Small Animal Emergency Medicine: Primary and Secondary Care

Written and verified by the vet Érica Terrón González

Last update: 21 December, 2022

All stages of emergency medicine are important to successfully deal with the critically ill patient. Once triage and initial evaluation are resolved, the next steps are primary and secondary care.

If triage allows for the classification of the patient according to clinical priorities, the initial evaluation makes it possible to determine the patient’s stability in more detail. Thus, in emergency medicine, it’s possible to decide how to deal with any immediate problem that threatens the life of the pet.

Once these foundations have been laid, what’s the following procedure? Do you know what the phases of primary and secondary care in a veterinary emergency clinic consist of? We’ll show you below.

Small animal emergency medicine: Primary and secondary care

During the initial evaluation, veterinarians assess the respiratory system, professionals assess the cardiovascular system, the central nervous system, and the urinary system. In this way, the veterinarian can classify the patient as stable or unstable. From there, they continue on with the process of emergency care.

Primary care for pets

In primary care, veterinarians assess practically the same physical parameters as in the previous phase, only in a more exhaustive way. We’ll tell you the most important parameters that require monitoring.

Breathing evaluation

The assessment of the respiratory system includes ensuring the proper functioning of the upper airways, the color of the respiratory mucosa, and other parameters. At this stage, perhaps the most important thing is to evaluate the frequency, rhythm, and effort of breathing.

The trachea and all areas of the chest should be carefully auscultated. A pulse oximetry–using a machine that measures oxygen in the blood–may also be of interest.

Hypoxia can lead to systemic problems because it prevents sufficient oxygen from reaching the tissues. Therefore, in the case of hypoxia–lack of air— immediate correction is required.

Recognition of the correct functioning of the cardiovascular system

The evaluation of tissue perfusion in the animal includes the following processes:

• Evaluation of mucosal color
• Capillary refill time–a test that evaluates circulation and dehydration levels
• Body temperature
• The auscultation of the heart
• Palpation of the frequency, rhythm, and quality of the pulse in the periphery–in veins of the extremities, neck, head, or tail

Signs of poor tissue perfusion are as follows:

• Pale or bluish mucous membranes
• A prolonged or too fast capillary filling time
• Abnormalities in the heart rate or rhythm

Any of these signs justify the need to search, quickly, for the underlying cause and definitive treatment.

Evaluation of the central nervous system

Extreme changes in the animal’s behavior, such as stupor, coma, or even seizures, require a quick search for the underlying cause. In addition, applying a treatment quickly will most often be the difference between an animal’s life and death.

There are many factors that cause central nervous system dysfunction, including prolonged epileptic seizures or hypoglycemia. They can cause irreversible damage if not treated quickly, so you have to identify the symptoms of these diseases quickly.

Similarly, increased intracranial pressure causes – among other things – stupor or coma. This increase can be due to numerous etiologies, some conventional ones such as a blow or a hematoma, and other more serious ones that will require a more extensive diagnosis, such as a tumor or an infection.

Secondary or specialized care for pets

Once the triage and initial evaluation phases are complete–and the animal has received primary care–it’s time to assess the need to continue with veterinary care. Thus, once the conditions that put the animal in imminent danger of death have stabilized, secondary care can proceed.

This phase already includes a complete and thorough examination. First, it’s necessary to obtain a detailed history of the pet, which is the responsibility of the owner. It’s recommended that all pet owners keep a record of any important data related to the health of their animals.

Second, a complete physical examination, an evaluation of the response to initial therapy, and any other diagnostic findings are essential. At this point, it may be advisable to resort to imaging diagnosis, through X-rays, ultrasound, or any pertinent laboratory test.

It’s during this phase when professionals can make a complete diagnostic and therapeutic plan and formulate an estimate of the prognosis and costs of the consultation.

The importance of going by stages in emergency medicine

In summary, primary care ensures the identification and immediate treatment of life-threatening conditions. This phase also allows confirmation of the identification of unstable patients, which allows for proper monitoring and the prevention of subsequent problems.

Once primary care has taken place, it’s time for more specific testing. The patient, in principle, is no longer in immediate danger. Therefore, tests that require more time and dedication can take place. Therefore, primary and secondary care allow for the resolution of the health emergency.