Nursing Procedures

of Base

The importance of knowing

to be a valid collaborator

1
 Course for Veterinary Technician
I Year

Summary

Chapter I 1
Being a valid collaborator 2
Approaching the dog 2
How to make a muzzle with a strap 2
How to lift a dog 3
Containment of a dog 5
Approach the cat 7
Containment of a cat 8
Chapter II 10
Not just cleaning 10
Hand hygiene 11
Hand washing 12
Social washing 13
Antiseptic washing 14
Preoperative washing 15
Hygiene of environments and materials 16
Critical areas of hospitalization 17
Box 17
Operating room 18
Disinfection of tools and equipment 18
Characteristics of disinfectants 19
Chapter III 20
Consumable materials and their use 20
Chapter IV 25
The administration of medications 25
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 The drugs are characterized by 25
Routes of administration of a drug 26
Inoculation sites and procedures 28
Routes of parenteral administration without injection 31
Chapter V 33
Organization of fluid therapy 33
Materials for fluid therapy 33
Administration of drugs during fluid therapy 36
Assemble a proper fluid therapy 36
Types of Fluids 36
Chapter VI 39
The role of the Veterinary Technician in the hospital ward 39
Duties of the Veterinary Technician in the hospital 39
Patient acceptance 40
Clinical diary update 40
Ordinary management of the hospitalized patient 41
Administration of medications 41
Care of the hospitalized patient 41
Clinical File and Diary of the hospitalized patient 44
Patient's Clinical File 44
Clinical diary 45
Chapter VII 47
Special management of the hospitalized patient 47
Treatment of pressure ulcers 48
Care of the immobilized patient 48
Emptying of the bladder 50
Physiotherapy of the immobilized patient 51
Support for paraplegic animals 51
Methods of physiotherapy and protocols to know and follow 51
Chapter VIII 53
Nursery 53

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Chapter I
Being a valid collaborator
A Veterinary Technician must be a valid collaborator for the Veterinarian: role
the technician's role is to fulfill many tasks to ensure that everything works and that it does not
there are incidents during the activity (animals that escape, that can bite, that
unable to carry out visits, therapies, etc.), for this reason it is important to start to
to know what the essential basic procedures are to start having
an inappropriate preparation.

Approaching the dog

First of all, you should never approach a dog suddenly or from behind,
but it is necessary to approach with delicacy, avoiding sudden movements and keeping the
low voice tone: the behavior of an animal in a situation of discomfort,
it can be risky for our and his safety.
It is important:
▪ Ask the owner what the dog's personality is.
▪ Ask the veterinarian if there are any special precautions to take.
▪ If necessary, put a muzzle or a strap around the snout.
▪ Lift and place the dog on the examination table.
▪ In the case of a large dog, it is possible to intervene by leaving it on the ground.
▪ Containment
▪ Never leave the dog unattended on the examination, surgical, or radiological table.

How to make a muzzle with a strap

Sometimes it is necessary to use a slip lead instead of the normal muzzle.
keeping the dog's mouth shut: when dealing with a rather patient
"distrustful" or in the case of some maneuvers that would make the normal slip off the muzzle
earplug, as can happen for ear treatments.

▪ It is usually used a strip about 1/1.5 m wide; if necessary, it can

a rope or the same leash, whether made of nylon or another fabric, can also work well
▪ A large knot is made in the center of the "legaccio".
▪ It slips around the dog's snout and
tightens
▪ The two ends cross below the collar.
▪ A knot is made at the back of the neck.

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How to lift a dog
This maneuver depends on the size of the dog, the type of problem it presents, and from
how many people are available to intervene.
By law, a man can lift a weight of 30 Kg on his own, a woman 20 Kg.

A person - small breed dog

Place one hand palm open under the chest, at the height of the armpits, with the other
arm pass under the chest and abdomen in order to support it when it is raised
from the earth.

A medium-sized person-dog
Place an arm and a hand around the dog's neck, as if to hug him, and
bring the other arm behind the abdomen.
Lift it then with both arms.

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A large-sized person-dog
Position an arm and a hand wrapping around the dog's chest and shoulder.
The other arm under the tail and hind legs.
Lift it then with both arms.

Two people–large dog

One person wraps the chest and thorax while the other simultaneously wraps the abdomen and
posterior art.
Simultaneously, the two operators will lift the dog.

Sometimes it is necessary for the patient to be placed on a blanket or support.

rigid (wooden boards, car trunk shelves): in this case, slide
the animal on the shelf and then lift it as if it were a stretcher.

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Containment of a dog
For those who work with animals, it is of considerable importance to know and be able to carry out the
containment.
Containment means to hold back, limit the movements of the animal: stop it!
Knowing how to handle a dog or a cat to allow for procedures such as examinations.
clinics, blood tests, radiographic examinations and more, is a practice aimed at ensuring that
the patient should stay still, not suffer damage from any potential incorrect restraint, not
it is "dangerous" for those close to it, and not least the action of those who contain the animal.
do not be an obstacle to those who work on this.

Not all dogs are collaborative, so it will be necessary to establish whether help is needed
another person for their containment, also it is necessary to consider whether to use or
less a muzzle or the leash.

With the dog, one must be kind but determined.

It is not said that small breed dogs are easier to manage, even though certainly
It is less tiring to be able to carry them onto a table or a surface.

Sometimes it is preferable to place a towel on the supporting surface on which

the dog will be arranged, especially in cases where there may be material losses
organic (urine, blood, feces)

Once the dog is brought to the examination table, arrangements will be made for its containment.

▪ Sitting dog:
One arm will wrap around the neck and the other arm will go around the side of the animal.
This maneuver prevents forward or backward movements of the dog.

▪ Dog standing (quadrupedal position)

One arm passes under the neck wrapping around the chest, the other arm wraps around the
posterior.

▪ Dog lying on its side (lateral decubitus)

With one hand, you hold a front limb and with the other a hind limb passing over.
to the neck and the abdomen respectively.
At this point, lift the limbs while keeping them in this position, sliding the dog onto the table.
Don't let go of the limbs, otherwise the dog will immediately try to get back up.
Furthermore, with both arms it will be possible to help oneself by providing adequate support.
pressure on the neck and on the rump, keeping it lying down.

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Large and/or particularly heavy dogs
With an imposing dog, it falls to the veterinarian and the technician to adapt: performing
the medical visit and any treatments leaving it on the ground.

To hold a dog on the ground, standing or sitting, one can do so by straddling it.
him, tightening his legs around the body and holding his head still by grabbing with the
handle the nape and the mandible.

Many times it is the owners themselves who agree to carry out this procedure.

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Approaching the cat
Cats are armed and capable of using their weapons if they want: their mouth with teeth
sharp and serrated mandibles, the legs with real claws!

They can cause serious injuries to both strangers and their owners.
They are not always predictable, therefore interacting with them in difficult situations requires
patience and skill.

Before any maneuver, close doors and windows well to avoid a leak.

Place the carrier with our patient on the table, it is necessary to open the door.
and wait for the cat to spontaneously decide to stick its head out.
In some cases, the owner can be helpful by taking it, or if reluctant, one can ...
facilitate the exit by gently but decisively pulling it by the collar or
sliding it out by tilting the carrier.
To try to calm him down, you can speak to him softly and pet him on the head.

It is important to understand as soon as possible if the patient we are approaching is one of

the cats that feel more constrained react more violently: in this case, we
he will approach the cat gently before increasing the firmness of our grip
without hesitation and without excessive forcing.

For many procedures, it is necessary for the cat to be kept as still as possible and
that it has been rendered harmless.

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Containment of a cat
The classic method of holding the cat by the scruff is not very suitable for its
containment during medical procedures: certainly the head is kept still but the
Both the front and back legs are free to move, jump, and "cause damage."
For the cat as well, one must know which is the most correct technique depending on...
of the intervention to which he must be subjected and, also, of his character!

▪ Cat in sternal decubitus

To 'press' the cat on the examination table, making it lie on its belly with the
Back up, one hand should be placed on the sides of the neck holding it with the index and middle finger.
while the thumb and the ring finger of the same hand are brought to the level of the elbows.
The other hand and part of the forearm rest on the back of the animal, in position
posterior.

▪ Cat in lateral recumbency and in dorsal recumbency

Sometimes the intervention of two operators is necessary, although for calm cats, it can
one is enough.
In the case of two technicians: one holds the head with one hand and with the other takes the limbs.
the front ones, the other grabs the back ones; the cat is slightly lifted in such a way that
remove the support base and lay it on its side or back.
The neck and limbs should be held firmly but not violently, gripping outside
above the olecrans and the hocks, placing a finger of each hand between them.
When the time comes to let the cat go free, it is important to release your hold.
simultaneously to avoid defensive reactions.
For any containment adopted, one can also make use of a
towel cover, useful for covering the cat, both to keep it calmer and
to avoid causing problems for those who are maneuvering.

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A valid alternative is the so-called 'containment bag': a kind of bodice.
In that case, the cat and, depending on the necessary operation, it is possible to make use of
apertures designed for intervention.

Containment cage or restraint

For particularly aggressive cats, for which sedation is necessary, they are
use containment cages.
These allow, with a sliding double wall system, to trap the cat.
and to be able to carry out the intramuscular administration of the drug through the
the bars of the cage itself.

