VTNE cheat sheet

Dose (mg) = dose rate (mg/kg) × body weight (kg); volume to draw (mL) = dose (mg) ÷ concentration (mg/mL).

CRI rate (mL/hr) = dose (mg/kg/hr) × body weight (kg) ÷ concentration (mg/mL).

Steady-state plasma concentrations are reached after roughly 4–5 half-lives; drugs with short half-lives also wash out quickly after the last dose.

Gentamicin and amikacin are nephrotoxic and ototoxic; avoid them in dehydrated or azotemic patients, and once-daily dosing reduces toxicity.

Never combine an NSAID with a corticosteroid or with a second NSAID - the risk of GI ulceration and renal injury rises sharply.

Cats glucuronidate drugs poorly: avoid acetaminophen, permethrin flea products, and high-dose aspirin; methemoglobinemia and Heinz body anemia result.

Ivermectin and other P-glycoprotein substrates cross the blood-brain barrier in ABCB1 (MDR1) mutant Collies, causing tremors, ataxia, mydriasis, and coma.

In the US, extralabel use under AMDUCA requires a valid VCPR, a medical rationale, and an extended withdrawal time in food animals.

DEA-controlled substances require a biennial inventory and records kept at least two years; log date, drug, amount, and patient or owner.

Sterile prep: chlorhexidine gluconate or povidone-iodine alternated with alcohol, scrubbed from the incision site outward in concentric circles for 3–5 minutes.

Metzenbaum scissors for delicate sharp dissection; Mayo scissors for heavy fascia; Kelly hemostats for small vessels; Adson forceps for fine tissue handling.

USP suture sizing: more zeros means a smaller strand - 3-0 is finer than 0, and 0 is finer than 2.

Common patterns: simple interrupted (skin, tension), simple continuous (speed, hollow viscera), cruciate (tension), purse-string (stoma or anal sac).

Gravity-displacement autoclave: 121°C (250°F) at 15 psi for 15–30 minutes; flash cycles run near 132°C for a few minutes on unwrapped items.

Penrose drains are passive and open; Jackson-Pratt drains are active, closed, suction-driven, and carry a lower ascending infection risk.

Postoperative checks: incisional swelling, discharge, dehiscence, and body temperature; an Elizabethan collar prevents self-trauma.

Count sponges and instruments before closure and again at the end of the procedure, and document the count in the record.

Adult dog: 42 permanent teeth (I3/3, C1/1, P4/4, M2/3 per side); adult cat: 30 permanent teeth (I3/3, C1/1, P3/2, M1/1 per side).

Triadan system: 100/200 = maxillary right/left, 300/400 = mandibular right/left; the last digit is tooth position (04 = upper fourth premolar, 09 = lower first molar).

Periodontal stage by attachment loss: 1 = under 25%, 2 = 25–50%, 3 = 50–75%, 4 = over 75% with furcation involvement or mobility.

Normal gingival sulcus depth is about 3 mm or less in dogs and 1 mm or less in cats; deeper probing indicates attachment loss.

An inflated endotracheal tube cuff plus a throat pack protects the airway during scaling, polishing, and extraction.

Maxillary incisors, canine, and premolars are blocked at the infraorbital foramen; mandibular teeth at the mental foramen and inferior alveolar canal.

A complicated crown fracture exposes pulp and requires extraction or endodontic treatment; an uncomplicated fracture involves enamel and dentin only.

Plaque control relies on daily brushing plus VOHC-accepted products; professional scaling alone does not stop periodontitis progression.

Lavender EDTA for hematology; red or serum separator for chemistry; blue citrate for coagulation; gray sodium fluoride for glucose.

Reference PCV: dog roughly 37–55%, cat roughly 30–45%; total protein by refractometer about 6.0–7.5 g/dL.

Platelet estimate: one platelet per 1000x oil-immersion field approximates 15,000/µL; an adequate smear shows about 8–10 per field.

On a blood smear, examine the feathered edge for platelet clumps and large cells and the monolayer body for leukocyte morphology.

Diff-Quik sequence: methanol fixative, eosin, then methylene blue/azure; air-dry the slide before staining and rinse gently.

Urinalysis order: physical (color, specific gravity) → chemical dipstick → sediment; warm and mix refrigerated samples first.

Zinc sulfate flotation (specific gravity ~1.18) is preferred for Giardia and most nematode eggs; centrifugation recovers more than passive flotation.

Collect bacterial cultures before starting antibiotics, use transport media, and label the collection site on the submission form.

Rectal temperature 100.5–102.5°F (38.1–39.2°C) in dogs and cats; heart rate 60–140 bpm in dogs and 140–220 bpm in cats.

Body condition is scored 1–9 with 4–5 ideal in most US practices; 1–5 scales are also used and map proportionally.

Maintenance fluids ≈ 60 mL/kg/day (or 30 × body weight + 70); add the dehydration deficit and ongoing losses before setting the rate.

