Primary Survey

Question 1

ABC

Answer 1

Airway (patent?)
Breathing (respiratory distress?)
Circulation (shock?)

Question 2

Airway and Breathing

Answer 2

• Evaluate RR, effort and noise
• 02 therapy likely for most
• Animals in respiratory distress may show: increased RR, open mouth breathing, abducted elbows, extended neck, cyanotic, behavioural changes due to stress, paradoxical abdominal movement

Question 3

Circulation

Answer 3

• HR and rhythm
• MM colour
• CRT
• Pulse quality
• Rectal and peripheral temperature
• Mentation
• BP

Question 4

MM / CRT

Answer 4

• Pale may be due to anaemia, pain, severe shock
• Pale to grey in cats may be in decompensatory shock
• Hyperaemic should be closely monitored along with CRT time, may be vasodilation of peripheries, can be life threatening
• Prolonged CRT is inadequate perfusion to extremities, vasoconstriction or systemic shock

Question 5

HR and Rhythm

Answer 5

• Persistent tachycardia may be early sign of shock (or only sign in cats)
• If concern for arrhythmia, pulse deficit, changes consider ECG
• Pericardial effusion can cause increased HR and muffled heart sounds
• Arterial blood pressure and lactate reading (anything higher than 2.5mmol/L may indicate reduced perfusion

Question 6

Neurological Status

Answer 6

• Mentation could be described as alert, obtunded (mentally dull) or stuporous (semi-conscious)
• Check pupil size/symmetry/pupillary light reflexes
• Menace response
• Facial symmetry/head tilt
• Posture
• Pain sensation, withdrawal reflexes
• Anal tone
• Consider extra and intracranial assessment
• Avoid analgesia until assessment done - drugs may affect exam

Question 7

Bradycardia

Answer 7

• Bradycardia can show with low level of consciousness pale MM and prolonged CRT in decompensatory shock
• Bradycardia can be in cats with hyperkalaemia (urinary issue, do ECG as often have arrhythmias)
• Bradycardia + head trauma - CARE, may be increased intracranial pressure. Monitor BP and elevate head (to detect Cushings reflex which may lead to brain herniation)
• Any cat with bradycardia should be investigated

Question 8

Pulses

Answer 8

• Weak/thready pulses = low cardiac output and decompensatory shock
• Bounding pulses = sepsis or systemic inflammatory response

Question 9

Urinary system evaluation

Answer 9

• Obstruction is a common emergency in cats
• Can lead to metabolic acidosis, hyperkalemia and cardiac arrhythmias
• If presenting with straining, anuria and large hard bladder take to treatment room