Sometimes it is possible to avoid the use of cages, such as when a cat needs to be
transported from one place to another for a short distance (from the recovery cage to the table
for a visit or other procedure), in that case, it is held with one hand for the
grab it by the hind legs with one hand while holding the other.
the body of the animal on the operator's own arm.

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Chapter II
Not just cleaning
In the medical field and, above all, in surgical practice, it is vital for the patient and not only for them.
less for the operators, both veterinary and technical, the respect for hygiene standards.
There are many infectious agents directly responsible for pathological manifestations.
or indirectly, as a complication of pre-existing clinical situations, as well as
responsible for contagion between different subjects and even between different species.

Biosafety is defined as the set of measures, policies, and procedures useful

to minimize potential risks to the environment and human and animal health related
a pathogens.
The definition provided by the World Health Organization (WHO) is the
the implementation of measures aimed at reducing the risk of introduction
(bioexclusion) and spread of pathogens (biocontainment); requires
the adoption of approaches and behaviors by everyone to reduce risks related to all
activities involving pets, wild animals, and exotic animals and their products.

It is good to know the definitions and procedures to obtain the environments in which one works.
and where the animals stay as safe as possible from a health point of view.

Let's talk about

▪ Sterilization
Process capable of destroying all forms of bacterial life, pathogenic and non-pathogenic.
present on any material or substrate (solid, liquid, gaseous)
Sterilization is considered a first-choice intervention in the presence of agents.
microbes or in situations where there is a high risk of infection.
The most commonly used procedure involves the use of physical means, such as heat or rays.
gamma; there are also chemical products suitable for this use.
The simplest procedure involves the use of an autoclave: a device used for
the sterilization of instruments, such as surgical tools, by means of saturated steam at 121°
under pressure, for a duration that varies from 15 to 30 minutes depending on the size
of the load and its content.
▪ Disinfection
It is a procedure that allows you to reduce the charge of the batteries numerically.
pathogens so as not to be a risk to health.
Disinfection is performed on surfaces or inanimate objects.
It can be carried out with physical means (heat) or chemical means (amuchina).
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▪ Asepsis
Behavioral mode aimed at preventing contamination by
microorganisms from those previously sterilized substrates
It is implemented in the surgical field to ensure the sterility of the operating area:
keeping it dry as moisture promotes bacterial growth.
The surgical instruments in the sterile field must be kept clean by
blood and other biological fluids. Only must be used inside the sterile field
sterile objects.

▪ Antisepsis
Method aimed at the elimination and/or reduction of microorganisms present in
skin load, mucous membranes of the natural cavities communicating with the outside, intestines and
eventually respiratory, biliary, and urinary tracts.
Thanks to the use of antiseptics for external use, such as alcohol, iodine tincture, acid
boric, antiseptics for internal use (iodo-chloro-oxychinoline for the intestinal cavity)

So, if the term 'disinfectants' refers to those chemical agents used for the
treatment of objects and surfaces, the term "antiseptic" should be used referring to
substances intended for use on living tissues.
The substances used in antisepsis can also be used in disinfection, but not
vice versa, because surface products can be harmful and damaging to fabrics
animals
In practice, although this is not very correct, the term is used interchangeably.
disinfectant, the important thing is to know the use for each product
destined.

Hand hygiene
The hands of healthcare personnel are the primary vehicle involved in the transmission.
from one subject to another, from one environment to another.
It should be noted that the operators themselves are also susceptible to contagion if they are not careful.
to hand hygiene and especially to avoid touching mucous membranes and skin (the mucous membranes,
the conjunctiva is an easy entry point for both infectious agents and
for substances)
On the skin of the hands, two types of microbes can be distinguished, the so-called microbial flora.
resident and the transient microbial flora

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▪ Resident microbial flora:
represents the normal bacterial population (microbiota) of an individual and rarely
is responsible for infections.
It resides in the deeper layers of the skin, so it is not easily removed with the
simple hand washing.

▪ Transitory microbial flora:

colonizes the skin surface of the hands after contact with infected animals or
contaminated surfaces.
In case of contact with susceptible subjects, because weakened or injured or subjected to
Surgical or invasive diagnostic procedures can easily cause infections.
However, these types of bacteria live less than 24 hours on the skin and can be removed.
with handwashing.

So handwashing is the most important and effective means to

prevent the transmission of infections in healthcare settings and beyond.
It serves to physically remove dirt, with the help of water and detergents, and the
majority of the transient flora of the skin.
Even before putting on gloves, hand hygiene is always necessary.

Hand washing
To wash your hands, it is best to use running warm water, more suitable than hot water because
does not alter the skin's hydrolipidic film, preventing the formation of cracks,
considering the frequent washing that the hands of operators are subjected to
sanitary!
It is preferable to use liquid soaps, even better in dispensers, compared to bar soaps:
if used, they must be rinsed after use and suspended on a
grid that allows water drainage, in order to prevent the proliferation of
microorganisms.

After washing your hands, it is important to dry them thoroughly.

they remain damp, which would favor the development of bacteria) with disposable paper
gently dabbing, excessive friction could cause small
skin abrasions.

Hand washing can be done in three ways:

Social washing (from 40 to 60 seconds)
Antiseptic washing (approximately 90 seconds)
Preoperative washing (about 5 minutes)

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Social washing

Was carried out:

at the beginning and at the end of each shift
before carrying out non-invasive procedures such as measuring temperature
before administering medication or food
after any contact with an animal
before putting on the gloves and after taking them off
after coming into contact with biological fluids
after coughing, sneezing, blowing the nose
after using the restrooms
before and after eating
before and after smoking

The purpose of social washing is:

▪ mechanically remove the dirt
▪ eliminate up to 90% of the transient microbial flora
▪ prevent the transmission of microorganisms from the environment to the patient and from an animal
on the other hand, in addition to preventing the contamination of the operators themselves

Required materials:
▪ warm running water
▪ liquid detergent (soap) dispensed from a dispenser with a unidirectional valve
▪ absorbent paper

Procedure:
▪ roll up the sleeves to the elbow
▪ remove rings, bracelets and watch
▪ moisten hands and wrists with lukewarm water (37°-38°C)
▪ apply a dose of detergent
▪ friction vigorously the soaped surfaces for at least 15''
▪ rinse thoroughly under running water
▪ dry thoroughly, dabbing with a disposable paper towel, from the tip
from the fingers to the forearm
▪ use the same cloth to turn off the tap, if it is not elbow or pedal operated

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Antiseptic washing
It has been carried out:

in high-risk infection procedures for the patient

before an invasive procedure (catheterization, intubation)
after contact with continuous solutions or biological material
Every time you move from one animal to another, in the shelter and during a visit
on the same patient between one procedure and another (dressings, injections)
after coming into contact with infected or suspected animals

The purpose of antiseptic washing is:

▪ remove dirt
▪ eliminate the transient microbial flora and reduce the resident flora

Required materials:
▪ warm running water
▪ liquid antiseptic detergent with dispenser or single dose, based on chlorhexidine or
iodopovidone
▪ disposable paper towels

Procedure:
▪ roll up the sleeves to the elbow
▪ remove rings, bracelets, and watch
▪ Soak hands and wrists in warm water (37°-38°C)
▪ apply the correct amount of antiseptic product, taking care to distribute it in
homogeneous manner
▪ add water and wash thoroughly paying particular attention to the spaces
periuṅgeal, subungual, and interdigital for at least 1 minute
▪ rinse thoroughly with running water
▪ dry thoroughly by dabbing with absorbent paper from the fingertips
to the forearm
▪ use the same towel to turn off the tap, if it is not elbow or pedal-operated
The sequence of antiseptic hand washing is identical to that of social washing.
The differences lie in the type of detergent used (antiseptic product) and in the time.
employee to carry out a proper washing.

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Preoperative washing
It has been done:
before surgical interventions
before undergoing invasive procedures

The purpose of preoperative washing is:

▪ minimize the presence of transient microbial flora
▪ to obtain the eradication of the resident flora, inhibiting its long-term development

Required materials:
▪ warm running water
▪ liquid antiseptic-disinfectant detergent with dispenser or single dose
(based on chlorhexidine or iodopovidone)
▪ sterile disposable wipes or towels

Procedure:
▪ roll up the sleeves to the elbow
▪ remove rings, bracelets and watch
▪ moisten hands and wrists with lukewarm water (37°-38°C)
▪ apply the correct amount of antiseptic product making sure to distribute it in
homogeneous manner
▪ massage thoroughly for at least 1/2 minutes, focusing on the various folds
of the cute
▪ extend the wash up to the elbows
▪ to rinse
▪ dry thoroughly starting from the tips of the fingers up to the elbows, using a
sterile telino
▪ close the tap with elbow or pedal

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Hygiene of environments and materials
A veterinary facility is essentially comparable to a clinic or a
hospital for humans

Cleaning and sanitizing environments are of significant importance to avoid the

to spread infections, to eliminate bad odors and to ensure comfort
to the operators.
Furthermore, it ensures that animals, even just in transit, cannot infect each other and
to agitate in the presence of foreign smells and that their companions find themselves in a
clean environment, not malodorous and safe from a health point of view.

