Our hospital features a Philips High Definition X11 ultrasound machine, a state of the art ultrasound machine capable of basic ultrasonography, color flow Doppler, tissue Doppler, and echocardiography, the same model used in many human hospitals. In emergency situations it is a vital tool that helps us quickly diagnose the extent of internal injuries to the chest and abdomen. It can be used to detect heart conditions and in obstetrics to diagnose uterine infections and check on puppies or kittens. Ultrasound technology is used to complement radiographic imaging and helps us to view organ systems in real time, allowing our emergency veterinarians to more accurately make the spur of the moment decisions necessary when working with unstable patients.
Ultrasound examinations are a routine component of our Internal Medicine service. When we are concerned that a patient may have an internal mass, fluid in their chest or around their heart, or enlarged organs indicating disease and radiographic detail is insufficient, ultrasound examination is the next diagnostic step. Use of the ultrasound allows us to collect cytology samples that can be evaluated in-house or sent to a pathologist for further interpretation.
Evaluation of the liver and gall bladder, spleen, urinary tract, gastrointestinal tract, pancreas, genital system, vascular system and lymph nodes are part of our routine ultrasound exam. Basic echocardiography for patients with suspected hypertrophic cardiomyopathy, dilated cardiomyopathy, congestive heart failure or cardiac masses is available.
Hematology is the study of the blood and its components. In emergency medicine, rapid evaluation of a patient’s blood can mean the difference between life and death. NVRH has acquired several types of blood analyzers that assist our doctors in providing accurate and timely patient care.
One of the key ingredients in accurate assessment of critical patients during an emergency/trauma event is speed. Diagnostics must be completed quickly. Blood has to be drawn, prepared and analyzed in the shortest possible time. To complicate matters, collecting the blood sample from injured patients who may be in shock is difficult. To enhance our diagnostic abilities in these emergency situations, NVRH recently purchased the Nova CCX blood analyzer which can complete a stat blood gas in less than 10 seconds with only 0.4 milliliters of blood. This allows our emergency doctors to obtain large amounts of information in seconds. The venous and arterial blood gas functions provide information about a patient’s acid-base status, electrolytes, and oxygenation/ventilation. The lactate function tells us how well or poorly blood is reaching the patient’s tissues. And all of this can be obtained from the amount of blood that fills the hub of an IV catheter.
We chose this machine because Nova Biomedical company is the worlds leader in development of electrode-based biosensor technology. They have been developing whole blood analyzers for the human critical care field for over 25 years and they are unsurpassed in accuracy and efficiency.
Like dueling banjos, NVRH’s twin Idexx Catalyst DXs sit side by side offering fast, accurate blood chemistry analysis using proven dry-slide technology. The Idexx Catalyst is capable of running up to 25 different tests in under eight minutes of time allowing us to get results sooner and manage cases efficiently.
The Idexx Lasercyte is able to perform complete blood counts (CBCs), including a true five-part differential and reticulocyte count, with the quality of a reference laboratory. This testing helps us evaluate your pet’s circulating white and red blood cells to look for evidence of inflammation or infection. This gives us comprehensive hematology results in real time and allows us to make more informed decisions more quickly.
The Idexx Snapshot DX combines a cutting-edge optical system with the proven SNAP® ELISA technology which has been trusted by veterinarians for years. The LED system captures images with a state-of-the-art digital camera for improved performance. The SNAPSHOT DX helps us test for diseases such as hypothyroidism; Cushing’s Syndrome; Addison’s Disease; liver diseases such as portosystemic shunts; canine pancreatitis; feline leukemia; feline immunodeficiency virus; heartworm, and tick borne diseases such as ehrlichiosis, Lyme disease and anaplasmosis.
NVRH utilizes a Sound Technologies Tru DR digital radiology system. The use of digital radiology means your pet will spend less time on the x-ray table and our veterinarian will have enhanced radiology capability, making it easier to see problems that otherwise might have been missed. This system allows us to quickly take digital images of your pet to help us diagnose conditions that include: injuries to the bone structure, size and placement of internal organs, the presence of internal masses or growths and the ingestion of foreign bodies. The images are imported into our computer and may be viewed by you in the examination room during your visit.
Upon your arrival, your pet will be evaluated by trained emergency room medical staff. If life threatening conditions exist, she/he will be transported immediately to the emergency room. The NVRH Emergency team lives by the motto ‘plan for the worst, hope for the best’; we firmly believe that success in an emergency situation is significantly affected by how prepared we are in advance. Back in our treatment area, an emergency station is maintained at all times complete with equipment and medications necessary to allow the veterinarian rapid assessment of your pet. Oxygen support and IV fluid administration is available immediately should your pet need it.
Accessible to the evaluation area are two oxygen support kennels. These temperature and humidity controlled units provide environmental support to patients who present with respiratory compromise.
Other warming support: Sometimes patients don’t need oxygen but do need thermal support. NVRH has two ‘Bair Hugger’ forced air warming devices and warm water heating blankets we can use, but sometimes a warm blanket from the clothes dryer feels best.
Similar to human hospitals EKG, blood pressure and oxygen saturation monitoring is available. Critical patients, like “Billy” (read story under exciting cases) may have several monitors in use at one time. Doppler and oscillometric blood pressure, oxygen saturation, and Surgivet multiparameter monitors are utilized.
No one likes to think about it but even your pet could need a blood transfusion someday. Used most often in trauma and severe anemia cases, blood transfusions save lives. NVRH stores both cat and dog blood and has several blood donors available at short notice. Dogs and cats can have transfusion reactions just like humans so blood typing and cross matching are performed prior to transfusion. There are some patients who are too unstable to wait for the pre-transfusion testing to be performed so we do carry blood from ‘universal donor’ animals in anticipation of this situation.
You already know that NVRH has a referral surgery practice but did you know that every one of our ER veterinarians is also available for emergency surgical procedures. When emergency surgery is necessary, we are ready. Some surgeries can’t wait for another day. That is why NVRH has a fully equipped ER surgical suite complete with electrocautery, LDS and TA surgical stapling devices that allow us to rapidly control bleeding. Sterile surgical procedures similar to those used in a human hospital are followed. Each patient is monitored by a dedicated team member utilizing appropriate monitoring devices. Instrumentation has been sterilized using autoclave or gas sterilization technology. Gas anesthesia is utilized and multimodal pain control techniques are used to make anesthesia as safe as possible in potentially unstable patients.