Shea Cox
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Be Prepared: Four Emergency Room Essentials
Lay the groundwork for quick, low-stress treatment
There are some things even a fortune-telling dog can

Working in the ER, I see a full range of preventable predicaments that complicate addressing a pet’s immediate health crisis. I’d like to highlight four simple measures you can take as a pet parent to prevent distress and concern should an emergency arise while you are away or if you need to seek care outside of your normal veterinary relationship.

Records!! Keep a copy of every medical record, radiograph and diagnostic test in a file. It allows a new veterinarian to quickly understand your pet’s health status. This is especially important if your pet has a history of illness such as kidney failure, cancer or multiple/ongoing disease processes.

Your pet file should also include a copy of vaccination records. I often get last-minute calls to fill out a health certificate for airline travel, but am unable to do so because owners do not have proof of their pet’s rabies vaccination. As is the case with most emergency hospitals, I am unable to administer another vaccine because we don’t keep any in stock (this is an area of health care that is left to general practitioners).

Advanced directive: I strongly recommend that every pet owner have in place an advanced directive with regards to their pet’s continued care in the event of physical decline in their absence. [Here’s a copy of an advanced directive form we provide that you can download and print.] This is especially important if you share your life with a geriatric pet or one who has ongoing medical issues or failing health. Discuss with your pet sitter, family members and your veterinarian your wishes and have a clear understanding of treatment limits in the event you cannot be reached.

I cannot tell you how many times I have seen family members or caretakers struggling to make the difficult decision of euthanasia in the event a pet is suffering and the owners are out of contact.

Pre-arrangement for payment in case of an emergency: Along the same lines as an advanced directive, pre-authorization for treatment is strongly recommended. It is not uncommon for owners to leave their pets in the care of a boarding facility, an in-home pet sitter or a family member during vacation, and then something goes wrong. It is heart-wrenching to navigate a situation where the temporary guardian brings in a pet and has no means of payment or way of contacting the owner to obtain approval for a treatment plan. We try to work as best as we can with these situations, but you can only imagine how heavy these decisions can be for everyone involved.

A common example is a pet who has been hit by a car. Although severe trauma can have an excellent outcome with treatment, the cost of stabilization and management can quickly reach thousands of dollars. Financial responsibility and decision to pay for this level of treatment is a big burden to place upon your sitter. I would give anything for this to be a world without financial concerns, but the hard reality is that emergency hospitals generally will not extend credit on good faith, especially if you have no previous relationship with them.

So before leaving town, stop by your local emergency clinic and your regular veterinarian to sign a release of payment in case of emergency. Your credit card number can be kept on file with your signature authorizing treatment in event of an emergency; you can also set the parameters of care at that time.

Plan ahead and anticipate medication shortages: I get many calls from owners asking to refill a pet’s medication because they are leaving town the next day and their regular vet is closed. What many people are not aware of is that legally we are not able to provide this service unless we perform a full physical examination on the pet, and with that, comes the cost of an emergency exam fee.

Although it can be understandably frustrating to have to pay an exam fee for an otherwise healthy pet for a “simple refill” of a medication, legally, hospitals cannot serve the role of a dispensing pharmacy. By law (and risk of our veterinary license) we cannot OK a refill of a medication without examining your pet, no matter how benign or common the drug. Because of this, I recommend keeping an extra bottle on hand, or getting in the habit of refilling your pet’s prescriptions when the bottle is approaching three-quarters empty.

Another tip: If you fill your medication at a human pharmacy, and it is a drug and dose that stays constant for a well-controlled disease state (such as medicated drops for eye disease or phenobarbital for seizures), ask your veterinarian to write an additional refill on the written prescription.

I hope these four simple proactive steps help raise awareness of potential situations that can arise while you are away, and help you to formulate a plan well in advance should any situation unexpectedly arise.


Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.

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Submitted by CJ Anderson | January 20 2012 |

Competely outstanding! the only thing I add to this information is that it is work its weight to scan you pets who have a medical history in because of the tendacy to no get to you home documents during a disaster or perhaps that would get lost. Frequently, you vet is in the affected area and the resplacement vet unable to get ahold of him, necessatating addional tests you have already pad for in order to get appropiate treatment or medications!

Submitted by Shea Cox DVM | January 23 2012 |

Thanks, CJ! And thanks for the excellent tip of scanning your pet's medical records!

With how much smart phones can do these days, you could easily make a copy of your pets medical records... I myself use an app called JotNot Pro for taking photos of pages in cookbooks with my iPhone, and the app then turns the photo into a pdf file that you can open up in an email or download... I can see how this app would be very useful for your suggestion, and used to actually take pictures of any medical record. Brilliant idea~ thanks for sharing!! - Shea

Submitted by sharon | February 7 2012 |

I work in a veterinary hospital and I too have seen situations occur when thing happen to a pet in an owner's absence.I just never expected it to happen to me.One of my dogs suffered an injury the day before we left on a cruise. I dropped him off at my clinic on the way to the airport with instructions to the pet sitter to pick him up that afternoon. I left written instructions to my coworkers to do 'whatever was needed" for my dog. Little did I know it was not just an injury but a tumor on his spine leading to paralysis and pain. His condition deteriorated rapidly, they had difficulty reaching us ( we were in the middle of the caribbean where no cell phones reach) He needed to get to a specialist, but hesitated because my instructions weren't very specific. Treatment at the specialist could lead to $1000s of dollars, not everyone can do that.
Once we were reached, we approved movement to the specialist for myelogram and CT, unfortunately, there was too much damage and they had to Euthanize him.I hated that we couldnt me with him at the end but even more I hated that he had to suffer needlessly while they tried to reach us.Of course, we never expected things to go the way they did but I wish we had been better prepared. We could have avoided putting my pet-sitter and my coworkers through some very stressful situations and my sweet boy through unnecesary suffering.
One very valuable learning experience I hope others dont have to suffer through.

Submitted by Shea Cox DVM | February 16 2012 |

Sharon- this is truly a heartbreaking story that I am sure was not easy for you to share with others. But I thank you for writing about your experience so that hopefully we all can learn; it really is one of those situations where you just don't always think about it until the unthinkable happens. My heart goes out to you. - Shea

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