Raising the Standard of Care with Advanced CPR Training
At Veterinary Emergency & Specialty Hospital of Wichita we’re always striving for excellence in the quality our patient care. We’re honored to announce eight of our Registered Veterinary Technicians have completed advanced training and are now certified in CPR Basic Life Support and Advanced Life Support from the American College of Veterinary Emergency and Critical Care through Cornell University College of Veterinary Medicine.
The Reassessment Campaign on Veterinary Resuscitation, or RECOVER, is a collaborative effort of the American College of Veterinary Emergency and Critical Care and the Veterinary Emergency and Critical Care Society. They discovered that less than 6 percent of dogs and cats who suffered cardiac arrest in hospital return to their owners. This shocking statistic led the arrival of the first evidence-based recommendations to resuscitate dogs and cats in cardiac arrest.
Our technicians completed 8.5 hours of RACE C.E. Credits in a series of 5 modules to:
1. Review the fundamental aspects of cardiopulmonary structure and function to help understand the basic mechanisms they employ to do chest compressions and ventilation in patients experiencing cardiopulmonary arrest (CPA).
2. Learn how to diagnose CPA rapidly in any unresponsive patient using a standardized airway-breathing assessment.
3. Choose the best approach to chest compressions in a dog or cat based on the patient's size and chest conformation.
4. Learn how to ventilate a patient during CPR using either the mouth-to-snout technique or continuous ventilation in an intubated patient.
5. Explore techniques for improving communication and team dynamics when treating an emergent case such as a patient in CPA.
According to the American College of Veterinary Emergency and Critical Care, when CPR is done according to established guidelines, survival to discharge can be as high as 50% in some populations of dogs and cats in CPA with acute, reversible disease. This course was a giant step to preparing our team to maximize outcomes in patients with CPA.
Our highly trained technicians are now trained to:
• Rapidly recognize patients with cardiopulmonary arrest
• Properly administer high-quality chest compressions using the most up-to-date approaches in dogs and cats
• Provide mouth-to-snout or intubated ventilation according to current evidence-based guidelines
• Utilize effective communication and team skills that will improve our ability to manage emergent and critically ill patients
• Choose the most useful monitoring devices for patients in cardiopulmonary arrest
• Read and interpret the data from the various monitoring devices
• Rapidly diagnose the arrest ECG rhythm to help choose the best ALS therapies for the patient
• Administer the most effective drugs and other adjunctive therapies for patients with cardiopulmonary arrest
• Perform life-saving procedures such as venous cutdowns, intraosseous catheter placement, use of defibrillator, and open chest CPR
We’re proud of the accomplishments of our team! Take a look at some hands-on training.
• Perform 100-120 chest compressions per minute of one-third to one-half of the chest width, with the animal lying on its side.
• Ventilate intubated dogs and cats at a rate of 10 breaths per minute, or at a compression to ventilation ratio of 30 to 2 for mouth-to-snout ventilation.
• Perform CPR in 2-minute cycles, switching the “compressor” each cycle.
• Administer vasopressors every 3–5 minutes during CPR.
• Using the defibrillator at 2-4 joules/kg for advanced life support.
Other guidelines pertain to how clinicians should be trained, how to perform CPR on dogs of different breeds and sizes, what drugs to give when and what follow-up care to provide.
Our certified team (from left, top row first): Chris Decker, Courtney Keazer, Lauren Greene, Tori Wilson, Cheryl Thornton (hospital Director: Brock Lofgreen, DVM), Josie Englert, Amanda Johnson, Sophie Snow.
Continued Education - Kansas Police Dog Association
Veterinary Emergency & Specialty Hospital of Wichita had the privilege of delivering a special educational seminar to the Kansas Police Dog Association, an organization that represents law enforcement from across the State of Kansas. Their training focuses on patrol, detection, tracking/trailing, and search and rescue. The KPDA aims provide top quality training for K-9 teams including an annual five-day certification. This year more than 37 full-time K-9 handers attended the certification course in Independence, KS.
Veterinary Emergency & Specialty Hospital of Wichita has a strong commitment to the community, including the K-9 teams who serve and protect. Several of our talented doctors and technicians volunteered to educate the handlers on emergency health and safety issues that are common in the police dog line of work.
