Q&A with Ken Yagi, MS, RVT, VTS (ECC), (SAIM)

Kenichiro Yagi, MS, RVT, VTS (ECC), (SAIM), Chief Veterinary Nursing Officer for Veterinary Emergency Group

Can you give our readers a little bit of background about yourself?

I’m a veterinary technician specialist in Emergency and Critical Care as well as Small Animal Internal medicine with 24 years of experience, starting as a veterinary assistant and growing up in a 24/7 general/emergency practice. Today, I am the chief veterinary nursing officer at Veterinary Emergency Group (VEG) overseeing over 2100 veterinary nurses and assistants in 88 hospitals.

What are the most critical physical signs that indicate a patient is in respiratory distress?

Glazed over eyes, lack of awareness, significant effort in breathing that looks like exhaustion, paradoxical breathing (chest and abdomen moving in different directions), and variable rate in breathing (fast sometimes, slow down in between) are all signs of severe respiratory conditions that will lead or respiratory and cardiac arrest. There are plenty of ways we can assess a patient’s respiratory status through visual (face, posture, breathing patterns) and auditory (breathing sounds, lung sounds) to catch respiratory distress before the situation becomes critical.

In what ways can a technician's immediate response impact the outcome for an animal in respiratory distress?

Respiratory conditions ultimately lead to lack of oxygen delivery to the heart, which leads to cardiac arrest. Being able to quickly respond and improve oxygen intake for the patient will buy them the time while the underlying causes of the respiratory condition is treated. While quickly intervening to address the patient’s medical need is important, equally important is alleviating the patient’s suffering (in this case, the feeling of suffocation and exhaustion) as soon as possible.

How does understanding the underlying causes of respiratory distress help in determining the appropriate emergency intervention?

Understanding the underlying causes of respiratory distress is crucial because it allows veterinary professionals to identify whether the issue is primarily due to airway obstruction, gas exchange impairment, or a circulatory issue, which in turn guides the interventions. For example, if the distress is due to an upper airway obstruction, interventions like providing a clear airway (e.g., removing the obstruction, intubating, tracheostomy or sedation) are necessary, whereas pulmonary edema due to congestive heart failure would require diuretics and oxygen therapy. Knowing the cause helps prevent inappropriate treatments (e.g., fluids in a patient with fluid overload) and ensures that interventions target the actual problem, such as improving ventilation in hypoventilation cases or addressing circulation in perfusion deficits.