The environments that make up a Veterinary Clinic differ from each other based on the
destination of use and consequently are divided based on biological risk

They are therefore recognized for:

▪ low-risk zone
common areas, therefore waiting room and corridors
offices and administrative rooms
▪ medium risk zone
ward areas
diagnostic-therapeutic intervention areas, such as consultation rooms, laboratory
▪ high-risk zone
operating room
intensive or invasive treatment area
infectious ward

In any case, cleaning and disinfection must be carried out regularly in all
the areas and in all premises, not just in those at higher risk.
All surfaces must be cleaned before disinfection since the material
Organic matter makes most disinfectants ineffective.
Dust should be removed as a first step, using damp cloths compared to those
dry ones prevent the dispersion of particles in the environment.
Cleaning starts from the least dirty areas to achieve a deep clean.
the dirtiest ones.
In high-risk areas, the use of vapor or high-level disinfectants is provided for.
concentration.

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Critical areas of hospitalization

Critical areas are considered the boxes for animal hospitalization, reserving greater attention.
attention to those present in the infectious areas, and the surgical room.
Box
The kennels for the shelter of animals are undoubtedly a very delicate part from the point
from a health perspective: in these, patients in not good conditions are hospitalized
health and therefore require to stay in a healthy and sanitized environment.
Box with the same animal patient
It is necessary to clean the cage in order to remove the dirt and
ensure proper hygiene.
Cleaning must always be done daily and should be repeated with every change of
litter or pad and every time the cage appears dirty.
If it is visibly dirty, the grating door must also be cleaned.
The materials that make up the cage setup (bowls, grids, bedding)
they must be cleaned with a detergent solution (dish soap) rinsed and
reinserted.
Empty box following resignation/movement/death
Every time an animal leaves the recovery cage, it must be cleaned and
thoroughly disinfected before the introduction of another patient.
The disinfection protocol must be followed to the letter starting from the part
upper part of the cage, then descending towards the side surfaces and finally the bottom, not
absolutely disregarding the grid and the drainage channel or hole.
The grating door must always be cleaned and disinfected according to the protocol, including
the locking systems.
All accessories inside the box must be washed and disinfected.
The uncleaned and disinfected empty cages must be marked with signs or
labels of a color chosen by the structure
In case of hospitalization of animals with infections transmissible to humans, or suspected to be such, it is
It is necessary to wear equipment that ensures the safety of the personnel.
cleaning staff
A cage whose sanitation is uncertain should be considered dirty.
It is forbidden to house a new animal in a cage that has not been properly cleaned and
disinfected.

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Surgical room
Surgical rooms are usually classified into regular surgical room,
interventions on soft tissues (abdominal and thoracic surgery or on external organs, eyes,
ears, cute) and a particular surgical room for orthopedic procedures.
In the surgical room, one always enters wearing either appropriate footwear or shoe covers over them.
clogs.
After each surgical procedure, in the case of subsequent interventions on the same day,
It is necessary to remove all the supplies, tools, and instruments used.
It is necessary to remove any residues of blood or liquids from floors, walls.
and from equipment.
After the last intervention, the operating room must be completely sanitized.

Disinfection of tools and equipment

All the instruments and equipment used both in surgery (tools, tracheal tubes) and
For diagnostics (endoscopes, mouth openers), they must be washed and disinfected between uses.
and the other.
The same applies to all those tools used in the normal outpatient process such as
thermometer, otoscope cone and various clamps or scissors.
Greater care should be taken if used on animals affected by infectious diseases.
or such suspicions.

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Characteristics of disinfectants
Disinfectants are effective when used on previously cleaned surfaces: it is
It is necessary, therefore, to ensure a thorough washing before using a product.
to remove greasy material and debris.
This is because the presence of dirt not only prevents the disinfectant from acting on the
microorganisms but why many of these tend to create incrustations that can
become a breeding ground for germs.
Each disinfectant has a different spectrum of action from that of another: this is due to
both to the characteristics of the product itself and to the resistance capabilities of many bacteria or
virus for a specific active ingredient.
It is possible to know the capacity for action by consulting the technical data sheet present in the
packaging, this also indicates the correct way to use it.
The containers of disinfectants are labeled by the manufacturer and the label should not go
I removed it, nor should the container be used for material other than that.
reported.
All disinfectants, if used improperly according to the instructions for use, can
determine unwanted effects: toxicity in animals and/or humans and damage to
materials.
Furthermore, it should be avoided that these come into direct contact with hands, mouth, mucous membranes or
with any material used for medical practices (cotton, gauze)
In case of transfer, use small bottles (no more than 500 ml).
Close the bottle immediately after use and keep it capped.
In case of a leakage of a certain amount of solution along the bottle, it is necessary to
dry immediately
Disinfectants in aqueous solution, prepared extemporaneously, can change.
therefore they must be used within 7-10 days of opening the bottle.

The storage of disinfectants must be away from heat sources and light.

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Chapter III
Consumable materials and their use
The task of the Veterinary Technician is also to ensure that there is never
lack of "consumables"
Consumable materials refer to all non-pharmaceutical supplies that are necessary.
the conduct of activities at a veterinary facility, the use of which involves
a reduction of stocks.
Usually in a clinic as in an outpatient clinic there is both a warehouse,
where is the stock of materials placed, both of the small furniture or drawers, inside the
various rooms, where everything necessary for daily use is provided.

The consumables that must always be present and ready

for use are:

▪ Syringes
Each syringe consists of three elements:
the cylinder, hollow, transparent and graduatedmeasurement notches
lostantuffo (piston) inserted inside the sealed cylinder
the connection (tip or cone) on which it is mountedtheago
The cylinder determines the capacity of a syringe, expressed inmilliliters(cc)
In the veterinary field, syringes ranging from 1 ml to 60 ml are used.
The syringes are special.the insulinthat, for human use, are available in formats
from 50 to 100 UI, for veterinary use, are from 40 UI, and have the needle already implanted.
The International Unit is aunit of measureof the quantity of a substance, based on
its effect or on itsbiological activity.
The lostan tuft, in cylindrical form, is contained in the syringe cylinder, so that
adhere to the internal walls of it while managing to do so with a light pressure
of the operator, to flow easily: the adherence to tightness and constant smoothness
and controlled are guaranteed by a rubber ring.
The plunger is in such a relationship with the syringe barrel that it makes it so that,
push it all the way in, do not leave any unusable parts of the medication.
The coupling can be of two types: interlocking, which allows the insertion of the needle on the
syringe with light pressure, and screwing, where the needle rotates
"stuck" on the cone, remaining trapped.
Each syringe is contained within a plastic and/or paper package necessary to
to preserve its sterility, the duration of which is guaranteed for 5 years.

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▪ Needles
Distinct syringe needles, butterfly (butterfly) and cannula needles (intravenous catheters).
Then there are needles for specialized use, such as those for biopsy.

Whatever the category, the needles differ in length and

caliber.
The unit of measurement of the internal caliber of a needle is the Gauge (G), whose value is
inversely proportional to the inner diameter of the needle.
Typically, needles from 14G to 26G are used, with a different color associated with each.
each measure, where a higher Gauge value corresponds to a smaller diameter.
The length of the needles, expressed in inches, is reported on the
packaging, converted into millimeters (mm), as well as Gauge.
All needles have the characteristic of being sharp because they have a point.
scalpel cut into a clarinet beak (beet), to be sterile, single-use, and apyrogenic.
Needles can already be connected to the syringe or free, in that case
they will be attached to the syringe at the time of use, choosing the most suitable needle for the
procedure to be carried out.
Butterfly needles are short needles, characterized by having
a plastic tube as an extension, with a length of 30 cm and capacity
to contain 0.46 ml of liquid, at whose end there is a fitting to be able to
fitted to the syringe.
They present tips to be easily used and are employed for sampling.
of blood or other bodily fluids and for infusions of small amounts of solutions or
medications.
The cannulae are used for intravenous administration of fluids.
(phleboclysis) or medications.
A cannula needle is made of a small tube, which is the actual cannula, made of soft plastic and
atraumatica: this is the one that is inserted into the vein and inside which there is a needle
non hollow (mandrel) whose function is to pierce the skin, to enter the vein
and to be a guide to the cannula giving it a certain rigidity.
Once penetrated into the vein, the stylet is retracted from the cannula in such a way
to leave only the cannula positioned
To ensure stability, the cannula is secured with adhesive tape.
The cannula needles may or may not have wings and fittings on the body for
allow the administration of drugs while the patient is on an IV.

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24
▪ Band-aids
Roll bandages are used, they can be of different heights and sizes.
they measure in cm
The band-aids can be made of fabric or paper, in white or brown color, and they are all adhesive.
having a part covered by a specific glue.

▪ Garze
They are the so-called cotton pads, woven in a more or less dense mesh, in shape
usually square, of various sizes, with one or more layers, with a bordered edge or
men, sterile or non-sterile.
Some (laparotomy) gauzes have a blue filo finish, which can be highlighted.
to the radiological exam.
In commerce, there are also "greasy dressings": dressings that have been immersed in
oily medications with healing function, contained in sealed and sterile sachets.

▪ Me too
They are woven cotton strips, organized in spools.
They are of various sizes both in height and length, they are hydrophilic.