Dr. Holly Smith began with a discussion on recognizing pain, which can hinder a working dogs ability to perform. Veterinary technician, Sophie Snow, explained basic anatomy, structure, and function of the heart along with canine CPR and essential life support techniques. Shannon Jacobs provided officers with quick reference emergency contacts, vital signs and instructions for treating common working K-9 injuries. The session ended with Dr. Douglas Winter, a specialist in dentistry and oral surgery. He stressed the importance of proper oral health in working K-9’s, whose bite work is an essential job function. He offered preventative care information and even performed a couple of consultations.
An open floor Q&A session allowed officers to receive quality feedback regarding specific “what if” scenarios they may encounter in the field. We hope to continue to provide educational services to working canines throughout the area. For more information on educational opportunities, please contact us!
Paw It Forward Success - House Fire Rescue Puppy
In November, a tragic house fire claimed the lives of several animals including the mother and littermates of this puppy. At just a few days old, he was rescued from beneath debris by firefighters and rushed to our care at Veterinary Emergency & Specialty hospital. He was treated for several days for third-degree burns and severe smoke inhalation.
Our staff knew he would be a perfect candidate to receive a little help from our Paw It Forward Foundation, a donation funded program used to treat sick and injured pets in financial crisis. Once adopted, the pup was cared for and nursed back to health with much love and support by the Wichita community, including a story with KWCH news.
Now Sindile is four months old and thriving with his loving adopted Mom, Briana. She’s sharing images of his journey toward a new life. Thank you to all those who donate to Paw It Forward; we hope this story captures the miracle of life that Paw It Forward brings to animals in our community.
National Pet Dental Health Month
If you’ve ever thought “my pet is too young for a dental cleaning” or “my pet’s teeth look clean” you may reconsider. Periodontal disease affects 85% of pets over 3 years of age.
Meet Gunner, a 3 ½ year old Golden Retriever, who suffers from bad breath and a total lack of personal space. That’s why his owner checked him into Veterinary Emergency & Specialty Hospital for a consult with Dr. Winter, a board-certified expert in veterinary dentistry and oral surgery.
Dr. Winter provides dental care based on the American Veterinary Dental College (AVDC) standards of excellence. He begins with an initial consultation before a thorough exam can be done under anesthesia. Anesthesia is the only way to perform a complete dental cleaning including x-rays.
In this initial examination, Dr. Winter will be evaluating Gunner to
• Confirm lymph nodes are not overly firm or enlarged
• Feel in-between the inner mandibular space to check for growths or swellings
• Observe facial symmetry
• Check for signs of eye drainage
• Count teeth
• Verify the occlusion is normal with a good scissor bite, making sure the jaw can close comfortably and completely
• Examine gum tissue for swelling or inflammation
After his initial evaluation, Gunner is back to receive a complete dental cleaning with a full oral exam. He’s already received a blood test to check for healthy organ function, to determine he’s healthy enough to undergo anesthesia.
Gunner is given a pre-anesthetic injection to help him relax, as well as provide initial pain management.
Now that he’s groggy, the remaining pre-operative procedures are less stressful. The leg is shaved and disinfected, and a catheter placed and secured. The catheter will allow the start of IV fluids.
An induction agent is given to further anesthetize Gunner for intubation.
An endotracheal tube will enable Gunner to breath in the anesthetic gas and maintain proper oxygen and anesthesia levels throughout the entire procedure. From this point forward, his vitals will be continually monitored and charted by our veterinary technician.
Dr. Winter begins with a systematic dental probing technique to check the attachment of the gum to the tooth, in three places, on both sides of each tooth. If the probe can enter beneath the gum line more than 2 millimeters, it’s likely that there is infection present beneath the gumline or that the tooth has abscessed. This assessment can only be confirmed through dental radiographic imaging, or xrays.
A scaler removes calculous from beneath the gumline and we see that it’s caused redness and inflammation on the gum tissue. After today’s cleaning, that tissue will heal and return to normal.
An ultrasonic scaling tool is used to deeply clean above and below the gumline. This is the most important step in the cleaning, which is why it requires full anesthesia. An awake patient simply would not tolerate the sound of the instruments or the lie still for this type of cleaning. The gum tissue is delicate and there’s a risk of breaking a tooth if the patient was awake. Removing tarter from just the exposed surface is cosmetic, and does nothing for the patient’s oral health.
Throughout the procedure a technician charts vitals as well as physically observes the patient. She’s using advanced medical equipment to monitor ECG, pulse oximeter, two modes of blood pressure monitoring, the patient’s temperature, how well he’s ventilating, and how he’s breathing. She’ll be making adjustment as needed.
