Category Archives: Clinic News

Dr. Brady Certified in CPR for Pets

Our clinic owner, Dr. Timea H. Brady, recently earned certification to perform cardiopulmonary resuscitation (CPR) on dogs and cats.

Dr. Brady’s certification by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) initiative required 8.5 continuing education hours of online coursework in basic and advanced life support followed by four hours of hands-on training using stuffed dog manikins in a live workshop setting. She completed the requirements on September 19 at Purdue University’s Fall Veterinary Conference, becoming one of approximately 1,000 “Certified RECOVER Rescuers” worldwide.

CPR Lab
Dr. Timea H. Brady (right), owner of Brownsburg Animal Clinic, uses a manual resuscitator on a CPR patient simulator in the September 19 RECOVER workshop at the Purdue Veterinary Conference while fellow Purdue College of Veterinary Medicine alumna Dr. Katharine Wentworth performs chest compressions. Purdue University photo / Kevin Doerr

“My staff wanted to learn more about CPR and how to do it, but I realized I had only very basic knowledge—certainly not enough to teach it,” said Dr. Brady. “When I saw Purdue was offering the course at their Fall Conference, I jumped at the chance to learn so I could improve my patients’ chances of survival as well as teach my entire team the evidence-based best practices.”

Dr. Brady set aside two full staff meetings for CPR training. The October 22 meeting focused on the basic and advanced life support coursework. In a follow-up training session on November 12, the staff will practice CPR techniques on a stuffed animal.

Using handouts, demonstrations and hands-on practice, the training covers how to recognize cardiopulmonary arrest, the CPR procedure itself and post-cardiac arrest care. Dr. Brady has ordered copies of the RECOVER guidelines and emergency drug dosage posters for permanent display in the clinic’s surgery and dental suites and treatment area.

“We’ll be practicing on a stuffed animal, but in the workshop at Purdue, we had dog-shaped CPR dummies called simulators that had an open mouth with teeth and a tongue so we could practice intubating them,” said Dr. Brady. “The simulators were also designed to give realistic resistance when we were doing the chest compressions. Our stuffed animal won’t have those features, but I think it will still be helpful in learning the techniques.”

In keeping with RECOVER recommendations, the clinic has ordered additional supplies for the emergency crash cart, fully stocking it with multiple sizes of endotracheal tubes and IV catheters, a manual resuscitator bag, fluids and emergency drugs such as epinephrine, atropine and naloxone.

“Our cart has just about everything paramedics for humans have on their trucks, but in more different sizes to suit the smallest to the largest pets,” said Dr. Brady. “Our staff training will cover what’s in the crash cart and where, so there will be no delays in accessing the tools and supplies we need during an emergency.”

About Veterinary CPR

Veterinary cardiopulmonary resuscitation (CPR) is called for when an animal’s breathing and heartbeat stop. The causes may include heart disease, metabolic diseases, low levels of oxygen in the blood, electrolyte imbalances, dehydration, adverse reactions to a drug, electrical shock or brain trauma.

The mortality rate is extremely high in veterinary cases of cardiopulmonary arrest (CPA). For animals experiencing CPA while hospitalized, only 1.6 to 6 percent of dogs and 2.3 to 9.6 percent of cats survive to be discharged from the hospital. In humans, approximately 24 percent of adults survive an in-hospital CPA.

CPR is the only treatment of cardiopulmonary arrest. In both animals and humans, the odds of survival after CPA improve with the quality of CPR delivery, including early recognition and response to CPA, skillful application of effective basic and advanced life support techniques and post-cardiac arrest care.

Although one person can administer basic veterinary CPR, alternating between timed chest compressions and breaths, having two people handle both simultaneously makes the procedure easier.

“Once you have an unresponsive dog or cat, it works best to begin immediately with chest compressions, with a second person handling respiration,” said Dr. Brady. “These two can swap places every two minutes, because the chest compressions are tiring, but you want to keep it up until you’ve given the heart a chance to start again on its own.

“If you’re in a hospital setting and your team is trained and available, they can provide advanced life support—things like inserting an IV catheter and administering drugs, intubating and getting the patient hooked up to oxygen and an EKG machine. Team members can also look in the patient’s medical history for health problems or adverse reactions to drugs and write down all that’s being done in the moment to revive the pet so we have it for our records.”

As in human medicine, Dr. Brady said CPR alone doesn’t always restart a cat or dog’s heart, and even if it does, long-term survival is far from guaranteed. “With CPR, we’re mainly trying to buy time and keep oxygenated blood flowing to the brain and heart in hopes of a successful resuscitation with minimal tissue damage. Ideally, if CPR works, the heart starts back up and you get them breathing again. If you can do that, you then have a chance to diagnose the problem and try to solve it.

“You have the best chances of a successful result when CPR’s a team effort, and what you’re doing is based on current, evidence-based best practices. That’s why I’m excited to pass on to my entire staff what I learned to get certified.”

