Veterinary Sector Spotlight: Emergency and critical care veterinary medicine

It’s the opportunity to solve medical puzzles that attracted Dr. Kelly Ross to emergency medicine. After graduating in 2008 from North Carolina State University College of Veterinary Medicine, she started out as a general practitioner but quickly found herself drawn to the emergency room (ER).

“I really enjoyed on-call shifts, and as I began to take on more on-call shifts, I got more experience and I found myself drawn into the more unusual cases—the ill pets rather than the wellness visits that came through the door,” says Dr. Ross, who is the emergency medicine director for BluePearl Pet Hospital in Nashville, Franklin, and Murfreesboro, Tennessee. “I really found myself enjoying the problem-solving aspects and the accomplishment you get when the pet gets better. That’s when I started to change paths from general practice and medicine to the ER.”

For Dr. Adesola Odunayo, her first exposure to emergency medicine came after graduating from Oklahoma State University in 2005. When she started her internship at Hollywood Animal Hospital in Hollywood, Florida, she didn’t know what kind of medicine she wanted to practice. “I thought hopefully (the internship) would give me more focus or, at the very least, I would get more training and feel more confident in my skills as a veterinarian,” she said.

She fell in love with emergency medicine. Pursuing a specialty internship at the Animal Emergency Center, a private practice in Glendale, Wisconsin, reaffirmed for her this was what she wanted to spend the rest of her life doing. She completed her residency in 2010 at the University of Missouri-Columbia and became a diplomate of the American College of Veterinary Emergency and Critical Care. Since then, she’s worked at Auburn University and the University of Tennessee veterinary colleges before joining in 2021 the University of Florida College of Veterinary Medicine as associate chair and clinical associate professor.

“I spend half time in emergency room where I serve as a front-line doctor. I work with interns and residents to see cases and assess and, depending on the level of acuity, they are discharged with a continued care plan or are hospitalized if they are sick or critically injured,” said the critical care specialist.

The other half of her job is spending time with patients who were admitted and are need of a higher level of support. She’ll adjust treatment plans or call for additional testing or medications. As an academician, Dr. Odunayo also has teaching and administrative responsibilities.

Rewards and challenges

Dr. Ross works three, 13-hour shifts a week—two overnight shifts providing care and one shift tending to administrative work and patient safety and improvement initiatives, such as addressing antimicrobial resistance.

Although every case that comes through the door is different, certain types of injuries and illnesses crop up regularly: trauma from pets being hit by a car and other accidents, skin issues, ear problems, and complications from diabetes and other chronic diseases. The biggest challenge in her job is not the complex cases nor the overnight hours. Instead, she said, the hardest part is managing clients who are stressed and worried about their pets.

“We encounter people during their most difficult moments,” says Dr. Ross. “Everyone coming is upset because their pet is unwell.”

Because so much of the work of emergency medicine veterinarians involves talking to anxious clients, excellent communication skills are key for any veterinarian considering a career in emergency medicine, she says, along with adaptability and an affinity for teamwork.

Dr. Odunayo says one of the best parts of the job is being able to immediately help a sick animal or at least get it stabilized.

“It’s really rewarding because for (some) sick pets, if they have any chance at survival, it’s because they came to hospital and that doctor can give pet best opportunity to recover from illness. It’s always nice to see them go home,” she said.

Dr. Odunayo also loves training students, interns, and residents, who she learns from just as much as they learn from her. They also keep her current and inspired. Her favorite time of year is graduation.

“It’s really incredible to watch them walk across stage, remembering the students when they started. They weren’t confident and had a lot of insecurities, so to see them not only walk across stage, but also an announcement of what they’ll do. I think it’s rewarding to hear and see them at the sending forth ceremony to see them go and fulfill their live as a veterinarian or veterinary specialist,” Dr. Odunayo said.

Dispelling myths

Fewer veterinary students seem to be selecting emergency medicine as a career because of the perception that it requires grueling shifts. However, Dr. Ross says, it’s a misconception that emergency care veterinarians can’t sustain a balance between work and their personal life.

“ER medicine has a reputation for long hours and unpredictable shifts, but if you have a good team that doesn’t happen,” says Dr. Ross. “We’ve made improvements in scheduling and make sure we take care of each other.”

Also, as a working mother, the compressed three-day schedule and overnight shifts gave Dr. Ross the chance to attend her children’s school activities during the day.

“It’s all about finding the right balance and prioritizing what’s important,” she says.

A myth Dr. Odunayo would like to dispel is that ER medicine is too stressful. Sure, there are some very sick patients that come through the door, but a lot of the cases are the same that show up to a general practice. That could be because the owner’s regular clinic is closed, or it doesn’t have all of the diagnostic tests needed.

“For the most part, veterinarians are trained to stabilize and manage ER cases, and the more cases you see and more confident you become. A place with good mentorship helps. It’s not as scary or intimidating as it seems,” she said.

For veterinarians considering getting into emergency medicine, her advice is to find a hospital that allows you to work a swing shift that overlaps with the day and night doctors. That way there’s someone you can always run questions by, she said. A rotating internship may also help provide that mentorship in a structured way.

Many emergency hospitals need help, she said, and are open to veterinarians doing relief work.

“Call your local ER clinic and pick up shift or two and see how you like it. It could be a gradual transition; it could be part time. It’s a way to help out and get different experience in practice in veterinary medicine,” Dr. Odunayo said.

For veterinary students interested in a career in emergency medicine, Dr. Ross encourages them to apply for an internship or mentorship in emergency medicine so they can shadow an emergency medicine veterinarian and work alongside them.

It’s crucial to encourage more veterinary students to consider emergency medicine as a career path, she adds.

“There are so many pets that I feel if the ER wasn’t open, I don’t know what would have happened to them,” says Dr. Ross. It’s such an important part of veterinary medicine and less and less people are going into ER medicine …. It’s not as scary as everyone thinks and with a good mentorship or internship, it’s actually a great career path.”