The field of Companion Animal Veterinary Emergency and Critical Care is undergoing rapid development in the United Kingdom with a proliferation of emergency clinics and increasing movement of patients between both first opinion and referral centres. This is due to the desire in the profession as a whole to continue to develop and evolve as well as an ever-increasing demand from pet owners for progressive veterinary care.

KAPPY (Specialised Ambulance for Veterinary Emergencies) was set up in response to the development and expansion in this area and the need to both transport patients in a more controlled environment and to provide first-aid treatment away from veterinary practices.

What equipment and facilities does the ambulance have available?

The ambulance is not intended to function as a mobile surgery. It has been designed and equipped at all stages to fulfil its remit as an Emergency and Critical Care vehicle.

• Oxygen therapy: piped around the rear from a fixed cylinder to multiple outlets; a purpose designed oxygen cage; a portable oxygen cylinder for use away from the ambulance; multiple masks of various sizes plus nasal prongs; a full range of endotracheal tubes and a laryngoscope; resuscitator bag and anaesthetic circuits
  

        

• Intravenous fluid therapy: an infusion pump; a readily portable syringe driver; an in-line fluid warmer; a selection of IV catheters, fluids and giving sets
  

        

• Body temperature: facilities to treat both hypothermia and hyperthermia
  

• A stretcher with restraints for collapsed dogs or those with spinal trauma; a walk-in kennel that allows the animal to remain on the stretcher throughout
  

• Wound management: sterile saline; a selection of primary and secondary dressings plus bandages; cling film, buster collars
  

• Drugs/Therapeutic agents: a selection of analgesics including opioids and NSAIA; various sedative agents plus diazepam; oral and injectible glucose; Oxytocin; soluble insulin; apomorphine; adrenaline and atropine and so on
  

• Monitoring: vital signs monitor including ECG, respiratory rate, oxygen saturation, temperature and non-invasive oscillometric blood pressure; additional pulse oximeter; blood glucometer; lactate monitor; refractometer
  

             

• A variety of animal handling and husbandry items

        

Practice profile

The KAPPY ambulance offers a groundbreaking new service in the veterinary profession that is most definitely here to stay. Being able to offer its use to your clients will raise the profile of your practice as a progressive and evolving team.

Transportation of existing patients

Vet: I think that Grace needs to be moved to our emergency clinic so that she can continue to receive the best care overnight. Owner: That’s fine, whatever you think is best for her. Vet: Are you able to take Grace there yourself or shall we try and arrange a pet taxi for her? Owner: Well, I can come and move her but surely there must be a special ambulance for moving the poor thing in the state that she is in? You know, like for humans? Vet: Well, there didn’t used to be, but there is now…………

      

While traditional pet taxis and ‘ambulances’ - ordinary vehicles staffed by lay people - may be acceptable for moving a proportion of your patients, there are a large number that would definitely benefit from the KAPPY service. Examples include:

• Dyspnoeic animals
  
• Trauma cases that may be severely injured or have unstable fractures
  
• Spinal cases that require minimal movement
  
• Post-operative cases that are hypothermic and hypoperfused
  
• Any animal being moved over a long distance that requires on-going fluid therapy or top-up analgesia

Many of these cases are ones that have to be moved for on-going care either to an emergency clinic or to a referral centre. Vets and nurses often feel obliged to move these animals themselves because of the inherent shortcomings of existing pet transport services - the KAPPY ambulance will avoid the need for your staff to do this. Many of these cases present and require transportation out of hours - KAPPY is here to help day or night.

New emergencies

Owner: please help, it’s my dog see, he’s collapsed and struggling to breathe. I want someone to come and help him. Emergency nurse: I’m sorry but we cannot do home visits at night as we cannot leave the clinic. And besides, even if we could, there is nothing we can do for him at home. Owner: But I haven’t got a car and I couldn’t lift him on my own anyway. Nurse: Surely you must have friends or family that can help? Owner: No I don’t dear, I’m all on my own and he’s all I have left. Nurse: Well, I tell you what. I’ll give you the number of a pet taxi and they will come to your house and if they can get your dog into their car they will bring him to us and then finally he will get some help!

Sound familiar? This conversation and many variations of it occur on a daily basis in practices and emergency clinics all over the United Kingdom. Until KAPPY there has been no way around it.

The ambulance will allow your practice to see cases it may not have previously seen as emergencies are only attended to on the understanding that they will be transported to the primary practice for more thorough care if needed, unless the animal is put to sleep or everyone agrees that he/she should be transported elsewhere, for example to a referral centre.

We will also ring you en route to advise you of the patient’s condition if you wish so that you know what to expect.

What are the pros and cons of using the ambulance service for emergencies?

Pros:

1 A highly experienced veterinary surgeon will assess and provide first-aid treatment to the patient before he/she is moved.
2 The patient will be transported in a controlled environment
3 This will allow you to see cases that you may not have otherwise seen
4 You will have accurate information on what to expect

Cons: If the owner has their own transport and lives near to your practice, it may well be quicker for them to bring the animal in (this situation will hopefully improve as more KAPPY ambulances are launched)

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