About the RECOVER Initiative

The RECOVER initiative is a non-profit, volunteer effort undertaken in 2010 by the American College of Veterinary Emergency and Critical Care and the Veterinary Emergency and Critical Care Society. More than 100 board-certified veterinary medical specialists spent 18 months systematically reviewing the experimental and clinical evidence in CPR research and devised evidence-based, consensus CPR guidelines for dogs and cats. The organization published its first RECOVER guidelines in 2012 and, based on its continuing work, anticipates publishing revised guidelines in 2020.

So far, about 9,000 veterinarians, veterinary technicians, veterinary nurses and students worldwide have completed the RECOVER online course. In addition to about 1,000 certified RECOVER Rescuers, there are about 190 certified RECOVER instructors qualified to lead certification workshops and labs.

Although the guidelines have been available since 2012, RECOVER Initiative Program Director Kenichiro Yagi said, “RECOVER is at its initial stages of adoption by the veterinary field. Progressive individuals and practices wanting to adopt the best evidence-based practice in veterinary CPR are the ones who find RECOVER.”

“We don’t have data to show whether the guidelines have led to increased survival,” said RECOVER Initiative Co-Chair Daniel J. Fletcher, PhD, DVM and Diplomate of the American College of Veterinary Emergency and Critical Care. “Until we have data to share, what we can say is that folks who complete the RECOVER certification process report feeling much more confident and less stressed when an arrest occurs and feel that they are now more prepared when an arrest happens. So we’re making some progress!”

“Until the RECOVER initiative, there were no published standards or guidelines about veterinary CPR, and that led to a wide range of approaches and I’m sure, a lot of chaos, too,” said Dr. Brady. “What veterinarians and technicians did know was often adapted from human protocols, and it turns out what works for humans doesn’t always work for dogs and cats.

“Fortunately, in general practice, cases of cardiopulmonary arrest are relatively rare. I’ve encountered fewer than a half-dozen or so in my 15 years as a general practitioner. Of course, every one of those cases was pretty stressful.

“Now, as a result of this training, my team and I will be prepared to recognize common cardiopulmonary arrest warnings, we’ll all know the evidence-based treatment strategies and proper drug doses to use and how best to care for surviving patients after CPR. I’m sure we’ll feel calmer and more confident, should we need to resuscitate a patient, and the animal’s chances of survival will improve.

“I feel empowered now! There is no longer any guesswork. I know what to do. No more chaos!”

To maintain certification, Dr. Brady will be required to take a comprehensive online course every two years. RECOVER CPR is the only official veterinary CPR certification recognized by the American College of Veterinary Emergency and Critical Care and the Veterinary Emergency and Critical Care Society.

For information about RECOVER certification programs for veterinary professionals, first responders and pet care professionals, and pet owners, visit the RECOVER Initiative website.

Expanding to Serve You Better

The Finishing Touches

After nearly a year of work on the project, we’re happy to report all the construction and renovation inside our facility is complete, with only some landscaping remaining to be done outside.

Our spacious new lobby is receiving lots of compliments from clients, as are the larger and more numerous exam rooms. The doctors and staff are enjoying the additional, more attractive workspaces and the significant positive impact these major changes to our facility are having on our workflow.

We have a few finishing touches to put on equipping and organizing the isolation room and our offices, but the separate surgery and dental suite are fully equipped and functioning just as we dreamed they would.

Even in its not-quite-finished state, we’re delighted at the impact the expansion and renovation are already having on our ability to serve our clients and care for our patients even better than ever.

Please ask for a tour next time you’re in for a visit. We’ll host an open house in the near future, too.

Update Impacting Clinic Visitors Saturday, August 3

We thought the paving was all done last Saturday, but a portion of the re-paved older lot needs a do-over, scheduled for Saturday morning, August 3.

Plenty of convenient parking is available in the new lot, and for the sake of our more anxious patients, we hope the noise from the heavy equipment will be minimal!

Update Impacting Clinic Visitors Wednesday, July 24 through Saturday, July 27

We’re almost done!

As we’re putting the finishing touches on our newly-renovated interior space, we have one more major undertaking left to complete on the outside: the parking lots.

In preparing for this phase of the project with our builder, we learned this is a two-day job. First, they have to rip up existing blacktop and haul that away, smooth everything out to prepare the surface and finally pave over both the old and new parking areas surrounding the clinic.

One option was to shut down the clinic for two days straight. But we said no to that! Instead, to minimize the impact on our clients and patients, we worked out the best compromise we could to allow us to stay open and still get our new parking lots done.

The ripping up and surface prep will begin on Wednesday, July 24, and the paving will take place on Saturday, July 27. During that time, parking will be limited to the grassy area just in front of the new gravel parking lot.

We know it’s going to be a mess from Wednesday through the rest of the week, with uneven terrain to cross over a greater distance from your car to the front door. There’s also going to be heavy, at times noisy equipment on site, so that your pet may feel anxious.

We apologize in advance for the inconvenience and commit ourselves to helping minimize the impact on you and your pet as much as we possibly can.

If you visit the clinic between now and Saturday and need help getting yourself and your pet into the building, use your mobile phone to call us from your car when you arrive, and a team member will be more than happy to come out and assist you. If you don’t have a mobile phone, call us when you leave your house and we’ll be on the lookout for you! We’ll also escort you and your pet back out to your car after your appointment to get you on your way back home without incident.

