At the heart of Blaise, you'll find our ICU, run by a dedicated team of ECC experts and caring nurses. This dynamic team complements the skills of other specialities in the hospital, seamlessly bridging gaps between surgery, anaesthesia and internal medicine, while also offering an ‘out of hours’ emergency service in partnership with Vets Now.
The ECC specialist service fulfils two main roles for the hospital; the ‘E’ - enabling rapid referral, assessment and stabilisation of acutely ill patients, and the ‘CC’ - taking charge of those critically ill patients in the ICU that need their specialist input.
What is an ECC Specialist?
An Emergency and Critical Care specialist is a vet who, after graduation, has undergone an immersive 3-year residency program in a referral private hospital or university teaching hospital. This specialised training focuses on the management of small animal emergencies and critical patients that require a high level of support or specialist interventions that might not be available in a regular practice.
Conditions that the ECC service commonly manages:
Respiratory conditions such as:
• Pneumonia
• Cardiogenic and non-cardiogenic pulmonary oedema.
• Hypoventilation (from cervical intervertebral disc disease, tetanus, etc.)
• Brachycephalic crisis
Our ICU is equipped with oxygen kennels, a high flow oxygen machine and a mechanical ventilator. In addition, the hospital offers a great variety of laboratory tests, including arterial blood gas analysis and can provide procedures such as CT scan and endoscopy to aid in the diagnosis and the best treatment course for the patient.
Metabolic conditions such as:
• Diabetic ketoacidosis
• Addisonian crisis
• Electrolyte disturbances
• Hepatic portosystemic shunt
Patients with metabolic conditions can become critically ill. Our hospital offers specialist care as well as a dedicated nursing team to provide continuous monitoring to the most critical patients.
Haematologic/coagulopathic conditions:
• IMHA
• IMTP
• Bleeding (trauma, coagulopathies, ruptured masses, etc.)
• Thromboembolism
The hospital is equipped with coagulation testing and thromboelastography, which can help guide the diagnosis and treatment of patients with bleeding and coagulopathic disorders. In addition, the hospital stocks different blood products including packed red blood cells and different forms of plasma ready to be used for any emergency.
Infectious diseases such as:
• Septic peritonitis
• Tetanus
• Pyelonephritis
Our ICU is equipped with advanced cardiovascular monitoring and supportive care by means of telemetry and point of care ultrasound or POCUS. POCUS is an invaluable tool that allows assessment of the cardiac chamber size, contractility, and volume status to guide the best therapy for the patient, which might include treatment with different vasopressors, inotropes, intravenous antibiotics, etc. More specialised testing such as blood cultures can also be performed if required.
Cardiac and neurologic emergencies such as:
• Respiratory distress
• Aortic thromboembolism
• Cluster seizures, status epilepticus
The ECC service plays a fundamental role in supporting both cardiologic and neurologic conditions in need of intensive care. An example of this is providing temporary external pacing to patients in need of pacemaker implantation or mechanical ventilation following ventral slot surgery.
Gastrointestinal disorders such as:
• Refractory vomiting and regurgitation
• Acute haemorrhagic diarrhoea syndrome
• Parvovirus
• Pancreatitis
• Nutrition provision: naso-gastric, PEG, jejunal tubes, parenteral nutrition
Gastrointestinal conditions are amongst the most common disorders that affect dogs and cats. Fluid loss combined with anorexia can make our patients severely hypovolemic. Our team of experts can help manage fluid balance and provide nutrition via a number of different routes. Some patents might require specialized intravenous nutrition if they are unable to tolerate enteral nutrition. For these, a jugular catheter is placed under general anaesthesia for the administration of total parenteral nutrition.
Renal disease:
• Ureteral and urethral obstruction
• AKI
• Uroabdomen
Our team of experts can help by means of advanced diagnostics including contrast studies to visualize stones in the urinary tract and palliative measures such as abdominal drains until a more definitive treatment is available (e.g. ureteral stents, urinary tract repair in case of rupture).
Finally, other conditions that might benefit from referral to the ECC service include:
• Intoxications
• Reproductive emergencies
• Environmental (smoke inhalation, drowning, etc.)
The ECC service frequently acts as the gateway into the hospital for urgent and critically ill patients, then works very closely with other
Specialist disciplines to provide exceptional care. True multi-disciplinary care is invaluable in managing these cases, leading to better outcomes.