GENERAL QUESTIONS
My pet is sick or injured, what should I do?
What signs might indicate that my puppy/dog is sick?
What signs might indicate that my kitten/cat is sick?
What are some common household foods or substances that may be toxic or dangerous to to my pet?
Are there any extra precautions I should take to protect my pet(s) around the holidays?
What items should I keep on hand as a pet first aid kit?
I am considering purchasing pet insurance, what questions should I ask before I buy?

BEFORE YOU COME IN
What should I do to prepare for my pet's endoscopy?
What do I need for my pet's appointment?
When should I arrive for my pet's appointment?
What do I need to do to prepare for my pet's surgical consultation?
What do I need to do the night before my pet's surgery?

AFTER SURGERY
What should I look for with the surgical incision?
What is the correct bandage care?
What happens if the bandage gets wet?
Why does my pet have to wear an e-collar?
When should I warm-pack and cold-pack?
When should I return for suture removal?
What is the correct care for drains?
Is it normal for my pet to sleep more when coming home?
What should I monitor my pet for at home?
Is it normal for my pet not to eat initially?
What do I do if my pet vomits or has diarrhea after surgery?
When should I expect my pet to start to defecate normally?
When should I expect biopsy or culture results to come back?

GENERAL QUESTIONS

My pet is sick or injured, what should I do?
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It can be very frightening when your pet is suddenly ill or hurt. If your family veterinarian's office is open, give them a call as soon as possible and be prepared to describe your pet's symptoms. If they are not open, Advanced Critical Care is open 24/7 to provide your pet with prompt medical attention. We can be reached by phone at (310) 558-6100, and are located in the City of Angels building, on the corner of Jefferson and Duquesne in Culver City (map). We have the latest equipment available, a state-of-the-art ICU, and a caring, highly skilled staff to deliver life-saving care. Your pet will be seen as quickly as possible, and treated with the utmost care.

What signs might indicate that my puppy/dog is sick?
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Below are some of the signs your puppy or dog may need to see the vet. If you notice any of these, or anything else that seems out-of-the-ordinary, be prepared to call your veterinarian.

Eyes: Swelling, redness, discharge, crusting, rubbing eyes.
Nose: Running, crusting, discharge, prolonged sneezing, etc. A dry warm nose might indicate a problem as well.
Ears: Discharge, debris, odor, twitching, scratching.
Coughing, gagging, honking, choking, sneezing, retching, or vomiting.
Irregular breathing, shortness of breath, prolonged or heavy panting, wheezing, etc.
Intestinal activity: Changes in color, consistency, frequency of bowel movements. Be alert for blood or parasites in stool.
Excessive gas or straining when having a bowel movement.
Changes in color, frequency or amount of urination.
Change in amount of food and/or water intake, or sudden change in body weight.
Eating grass more than once a day.
Changes in normal odor
Coat & Skin: Hair loss, wounds, lumps, or changes in color, excessive scratching, biting or licking.
Behavioral changes such as seizures, excessive aggression or submission, fatigue, trembling, stumbling, limping or anxiety.

What signs might indicate that my kitten/cat is sick?

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Signs of illness in kittens and cats include lethargy, excessive sleeping, anorexia, open mouth breathing, vomiting, diarrhea, weight loss, excessive drinking, sneezing, eye or nasal discharge, straining to urinate or defecate.

What are some common household foods or substances that may be toxic or dangerous to to my pet?
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In 2008, the ASPCA handled 140,000 animal poison related emergencies. Below is a quick reference guide to the most common household foods and other substances that are toxic to almost all animals. If you have these items around, you need not dispose of them--just keep them away from your pets. While it is impossible to list all possible poisons, the list below may help you begin to place many potential problems out of reach.

Are there any extra precautions I should take to protect my pet(s) around the holidays?
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Yes! The holidays can be a dangerous time for pets. The number of poisonings, injuries, accidents and preventable illnesses rises dramatically from late November through early January. Below, we've listed the 5 most common holiday hazards to help you keep your pets safe and happy this holiday season.

1) Holiday Food
The incidence of pancreatitis in dogs increases dramatically around the holidays, as well-intentioned owners feed their dogs fatty foods and even fat trimmings, which can cause a very dangerous inflammation of the pancreas. Chocolate-- especially semisweet "bakers" chocolate-- contains caffeine and theobromine, which is toxic to many animals. Bones can cause intestinal obstructions, punctures and tears to the intestinal tract, so as tempting as they may seem to your dog, keep them away. If you want to include your pet in your holiday meal and they are in good health otherwise, a small amount of turkey and stuffing with the cat or dog's normal food is usually ok, however, be careful about stuffing that contains raisins or nuts.

Prior to the holidays, pet owners should learn what foods are toxic to dogs and cats and keep your veterinarian's phone number handy. Advanced Critical Care is available 24 hours a day, 7 days a week at (310) 558-6100.

2) Holiday Plants
Poinsettias, mistletoe, holly berries and some Christmas trees (cedar) can cause gastrointestinal irritation, vomiting and diarrhea in dogs, cats, and birds. Although often thought of as toxic, most poinsettia plants varieties that are sold at holiday time are not toxic, but can still cause irritation of the mouth, excess salivation and even vomiting. The increasingly popular potted bulbs in the lily family can cause kidney failure in cats.

