dystosia.
+/- Ocytocin
+/- Calcium Gluconate
+/- Surgical intervention