Emergency & Critical Care
An intensive care unit (ICU) is a specialised unit within a hospital where individuals with severe and life-threatening injuries and illnesses are hospitalised.
The ICU at the City University Veterinary Medical Centre (CityU VMC) is no different, we provide life-saving therapy combined with intensive care and monitoring to Hong Kong’s most critical veterinary patients. Our state-of-the-art ICU is open 24 hours a day, 365 days a year.
The ICU is the only one-of-its-kind in Hong Kong, managed by a board-certified emergency and critical care specialist of the American College of Veterinary Emergency and Critical Care (ACVECC Diplomat). In addition, the unit is operated by a team of experienced nurses, emergency doctors, and multiple board-certified specialists. Our ICU team is dedicated to delivering the best in collaborative care, with the ultimate goal in mind: providing patients with the best possible chance of survival.
Our doctors and nurses work in tandem to serve the needs of the most critically-ill and injured veterinary patients. To learn more about our 24-hour emergency service, please visit here. We support the referring veterinary community, many of the cases hospitalised within the ICU are referred by their primary care veterinarian for this specialised care.
ICU unit is equipped with multiparameter monitoring and advanced therapies, such as high-flow oxygen therapy and mechanical ventilation, providing patients with an advantage of life-supporting modalities. Survival would not be possible in many cases with the support and unput from this multi-specialist team.
Why is my pet being admitted to the ICU?
If your pet has been admitted into the ICU, this is because they have a complex disease or condition which requires close monitoring or have a life-threatening disease or injury. Additionally, some patients are admitted to the ICU in what is deemed a stable condition, but they possess certain risk factors or diseases which require close monitoring.
Other patients are admitted into the ICU as post-surgical patients, who require multi-modal analgesia for the first 24-48 hours; neurosurgical cases are frequently hospitalised in the ICU post-operatively.
Some conditions which require admission to the ICU:
- Respiratory distress (tracheal collapse, laryngeal paralysis, brachycephalic airway)
- Cardiac diseases: Congestive heart failure (CHF), arrhythmias
- Pulmonary Hypertension (PAH)
- Acute kidney injury (AKI)
- Diabetes, of complications of diabetes: DKA, hyperglycaemic hyperosmolar syndrome
- Acute abdominal disease
- Multiple organ dysfunction syndrome (MODS)
- Clotting or bleeding disorders
- Transfusion recipients
- Sepsis or septic shock
- Post cardiac arrest care
- Snake bites, antivenom administration
- Recovery from neurosurgery or other surgical procedures
- Seizures, status epilepticus (SE), or increased intracranial pressure (ICP)
- Heat stroke
- Disseminated intravascular coagulation (DIC)
Therapeutic and supportive modalities provided to patients include:
- Advanced fluid therapy plans
- Blood products/ component therapy
- Immunoglobulin therapy
- Cardiopulmonary resuscitation (CPR) and post-arrest care and optimisation
- Oxygen supplementation and high-flow oxygen therapy
- Advanced analgesia (constant rate infusions, epidural anaesthesia, regional blocs)
- Mechanical ventilation
- Nutritional support
- Wound care, including vacuum-assisted wound care (VAC)
- Chest drain and catheter management
- Post-surgical and post-neurosurgical care
- Complications of chemotherapy, acute tumour lysis syndrome (ATLS)
Advanced monitoring provided in the ICU:
- Blood gas analysis
- Capnography and waveform analysis
- Urine output monitoring
- Pulse oximetry
- Electrocardiogram for assessment of arrhythmias
- Point-of-care ultrasound: AFAST, TFAST, Bedside lung evaluation
- Bedside measurement of haematocrit, glucose, lactate, electrolytes, and acid-base monitoring
What is an ACVECC Diplomat?
A Diplomat of the American College of Veterinary Emergency and Critical Care (DACVECC) is a veterinarian that has gone through an extensive amount of additional education after veterinary school, typically an additional 4 years is required to become specialised. This consists of an internship, followed by a 3-year residency in the field of emergency and critical care. In addition, the doctor must submit and publish in a peer-reviewed journal to be allowed to sit for their certifying examination, to become board-certified by ACVECC. Board certification is a rigorous, 2-day test in the candidate must successfully pass to be considered a specialist in the field of emergency and critical care. The residency trains and prepares the resident for the most current, evidence-based therapy for diagnosing and managing life-threatening emergencies as well as managing the most critical patients with complex disease processes.