NV Vet Tech cheat sheet

Controlled substances: Schedule II drugs (morphine, fentanyl, oxymorphone) require DEA Form 222 or CSOS ordering, secure storage, and a biennial inventory; Schedule III–V require recordkeeping but not Form 222.

Drug half-life (t½) determines dosing interval; a drug reaches roughly 97% steady state after 5 half-lives, so interval changes take ~5 t½ to reflect fully.

Volume of distribution (Vd) = dose / plasma concentration; large Vd means more tissue distribution and less removal by dialysis or plasma exchange.

Clearance (Cl) = elimination rate / plasma concentration; maintenance dose rate = Cl × target concentration ÷ bioavailability (F).

Loading dose = (Vd × target concentration) ÷ F; loading dose does not depend on clearance, so it is unchanged in renal or hepatic impairment.

First-pass hepatic metabolism reduces oral bioavailability; drugs with high first-pass effect (e.g., morphine, lidocaine) are given parenterally or at higher oral doses.

Bactericidal vs bacteriostatic: bactericidal kill (penicillins, aminoglycosides, fluoroquinolones); bacteriostatic inhibit growth (tetracyclines, chloramphenicol) and depend on host immunity.

Aminoglycosides (gentamicin, amikacin) are nephrotoxic and ototoxic; monitor renal values and trough levels, and avoid concurrent nephrotoxins such as NSAIDs or amphotericin B.

NSAID cyclooxygenase inhibition: COX-1 blockade reduces gastroprotective prostaglandins and platelet thromboxane (bleeding risk); COX-2 selectivity spares platelets but not renal prostaglandins.

Aseptic technique hierarchy: sterile field items only; gown and gloves for open cavities; cap, mask, and sterile gloves for minor procedures; clean gloves for non-sterile contact.

Instrument categories: cutting/dissecting (scalpel, scissors), grasping/holding (thumb forceps, towel clamps), hemostatic (Kelly, Crile, Rochester-Carmalt), retracting, and suturing/needle holders.

Suture selection: absorbable (poliglecaprone, polyglactin 910, chromic gut) for internal or mucosal tissue; nonabsorbable (nylon, polypropylene, silk) for skin and tension-bearing areas.

Suture size: USP 3-0 to 5-0 for small animal skin and viscera; larger numbered sizes (0, 1, 2) for large animal or high-tension closure; smaller (6-0, 7-0) for ophthalmologic work.

Surgical drapes are placed from the incision site outward; once a drape is positioned it is not moved toward the incision because that recontaminates the field.

Postoperative monitoring priorities: temperature (hypothermia common), perfusion (mucous membrane color, CRT, pulse quality), respiration, pain score, and incision integrity.

Patient prep: clip hair widely, remove loose hair, and perform antiseptic scrub (chlorhexidine or povidone-iodine) with contact time per label; alcohol alone is not a substitute for an antiseptic.

Surgical counts and sponge tracking: count sponges, needles, and instruments before and after the procedure and record the result in the medical record.

Wound classification: clean, clean-contaminated, contaminated, and dirty/infected; classification guides antibiotic use and closure decision.

Dental formula of the dog: 2 × (I 3/3, C 1/1, P 4/4, M 2/3) = 42 permanent teeth; the cat has 30 permanent teeth with I 3/3, C 1/1, P 3/2, M 1/1 per side.

Tooth numbering uses the modified Triadan system: quadrant 1 = right maxilla, 2 = left maxilla, 3 = left mandible, 4 = right mandible; the permanent canine is 104/204/304/404.

Periodontal disease staging uses attachment loss: Stage 1 gingivitis only, Stage 2 <25% attachment loss, Stage 3 25–50%, Stage 4 >50% with furcation involvement.

Periodontal probing depth >3 mm in the dog or >1 mm in the cat suggests attachment loss and warrants radiographs and treatment planning.

Dental radiography is required for diagnosis: 60% of crown and much of the root are below the gingiva, and feline tooth resorption is often invisible without imaging.

Tooth resorption in cats (formerly FORL) is common in premolars and molars; treatment is extraction or crown amputation, not scaling alone.

Dental scaling must be followed by polishing because scaling leaves microscopic scratches that accelerate plaque accumulation; polishing uses a fine-grit paste.

Anesthesia for dentistry requires a cuffed endotracheal tube with the cuff inflated and pharyngeal packing to prevent aspiration of debris and water.

Extraction principles: use a dental elevator to sever the periodontal ligament, avoid excessive apical force, and close extraction sites to protect the clot.