▪ I also have adhesive elastic

Known as Vetrap.
They are bandages typically used for completing dressings and for the
protection of the deflector during intravenous therapy.
They are of various sizes, such as height, and of different colors.

▪ Cotton wool
It's the classic 'cotton wool'
It is available on the market in the form of tufts or in large reels.

▪ German Cotton
It is a bandage, in rolls of various sizes, made of polyester and other materials
synthetic materials worked like cotton filaments.
It is used to protect injured areas, especially in the limbs, or to be
placed under adhesive bandages to avoid skin irritations or under splints of
containment in case of fractures.

▪ Bladder catheters
They are catheters used to be inserted into the bladder through the urethra.
They are used in animals with difficulty urinating (presence of stones) or for
collect urine in a 'clean' manner in order to perform specific analyses
They are distinguished into flexible or rigid catheters, for dogs or for cats.

25
▪ Medical gloves
These are disposable gloves, usually non-sterile, different from surgical ones.
therefore, also called exploration.
They are essential devices for the protection of both operators and patients from
biological agents, physical factors, and chemical substances.
The use of gloves is required when coming into contact with biological material, with
patients at risk of infection, with damaged skin areas as well as with contaminated surfaces
For every operation that is carried out, from dressing a wound to the simple
manipulating an animal, the gloves must be replaced, to prevent them from being a vehicle themselves
of contamination and infection for the same operator and for other animals.
The material they are made of is of different types: they can be made of latex, vinyl,
in PVC

▪ Surgical gloves
They are gloves intended almost exclusively for surgical use.
They are sterile, soft but durable, hypoallergenic, and are made with material
certainly not toxic nor harmful to tissues.
They are contained in sealed and waterproof pouches.

▪ Deflators
The deflector is a device used in fluid therapy.
It consists of a flexible tube with a tip made of material at one end.
rigid plastic necessary to pierce the appropriate cap of the fluid container and a
siphon camera, at the other end there is a fitting necessary for insertion
the diffuser on the needle-cannula.
Inserted along the diffuser is a fluid flow regulator, equipped with a small wheel.
to regulate the descent of the drops of the fluid to be injected.
The diffusers are distinguished into diffusers with macro or micro-drippers respectively.
the amount of solution in drops that release in 1 ml
A normal dripper (with macro dripper) used with standard solution
it provides 20 drops/ml, the drop factor is therefore 20
Blood transfusion deflectors are also recognized, characterized by having a
filter in the dropper chamber, to stop any clots.

26
▪ Antiseptics/Disinfectants
The disinfectant/antiseptic products present in a medical environment are
multiple: those active on skin are recognized, distinguishing damaged or intact skin
(antiseptics), those suitable for medical and surgical devices and those appropriate for the
surface disinfection (disinfectants).
The most represented are hydrogen peroxide, chlorhexidine, betadine, alcohol.
And again, quaternary salts, sodium hypochlorite, ammonia

▪ Detergents
They are the products used for dirt removal and charge reduction.
battery.
They are distinguished, based on their use, into skin cleansers or surface cleansers (tables,
floors) or for the sole cleaning of surgical instruments or common use items
(trimmers).
Mild cleansers and medicated shampoos are used for the skin, while for surfaces
surfactant-based detergents are used.

27
Chapter IV
The administration of medications
The drug is a chemical product recognized for performing a function in the field.
doctor

The drugs are characterized by

▪ Active Ingredient
It is the substance or the set of substances that characterize the action of that particular
medicine.
Active ingredients can be synthetic, semi-synthetic, or natural and constitute the part
pharmacologically active pharmaceuticals.
▪ Eccipient
An excipient is an additional substance necessary to characterize a drug in the
its pharmaceutical form, in taste and smell, and lastly, in the way of
absorption or release of the active ingredient.
It is a definition that includes any material found in the finished drug that is not
the active ingredient.
▪ Pharmaceutical form
It is the way a drug is presented: liquid form (alcoholic, oily-based, in
aqueous solution), solid (tablets), powdered, granular both in capsules and in
packets or vials.
▪ Route of administration
Indicate how a medication should be administered to the patient.
Whether orally, intramuscularly, intravenously or otherwise
▪ Duration of effect (often for drugs, this is referred to as half-life)
Important to know how many times a day it should be administered.
a specific drug, so that its plasma concentration is constant.
For this purpose, the following abbreviations are used when setting up a therapy:
SID: once a day (from Latin Semel In Die)
BID: 2 times a day (from Latin Bis In Die)
TID: 3 times a day (from Latin Ter In Die)
4 times a day (from the Latin Quater In Die)

28
Routes of administration of a drug
Alright
Parenteral (intramuscular, subcutaneous, intradermal, intravenous)
Transcutaneous
Pulmonary

▪ Orally
It is the administration by mouth (PO, per OS)
The oral administration involves the absorption of the drug at the level of the cavity.
oral (mucous membranes of the mouth and tongue) and/or of the gastrointestinal tract.
Oral medications can be given directly in the mouth and, if not planned the
administration on an empty stomach, they can be added to food.
The pharmaceutical form can be in tablets, capsules, drops, syrup, paste, and in
granular format.
Some are already ready to use, while others need to be dissolved in water, as happens
for granular pharmaceutical forms.
The oral administration can be easy if the medication is added to food and does not
it neither alters the taste nor the smell.
In the case of 'difficult' animals, it will be the owner's responsibility to provide 'forcibly' for the
therapy: the Technician's task is to instruct how to act in the most correct way and
as little traumatic as possible.

Procedure
Choose a comfortable workstation
With one hand, hold the tablet between your index finger and thumb.
With the other hand, hold the snout firmly and squeeze the cheeks against the
upper premolars
Lift your head up so that your jaw will automatically drop.
downward revealing the jaws
With the hand holding the pill, further force the mouth open and
place the tablet as far back as possible, at the base of the tongue
Close the mouth immediately by repositioning the head axis to its normal position.
position
Massage the throat to stimulate swallowing
Check that the tablet has been swallowed

29
▪ Parenterally
It is the administration of medications that are not taken orally.
Parenteral administration is used in the case of drugs with active ingredients that
if ingested, they would lose effectiveness or prove to be harmful to the mucous membranes
of the digestive system or for other tissues; to ensure distribution in areas
from the organism otherwise unreachable; to obtain an action in a district
without involving the entire organism; in case of emergency for a rapid effect.

The most common routes of parenteral administration with injection are

Sottocute (S.C.)
Muscle (I.M.)
Vene(E.V)

Other routes used for particular situations, often of exclusive medical competence
I am
Intraosseous. The internal space of the bone is made up of vascularized spongy tissue.
able to absorb the substances introduced with some ease and to allow their
distribution in the systemic circle
Intradermal. Right in the thickness of the dermis
Intra-articular. Inside the cavities of a joint.
Epidural.
Intratecale.

Parenteral administration through injection requires competence and

accuracy: some drugs can be damaging to tissues and it is therefore important
to know how to proceed to avoid as much as possible the possibility of having small ones
hemorrhages, inflammation and necrosis of tissues, septic phenomena.
Furthermore, during administration, especially intravenous, it is very important
respect the inoculation times.

30
Inoculation sites and procedures

▪ Subcutaneous (S.C.)
The most commonly used site is the subcutaneous area between the shoulder blades, although sometimes it
they prefer other skin areas

Procedure
Sometimes disinfection of the part is required.
Lift a skin fold
Insert the needle at the base of the skin fold.
Perform a small suction to ensure that a vessel has not been involved.
Inoculate the drug
Extract the needle
Release the skin
Check that the medication has not leaked
Gently massage for a few seconds
Also know that the S.C. administration is a route with slow absorption, not
predictable in terms of timing and quantity of the drug being released into circulation,
because it is also related to the patient's conditions (hydration status, temperature
corporeal). The standard dose to be adhered to in this type of administration is 10 -
20 ml per inoculation site. Local reactions at the inoculation site are possible, both for the
characteristics of the drug, what one needs to know to prepare for
precautions, both for issues specific to the animal in treatment, not always predictable.
Possible reactions at the inoculation site, both due to the characteristics of the drug,
what one must know to implement measures, both for one's own issues
of the animal in therapy, not always predictable.

31
▪ Intramuscular (I.M.)
The injection site is usually in the thigh (quadriceps or semitendinosus -
semimembranosus), but one can opt for the shoulder muscle or the musculature
paravertebral.
Pay attention to the way the needle is inserted when injecting the medication.
in the semitendinosus-semimembranosus muscles: the needle should not be inserted into
cranial direction, as there is a risk of damaging the sciatic nerve which runs between the
two muscles

Procedure
Sometimes disinfection of the area is required.
Locate and block the muscle between the fingers
Gently tap the injection site (this is to 'prepare' the muscle for
needle penetration and slightly recalling the blood on the part)
Introduce the needle
Perform a small aspiration to ensure that no vessel has been involved.
Gently inoculate the medication
Pull out the needle
Gently massage
The absorption of the drug is quite rapid, occurring in a few minutes, in such a way
predictable and constant, regardless of the patient's condition.
Furthermore, in certain situations, the I.M. route allows for a direct effect on the
same vaccination site.
Some medications trigger a painful reaction at the injection site, which is why many
Sometimes it is necessary to add small amounts of local anesthetic (lidocaine).
directly into the syringe.

