Triage is a term derived from the French language, meaning a process of selecting or prioritising.
In feline medicine, triage is a pragmatic process of prioritizing patients based on the severity of their condition and the underlying life-threating nature of that illness. It focuses on treating those illness in an appropriate logical manner to avoid unnecessary, contraindicated or expensive treatment.
As a general rule, a comatosed, recumbent cat which has been so for 3 days is less critical than an acutely feverish cat that has become comatosed in the preceding hour. Also, a cat with a femoral fracture that presents 6 hours after the motor vehicle accident, is less critical than a cat which is vomiting frank blood.
Emergency medicine requires rapid diagnostic skills and experience to interpret signs which are often masked by the cat’s temperament (often fractious when injured) and the care-giver’s frantic appeal for veterinary intervention.
Normal clinical values for cats:
| Temperature | 37.8°C – 39.3°C |
| Heart rate | 120 – 140 bpm |
| Respiratory rate | 16 – 40 bpm |
| Capillary refill time (CRT) | < 2 sec |
| Capillary colour | pink/red |
| Urine volume | 10 – 20 mL / Kg / day |
| Urine specific gravity (USG) | 1.020 – 1.040 |
| Blood pressure | < 160/130 mm Hg |
Principles
- The ‘A, B & C’ of triage
- Normal TPR, haematology and biochemistry values
- Fluid therapy
- – Sodium imbalances (Na+) – Hyponatremia, Hypernatremia
- – Potassium (K+) imbalances – Hyperkalemia, Hypokalemia
- – Phosphorus (P) imbalances – Hyperphosphatemia, Hypophosphatemia
- – Calcium (Ca2+) imbalances – Hypocalcemia, Hypercalcaemia
- – Acid/alkali (pH) imbalances – Acidosis/alkalosis, D-lactic acidosis
- General anaesthesia
Triage cases
- Status epilepticus
- Shock
- Dyspnoea
- Blood transfusion
- Acute renal failure
- Pyometron
- Gastric-dilation volvulus
- DIC – disseminated intravascular coagulation
- Peritonitis
- Refeeding syndrome