Dehydration estimates: under 5% not reliably detected, 5–6% mild, 7–9% moderate, 10% or more severe with persistent skin tent and sunken eyes.

Capillary refill time longer than 2 seconds, pale or muddy mucous membranes, and weak pulses indicate poor perfusion.

Common venipuncture sites: cephalic, jugular, and lateral saphenous veins; apply pressure after arterial or difficult draws.

Resting energy requirement (kcal/day) = 70 × body weight (kg)^0.75; multiply by 1.2–1.4 for most hospitalized patients.

Parvovirus disinfection: 1:32 dilution of household bleach (0.5% sodium hypochlorite) with a 10-minute contact time.

Premedication typically pairs an opioid with a sedative (acepromazine or dexmedetomidine) and optionally an anticholinergic for bradycardia.

Induction with propofol or alfaxalone IV to effect, or ketamine-diazepam for cardiovascular-sparing induction; maintain on isoflurane or sevoflurane.

Depth indicators: loss of palpebral reflex, jaw tone, and ventromedial eye rotation; monitor HR, RR, SpO2, ETCO2, blood pressure, and temperature.

Targets during anesthesia: SpO2 above 95%, ETCO2 35–45 mmHg, mean arterial pressure above 60 mmHg, temperature above 97°F.

A flat capnograph waveform after intubation suggests esophageal placement or cardiac arrest - auscultate and recheck the tube.

Reversals: atipamezole for alpha-2 agonists, naloxone for opioids, flumazenil for benzodiazepines.

Lidocaine 2% contains 20 mg/mL; do not exceed about 4–6 mg/kg in dogs. Bupivacaine maximum is about 2 mg/kg and is never given IV.

Fasting: about 4–6 hours for food in healthy adults and water until roughly 2 hours before induction; shorten for pediatric and small patients.

Primary survey: airway, breathing, circulation, disability, then exposure; treat immediate life threats before completing the history.

Shock bolus: crystalloid 20 mL/kg in dogs or 10–15 mL/kg in cats over 15–20 minutes, then reassess perfusion before repeating.

CPR: 100–120 compressions per minute, 1/3 to 1/2 chest depth, 30:2 compression-to-ventilation ratio, pauses under 10 seconds.

Arrest drugs: epinephrine 0.01 mg/kg IV (low dose) or 0.1 mg/kg (high dose); atropine 0.04 mg/kg for bradycardia; repeat every 3–5 minutes.

GDV: decompress the stomach, place IV catheters, resuscitate for shock, and proceed to surgery once stabilized.

Seizures: check glucose and calcium, give diazepam 0.5 mg/kg IV or rectally, and avoid hyperthermia.

Heat stroke: cool with room-temperature water and fans, and stop active cooling near 103°F to prevent overshoot hypothermia.

Toxicities: xylitol (hypoglycemia, hepatic necrosis), grapes and raisins (renal), lilies (feline renal), permethrin (feline neurotoxicity), chocolate (theobromine).

Transfusion: type or crossmatch first, start at 0.5–1 mL/kg over 15–30 minutes, and monitor for transfusion reactions.

Multimodal analgesia combines an NSAID, an opioid, and a local anesthetic block so each acts at a different point in the pain pathway.

Opioid classes: pure mu agonists (morphine, hydromorphone, fentanyl), partial agonist (buprenorphine), agonist-antagonist (butorphanol).

Buprenorphine 0.01–0.02 mg/kg IV or IM every 6–8 hours; transmucosal administration is effective in cats.

NSAIDs are contraindicated with dehydration, renal disease, GI ulceration, coagulopathy, and concurrent corticosteroid use.

Fentanyl CRI 2–5 µg/kg/hr; lidocaine CRI 25–50 µg/kg/min in dogs, avoided in cats.

Pain signs: tachycardia, tachypnea, hypertension, salivation, guarding, reluctance to move, and reduced grooming.

Ketamine at subanesthetic doses (about 0.5 mg/kg) blocks NMDA receptors and reduces central sensitization and wind-up.

The Feline Grimace Scale scores ear position, orbital tightening, muzzle tension, whisker position, and head position to detect hidden pain.

SOAP format: Subjective, Objective, Assessment, Plan; the medical record is a legal document and entries must be contemporaneous.

A valid VCPR requires recent examination of the patient and availability for follow-up; it is required before prescribing or dispensing.

Controlled substances: biennial inventory, double-locked storage, and a running log with date, drug, amount, and patient.

OSHA requires an SDS for every hazardous chemical, appropriate PPE, and a written hazard communication and needlestick plan.

Informed consent covers the diagnosis, all options including declining care, risks, and an itemized cost estimate before treatment begins.

Open-ended questions and reflective listening improve history quality; teach-back confirms that the client understands the plan.

Inventory control: first-in-first-out rotation, expiration checks, and par levels to prevent stockouts of emergency drugs.

Delivering bad news: private setting, warning shot, plain language, pause for response, and explicit next steps.