32
▪ Via intravenous (I.V.)
For IV administration, all veins could be suitable: in non-emergency situations
it is preferable to choose easily accessible pots that are of good
caliber, in good condition; many times the choice of a blood vessel is conditioned
from the type of medication to be used, from its quantity, and also from not creating
discomfort in the animal.
In dogs and cats, the radial artery is used, sometimes also the femoral.
When administering an IV, it must be prepared carefully.
venous access.
The intravenous route is used to administer both small doses of medication and
large amounts of fluids in a constant manner, mainly used in cases of shock
this can also be used in case of coagulation problems: it allows to
to achieve a predictable and constant blood concentration over time.
It is necessary to prepare the materials such as: trimmer, alcohol-soaked cotton, tourniquet
emostatic, butterfly or cannula needle, plaster, perforable cap, syringe with solution
flush, vetrap

Procedure
Choose the most suitable vein
Perform the trichotomy
Local antisepsis with Chlorhexidine and/or Alcohol
Practice hemostasis with a tourniquet or with the help of another operator for the
digitopressure
Visualize the vein chosen for access
Insert the cannula needle until blood is visible in the hub.
Sometimes it is necessary to perform a cut-down (surgical venous access), when the
the cute animal is not very elastic, making it difficult to introduce the needle or apply pressure
the blood is so low that the vein is not visible, despite the compression
of the same.
The cut-down involves making a small incision with a scalpel blade.
on the skin near the vein.
Slide the catheter into the vein, keeping the stylet steady.
Extract the spindle
Interrupt the pressure on the vessel
Secure the needle-cannula with adhesive tape
Screw on the perforable cap
Secure everything with some more tape.
Inject, if necessary, the heparinized flush solution or only physiological saline solution.
Protect the venous access created by a light bandage
The slow administration is important and will have its precise timing.
related to the type of drug and the amount of liquid

33
Routes of parenteral administration without injection are

Transcutaneous
Conjunctival
Inhalator

▪ Transcutaneous
The transcutaneous route allows for the absorption of a drug through the skin. With the
possibility of action both locally and systemically. The drugs used are presented
in the form of patches (transdermal) capable of containing the active ingredient and its
absorption in the body is somewhat unpredictable, it typically occurs for 6/8 hours after
the application.

It is the owner who takes care of the therapy: it is up to the technician to teach the procedure.

The areas of the body chosen for the application of the medicated patch depend on the type of
drug, based on the characteristics of the coat and the nature of the animal
Often it is the inner face of the auricle.

Procedure
Choose the point of application
Perform the trichotomy of the part
Pass a cotton ball soaked in alcohol to remove grease.
Wait for it to dry
Apply the medicated patch, ensuring it adheres well to the skin.

▪ Conjunctival route
Through the conjunctiva: capable of rapid and effective absorption
The medications used are in the form of drops, ointments, gels.
The technician will train the owner for the execution of the procedure.

Procedure in case of ophthalmic ointments

Clean the eyes of any present discharge.
Extend the patient's head
Lower the lower eyelid
Apply a strip of ointment to the conjunctiva inside the lower eyelid.
Gently massage

Procedure in case of eye drops (eye drop)

Clean the eyes of any present discharge.
Extend the patient's head
Lift the upper eyelid
Drop some drops on the cornea, preferably in the lateral portion.
34
Gently massage

▪ Inhalation
The inhalation route involves the active ingredient passing through the respiratory tracts.
higher, until reaching the alveolar level.
The alveoli will allow for gas exchange and the absorption of the active ingredient.
the absorbing surface in the alveoli is about 90 square meters in a dog
large size).
A local or systemic effect can be obtained, depending on the chosen drug.
The pharmaceutical form can be in powder (solid particles) or, in the vast majority
in the majority of cases, in aerosol (liquid particles).

Procedure
Cages prepared for aerosol therapy can be used for animals.
many veterinary facilities are equipped with, or in the market, you can find some
portable inhalers.
For small dogs and cats, for domestic use, one can use a pet carrier.
wrapped in a plastic sheet, well sealed, in which a hole will be made through which will be
inserted the appliance connector.

35
Chapter V
Organization of fluid therapy
Fluid therapy refers to the intravenous administration of fluids necessary for the
restoration of the homeostatic conditions of a patient’s organism, such as the
normalization of hydration status, replenishment of electrolytes and proteins or for
facilitate the administration of drugs such as in chemotherapy or antibiotic therapy intravenous.

The veterinary technician plays a crucial role both in setting up the therapy and
in the monitoring of the patient during the administration of it.

Materials for fluid therapy

Scissors clippers, necessary for shaving the hair in correspondence with the vein chosen for
the administration of fluids.
In commerce, there are various types and brands of clippers, the most common ones are the ones with
wire and the so-called 'wireless', the latter smaller and more manageable but above all
silent, very suitable in case of frightened, stressed animals and cats.
Alcohol, for the removal from the skin of foreign material, especially grease, and in the
infection prevention, as well as to facilitate the introduction of the needle since
cleans the area by highlighting the vein on the animal's skin.
Antiseptic solution, based on povidone iodine or chlorhexidine, for disinfection
furthermore the area, under certain conditions.
Cotton, like a swab, used to apply antiseptic and alcohol.
Scalpel blade, sometimes necessary to perform the "cut down": this technique, which
consists of a small incision of the skin near the vein, allows a
better viewing of the vase, if it is collapsed, and it avoids the 'crumpling' of the
needle tip-cannula during its insertion in case of severely injured animals
dehydrated or with particularly thick skin.
Bandage, to secure the venous catheter
We know three different types depending on the material they are made of.
Incarta, delicate for the skin and easy to remove
Inseta, very delicate for the skin, easy to apply and remove, leaves no residue.
residue of glue and does not pull out the animal's hair
Intela, used in most cases because it is easy to apply, adheres well.
it is cute and allows the cannula to stay in the vein even in the case of lively patients
It should be secured properly and not too tight.
Suitable for long-term fluid therapy.
Sometimes it proves too tenacious in adhering to the patient's skin and fur, for the
the removal requires the use of alcohol to dissolve the glue.
36
Vetrap or elastic bandage, to be applied as a bandage once the needle-cannula,
secured with the bandage, it should be connected to the drip, so as to ensure that
the animal does not tear the needle, rendering the therapy useless

The cannula, the size of which will be chosen based on the diameter of the vein.
Drillable plugs. They are rubber plugs used to ensure closure.
of the needle-cannula, once the fluid therapy is finished, allowing, thanks to the
their structure, to be able to equally administer medications or other fluids intravenously.
Deflusher, to allow the fluid from the bottle to flow to the needle placed in the vein.
It is composed of

Punch: it is used to pierce the rubber stopper of the solution bottle.

to impart
Drip chamber: where you can observe the drops falling and
monitor the infusion drip of the solution.
This is equipped with an air intake with an antibacterial filter that allows the bottle to
stay vacuum-sealed.
Flow regulator or knob, capable of opening or closing by compression the
diffuser tube, in order to adjust the falling speed of the solution
Screw connector (luer lock) or compression to connect the diffuser to the needle
cannula or butterfly.
For blood transfusions, a special drip set is used, equipped with a chamber of
dripping with a filter to stop any clots.

37
Suitable fluid. Based on the patient's conditions, the veterinarian will indicate the type of
fluid of having to infuse
Always check the expiration date and inquire if it needs to be heated.
the liquid, something that can be done in a microwave or in a double boiler, and on the
infusion speed to be adopted.
Infusion pumps. They are a sophisticated system for the administration of fluids.
endovenous. They allow the correct infusion of fluids in a certain unit of
time (chosen by the veterinarian based on the state of health, the diagnosis, or the age of the
patient) and are equipped with an alarm that activates when interruptions occur.
fluid flow (occlusions) or when the set infusion volume has been reached
ends (the pump automatically blocks and does not allow air to be introduced into
deflusher).
Each infusion pump varies in mechanics and software from brand to brand and
with this also the respective diffusers (except for some that allow the correct
operation of the circuit even with the common diffusers).
There are at least four types of infusion pumps available on the market:

linear infusion pump: there is a helical structure that crushes and presses the
deflector in order to facilitate the passage of the liquid inside
rotary infusion pump: there is a rotating structure that performs the
the same action as the linear one, namely the crushing of the liquid inside
-piston pump: used for small quantities of fluids, they are made up of a
fluid flowing in a cylinder that pushes the fluid
Syringe pumps: they exploit a push mechanism that presses the piston of the
syringe with fluids to be administered directly into a connector attached to the
patient's cannula.
Does not require a diffuser and is often used for administration.
small amounts of fluids

Heparinized flush solution. It is a sterile solution that is prepared within a

syringe with saline solution and heparin (concentration of 2UI/ml).
A valid and more common alternative to the heparinized solution is the so-called flush.
with physiological solution (NaCl 0.9%), both should be used with syringes
suitable (for small/medium-sized cats or dogs, 2.5 ml syringes are used; for dogs
large size 5ml syringes
Sometimes it is necessary to inject the solution before connecting the drain to the needle.
cannula, used to dissolve any potential small clots that may have formed.