Dr. Winter blows air between the tooth and gum, checking to make sure he has removed every bit of tarter.
Gunner’s teeth are polished to smooth out any micro etches caused by our instruments. The paste leaves a clean and smooth enamel surface and is then rinsed away with a disinfecting solution. That’s it! Gunner is ready to be woken up and move to recovery for a few hours before going home.
This entire procedure takes at least an hour depending on the severity of your case. A few signs it’s time for a cleaning are: bad breath, trouble eating, red or inflamed gums, loose or broken teeth. If you’re still not sure, check with your primary veterinarian. They should provide you with a referral for a consultation with Dr. Winter for your dental cleaning. Or, you can call to request an appointment directly. There will be a video of this entire procedure, stay tuned!
Doug Winter, DVM, Dip AVDC
Dentistry and Oral Surgery
Holiday Pet Safety Tips
The holidays are upon us, and nothing can spoil the festivities like an emergency trip to the veterinary hospital. Veterinary Emergency & Specialty Hospital of Wichita wants you and your pets to enjoy your traditions, while staying safe, by providing some tips to avoid common holiday pet disasters. Always keep our number in an easy-to-find and know where our hospital is located in case of an emergency:
Veterinary Emergency & Specialty Hospital of Wichita (open 24/7/365)
Phone (316) 262-5321
Address 727 S Washington, Wichita
Another important number to have on-hand is ASPCA Poison Control Hotline 1 (888) 426-4435.
SAFE DECORATING TIPS
Dogs are opportunistic, typically keeping things out of reach seems to do the trick. However, during the holidays, there are new temptations. Make this holiday season drama free with these learned-from-experience tips.
In general, place decorations on high branches or put a gate up around the tree to keep your pet safe. You may also consider anchoring your tree so it doesn’t get knocked over.
Ornaments: Glass ornaments can cause lacerations while popular salt dough ornaments are toxic to dogs.
Tinsel and ribbon: If ingested, tinsel can become bound in the intestinal track and require surgical removal.
Tree lights: Those twinkling lights are a thing of beauty but could pose the threat of electric shock if the wires become torn and chewed through.
Artificial snow: Indoor snow may look magical, but the fake stuff on trees and wreaths may contain highly toxic chemicals
Be mindful of holiday goodies
Do not underestimate a hungry dog’s determination when delicious food is all around! Keep pets away from these dangerous foods.
Fruits & Veggies: Avoid garlic, onions, leeks, scallions, chives, and shallots as they are toxic to both cats and dogs. Grapes, raisons, and currents are highly toxic as well.
Alcohol: Keep eggnog and other alcoholic beverages up and away from reach.
Nuts: Absolutely do not feed pets macadamia nuts. Also avoid black walnuts, raw cashews, English walnuts, and pecans.
Candy: Chocolate, especially dark or baker’s chocolate contains theobromine and may cause devastating effects. Sugar-free candy and desserts that contain Xylitol can be lethal even in small doses.
Bones and Strings: Bones can cause intestinal upset, blockages or splinter once chewed. Keep pets away from meat-soaked string around roasts, and poultry as they can become bound in the intestines.
Caffeine: The holidays can be exhausting and although you may need an extra cup of Joe, be sure to keep your cats and dogs clear of caffeinated beverages, including coffee grounds.
Garbage and Countertops: During and after food prep, counters and trash cans are often filled with cooked bones, scraps, plastics and other dangers. Keep counters clear if your pet can reach, and put a lid on the trash.
Avoid decoration disasters
Decorating for the holidays can be a joy with these safety tips.
Candles: Be cautious of open flames, if you leave the room, put the candle out. A wagging tail or curious cat can easily knock it over. Modern flameless candles mimic the flickering flame and are pet safe.
Plants: Toxicities in common holiday plants can cause mild to severe effects. It’s best to avoid amaryllis, daffodils, poinsettias, holly, and mistletoe. Try pet friendly silk or plastic plants instead.
Stockings: If your pet can jump or otherwise gain access to stockings, avoid filling them with items that could be toxic, easily swallowed, or choked on.
The average cost of treating common holiday emergencies:
Chocolate Toxicity - $500-2000
Other Toxicity - $500-5000
Fracture repair - $2500-450
GI foreign body - $2500-4000
Pancreatitis - $1000-2500