Whether or not you will be visiting us during the parking lot paving, to all our clients—thank you so much for your patience and encouragement during our expansion and renovation project. You’ve all been so understanding and so complimentary as our long-dreamed-of facility has taken shape. We can’t even begin to tell you how much we appreciate your bearing with our mess over these many months!

We look forward to serving you in our spacious new, improved facility for many years to come!

Friday, June 28 Update

With new construction done, we’ve been hard at work, radically reconfiguring and renovating our original spaces. We’re especially excited to see our new dental suite taking shape in the space formerly occupied by exam rooms two and three and the pharmacy. Our new table and light will be installed the first week of July, and all our dental equipment—previously in the shared surgical suite—will be moved to this dedicated space for dental procedures soon afterwards.

Below are photographs taken Friday, June 28, of the space reclaimed for doctors’ offices from exam room three, plus a little extra space from the previous reception area. Dr. Brady’s office will occupy the remaining reception area space. Those brand new cabinets are being installed in our new pack and prep area.

Monday, May 6 Update

As of Monday, May 6, we began welcoming clients and patients to our spacious new wing! Our new entrance, lobby and four exam rooms are now in use!

Phase two of our expansion and renovation projects is now underway, and will involve the renovation of the original building to house exam rooms five and six, a dedicated dental suite, a dedicated surgery room and doctors’ offices.

We promise to have an official open house once all construction is complete!

It won’t be long before we’ll be welcoming clients and patients to our new lobby!

Inside our new addition, walls and floors and being finished. Outdoors, concrete walkways have been poured.

The brick work is done!

Brownsburg Animal Clinic expansion

We’re delighted to be at the drywall stage!

Progress! We are so excited to see our dreams of a bigger, better facility being realized right before our eyes!

Taking shape, inside and out!

Hoping the rain holds off another day!

The addition is taking shape! The trusses were put in place on December 19.

As of Saturday, December 15, our concrete slab is in place! First, the pea gravel:

Then, the finished concrete. With every construction milestone, we grow more excited about welcoming clients and patients to our new space!

 

Here’s how the foundation looked, as of November 29.

The footings were poured on November 20.

After years of dreaming, planning and preparation, Brownsburg Animal Clinic’s expansion and remodeling project  is at last underway!

We’re building an addition that will double the size of our hospital as well as reconfiguring and remodeling our existing space. When the project is completed in Spring 2019, we will offer our clients and patients—

  • A spacious new lobby
  • Four more, larger exam rooms
  • Dedicated surgical and dental suites
  • An updated pharmacy
  • An updated business office
  • An expanded parking area

New construction and remodeling are scheduled to be completed this Spring. In the meantime, we apologize for any inconvenience.

Find out more about our expansion and renovation project.

Our One-Star Review

Recently, Brownsburg Animal Clinic received its first one-star online review. We discovered it among our eight five-star ratings on Google, and it dropped our overall rating to 4.5. Our perfect 5.0, based on 37 reviews, still stands on Facebook. We also have three 5-star ratings on Yelp.

The one-star review was from someone whose cat had died, and the reviewer blamed the drugs the cat was taking–Cerenia, used to treat vomiting in dogs and cats, and “Covenina,” most likely a reference to Convenia, which we prescribe to treat urinary tract infections in cats.

The reviewer also blamed us. The rest of the review criticized our veterinarians personally as “archaic” and “old school young but stupid” doctors who might be able to treat dogs, but “cats not so much!”

The review concluded with a suggestion that we fire our “partner.”

Naturally, we found this review distressing. Our first impulse was to respond to it online, but upon further reflection, we decided it was better to flag it for review by Google, which prohibits personal attacks in its online reviews, and hope it will be taken down.

Meanwhile, we want to express our sympathy to the client for the loss of his or her cherished cat. Every one of us at the clinic has lost pets of our own, and we understand the pain, grief and yes, sometimes even anger, that are often part of the recovery process.

We also want to note that the drugs mentioned as “killers” are both safe, highly effective medications that have been in use for the past 5 to 10 years–hardly “archaic.” If your pet is taking either of these drugs and you have concerns, please call us to discuss the benefits and risks of the drugs for your pet.

Finally, we want to assure our clients that all of our doctors and medical staff are well-qualified, dedicated general practitioners who follow best practices and protocols in both feline and canine medicine. As small animal practitioners, we keep up with the veterinary medical literature concerning both cats and dogs, and all of us meet all continuing education requirements. We are capable and confident of our ability to provide high-quality medical care for your pet. When more specialized care is called for, we do not hesitate to refer you to the appropriate specialist.

We hope all our clients will feel free to discuss any issues they have about the care we provide in our clinic. If you have a question or concern with our diagnoses or treatment recommendations, we encourage you to discuss it at the time of your visit. While our veterinarians are not always available to take phone calls for much of the day, we are happy to return calls to answer your questions. So please, leave us a message and we will contact you as soon as we are able.

Thank you to all the clients who have awarded us top ratings. We dedicate ourselves to continuing to deserve your trust and loyalty!