PCV reference ranges in dogs are roughly 37–55% and in cats 30–45%; PCV is measured by centrifugation of a microhematocrit tube, and the buffy coat lies just above the red cell column.

Total protein by refractometer is affected by lipemia, hemolysis, and hyperglycemia; correct the reading when lipemia is present because it falsely elevates the result.

Azotemia: prerenal (dehydration, reduced perfusion, concentrated urine), renal (loss of concentrating ability), or postrenal (obstruction, rupture); urine specific gravity distinguishes prerenal from renal.

Urinalysis sequence: evaluate color/clarity, specific gravity, dipstick chemistry, then sediment; sediment is examined on the unstained wet mount first, then stained.

CBC interpretation: anemia is regenerative with reticulocytosis or polychromasia; nonregenerative anemia suggests chronic disease, marrow disease, or iron deficiency.

Platelet counts below roughly 50,000/µL carry spontaneous bleeding risk; below 20,000/µL risk is high, and platelet function can be impaired even with normal counts.

Blood culture and urine culture should be collected before antibiotics; a quantitative urine culture with >100,000 CFU/mL is generally significant in a cystocentesis sample.

Coagulation: prothrombin time (PT) evaluates the extrinsic and common pathway; activated partial thromboplastin time (aPTT) evaluates the intrinsic and common pathway.

Fecal flotation uses a solution with specific gravity around 1.20–1.30 so parasite eggs float; direct smear is better for motile trophozoites such as Giardia.

Normal canine temperature is roughly 38.0–39.2 °C (100.5–102.5 °F); feline 38.1–39.2 °C (100.5–102.5 °F); rectal temperature is the standard nursing measurement.

Normal heart rates: dog 60–160 bpm (higher in small breeds and puppies), cat 140–220 bpm; respiratory rates roughly 10–30 breaths/min in dogs and 20–30 in cats.

Capillary refill time normally under 2 seconds; prolonged CRT suggests poor perfusion, and a very rapid CRT can occur with vasodilation or shock.

Body condition score uses a 1–9 or 1–5 scale; 4–5 of 9 is ideal, and scoring at every visit detects trends before weight change is obvious.

Fluid deficit (mL) = body weight (kg) × estimated dehydration (%) × 1000; add maintenance (roughly 50–60 mL/kg/day in dogs, 40–60 mL/kg/day in cats) plus ongoing losses.

Nutritional assessment: calculate resting energy requirement as 70 × (body weight in kg)^0.75; multiply by an illness factor only when justified, since overfeeding is common.

Kennel and isolation protocols: separate infectious patients, use dedicated equipment, and follow hand hygiene and PPE sequence; parvovirus and panleukopenia require bleach-effective disinfection.

Restraint principles: minimal restraint, species-appropriate handling, and chemical restraint when manual restraint would cause pain or injury; cats are scruffed only when necessary and never by the tail.

Vital sign trends matter more than single values; record trends on the treatment sheet to detect deterioration early.

Anesthetic depth assessment: jaw tone, palpebral reflex, eye position, and respiratory pattern; a central or ventrally rotated eye in the dog suggests a surgical plane.

Premedication goals are sedation, analgesia, and reduced induction and maintenance drug requirements; common classes are alpha-2 agonists, benzodiazepines, and opioids.

Alpha-2 agonists (dexmedetomidine, xylazine) cause bradycardia, vasoconstriction, and decreased cardiac output; avoid or reduce dose in cardiovascularly compromised patients.

Propofol causes dose-dependent respiratory depression and apnea; it is not analgesic, so an analgesic plan must accompany induction.

Isoflurane and sevoflurane lower arterial blood pressure and cause dose-dependent vasodilation; MAC is the minimum alveolar concentration preventing movement in 50% of patients.

Endotracheal intubation: cuff inflation should be just enough to seal without tracheal pressure; verify by capnography (end-tidal CO2) and chest excursion.

Monitoring standards: heart rate and rhythm, respiratory rate, blood pressure, oxygenation (SpO2), temperature, and depth; capnography detects esophageal intubation and disconnection early.

Hypotension under anesthesia is commonly defined as mean arterial pressure below 60 mmHg; address depth, volume, and vasopressor support in that order.

Anesthetic recovery: extubate when swallowing returns, monitor until sternal and then standing, and continue temperature and pain assessment.

Triage categories: emergent (airway, breathing, circulation, uncontrolled bleeding, seizures), urgent (stable but requires prompt care), and non-urgent; ABCs come before history.

Shock resuscitation: recognize tachycardia, pale or injected mucous membranes, prolonged CRT, weak pulses, and altered mentation; treat with isotonic crystalloid boluses (roughly 10–20 mL/kg) and reassess.

