Up to 11,000 critical care patients are treated in the Emergency Room of the Foster Hospital for Small Animals on the campus of Tufts Cummings School of Veterinary Medicine in Grafton, MA each year, according to Dr. Armelle de Laforcade, who discussed the hospital's emergency services during the inaugural lecture in "The Doctor is In" series last night.
"If your pet collapses, said de Laforcade, "we're here. That's what we're good at." The hospital's ER is open 24/7, and the veterinarians who work there have to be equipped with diverse surgical, cardiological, radiological, and even counseling skills because of the unpredictable nature of the cases they see. "We have to be problem solvers and detectives because our patients don't talk. So much of what we do is based on what we call an 'index of suspicion,'" explained Dr. de Laforcade, who is one of just 170 Diplomates of the American College of Veterinary Emergency and Critical Care in the U.S.
The Tufts small animal ER specializes in intensive treatment of critically ill or wounded pets, and offers life support measures to animals who have "a very high chance of not surviving," according to Dr. de Laforcade. A significant portion of the animals who arrive at the ER have sustained some kind of trauma; dogs and cats who have been hit by cars represent the most common emergencies. Many of those cases are fixable, she said. "An animal started out their day okay, then something happened, and now they're here."
"We have to be able to quickly determine which ones require surgical stabilization and which ones can be stabilized by a splint," explained Dr. de Laforcade, citing the ER's reliance on state-of-the-art CT scanners that can provide a three-dimensional image of internal damage that isn't possible to see on normal X-rays alone. "In the ER, we have to be willing to entertain the craziest possibilities," she said, adding that "Everything we know about trauma is drawn from human medical literature, which is based on the kinds of injuries that occur on a battlefield. We operate on the forefront of veterinary medicine."
Bite wounds are the second most common reason that small animals are brought to the Foster Hospital's ER. "They often don't look bad on the surface," Dr. de Laforcade said, "but because an animal has typically been shaken, there might be a lot more trauma inside the wound than what you can see at first glance." She noted, though, that even some of the worst-looking cases can have good outcomes.
The Foster Hospital maintains a blood bank that provides blood for some of the 1000 transfusions that are performed there each year. Some of the blood is purchased from outside sources, but the hospital also relies on contributions from a block of local donor dogs. "They have to weigh over 50 pounds, they have to be nice, and they have to be happy to be here," said de Laforcade, whose own dog, a beautiful black and white springer spaniel, had donated blood just hours before she spoke.
In addition to their finely tuned medical skills, the veterinarians who staff the Foster Hospital's ER have to know how to listen to and counsel their patients' families and caretakers during what is inevitably a time of extreme stress and anxiety. "Caring for the pet's family is at least 40% of our job," Dr. de Laforcade explained. "You have to find solutions that work for the families. It's not something you can learn from a book."
There are three more lectures in this spring's "The Doctor is In" Faculty Speaker series, including "The Cancer We Share: What Our Pets Teach Us about Oncology," which will be presented by Dr. Barbara Davis on April 13th, and "The Athlete Horse: Running A Winning Equine Sports Medicine Program," a presentation by Drs. Melissa Mazan, Jose arcia-Lopez, and Katherine Chope. The lectures are free, but an RSVP is required. If you're interested in attending, send an Email to vetevents@tufts.edu with "RSVP" and the program dates in the subject line, or call: 508-887-4304 to make a reservation.
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