38
Stand. It is the rod designated to hold the infusion liquid bottle.
Hemostatic tie. To facilitate compression and visualization of the vein from
to use
Basket. A container that, hanging from the pole, allows for holding the
bottle of infusion solution.
On the sides, there are small hooks through which the tube passes.
defluffor, when not connected to the patient, to prevent it from touching the ground.
Stethoscope and thermometer. Necessary to monitor the patient during
administration of fluids intravenously

39
Administration of drugs during fluid therapy
The administration of a drug intravenously during fluid therapy can
to be performed:
-dalgomminoa valley of the deflussore, inserting the needle of the syringe containing the
drug.
It is necessary to pay close attention not to pierce the rubber from one side to the other.
same.
the grafting point of the butterfly needle connected to the piercing cap
of the needle-cannula.
-injecting it into the same vial, in case of continuous infusion of the drug.
Each drug has its own chemical composition and should be administered intravenously.
slowly and diluted except for exceptions.

Assemble a correct fluid therapy

▪ select the appropriate vial to administer
▪ remove the deflector from the sterile container
▪ remove the cap from the sterile punch upstream of the diffuser and insert it into the
aseptic bottle stopper
▪ close the diffuser's little wheel
▪ press the tank or drip chamber and fill it to at least half with
the solution
▪ gently open the roller and remove the air inside the diffuser
▪ insert the sterile connector (located at the base of the diffuser) into the needle tubing
butterfly, being careful not to compromise its sterility.

Types of Fluids
The fluids that we can use for the therapies of our animals are various and their
employment is linked to the clinical situation of the individual: depending on the necessity and the
pathology has a different protocol. Administration can be continuous and
monitored over time, and the intravenous route is the best one to use, especially
in case of shock, because it has an immediate effect.
Among the different types of fluids used in intravenous therapies, we recognize two classes.
which are called Crystalloids of Colloids.

40
Crystalloids: they are aqueous solutions of salts or other water-soluble substances that
They differentiate based on their osmolarity into Hypotonic, Isotonic, and Hypertonic.
Osmolarity expresses the concentration of a solution, highlighting the number of
particles dissolved in it regardless of electric charge and size.
Osmolarity is expressed in osmoles per liter (osmol/L or OsM) or - when the solution is
particularly diluted - in milliosmoles per liter (mOsM/L). A crystalloid can
to be defined as balanced when its chemical composition is very similar to the liquid
extracellular.
Isotonic crystalloid solutions are the most widely used and are characterized
from having an osmolarity very similar to that of blood plasma.
I am:
Physiological solution consisting of 0.9% Sodium Chloride in purified water and
having an osmolarity of about 300 mOsm/l
Lactated Ringer's and Acetated Ringer's containing Sodium, Chloride, Lactate/Acetate,
Potassium, Calcium.
They find employment in conditions of dehydration, saline alterations, and in case of
mild or moderate acidosis due to the presence of lactate/acetate
5% glucose solution used to correct states of dehydration
accompanied by malnutrition and hypoglycemia, as occurs during vomiting and/or
diarrhea. Whatever type of concentration Glucose may have, it will always go
administered intravenously because other routes could cause injuries
cell phones.
Isotonic crystalloid-based fluid therapies have the characteristic of diffusing,
once infused into the bloodstream, in the interstitium quickly and significantly
quantity, abandoning the blood circulation: this involves a hydration of the
fabrics but not a variation in the circulating volume corresponding to the quantity of
liquid introduced: to increase the circulating volume by 1 liter, 4 liters are needed
of solution, as only 1/4 of it remains in the vascular bed

Hypertonic crystalloids are characterized by having an osmolarity higher than that

of plasma and therefore isotonic solutions (500-1,000 mOsm/l) in fact, introduced into
circles, drawing water from the tissues and endothelial cells in the vascular lumen.
Among the hypertonic solutions, there is a 20% glucose solution (1.112 mOsm/l),
bicarbonate at 8.4% (2,000 mOsm/l) and mannitol at 18%
Their use is required when it is necessary to mobilize liquids from a compartment.
organic and circulate it (a classic example is cerebral edema)
The use of hypertonic solutions must be carried out with the utmost care and
ocular damage due to osmolarity can cause harm
to the vascular endothelium, triggering an inflammatory process and the development of phlebitis.

41
Colloids: also called Plasma Expanders, are aqueous solutions containing
high molecular weight particles that, thanks to their residence time
prolonged intravascular, and the absence of interstitial dispersion, are able to
increase the circulating volume, in significantly reduced time, with a ratio of
1 to 1.

Colloids are divided into: Natural and Synthetic.

Natural colloids include whole blood, plasma, concentrated albumins and
difficulties.
They can cause adverse reactions, like blood transfusions (fever, reactions)
immuno-hemolytic, allergic reactions...); they are expensive and not always
easy to find them.
The synthesis colloids are preparations based on oxy-polygelatin, dextrans, and hydroxyethyl-
amid
Each active ingredient has its own pharmacological characteristics; moreover, they are
responsible for possible side effects such as coagulopathy, hypocalcemia,
acute renal failure and anaphylaxis.

FORMULA TO CALCULATE DROPS PER MINUTE:

"X" gtt/min = hourly volume x drop factor of the infusion set

(125 ml) (15 drops/ml drop factor)

FORMULA TO CALCULATE VOLUME/HOUR

Total volume ÷ administration time = ml (volume)/h

42
Chapter VI
The role of the Veterinary Technician in inpatient care

In a Veterinary Clinic, the areas designated for the hospitalization/rehabilitation of patients are usually
divided into:
Degenza Dogs
Degenza Gatti
Infectious Animal Degeneration
Sometimes dogs and cats can be placed in the same room, but in any case, the
Animals with infectious diseases are hospitalized separately from others.
The cages for the stay are arranged in such a way as not to allow the animals to
to be able to look at each other and the cats are placed in higher cages than the dogs.
In each ward, there is a designated table for visiting and
perform interventions on hospitalized animals, move or shelve necessary products,
both for ordinary cleaning and consumable materials, a tank for cleaning the
animals and sinks.
When entering a hospital ward, it is good practice for everyone to take advantage of the norms.
of behaviors to avoid problems for the hospitalized animals and for themselves
present operators, whether they are Veterinarians or Technicians.

Duties of the veterinary technician in inpatient care

Patient acceptance
Completion of the Patient Admission File
Clinical Diary Update
Administration of medications
Patient care
Communication with Veterinarians and other colleagues about clinical conditions
and on the procedures to be implemented with each hospitalized patient
Resignation

43
Patient acceptance
The Technician present at the time of admission, therefore, who assists the Veterinarian in
At the time of the visit, they take care of the patient in the early stages of their accommodation.
in the patient room

Choice of the workstation

▪ check the situation inside the shelters and identify the most suitable cage
▪ prepare the cage by putting absorbent crossbars, blankets, and bedding inside
▪ on the Veterinarian's recommendation, also water and what type of food
▪ if necessary, a heating mat will be placed inside or a lamp will be installed
▪ organize the admission folder with all the patient's related data: weight,
body temperature, clinical signs, reason for hospitalization, special attention from
to lend for the health of the subject and the operators (transmissible zoonoses)
The therapy and the analysis schedule will also be indicated on the same folder.
and other checks for a more in-depth diagnosis and treatment

Hospitalization
▪ With extreme care, the patient is placed in their position.
▪ the 'clinical diary' is placed on the gurney where the therapies that must be recorded are transcribed.
to be carried out and that will update all procedures and clinical conditions
that are detected daily
▪ the necessary medications for the ...
therapy

Clinical diary update

The clinical diary is a form prepared to record everything related to the patient.
at every special moment of each day spent in hospitalization
Everything indicated by the Veterinarian must be reported, as well as any
observation or observation that each Technician makes (vomiting, loss of appetite,
diarrhea, aggression, lethargy
The schedule for therapies is indicated and marked when they are carried out.
parameters measured during various checks (body temperature, condition of
dehydration, color of the mucous membranes), if the animal needs to be fasting at a given
moment for the execution of analysis or interventions

44
Ordinary management of the hospitalized patient

It is important to establish an empathetic interaction and as much trust as possible with

the hospitalized patient, understanding their state of discomfort, often suffering and fear.
One must address animals in a low voice, with gentle tones and delicate movements.
"never 'let your guard down': an animal under stress can develop"
behaviors that are also aggressive!
For some maneuvers, especially in painful or particularly fearful dogs, it is preferable
use the muzzle and with cats, use blankets to cover them and avoid them
they can escape or scratch.
For the care and hygiene of the hospitalized patient, it is sometimes appropriate to encourage him to
perform a "grooming" action (body cleaning) with the help of wipes
moisten or remove the Elizabethan collar if the patient has one for
a specific reason.
Administration of medications
Every time a therapy must be administered to a patient, one must be very
careful and meticulous:
▪ identify the specific patient to whom to administer the therapy
▪ to follow the doctor's prescription
▪ calculate the dose of the drug to be administered (based on the prescription)
▪ to know if a medication should be taken on an empty stomach or after a meal
▪ to know if an injectable drug is for intramuscular, subcutaneous, or intravenous use
▪ in case of products for EV use, know the infusion speed
▪ assess the patient's disposition (in order to decide if assistance is needed or if
the muzzle needs to be put on
▪ to have the awareness and sensitivity not to instill fear in the animal when one
administers the therapy
▪ wash your hands before and after administering the therapy
Care of the hospitalized patient

In addition to administering therapies, following the Veterinarian's instructions, and

updating the clinical diary, it is also the Technician's task to ensure the
maintenance of the animal's hygiene, the cage as well as the entire designated area
the whole stay
Patient hygiene
One must never neglect the cleaning of an animal by providing for
▪ Promptly remove the waste.
▪ Disinfect and treat the mucocutaneous junctions and the irritated skin.
▪ Proceed with the suturing (also preventive) of the perineal region.
▪ Clean the eyes and ears from secretions, trim the nails, brush the coat
▪ In case of necessity, you can also dedicate yourself to a partial or complete wash.