3) Holiday Decorations & Gifts
The Christmas tree can be dangerous for cats if they try to climb up it and it falls over, breaking glass ornaments and light bulbs in the process. Cat owners should either keep the tree in an area that is off-limits to the cat when no one is around to watch, or, tether the tree using some wire and a few strategically placed eye hooks.

Glass ornaments can be hazardous to dogs and cats if they get knocked off the tree and break. If you must use them, place the breakable ornaments on the higher tree limbs. Also, try to avoid using tinsel at al if possible, especially if you have cats. Tinsel itself is not toxic, but can cause gastrointestinal blockage in dogs and cats that can be life-threatening. Many cats are drawn to tinsel.

If a gift contains a food item, such as gourmet chocolates, a dog will smell them. Before placing presents under the tree, always ask the gift giver if the contents include any food items.

4) The Kitchen
Dogs and cats can easily get under foot while busy cooks are preparing holiday meals. This could lead to burns, cuts or injuries if someone trips over them while carrying a hot food item or a glass container. It's best to keep cats and dogs out of the kitchen.

5) Guests and Visitors
As guests come and go from your home over the holidays, dogs, cats, and birds can sometimes escape, so keep pets secured when holiday guests are expected. Children who do not know how to properly interact with a dog or cat may end up getting bitten or clawed, so monitor your small guests' interactions closely at first.

Well-intentioned visitors may feed an inappropriate or toxic food to a pet, or leave potentially toxic food items (chocolates, for example) inside their guestroom or in their open luggage. Ask guests to be cautious about leaving food out or feeding anything other than animal treats to your pet.

What items should I keep on hand as a pet first aid kit?
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The American Red Cross advises pet owners to keep the following first-aid supplies on hand for their pets:
Gauze pads
Gauze roll/bandages
Roll of cloth
Thermometer
Tweezers
Hydrogen peroxide
Antibiotic ointment
Q-tips
Instant cold pack
Rags/rubber tubing to make a tourniquet
First-aid book

I am considering purchasing pet insurance, what questions should I ask before I buy?
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Pet insurance can give you peace of mind if your pet ends up needing extensive or emergency medical care. When shopping for a plan, here are some of the basic questions that you may want to inquire about:

How much is the annual premium, and what are the payment options?
Is my pet covered for pre-existing conditions?
Can I use a veterinarian of my choosing?
Does the insurance cover my pet regardless of age?
Does the policy cover diagnosis of my pet, or is it limited?
Is there a flat reimbursement?
What is the annual deductible?
Do you offer discounts for insuring multiple pets in the same household?
How are claims handled, and how long do they typically take?
What are the policy limits, per year and per incident?
Does the insurance cover accidents, illness, and routine care?
Does the policy cover diseases such as cancer?
Are surgical procedures covered?
Does the policy cover emergency care?
Is specialist care included in the policy?
What are the exclusions, if any?
Is your company licensed by the state?
Is there a waiting period before the policy takes effect?
Are prescriptions included in the coverage?

These are just some of the questions you may wish to ask several pet insurance companies so that you may compare policies.

BEFORE YOU COME IN

What should I do to prepare for my pet's endoscopy?
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Please do not feed your pet after 10 pm the night before your appointment. Your pet may have water overnight.

What do I need for my pet's appointment?
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Please bring all of your pet's records, including any previous bloodwork tests, x-rays, ultrasound reports, and physical examination reports from your referring doctor(s).

When should I arrive for my pet's appointment?
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Please arrive at least 20 minutes before your scheduled appointment time. This will give you time to fill out the required paperwork prior to your pets appointment, and maximize the amount of time that you have to speak with the specialist about your pet's condition.

What do I need to do to prepare for my pet's surgical consultation?
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Please make sure not to feed your pet after 10pm the night before your pet’s surgery consultation in case they need to be sedated for xrays (radiographs) .  They can have access to water all night before this consultation.

Please also make a list of all medications your pet has been taking over the past month including nutraceuticals or homeopathic medications.

If some of your family members have appreciated abnormalities at home and they are not able to be present for the consultation please speak to them before coming in to confirm the duration of the abnormality, the extent of the abnormality, and when it seems to be occurring most commonly.

What do I need to do the night before my pet's surgery?
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Please make sure not to feed your pet after 10pm the night before surgery.  They can have access to water all night before surgery.  Please bring them in for surgery by 7:30am.

AFTER SURGERY

What should I look for with the surgical incision?
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Please monitor your pet’s incision for any redness, swelling, discharge, or opening of the skin incision.  If you have any questions or note a change in the incision’s appearance please call Advanced Critical Care.

What is the correct bandage care?
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Bandages are typically placed to cover wounds or to cover drains.  On the limbs bandages are typically placed to keep splints in place and prevent movement of the limbs.   Limb bandages should be monitored for any redness, swelling, or discharge.  Also check her toes to make sure the toes are not spreading apart and that they are not cold.  

