100+ Free ACVECC Practice Questions

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What is the standard shock dose of isotonic crystalloid for a dog in hypovolemic shock?

10-20 mL/kg IV over 1 hour

60-90 mL/kg IV in divided boluses

200 mL/kg IV as rapidly as possible

5 mL/kg IV over 24 hours

to track

2026 Statistics

Key Facts: ACVECC Exam

100

FREE Practice Questions

OpenExamPrep ACVECC question bank

3 yr

ACVECC-Approved Residency

Required training prerequisite

~12%

Shock & Resuscitation Weight

Largest single domain on 2026 ACVECC content outline

~$1,500-$2,500

2026 Certifying Exam Fee

ACVECC (verify current schedule)

2024

RECOVER CPR Guidelines

Current standard for veterinary CPR

1:1:1

PROPPR Transfusion Ratio

pRBC:FFP:platelets in massive transfusion

The ACVECC Certifying Exam is a multi-day, criterion-referenced board examination from the American College of Veterinary Emergency and Critical Care. Content spans shock/resuscitation (~12%), CPR (~10%), trauma/transfusion (~10%), respiratory/mechanical ventilation (~10%), GI/hepatic (~10%), cardiology (~8%), renal (~8%), neuro (~8%), heme/coagulation (~8%), toxicology (~8%), endocrine (~6%), perioperative (~6%), abdominal/reproductive (~4%), and fluids/electrolytes/acid-base (~2%). Fee is ~$1,500-$2,500; requires completion of an ACVECC-approved 3-year residency.

Sample ACVECC Practice Questions

Try these sample questions to test your ACVECC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What is the standard shock dose of isotonic crystalloid for a dog in hypovolemic shock?

A.10-20 mL/kg IV over 1 hour

B.60-90 mL/kg IV in divided boluses

C.200 mL/kg IV as rapidly as possible

D.5 mL/kg IV over 24 hours

Explanation: Canine shock dose is ~60-90 mL/kg (approx. blood volume) given as 1/4 to 1/3 aliquots (15-30 mL/kg) over 10-15 min, reassessing perfusion parameters (HR, MM color, CRT, pulse quality, lactate) between boluses. Cats are more sensitive — use 40-60 mL/kg in smaller aliquots.

2Which hemodynamic pattern is MOST characteristic of early (hyperdynamic) septic shock in a dog?

A.Low cardiac output, high SVR, cold extremities

B.High cardiac output, low SVR, bounding pulses, injected mucous membranes

C.Normal cardiac output, normal SVR, normothermia

D.Low cardiac output, low SVR, jugular distension

Explanation: Canine distributive/septic shock classically presents hyperdynamic: vasodilation drops SVR, giving bounding femoral pulses, brick-red/injected mucous membranes, rapid CRT, fever, and a compensatory high cardiac output. Cats rarely show this hyperdynamic phase and typically present cold and bradycardic.

3How many SIRS criteria (of 4) must a dog meet to be classified as having SIRS?

A.1

B.2

C.3

D.All 4

Explanation: Canine SIRS requires at least 2 of: temperature (<100.6 or >102.6 F), HR >120, RR >20 (or PaCO2 <32), and WBC <6, >16, or >3% bands. Sepsis = SIRS + documented/suspected infection. Severe sepsis adds organ dysfunction; septic shock adds refractory hypotension.

4Hypertonic saline (7.5% NaCl) for resuscitation in a euvolemic patient with head trauma is typically dosed at:

A.0.5 mL/kg IV push

B.4 mL/kg IV over 5-10 minutes

C.20 mL/kg IV over 20 minutes

D.60 mL/kg IV over 1 hour

Explanation: 7% to 7.5% hypertonic saline is dosed at 4 mL/kg IV (dogs) over 5-10 min, drawing fluid intravascularly from interstitium. Useful in head trauma, GDV, and large patients where rapid volume restoration is needed. Follow with isotonic fluids; contraindicated in dehydrated/hypernatremic patients.

