Patient Assessment

Question 1

Visual Assessment

Answer 1

• Demeanour (e.g dull, obtunded, BAR, stressed, excitable, calm and sleeping)
• RR and effort
• Positioning
• Others (coat condition, body condition, odours, abnormal sounds, MM colour if open mouth breathing)

Question 2

Animals Demeanor/Mentation

Answer 2

• BAR
• QAR
• Distressed/anxious
• Dull/flat
• Obtunded/stuporous (severely unwell)
• Comatose (does not respond to noxious stimuli, require aggressive intervention)

Question 3

Respiratory Rate and Effort

Answer 3

• Normal rate = 12 to 24 bpm
• Neonate rate = 24-60 bpm
• Panting = over 100 bpm (can be associated with pain, anxiety, hyperthermia or respiratory distress, not normal in cats)
• Bradypnoiec = less than 10 bpm (can arrest quickly)
• Shouldn’t be any exaggerated effort or abnormal sounds
• Cats with saddle thrombus have a distinctive scream
• Tick paralysis patients have a deep vocal sound due to laryngeal paralysis
• Brachycephalic patients with airway disease have a high pitched wheeze and increased respiratory effort

Question 4

Positioning

Answer 4

• Standing (hesitant to move, tail tucked, wagging the tail, pacing, bright and alert)
• Crouched (painful, scared, defensive, licking lips, panting, growling)
• Hunched (abdominal discomfort often presents with prayer position, spinal disease often presents with centred sit with splayed hind legs)
• Recumbent (laying down potentially sleeping but could be unwilling to move if in pain, paralysed or mentally altered. Most cats will not lay in lateral recumbency)
• Bread load (relaxed and content position in cats)

Question 5

Performing a TPR

Answer 5

• Done in reverse
• Care with startling patients - talk to them calmly before you approach the cage
  #1: Visual Assessment
  #2: Physical Assessment

Question 6

Physical Assessment

Answer 6

• Calm/confident manner
• Open cage slowly and introduce yourself to the pet
• If possible give TLC before the treatment
• SPO2 97%+ on room air
• Auscultating chest/lungs (both sides of chest!)
• Auscultating chest/heart (start from left side between the 3rd and 6th rib of the ventral aspect of chest, palpate pulse at same time
• Normal dog HR = 60 to 100 bpm (neonates higher ~200)
• Normal cat HR = 100 to 120 bpm (neonates righter 140 to 220)
• MM/CRT
• Blood pressure
• Temperature
• Walk

Question 7

MM Colour

Answer 7

• Pink
• Pale pink = reduced perfusion, mild anaemia
• White/grey = poor perfusion, shock, severe anaemia, common in HBC patients
• Cyanotic/blue = severe hypoxemia
• Red/injected/hyperaemic = sepsis, fever, tissue damage, heat stroke or excitement
• Jaundice/yellow = increased bilirubin (liver disease), increase in red cell destruction or bile flow obstruction

Question 8

MM texture and CRT

Answer 8

• Moist = normal
• Tacky = mild dehydration
• Dry = dehydration, animals given atropine (may temporarily dry up secretions)
• Short CRT = fever, excitement or sepsis

Question 9

Non Invasive Blood Pressure

Answer 9

• Take before bloods, walk, temperature etc
• Hypotension = MAP <60 mmHg or systolic <90 mmHg
• Hypertension = systolic >140 mmHg in dogs or systolic >180 mmHg in cats
• Trends are important
• Doppler can sometimes be more accurate
• Use correct size and keep at heart level

Question 10

Temperature

Answer 10

• Have someone help restrain
• Use clean thermometer with cover slip and lube
• Avoid inserting into faeces
• Common for temp to spike in hospital
• If patient not tolerating, check with vet how offers they require
• Axillary temp can be attempted but have poor accuracy

Question 11

Walk

Answer 11

• Done last as may excite/cause pain
• Good time to assess pain freely
• Reward for tolerating TPR
• Allows to stretch, urinate, defecate, sniff, explore
• Prepare for walk (harness, lead, sling)
• Care with distance, only walk them as far as they can go without deterioration