What happens if the bandage gets wet?
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If the bandage gets wet or dirty it MUST be changed immediately as it could cause serious damage if not managed appropriately.  Bandages swell internally rather than externally and can cause a drop in the blood supply to the lower limb if allowed to remain wet and swollen.  Bandages can cause the loss of toes or limbs if they are not managed appropriately and changed when soiled or wet.

Why does my pet have to wear an e-collar?
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Dog and cat mouths are very bacteria-laden and dirty.  If your pet licks at the surgical incision bacteria can be introduced into the wound and create an infection.  By keeping an effective Elizabethan (“E-collar”) collar in place that prevents them from licking at the incision you can dramatically decrease the likelihood of a postoperative infection or opening of the skin incision.  Please make sure your pet wears their E-collar at all times while at home to prevent them from licking or irritating their incision. 

When should I warm-pack and cold-pack?
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Cold-packing decreases inflammation and pain associated with incisions and can help to decrease postoperative swelling.  Typically we like to cold-pack incisions for 24-48 hours after surgery to help control this inflammation.  Make a cold-pack by placing ice and water in a ZipLoc bag. Place a towel over the incision (one layer) and then hold the ice-pack over the area for 5-10 minutes.  Please repeat this 3-4 times a day.

Warm-packing helps to increase blood flow to the incision and helps soothe the area.  Please warm-pack your pet’s incision 3-4 times a day starting two days after surgery.  You can make a warm pack by moistening a facecloth and microwaving it until warm.  Please check the heat on your inner forearm to make sure it is not too hot.  Place the facecloth in a plastic bag or ZipLoc bag while warm-packing the incision.  Do not allow the incision to get wet or moist.   

When should I return for suture removal?
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Incisions take about 10-14 days to heal properly.  Please schedule an incision recheck and suture removal with the surgery service at Advanced Critical Care at the City of Angels Veterinary Specialty Center by calling 310.558.6100.

What is the correct care for drains?
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Drains allow fluid to move from underneath the skin to the outside world and help to prevent accumulation of fluid pockets that can result in delayed wound healing or infection.  There are two main types of drains: closed suction drains (e.g. Jackson-Pratt drains) that drain fluid into an enclosed container, or passive open drains (e.g. Penrose) drains that allow fluid to drain into a bandage or material covering the drain area.  If your patient goes home with a drain please make sure to bring your pet in for bandage changes or drain rechecks based on the schedule in your pet’s discharge instructions.  Typically drains remain in place until the fluid production wanes to a sufficient degree to warrant removal of these drains.  This period is usually 1-4 days after the surgery.

Is it normal for my pet to sleep more when coming home?
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Pets are often stressed in the hospital and surrounded by other patients, activity, and nurses performing their treatments, which interrupt their normal sleep patterns.  Also some medications can change the way pets sleep while hospitalized.  Once home some owners notice that their pets sleep much more than is normal for them.  If you are concerned that your pet is more lethargic or continues to sleep much more than is normal for them please call Advanced Critical Care.

What should I monitor my pet for at home?
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Please monitor your pet for any side effects including but not limited to: vomiting, diarrhea, lethargy, anorexia, collapse, seizures, shaking, trembling, respiratory rate increase, or respiratory effort increase.  If you notice that your pet is doing something that you did not expect or concerns you please feel free to call your doctor or Advanced Critical Care any time as there is always a doctor present 24 hours a day, seven days a week. 

Is it normal for my pet not to eat initially?
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Some pets are more affected by anesthesia and pain medications than other pets.  Most pain medications including hydromorphone, buprenorphine, fentanyl, and NSAIDs such as Deramaxx, Rimadyl, or Previcox can cause vomiting, diarrhea, inappetance, anorexia, or transient nausea.  Typically offering small amounts of different types of food (e.g. boiled chicken and rice, cold cuts such as turkey or lean roast beef, or bland wet food) to entice them to eat is beneficial and usually gets them to eat.  If you are concerned or your pet seems to be worsening please call Advanced Critical Care.

What do I do if my pet vomits or has diarrhea after surgery?
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Although some medications can cause regurgitation, vomiting, or diarrhea, a change in your pet’s status may be cause for concern and is better evaluated early.  Please call Advanced Critical Care to determine whether this change in your pet’s status needs further evaluation or treatment.

When should I expect my pet to start to defecate normally?
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Anesthesia and surgery can affect the normal defecation schedule of patients.  Sometimes dogs will not defecate for up to five days after surgery and anesthesia.  If your pet is otherwise alert, eating well, and not having any vomiting do not be concerned.  However, if your pet starts to strain significantly or is not defecating five days after surgery please call Advanced Critical Care. 

When should I expect biopsy or culture results to come back?
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Masses or samples submitted for biopsy are typically submitted to VDx, a diagnostic laboratory in Davis, California.  The results usually take 3-5 business days before they are available.

Cultures are typically sent to Antech, Idex, or CalMicro.  Culture results can take up to 7 days depending on the complexity of the infection.

The doctor in charge of your pet’s care will call you as soon as the biopsy or culture results are available.