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ADV- Lesson 2-Secondary Survey

The secondary survey follows the initial triage and involves a complete physical exam. Abnormalities found during triage are evaluated further during this time period. This may include basic monitoring and baseline lab values. Urine production should be monitored over a period when nursing critical patients. The normal amount of urine that is produced should be 1-2mL/kg/hour. The urine production helps evaluate kidney function, kidney perfusion, and heart function.

Specific Disease Considerations

  • Acute Weakness in big dogs – May be hemoabdomen and can decline suddenly. * Get to a veterinarian immediately*
  • Addisonian Crisis – May present for vomiting, diarrhea, lethargy, anorexia or decreased appetite, acute onset of weakness or collapse, dull or unresponsive. Increased potassium (K) that slows and eventually stops the heart
  • Anticoagulant Rodenticides (Warfarin, brodifacoum, bromodiolone, diphacinone) – Causes bleeding 2-3 days after ingestion
  • Bloat/GDV (Gastric Dilatation Volvulus) – * Get to a veterinarian immediately* Retching/non-productive vomiting, abdominal distention, pacing, cardiac arrhythmias, cardiovascular collapse
  • Diabetes Hypoglycemia – weakness, depression, seizures
  • Prolonged hyperglycemia – weakness, depression
  • Dyspneic Patients – * Get to a veterinarian immediately * Oxygen, no stress, handle minimally
  • Hemorrhagic Gastroenteritis (HGE) – Bloody diarrhea, +/- vomiting, PCV often >60% but can be normal to low
  • Hives/Swollen Face – Can be caused by insect bite, bee sting, or other allergic reaction, even to vaccines. May cause throat to swell or anaphylactic shock if it goes untreated.
  • Laryngeal Paralysis (Lar Par)/Upper Airway Obstruction – Get doctor immediately Difficulty breathing IN No stress, handle minimally
  • Leptospirosis – May present with anorexia, lethargy, vomiting, polyuria and polydipsia, icterus, fever, abdominal pain, muscle pain and stiffness, uveitis, dyspnea, and coagulopathies.
  • Parvovirus – Isolate Bloody diarrhea, vomiting, lethargy. Usually affects young, unvaccinated puppies.
  • Penetrating Wounds – Dangerous if over chest or Monitor closely even if patient appears stable, especially respiratory rate/effort.
  • Saddle Thrombus – Should be handled with minimal stress. It is very Often very vocal. Usually dragging hind end, rear extremities cold, possible lack of anal tone.
  • Seizures Prolonged/repeated – hypoglycemia, hyperthermia, brain swelling
  • Tylenol (Acetaminophen) – Toxicity in Facial swelling, blue or chocolate-colored mucous membranes. Deteriorates over time. Maybe stable initially.
  • Urethral Obstructions (UO) Increased potassium (K) – slows the heart. Often present with other complaints such as vomiting,
  • Vestibular Disease Nystagmus – circling, head tilt, falling to one side (usually toward the side of the lesion), ataxia
  • Young Animals – Hypoglycemia
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