5A typical starting CRI dose of norepinephrine for catecholamine-refractory canine septic shock is:

A.0.001 µg/kg/min

B.0.1-2 µg/kg/min

C.10 µg/kg/min

D.100 µg/kg/min

Explanation: Norepinephrine (primarily α1 with some β1) is the first-line vasopressor for canine septic shock after fluid resuscitation, dosed 0.1-2 µg/kg/min IV CRI. Titrate to MAP >65-80 mmHg. Add vasopressin (1-4 mU/kg/min) if refractory; consider hydrocortisone for relative adrenal insufficiency.

6Which inotrope is preferred to support myocardial contractility in cardiogenic shock without excessive vasoconstriction?

A.Phenylephrine

B.Vasopressin

C.Dobutamine (β1 agonist)

D.Epinephrine at 1 mg/kg bolus

Explanation: Dobutamine (5-20 µg/kg/min) is a β1 agonist that increases contractility and cardiac output with minimal vasoconstriction — ideal for cardiogenic shock or myocardial dysfunction in sepsis. Phenylephrine/vasopressin are pure vasoconstrictors. Dopamine has dose-dependent effects; high doses behave like norepinephrine.

7What is the appropriate initial bolus dose of hetastarch (6% HES 670/0.75) in a dog in shock?

A.0.5 mL/kg

B.5-10 mL/kg IV over 15 min (up to 20 mL/kg/day)

C.40 mL/kg bolus

D.90 mL/kg bolus

Explanation: Synthetic colloid hetastarch is dosed at 5-10 mL/kg IV over 15 min in dogs (2-5 mL/kg in cats) with daily maximum ~20 mL/kg. Concerns regarding AKI and coagulopathy (particularly with older higher MW products) have reduced routine use. Benefit: smaller volume for oncotic pull vs crystalloid alone.

8Lactate clearance of what percentage within 6 hours is associated with improved survival in septic patients?

A.<5%

B.>10-20% (often targeted ≥50%)

C.>90% immediately

D.Any increase in lactate

Explanation: A ≥10-20% decrease in lactate within 2-6 hours of resuscitation (many protocols target ≥50% clearance) is associated with improved outcomes. Persistently elevated or rising lactate despite therapy indicates ongoing tissue hypoperfusion or mitochondrial dysfunction and predicts worse outcome.

9Obstructive shock is MOST commonly caused by which of the following in small animals?

A.Hemorrhage

B.Cardiac tamponade or tension pneumothorax

C.Anaphylaxis

D.Systemic infection

Explanation: Obstructive shock arises from mechanical obstruction of venous return or cardiac output — classically cardiac tamponade, tension pneumothorax, GDV, heartworm caval syndrome, and pulmonary thromboembolism. Treatment targets the obstruction (pericardiocentesis, thoracocentesis, gastric decompression) rather than volume alone.

10A typical target MAP endpoint during resuscitation of a septic dog is:

A.>40 mmHg

B.≥65-80 mmHg

C.≥120 mmHg

D.MAP is not clinically useful

Explanation: MAP ≥65-80 mmHg is the standard resuscitation endpoint for perfusion of abdominal organs and kidneys in veterinary septic shock, mirroring Surviving Sepsis human guidelines. Combine with lactate clearance, urine output (≥1-2 mL/kg/h), improvement in mentation, and normalizing CRT.