45
Nail cutting
In immobilized patients, elderly individuals, or those with specific conditions, the nails are not
subjected to normal consumption or characterized by anomalous growth.
Furthermore, if the nails are not regularly trimmed or cut, they can curl back.
and managing to embed itself in the corresponding bearing causing an infection and a
painful situation for the animal, so much so that it prevents it from walking.

It is the Veterinary Technician's duty to ensure that the patient's nails are in a
correct length and, if a local infection has occurred, report it to the
veterinarian and then provide disinfection and care for the area.
If, during the nail cutting, a blood vessel is accidentally cut,
inside, a small amount of adrenaline can be applied or the nail can be compressed
bleeding with a gauze.
Pay particular attention and caution when cutting pigmented nails.

Emptying of the anal sacs

The anal sacs are two and are located laterally to the anus, slightly lower.
in relation to it.
The anal sacs are connected to the anus through ducts and discharge a secretion externally.
from the rather pungent and unpleasant odor.
They usually tend to empty spontaneously during defecation or when
the animal is in a state of particular stress, excitement or fear.
If this does not occur (for example due to excessively soft stools that therefore
during expulsion they do not "press" properly against the anal sacs)
they will become swollen, painful, and reddened, and they could even become fistulous.
To avoid all this, it is necessary to manually empty the bags.
The procedure for their emptying includes:
▪ keep the animal in a quadrupedal station (standing)
▪ to preemptively put on the muzzle (it can be a painful procedure)
▪ wear disposable gloves and lubricate the fingers with a gel (Luan)
▪ introduce the index finger into the anus and gently oppose the thumb from the outside
compressing the bag, or performing the maneuver from the outside by compressing the
scoops simultaneously while with the other hand he/she holds up the tail
▪ collect the material on a gauze and clean the perianal area with warm water
and a detergent

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Ear cleaning
Before proceeding with ear cleaning, it is necessary to ensure that there are no
anomalies, irregularities or particular pathological conditions
It is always necessary to ask the Veterinarian if and how to proceed with them
cleaning.
Cleaning the ears and instilling medications can cause harm if
the procedure is not executed correctly; therefore, care must be taken regarding the type
of disinfectant that is used (the concentration of Chlorhexidine must not exceed the
0.4%) and the instruments used within the ear canal.
Cures and improper behaviors can cause damage to hearing and vestibular syndromes.
(form of hyperacute imbalance with head tilted, tendency to fall to the same side,
ataxia, nystagmus, nausea and vomiting
Sometimes, to sanitize the ear canal and clean it of secretions, only
NaCl sterile or hydrogen peroxide.
Report to the Veterinarian the possible presence of ulcers, inflammations, proliferations
tissue, stenosis (narrowing) of the ear canal
In case of excessive hair presence, it is necessary to remove them gently using
tear with the help of tweezers.

Cleaning of the external auditory canal

▪ Collect any material from the ear canal with a cotton swab.
▪ Take the fin and gently stretch it to insert the dropper of the bottle.
of the washing solution
▪ Instill the solution until it nearly overflows from the ear canal.
▪ Massage the base of the auricle at the point of attachment to the head
▪ Hold the animal's head for a few seconds to prevent it from being able to
scoot it away immediately
▪ If necessary, provide another swab after drying the ear canal.
and the instillation of drops for otological use, if prescribed.

Hygienic bathroom for the dog

It is good to organize everything needed to wash the dog: brush, scissors, clipping machine,
towels, hairdryer.
The bathtub should not be slippery, for this reason, place a mat on the bottom.
anti-slip or a towel
In case of using medicated shampoos, follow the instructions for use.
For some types of shampoo, it is preferable to wear rubber gloves.
The animal's fur should not be knotted; therefore, as much as possible, it is necessary
Before starting the washing, make sure to brush it and cut or trim the most problematic areas.
intricate. The washing must certainly be careful but quick, lingering on
especially on areas of the body that require more care, such as the area
anal and skin folds
It is important to rinse the coat well and ensure it dries.
47
Resignations
The patient's discharge falls within the duties of the Technician and completes the
management of a hospitalized patient.
Before an animal leaves the Structure, it is good to ensure that it is clean and that it has been
removed all medical devices (band-aid, needle-cannula, catheter).
Return to the owner a package with all the belongings of the patient
like little dolls, leash and collar, blankets.
Deliver the documentation related to the hospitalization (Clinical File and
Diary): it is the Veterinarian's duty to close the Clinical File, completing it with the
instructions to follow.
The folder will be delivered to the owner while the various sheets that constituted the
The clinical diary of the subject will be kept in the clinic.

The medical record, as well as the diary, also has legal medical significance.

48
Clinical Folder and Diary of the hospitalized patient

Folder and Diary are very important documents both because they contain all the data
of the patient and his clinical history, past and current at the time of admission, both because
"they recount" everything that was done during his stay and the evolution of
clinical situation
Moreover, they are a communication tool among all staff members.

Patient's Medical Record

It is a proper folder, both in paper and digital format, that will be handed over.
by hand enriching itself with writings and leaves
regarding the patient's presence in the veterinary facility's ward
At the time of admission, the Clinical Record consists solely of a form of
recovery in which the owner's details are reported (first name, last name, address,
phone) and the patient's data.
During the hospital stay, the Clinical Record will be enriched with various "sheets":
analysis reports, radiographic or ultrasound examinations, specialist visits

Patient data
name
Indole (docile, aggressivo, pauroso)
Environmental history (where they live: inside or outside the house, alone or with other animals)
Eating habits
Use of pesticides and vaccines
Remote anamnesis (past medical history)
Recent medical history (what happened to go to the clinic)
Report of the clinical visit
Diagnostic investigation program
Therapy

Clinical Diary
It is a form, usually displayed on the cage of the patient in question, in which there are
systematically reported throughout the day
the therapies that are carried out (which medication, at what time)
the observations on the animal's condition (vomiting, diarrhea, depression)
the GFO
clinical monitoring (temperature, heart rate, and breathing)
the indications on the procedures to be followed (fasting for blood draw)
medical procedures (dressing changes, bladder emptying)
Next to each entered data, the signature of the person who operated must be affixed.

The medical record, as well as the diary, also have legal medical significance!
49
Chapter VII
"Special management" of the hospitalized patient

Special management is the care of animals in decubitus: of those patients unable to move.
to move for short periods, such as following traumas that can be resolved, or that
they will spend the last part of their lives in a state of permanence
immobility
Caring for these animals, both in the hospital and at home, is often the responsibility of the
Veterinary Technicians, whose preparation and commitment in performing this task
they depend on the duration and comfort, in case of hospitalization, such as prevention and
resolution of many of the problems that may arise.
Following the decubitus, the areas subjected to pressure undergo an alteration of the
blood circulation with ischemia and tissue necrosis phenomena and formation of
bedsores: these can develop in a short period of time and can be resolved
with difficulty.
In addition to compression, in animals with motor difficulties, the wounds can
they originate when the skin rubs against hard surfaces as happens when an animal
is dragged or moved even just to change its position or can involve a
zone of a paw for rubbing the part, as happens in an animal with
abnormal gait following paralysis affecting a single limb
However, the appearance of pressure sores depends on the combination of multiple factors.
factors: total or partial immobility of the animal (due to pathological conditions,
such as multiple fractures, thrombosis of large vessels, intervertebral disc herniation, deficiencies
neurological), precarious pre-existing general health conditions (poor health status
nutrition, circulatory problems), improper management of the immobilized animal (keeping
the patient is too still, not cleaning him properly from the excrement, making him stay up
inappropriate surface
It is really important to commit to preventing the formation of sores and intervenes
promptly at the first signs of tissue suffering.
Not intervening immediately also involves the plans.
underlying the skin, affecting the bone structures (osteomyelitis, septic arthritis).
The areas most susceptible to necrotic phenomena with the appearance of sores
from the supine position, there are bony prominences as they are less covered by soft tissues which
physiologically they act as a cushion.
The animals at the highest risk are those that are large and heavy, or with skin.
delicate and thin.

