When Seconds Count: All About Veterinary Critical Care and the ICU

If your pet is facing a critical emergency, a critical care vet can help stabilize, monitor and treat your pet. They have the knowledge, training and technology to create the best possible outcome when second count.

What is veterinary critical care?

Similar to human medicine, veterinarians can specialize in specific areas of medicine. Emergency and critical care is a specialty that focuses on providing life-saving interventions and therapy for sick pets.

Veterinary criticalists typically work in emergency or multi-specialty hospitals that are open 24/7 or after hours, so you can access critical care when your family veterinarian isn’t available or your pet experiences a medical crisis.

Veterinary critical care training

Just like other veterinarians, critical care vets start by earning their doctorate degrees in veterinary medicine and passing their national licensing exam.

When they choose to specialize in emergency and critical care, they complete several more years of training, including internships and residency programs for hands-on training with senior specialists.

Finally, they take a rigorous exam to become board-certified by the American College of Veterinary Emergency & Critical Care, earning them these credentials:

• Veterinary criticalist
• DACVECC after their name, which stands for “Diplomate of the American College of Veterinary Emergency & Critical Care”
• Board certified in emergency and critical care

Board-certified specialists are highly experienced professionals in their respective fields of medicine.

What types of cases do critical care specialists treat?

No two days are the same for a critical care specialist. They treat the most severe cases, which include emergency symptoms and conditions like:

• Major trauma
• Breathing difficulties
• Complications from severe vomiting and diarrhea
• Ingestion of poison or a toxic substance
• Bites from venomous animals
• Loss of consciousness
• Heart failure
• Kidney failure

They practice collaborative medicine, meaning that emergency clinicians and other specialists may work closely with a criticalist in situations like when patients:

• Experience medical distress during surgery (such as going into cardiac arrest or experiencing breathing problems)
• Quickly escalate from urgent to critical level symptoms
• Become unresponsive
• Have a highly complex or challenging condition
• Are high-risk for certain reasons (like pregnant or senior pets, or pets with chronic conditions)

They have the experience, quick-thinking skills and advanced training to help save the lives of pets facing life-threatening emergencies.

What goes on inside a critical care unit?

Many emergency pet hospitals are equipped with critical care units, also known as intensive care units or ICUs. Veterinary ICUs are the most medically advanced suites in the hospital. They house the most challenging cases under the constant watch of the critical care team.

The resources and technology of an ICU can vary greatly from hospital to hospital, and not all locations have a dedicated critical care space. But typically, ICUs have the following features:

Oxygen cages

Many critically ill pets need supplemental oxygen to improve their breathing or recover from an emergency.

Oxygen cages are enclosed chambers that ventilate oxygen gas throughout. They’re often made of glass or a transparent material, and they have cozy bedding to keep your pet comfortable.

While every pet is different, this is generally a lower-stress method of delivering oxygen to a pet compared to oxygen masks or breathing tubes.

Intravenous (IV) therapies

Similar to ICUs in human medicine, veterinary critical care units have a variety of IV therapies available. IV fluids are given through a catheter inserted into your pet’s body (typically in the neck, leg or arm).

Your pet’s critical care team can rapidly deliver medications through your pet’s IV line, including antibiotics, pain relievers, hydration remedies and more.

Heart and respiratory monitoring

If your pet is in the ICU, the team will check their vitals continuously. That means around-the-clock monitoring of important health information like:

• Heart rate
• Respiratory rate
• Oxygen levels
• Blood pressure

Many ICUs have advanced heart monitoring equipment like electrocardiogram (EKG) machines.

Laboratory and diagnostic testing

While most veterinary hospitals have in-house laboratories, it’s common for the ICU to have its own lab. Because these cases are critical and timely, the ICU laboratory offers rushed (and sometimes immediate) insight into diagnostic tests like bloodwork and urinalysis.

The ICU also works closely with the radiology department to review imaging tests like x-rays, ultrasounds, CT scans and MRIs in a timely fashion.

Other advanced equipment

Other common resources found in the ICU include equipment for pets in severe medical distress, like:

• Ventilators (to move air in and out of the lungs)
• Feeding tubes (to provide nutrition, fluids and medications)
• Chest tubes (to help the lungs expand properly by removing surrounding air or fluid)
• Urinary catheters (to drain urine from the bladder)
• Hemodialysis or plasmapheresis machines (to help clear certain toxic substances from the blood)

Dedicated team

The ICU is led by the veterinary criticalist. They have teams of dedicated technicians and assistants who are trained specifically to work in the ICU and perform duties like:

• Running diagnostic tests
• Administering medications when needed
• Closely monitoring patients
• Supporting criticalists with life-saving measures

They also provide gentle love and affection for your pet when they need it the most. They’re highly trained professionals who are also animal lovers and pet parents – so they understand how a calm presence can help a severely sick pet feel comforted and less afraid.

What should I expect if my pet is in critical care?

Your pet could be entrusted to the capable hands of the critical care team if:

1. They arrive at the hospital critically ill or injured
2. They arrive at the hospital with only urgent or emergency-level symptoms, and their situation quickly escalates to the point of needing life-saving care
3. They have a highly complex condition (possibly relating to a chronic condition or high-risk factor) and need advanced care to heal

Regardless of how and when they get there, here are a few things you can expect during your pet’s critical care experience:

Clear communication and updates

The critical care team knows that strong communication is vital in helping your pet feel better (and helping you feel less afraid and stressed). They’ll stay in close communication with you and provide frequent status updates.

Treatment planning and decision making

During your pet’s stay at the hospital, their attending vet will present you with treatment options (including cost estimates) specific to their unique medical situation. Together, you can decide on the best course of action to help your pet heal.

Because critical care cases can quickly change for the better or worse, you may have to approach your pet’s treatment plan in steps and revisit decisions as their situation develops. Your pet’s medical care team is at your side for questions, concerns and updates as your pet receives care.

Patience and waiting

It takes time for critically ill pets to recover and stabilize. Sometimes, pets in the ICU take hours, days or even weeks to reach a point where they’re healthy enough to return home.

If your pet is facing a long recovery, you may choose to go home and wait. Your pet’s team knows the wait is difficult, so they’ll keep in touch with you and they’re always a phone call away.

Follow-up care

Once your pet is stable and their situation is no longer considered critical, they’ll move to the next phase of recovery. Depending on their situation, you may be advised to take one or more of these follow-up care steps:

1. Referral to your family vet. Your pet’s critical care vet will likely send a summary or report to your family vet, and they may recommend you schedule a follow-up appointment to promote ongoing health and wellness.
2. Referral to another specialist. For the management of a chronic or complex condition, you may be referred to another specialist, such as a cardiologist, oncologist or internist.
3. Return home and rest. If your pet fully recovers without complications, they may be able to return home. The vet may recommend rest, medications or lifestyle changes.