About the ACVECC Exam

The ACVECC Veterinary Emergency and Critical Care Certifying Examination validates core knowledge for independent specialty practice in small animal emergency and critical care. Content spans shock and resuscitation (crystalloid/colloid, hypertonic saline, Surviving Sepsis analogs, norepinephrine), CPR per RECOVER 2024 (compression 100-120/min, low-dose epinephrine 0.01 mg/kg, ETCO2 >15 mmHg), trauma and transfusion (FAST/AFAST/TFAST, PROPPR 1:1:1, TXA, damage control), respiratory emergencies and mechanical ventilation (ARDS lung-protective 6 mL/kg), cardiology (CHF, DCM/HCM, ATE saddle thrombus, VT lidocaine 2 mg/kg, tamponade), GI/hepatic (GDV, septic peritonitis, pancreatitis, NAC), renal (AKI, ethylene glycol fomepizole, urethral obstruction, hyperkalemia), neurology (TBI with MGCS, mannitol 0.5-1 g/kg, status epilepticus, IVDD), hematology/coagulation (IMHA ACVIM consensus, rodenticide, TEG/ROTEM), toxicology (NSAID, xylitol, acetaminophen, lily, grape), endocrine (DKA insulin CRI 0.05-0.1 U/kg/hr, Addisonian crisis), perioperative/analgesia (multimodal, ketamine/lidocaine/fentanyl CRI), abdominal/reproductive (pyometra, dystocia, eclampsia), and fluids/electrolytes/acid-base. Requires completion of an ACVECC-approved 3-year residency.

Questions

100 scored questions

Time Limit

Multi-day certifying examination at designated testing sites

Passing Score

Criterion-referenced scaled score set by ACVECC (modified Angoff standard)

Exam Fee

~$1,500-$2,500 Certifying Examination fee (ACVECC 2026 — verify current schedule) (American College of Veterinary Emergency and Critical Care (ACVECC))

ACVECC Exam Content Outline

~12%

Shock & Resuscitation

Shock classification (hypovolemic, distributive, cardiogenic, obstructive), end points (lactate clearance, ScvO2, MAP ≥65-70), crystalloid/colloid, hypertonic saline 7.2% 4 mL/kg, balanced vs 0.9% NaCl, SIRS/sepsis (Surviving Sepsis Campaign analogs), EGDT, norepinephrine first-line vasopressor, vasopressin adjunct, dobutamine inodilator.

~10%

CPR & Cardiopulmonary Arrest

RECOVER 2024 guidelines: compressions 100-120/min at 1/3-1/2 chest width, 2-min cycles with minimal interruption, 10 breaths/min intubated, low-dose epinephrine 0.01 mg/kg IV every other cycle, vasopressin 0.8 U/kg alternative, atropine 0.04 mg/kg for vagally mediated arrest, ETCO2 >15 mmHg indicates effective CPR, biphasic defibrillation 2-4 J/kg, post-arrest TTM and neuroprotection.

~10%

Trauma & Transfusion

Animal Trauma Triage (ATT) score, FAST/AFAST/TFAST, damage control resuscitation, permissive hypotension in penetrating trauma (SBP 80-90), PROPPR 1:1:1 pRBC:FFP:platelets, massive transfusion protocol, TXA 10-15 mg/kg for trauma hemorrhage, tension pneumothorax (needle thoracocentesis), pulmonary contusion, diaphragmatic hernia, hemoabdomen (autotransfusion indications).

~10%

Respiratory Emergencies & Mechanical Ventilation

Upper airway obstruction (BOAS, laryngeal paralysis tie-back), lower airway (feline asthma — terbutaline, albuterol), cardiogenic vs non-cardiogenic edema (ARDS Berlin criteria analog), pleural disease (pyothorax, chylothorax), ARDS lung-protective ventilation (6 mL/kg TV, PEEP titration, plateau <30 cmH2O), SBT weaning, mechanical ventilation indications (PaO2 <60 on >50% FiO2 or PaCO2 >60).

~10%

GI & Hepatic Emergencies

GDV (decompression, shock resuscitation, emergency gastropexy, lactate prognostic), septic peritonitis (abdominal effusion glucose >20 mg/dL below peripheral, lactate >2 mg/dL above), mesenteric volvulus, foreign body obstruction, acute pancreatitis (Spec cPL/fPL, analgesia, IV fluids, early enteral nutrition), acute liver failure (NAC for xylitol/acetaminophen, lactulose/rifaximin for HE), cholangitis.