Cardiopulmonary resuscitation: compressions at roughly 100–120 per minute with a compression-to-ventilation ratio of 30:2 for a single rescuer; minimize interruptions.

Hypoglycemia in neonates and small patients: treat with dextrose solution; monitor glucose after treatment because rebound and recurrence are common.

Heatstroke: cool actively with water and airflow, not ice immersion; monitor for DIC, acute kidney injury, and hypoglycemia after cooling.

Parvovirus: isotonic fluids, antiemetics, analgesia, and nutritional support; isolation and disinfection prevent nosocomial spread.

Gastric dilatation-volvulus: distended abdomen, nonproductive retching, and shock; stabilize perfusion and decompress before surgery.

Poisoning triage: identify toxin, time of exposure, and amount; decontamination is time-sensitive and emesis is contraindicated in caustic ingestion, seizures, or impaired consciousness.

Emergency drug routes: intravenous is preferred; when IV access is not available, intraosseous access provides equivalent delivery for resuscitation fluids and drugs.

Radiographic density scale from least to most attenuating: gas, fat, soft tissue/fluid, bone/mineral, metal; understanding this scale is the basis of film interpretation.

Orthogonal views are required: at least two views at 90 degrees for any lesion; a single view can hide or mislocalize a lesion.

Thoracic radiography is best taken at peak inspiration; expiratory films mimic pulmonary disease by increasing opacity and crowding.

Abdominal radiography: contrast between organs is low, so radiographs survey for size, position, obstruction, and free gas; ultrasound is preferred for parenchymal detail.

Radiation safety: use the smallest collimated field, wear lead apron and thyroid shield, use dosimeters, and never hold a patient in the primary beam.

Ultrasound artifacts: acoustic shadowing behind bone or gas, enhancement behind fluid, and reverberation from gas; recognizing artifacts prevents misdiagnosis.

Ultrasound is real-time and non-ionizing; it is useful for pregnancy, effusion, bladder, and cardiac evaluation, but gas and bone limit deep evaluation.

Contrast studies: barium for gastrointestinal mucosal detail, iodine compounds for urography; know the contraindication of barium when perforation is suspected.

Positioning labels and markers: place a right/left marker and record patient position; mislabeled films cause wrong-side errors.

Pain pathways: transduction, transmission, modulation, and perception; multimodal analgesia targets more than one site to reduce total drug dose and side effects.

Preemptive analgesia given before the painful stimulus reduces central sensitization and postoperative analgesic requirements.

Opioid receptors: mu (mu) agonists provide the strongest analgesia (morphine, hydromorphone, fentanyl); buprenorphine is a partial mu agonist with a ceiling effect.

NSAIDs act on cyclooxygenase; they reduce prostaglandin-mediated pain and inflammation but carry gastrointestinal and renal risk, especially with dehydration or hypotension.

Local anesthetics block sodium channels; they provide regional analgesia and reduce general anesthetic need; do not add epinephrine in areas supplied by end arteries.

Pain assessment tools: use a validated scale such as the Glasgow Composite Measure Pain Scale or Colorado State University scale; physiologic changes alone are unreliable.

Signs of pain in dogs and cats: altered posture, guarding, reluctance to move, reduced grooming, abnormal vocalization, and changes in appetite or behavior.

Neuropathic pain responds to drugs such as gabapentin or amantadine rather than to opioids alone; recognize when pain does not respond to standard analgesia.

Chronic pain management includes weight control, physical rehabilitation, and environmental modification in addition to medication.

Veterinary-client-patient relationship (VCPR) requires the veterinarian to know the patient, have sufficient recent knowledge of the patient's health, and be available for follow-up; it is the legal basis for prescribing.

Confidentiality: medical records and client information are confidential; release requires owner authorization or a legal requirement.

Medical record standards: record date, history, exam findings, diagnosis, treatment, drugs and doses, and client communication; records are the legal defense in disputes.

Informed consent: explain diagnosis, options, risks, benefits, and costs, and document the client's decision before proceeding.

Controlled substance logs must be accurate and contemporaneous; discrepancies are a legal and licensing issue, and disposal must follow DEA and local rules.

Telemedicine: without an established VCPR in the state, a veterinarian generally cannot diagnose or prescribe; follow state board rules on telemedicine.

Billing and estimates: provide written estimates before procedures, and obtain authorization for costs beyond the estimate.

Ethical duties include reporting suspected animal abuse per state law, avoiding conflicts of interest, and maintaining professional boundaries with clients and staff.

OSHA and workplace safety: hazard communication, sharps handling, radiation safety, and injury reporting are practice management responsibilities.