Veterinary Emergency and Critical Care
Core concepts
The emergency and critical care domain tests whether you can stabilize a patient, recognize shock physiology, and reason about perfusion, oxygenation, and organ support. Expect content on triage and the ABCs, fluid resuscitation (crystalloid vs colloid, bolus vs titration to endpoints), vasopressor and inotrope selection, and monitoring (lactate, blood pressure, central venous pressure, urine output, mentation, mucosal color). You must also know cardiopulmonary resuscitation principles, arrhythmia recognition, respiratory support (oxygen supplementation, ventilation), transfusion medicine, sepsis and SIRS, trauma, toxicology, and analgesia/sedation in the unstable patient.
Traps in questions
Distinguish distributive (sepsis, anaphylaxis), hypovolemic, cardiogenic, and obstructive shock, because therapy differs. Do not reflexively give large crystalloid boluses to a cardiogenic or obstructive patient. Know that lactate trends matter more than a single value. Watch for questions confusing hypotension with hypoperfusion; a normal blood pressure does not exclude poor perfusion. For CPR, recall compression rate/depth, ventilation ratio, and that reversible causes (hypovolemia, hypoxia, acidosis, electrolytes, tension pneumothorax, tamponade, toxins, thrombosis) should be sought. Be careful with drug doses in small or exotic patients and with the difference between maintenance and shock fluid rates.
Worked example
A dog presents collapsed with pale gums, tachycardia, weak pulses, and lactate 6 mmol/L after vomiting and diarrhea. This is hypovolemic shock: give an isotonic crystalloid bolus (e.g., 10–20 mL/kg) and reassess perfusion, repeating as needed rather than committing to a fixed volume. If hypotension persists after volume, add a vasopressor and reassess. Rule of thumb: resuscitate to endpoints (improved mentation, pulse quality, lactate clearance, urine output), not to a number on the pump.