~8%

Cardiology & Arrhythmias

CHF (furosemide 2-4 mg/kg IV/CRI, pimobendan, oxygen), DCM (Doberman, Great Dane), HCM (cat — ATE risk), ATE saddle thrombus (clopidogrel, rivaroxaban, analgesia, NO rapid reperfusion), pericardial tamponade (pericardiocentesis, Beck's triad), VT (lidocaine 2 mg/kg IV bolus then 25-80 µg/kg/min CRI dog), AFib (diltiazem rate control), bradyarrhythmias (atropine response, pacing).

~8%

Renal & Urinary Emergencies

AKI IRIS staging, oliguria/anuria, ethylene glycol (fomepizole dog 20 mg/kg load, ethanol cat), grape/raisin AKI, lily nephrotoxicity (cat), leptospirosis (doxycycline, PPE), feline urethral obstruction (decompressive cystocentesis, unblock, K management), hyperkalemia (calcium gluconate 10% 0.5-1 mL/kg, insulin/dextrose, bicarbonate), intermittent hemodialysis/CRRT, peritoneal dialysis.

~8%

Neurologic Emergencies

TBI with Modified Glasgow Coma Scale (MGCS), mannitol 0.5-1 g/kg over 15-20 min or 7.5% hypertonic saline 4 mL/kg, head elevation 15-30°, avoid jugular compression, status epilepticus (diazepam 0.5-1 mg/kg IV, levetiracetam 30-60 mg/kg, phenobarbital load, propofol/midazolam/ketamine CRI), IVDD (decompressive surgery, no steroids), vestibular disease, myasthenia gravis (edrophonium, pyridostigmine), tick paralysis.

~8%

Hematology & Coagulation

IMHA (prednisolone + adjuncts; ACVIM consensus thromboprophylaxis — clopidogrel + rivaroxaban), ITP, DIC, vWD, hemophilia, rodenticide anticoagulation (vitamin K1 2.5-5 mg/kg PO × 3-4 weeks, FFP for active bleed), TEG/ROTEM interpretation, heparin CRI, transfusion medicine (crossmatch — DEA 1.1 dogs, AB cats; acute vs delayed hemolytic, TRALI/TACO).

~8%

Toxicology

Decontamination (apomorphine dog, dexmedetomidine cat; activated charcoal 1-2 g/kg — avoid in caustics/petroleum), NSAID (GI ulcer, AKI — misoprostol, sucralfate, fluids), acetaminophen (NAC — dose-dependent feline methemoglobinemia), xylitol (hypoglycemia, hepatic necrosis), chocolate (methylxanthines), grape/raisin, lily (cat AKI), ethylene glycol (fomepizole), marijuana, sago palm (cycasin), pyrethroid (cat), SSRI/amphetamine (serotonin syndrome — cyproheptadine).

~6%

Endocrine & Metabolic Emergencies

DKA (regular insulin CRI 0.05-0.1 U/kg/hr after fluid and K correction, dextrose added at BG <250, transition to long-acting after resolution), HHS, Addisonian crisis (IV fluids, dexamethasone SP, DOCP/fludrocortisone), diabetes insipidus, hypercalcemia of malignancy (fluids, furosemide, bisphosphonates), hepatic encephalopathy, insulinoma (dextrose, diazoxide).

~6%

Perioperative & Analgesia

Anesthetic monitoring (capnography, pulse oximetry, invasive BP, ECG), multimodal analgesia (methadone, hydromorphone, fentanyl CRI 2-5 µg/kg/hr, buprenorphine cat), NMDA antagonists (ketamine CRI 2-10 µg/kg/min), lidocaine CRI dog only (25-75 µg/kg/min), dexmedetomidine, regional anesthesia, Glasgow Composite and Colorado State pain scoring, NMB with TOF monitoring, delirium/dysphoria management.