50
The bony prominences most affected by pressure sores are:
- Lateral condyle of the humerus
- Greater trochanter
- Calcaneal tuberosity
- Ischial tuberosity
- Iliac tuberosity

The bony prominences that are less common are:

- Lateral condyle of the tibia
- Acromion of the scapula
- Olecranon
- Sterno
- Fifth finger

Treatment of bedsores
If the patient, unfortunately, shows signs of pressure sores, it would be
It is appropriate to intervene promptly for the resolution of the injury
Depending on the severity and surface extent of the wound, one can resort to
a so-called conservative therapy or to surgical therapy
Conservative therapy aims to further reduce pressure on the parts.
involved, to ensure the asepsis of the lesions with medicated washes and the use of ointments or
healing gels, to ensure the patient a good supply of high nutrients
protein content, to ensure sufficient hydration.
If the situation of bedsores is serious, it is necessary to resort to
surgical treatment
This involves the removal of necrotic tissue, reconstruction of the relationships between
muscle and underlying bone component and subsequent treatment as per therapy
conservative

Care of the immobilized patient

Daily, an animal forced into immobility must be monitored with
carefully and attentively looked after
From the early days of reduced or completely absent movement, it is good to examine the parts.
of the skin subjected to stress: the at-risk areas for the appearance of pressure ulcers must
therefore to be checked for color and integrity.
Assessing the good condition of the skin can be done, in addition to the visual examination of the
colored, even with digital compression, applying the same method used for
the determination of the capillary filling time on the mucous membranes, that is a slight
digital pressure on the point to be examined in order to create a small stain
pale that will return pink as soon as the pressure (1-2 seconds in conditions is released.
(normal), if this does not happen it is highly likely that there is already damage.
of the capillary bed.
To avoid or at least reduce as much as possible the appearance of bedsores is to
fundamental importance to follow procedures such as:

51
Animal hygiene
Prevent the animal from being soiled by urine and feces and, if it happens, take care of it.
immediately after washing the affected parts and drying them.
It may be helpful to shave the perineal area and apply zinc oxide ointment.
To protect the skin, it may sometimes be necessary to insert a urinary catheter.
The maceration and irritation caused by enzymes and the moisture from urine and feces can
cause a break in the natural hydrolipidic skin barrier.

Change the patient's position

Change the position of the animals often throughout the entire day.
It is necessary to use techniques that also involve small repositioning,
such as slight movements of the limbs.
Among other things, the animal's repositioning maneuvers represent the moment
ideal for assessing pressure on bony prominences and other parts of the body,
Moreover, simply changing position prevents the collapse of the lung alveoli.
with consequent reduction of gas exchanges (atelectasis)
After the change of position, it is good to stimulate the areas that have been subjected to
pressure with gentle massages that promote blood circulation in those
districts.
The positioning of the cushions will also be changed to vary the support base and others.
they will be placed between the (front and back) legs to ensure good alignment
of the arts (avoid them stacking on top of each other).
When possible, efforts will also be made to encourage the patient to stand up.

Adequate bed
Even an adequate "bed" on which to lay the animal can influence the onset.
of pressure sores. The best materials must be able to absorb
possible urine or other organic material or at least not to determine stagnation.
Grids, sometimes present in certain types of boxes or cages, work well in this way.
scope, although they are made of a material that is too hard and therefore from this point
to predispose to skin ulcers.
The ideal solution can consist of foam mattresses of a certain
consistency, placed under an absorbent crossbar.
The application of towels in correspondence can be very helpful.
bony prominences or rolled up to be placed between the legs.

Nutrition
Water and food should be placed in appropriate containers to allow the animal.
to access it easily without dragging.

52
Emptying of the bladder
Some forms of paralysis can lead to a paralytic bladder: the animal is not in
degree of spontaneously emptying the bladder with urinary retention and further loss
of the vesical function if it were not provided for its manual emptying by
trained personnel
At other times, it is necessary to facilitate the emptying of the bladder with the use of
bladder decatheterization, which can also occur in non-paraplegic animals but
they must remain in a lying position for a certain period of time

How to manually empty the bladder

▪ Place the patient in a quadruped position, or in the position that is least stressful for them.
usually on one side
▪ Identify the bladder with a gentle yet deep palpation.
▪ One hand will be flat
▪ The other hand will be like a spoon
▪ Apply a light, constant, and uniform pressure (with both hands)
▪ Maintain pressure gently but steadily for a few seconds.
In small dogs and cats, one hand can be used, while for large dogs,
you will need to use both.
Urination will not happen immediately as it will take a few seconds to
overcoming the resistance of the bladder sphincter
The evacuation of the bladder must occur every 4-6 hours.

53
Physiotherapy for the immobilized patient
For an animal with mobility difficulties, assistance and veterinary care are not
limited exclusively to ensuring that this situation does not worsen, but the purpose and
the function of a team is to ensure that the patient begins to move again
autonomously.
The foundations of physiotherapy treatment include massage to ensure the
circulatory perfusion of the compromised areas and the stimulation of the muscles and the
proprioceptive stimulation to prevent loss or to recover, for as long as
possible, the neurological control over striated muscles in the animal
For this reason, it is important that a Veterinary Technician also has a
preparation in physiotherapy field
Methods of physiotherapy and protocols to know and follow
Type of
Function Technique
physiotherapy
Exercises with a trolley or
Active exercises Contract the muscles rotating carpets.
Hydrotherapy.
Stimulate blood circulation with warm mats.
provoking vasodilation: with bottles or bags of
Heat
oxygen supply to the area as well as hot water.
dealt with. IR ray lamps.
Increase cell activity and Use of generators
Laser therapy metabolic thanks to absorption
ideal
of the photons
Magnetic field
4-6Hz reduce edema product close to
10Hz improves circulation area to be treated
Magnetotherapy
25Hz for bone problems

An electrical signal
Stimulus on The muscles are stimulated to contract in
simulates the impulses of a
muscles in a way to prevent atrophy.
motoneuron.
The joint from
treating is done
To prevent loss or to restore movement, according to its
Passive exercises
joint mobility physiological range
5-10 times a
treatment.
High sound waves
Heat production within the tissues: frequency (movements
Ultrasound
will help rehabilitation cellphones

54
Supports for paraplegic animals
Some dogs, in stable conditions of paraplegia (paralysis of the hind limbs), are
supported, for walking, by walkers.

Use of the cart

The cart allows the dog to move, ensuring it a certain degree of autonomy.
The use of the cart must, however, take place for limited periods during the day.
(otherwise one may incur the formation of lesions and thus sores at the points of
body constrained by safety straps) and under strict control of the owner
or by those who represent him (the cart may get stuck or tip over).
Furthermore, it is absolutely to be avoided that the ends of the hind limbs rub against the
soil.

55
Chapter VIII
Nursery
In many veterinary facilities, there are areas for the care of orphaned puppies.
both cats and dogs
Usually, they are placed in cages by litter to avoid
spreading of any infectious agents, being able to manage nutrition by age groups,
to uniformly implement the treatments and monitor growth.
For the smaller puppies, the temperature is constantly monitored.
of the environment: newborns are not able to thermoregulate and easily become
hypothermia
For this purpose, infrared heating lamps are installed on the cages.
Veterinary Technicians are entirely responsible for the management of puppies, from their
competence and dedication greatly depend on their chances of survival even if,
However, the mortality rate remains high: if the young ones have not received colostrum.
from the mother can often become ill with forms of enteritis and/or pneumonia not always
solvable; if they have been abandoned by their mother it is very likely because they are
puppies with vitality problems and, again, breast milk compared to formula milk
artificial, although of excellent quality, remains irreplaceable for the growth of newborns.
It is still a great satisfaction to be able to raise even just one puppy.
of an entire brood, destined for certain death!
The commitment in the nursery is significant, especially with newborns until weaning.

The care of the little ones includes:

Feeding every 2 hours even at night

Stimulation of defecation and urination
Eye cleaning
Washing of the genitals
Often administration of medications
Thorough cleaning of the bunk
Ambient temperature control
Beginning of weaning
Control of infestations by internal and external parasites

The exclusively milk-based diet, given from the first days of life until
weaning, is administered using a bottle and puppy milk, distinct for
cats and for dogs (the characteristics are different especially in the fat content and
sugars)

56
For the preparation of powdered milk, hot water is used; for the milk in liquid form
It is sufficient to heat it in a water bath.
The amount of milk to be given to a puppy should be adjusted based on its appetite.
ensuring that it takes the minimum necessary
Some newborns can be so immature or weak that they have not yet
developed the sucking reflex: for these it will be appropriate to use a syringe for
introduce the milk drop by drop into the mouth.
After each feeding, each puppy must be encouraged to defecate and urinate:
this will be done by rubbing the perineum with cotton wool soaked in warm water or with a
a little bit of sweet almond oil: the movement of the fingers should simulate that of
licking done by the mother.
It is important to clean the puppies with special wipes or with water and soap.
delicate and dry them.
A zinc oxide ointment is then applied to the affected areas to prevent redness.
cute.
Once the bedding is arranged, the puppies are left to sleep.
In case of need, medications are also administered, usually in drops to be taken.
in milk or to be taken as it is; eye drops or ointments.
At the weaning stage, around 25 days, therefore earlier than how
it would be like being with mom, we start giving the puppies very soft food,
rich in protein, minerals and vitamins.
In case of intestinal parasitism, it will be possible to administer a dewormer.
There are puppies available in the market in paste.

At the age of 2/3 months, after at least one vaccination, the little ones can go to
adoption.

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