~4%

Abdominal & Reproductive Emergencies

Pyometra (open/closed — fluids, antibiotics, OHE; aglepristone/prostaglandin for breeding animals), dystocia (oxytocin, calcium gluconate, C-section), eclampsia (calcium gluconate 10% 0.5-1.5 mL/kg slow IV), mastitis, prostatitis/abscess, peritonitis (primary/secondary/tertiary), intra-abdominal hypertension and abdominal compartment syndrome (IAP >20 mmHg with new organ dysfunction).

~2%

Fluids, Electrolytes & Acid-Base

Maintenance vs resuscitation vs replacement fluids, balanced isotonic crystalloids (LRS, Plasma-Lyte, Normosol-R), colloid controversies, hypo/hypernatremia (correction <0.5 mEq/L/hr to avoid osmotic demyelination/cerebral edema), K disturbances, Ca and Mg disorders, acid-base analysis (anion gap, strong ion difference/Stewart, mixed disorders).

How to Pass the ACVECC Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ACVECC (modified Angoff standard)
Exam length: 100 questions
Time limit: Multi-day certifying examination at designated testing sites
Exam fee: ~$1,500-$2,500 Certifying Examination fee (ACVECC 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ACVECC Study Tips from Top Performers

1RECOVER 2024 CPR pearls: chest compressions 100-120/min at 1/3-1/2 chest width in 2-minute uninterrupted cycles, ventilation 10 breaths/min (intubated), low-dose epinephrine 0.01 mg/kg IV every OTHER BLS cycle (high-dose 0.1 mg/kg only after prolonged CPR), vasopressin 0.8 U/kg as epinephrine alternative, atropine 0.04 mg/kg for vagally mediated arrest. ETCO2 >15 mmHg indicates effective CPR and <15 or sudden drop triggers technique reassessment. Defibrillation biphasic 2-4 J/kg for VF/pulseless VT.

2Feline arterial thromboembolism (ATE, saddle thrombus) is an HCM complication. Classic 5 Ps: pain, pallor, pulselessness, paralysis, poikilothermia (cold limbs). Management: aggressive analgesia (opioid ± ketamine CRI), antithrombotic therapy (clopidogrel 18.75 mg PO q24h + rivaroxaban or unfractionated heparin CRI), supportive care — do NOT attempt rapid surgical or pharmacologic reperfusion (reperfusion injury with lethal hyperkalemia). Monitor K closely. Prognosis guarded; prevention in HCM with clopidogrel (FATCAT study).

3DKA management cascade: (1) Fluid resuscitation with balanced crystalloid — deficit + maintenance over 24-48 hr; (2) Correct hypokalemia BEFORE starting insulin (K <3.5 mEq/L — hold insulin, supplement K aggressively up to 0.5 mEq/kg/hr); (3) Regular insulin CRI at 0.05-0.1 U/kg/hr IV (or IM protocol); (4) Add dextrose to fluids when BG drops to ~250 mg/dL — keep BG 150-300 until ketosis resolves; (5) Transition to long-acting insulin SQ once eating and ketone-free.

4TBI Modified Glasgow Coma Scale (MGCS) grades motor activity, brainstem reflexes, and level of consciousness (3-18 points; <8 grave). Hyperosmolar therapy: mannitol 0.5-1 g/kg IV over 15-20 min (avoid hypovolemia — do NOT use in dehydrated patients) OR 7.5% hypertonic saline 4 mL/kg. Head elevation 15-30°, avoid jugular compression (no jugular samples/central lines), maintain normocapnia (PaCO2 35-45) — hyperventilation only as rescue, normoglycemia, normothermia (treat hyperthermia aggressively).

5Septic peritonitis abdominal fluid diagnostics (high-yield): blood-to-fluid glucose difference >20 mg/dL (fluid glucose LOWER than blood) and blood-to-fluid lactate difference >2 mg/dL (fluid lactate HIGHER than blood) are highly specific for septic peritonitis in dogs. Cytology confirms with intracellular bacteria. Management: prompt surgical source control + broad-spectrum IV antibiotics + aggressive fluid resuscitation + lactate-guided endpoints + multimodal analgesia.

Frequently Asked Questions

What is the ACVECC Certifying Examination?

The ACVECC Veterinary Emergency and Critical Care Certifying Examination is administered by the American College of Veterinary Emergency and Critical Care and is the capstone assessment for board certification as a small animal emergency and critical care specialist (Diplomate, ACVECC). It validates breadth and depth of knowledge across shock and resuscitation, CPR, trauma, respiratory and mechanical ventilation, cardiology, GI/hepatic, renal, neurology, coagulation, toxicology, endocrine, perioperative care, and fluids/electrolytes/acid-base.

Who is eligible to take the ACVECC Certifying Exam?

Candidates must hold a DVM, VMD, or equivalent veterinary degree and complete an ACVECC-approved residency training program (typically 3 years) under direct supervision of ACVECC diplomates. Additional requirements include submission of case logs, a first-author peer-reviewed publication (or equivalent scholarly activity), and credentials approval by the ACVECC Credentials Committee.

What is the format of the ACVECC Certifying Exam?

The ACVECC Certifying Examination is a multi-day assessment administered at designated testing sites. It comprises multiple components including multiple-choice questions and practical/case-based components designed to assess clinical reasoning in emergency and critical care scenarios. Content is blueprinted to the ACVECC content outline spanning shock, CPR, trauma, respiratory, cardiology, GI, renal, neuro, coagulation, toxicology, endocrine, perioperative, and fluids/acid-base.

How much does the 2026 ACVECC Certifying Exam cost?

The 2026 ACVECC Certifying Examination fee is approximately $1,500-$2,500 — always verify the current schedule on the ACVECC website. Diplomates also pay annual Maintenance of Certification (MOC) dues after passing. Cancellation and refund policies follow the ACVECC schedule with decreasing refunds as the exam date approaches. Retakes require re-registration and full fee payment within the allowed qualification window.

When is the 2026 exam administered?

The ACVECC Certifying Examination is typically offered once annually. Applications and credentials must be submitted well in advance, and candidates are scheduled after credentials approval. Exact 2026 dates should be confirmed on the ACVECC certification page.

How is the exam scored?

ACVECC uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts using a modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports include domain-level feedback when available, and candidates must pass all examination components to earn Diplomate status.

What are the highest-yield topics?

Highest-yield topics include RECOVER 2024 CPR algorithm (compression 100-120/min, low-dose epinephrine 0.01 mg/kg, ETCO2 >15), PROPPR 1:1:1 damage-control transfusion with TXA, ARDS lung-protective ventilation (6 mL/kg, plateau <30), ATE feline saddle thrombus (clopidogrel/rivaroxaban, no rapid reperfusion), lidocaine 2 mg/kg IV for VT, MGCS and mannitol 0.5-1 g/kg for TBI, insulin CRI 0.05-0.1 U/kg/hr for DKA, ethylene glycol fomepizole, feline urethral obstruction and hyperkalemia, IMHA ACVIM thromboprophylaxis, and GS-441524 for FIP.

How should I study for this exam?

Use a structured 18-36 month plan layered on residency training. Map to the ACVECC content outline: begin with shock, CPR (RECOVER 2024), and trauma/transfusion, then respiratory/mechanical ventilation, cardiology, and neurology, followed by GI/hepatic, renal, endocrine, hematology/coagulation, and toxicology, and conclude with perioperative care, abdominal/reproductive, and fluids/electrolytes/acid-base. Integrate JVECC literature, Silverstein & Hopper's Small Animal Critical Care Medicine, VECCS conference review, and high-volume MCQ practice with 2-3 full-length mock exams.