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According to the 2012/2024 RECOVER guidelines, what is the recommended chest compression rate during CPR in dogs and cats?

100 to 120 compressions per minute

60 to 80 compressions per minute

140 to 160 compressions per minute

80 to 100 compressions per minute

to track

2026 Statistics

Key Facts: VTS (ECC) Exam

200

Multiple-Choice Questions

AVECCT

$325

2026 Exam Fee

AVECCT

$75

Application Fee

AVECCT

6,000 hrs

Minimum ECC Experience

AVECCT

25 hrs

Minimum CE Required

AVECCT

1 annually

Exam Sittings (IVECCS)

AVECCT

The VTS (ECC) is a 200-question multiple-choice specialty examination held annually in September at IVECCS by the Academy of Veterinary Emergency and Critical Care Technicians and Nurses (AVECCTN). Eligible candidates must be credentialed veterinary technicians with at least 6,000 hours of ECC experience over 3+ years, 25+ hours of ECC continuing education, a completed skills list with RECOVER CPR certification, 50 case logs, and 4 case reports. The 2026 exam fee is $325 plus a $75 non-refundable application fee.

Sample VTS (ECC) Practice Questions

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

1According to the 2012/2024 RECOVER guidelines, what is the recommended chest compression rate during CPR in dogs and cats?

A.100 to 120 compressions per minute

B.60 to 80 compressions per minute

C.140 to 160 compressions per minute

D.80 to 100 compressions per minute

Explanation: The RECOVER guidelines recommend chest compressions at a rate of 100 to 120 per minute for both dogs and cats, delivered at a depth of one-third to one-half the width of the chest. This rate is identical to current human BLS guidelines and is supported by Class I, Level A evidence.

2A 20 kg dog is in asystole during CPR. What is the correct low-dose epinephrine dose per the RECOVER guidelines?

A.0.2 mg IV (0.01 mg/kg)

B.2 mg IV (0.1 mg/kg)

C.0.04 mg IV (0.002 mg/kg)

D.0.5 mg IV (0.025 mg/kg)

Explanation: RECOVER recommends low-dose epinephrine at 0.01 mg/kg IV (equivalent to 0.01 mL/kg of 1:1000 concentration) for non-shockable rhythms such as asystole and PEA, administered every other BLS cycle (every 3-5 minutes). A 20 kg dog therefore receives 0.2 mg (0.2 mL of 1:1000). High-dose epinephrine (0.1 mg/kg) was removed as a routine recommendation in the 2024 update because studies linked it to worse neurologic outcomes.

3Which ECG rhythm is a shockable rhythm during veterinary CPR?

A.Ventricular fibrillation

B.Asystole

C.Pulseless electrical activity (PEA)

D.Sinus bradycardia

Explanation: Ventricular fibrillation and pulseless ventricular tachycardia are the only shockable rhythms. Asystole and PEA are non-shockable and are managed with CPR, epinephrine, and reversible-cause correction. Per RECOVER, the first biphasic defibrillation dose is 2 J/kg, doubled to 4 J/kg if the first shock fails.

4A 15 kg dog with sustained ventricular tachycardia requires lidocaine. What is the appropriate initial IV bolus dose?

A.30 mg IV (2 mg/kg) slowly over 30-60 seconds

B.150 mg IV (10 mg/kg) rapid IV push

C.3 mg IV (0.2 mg/kg) slow IV

D.0.75 mg IV (0.05 mg/kg) slow IV

Explanation: The canine lidocaine dose for ventricular arrhythmia is 2 mg/kg IV slowly over 30-60 seconds, which equals 30 mg for a 15 kg dog. Boluses may be repeated up to a cumulative maximum of 8 mg/kg. If effective, a CRI of 25-75 mcg/kg/min maintains rhythm control. Rapid bolus administration can cause hypotension, and cats are exquisitely sensitive to lidocaine (dose 0.25-1 mg/kg).

5During CPR, what end-tidal CO2 (EtCO2) value is associated with effective chest compressions and predicts ROSC in small animals?

A.Greater than 18 mm Hg

B.Less than 5 mm Hg

C.Greater than 45 mm Hg

D.Between 5 and 10 mm Hg

Explanation: Per RECOVER, EtCO2 values greater than 18 mm Hg during CPR correlate with adequate pulmonary blood flow from effective compressions and predict return of spontaneous circulation. A sudden spike in EtCO2 often signals ROSC. Persistently low EtCO2 (<10 mm Hg) usually indicates poor compressions or inadequate venous return.

6A dog is in ventricular fibrillation during CPR. What is the correct first biphasic defibrillation dose per RECOVER?

A.2 J/kg

B.10 J/kg

C.4 J/kg immediately as first dose

D.0.5 J/kg

Explanation: The initial biphasic defibrillation dose in RECOVER is 2 J/kg. If the first shock is unsuccessful, the second shock (after one compression cycle) is doubled to 4 J/kg, and all subsequent shocks remain at 4 J/kg. Monophasic defibrillators require higher doses (4-6 J/kg initially).

7Which drug is indicated for bradycardia associated with high vagal tone during CPR?

A.Atropine 0.04 mg/kg IV

B.Epinephrine 0.1 mg/kg IV (high-dose)

C.Lidocaine 2 mg/kg IV

D.Amiodarone 5 mg/kg IV

Explanation: Atropine at 0.04 mg/kg IV is recommended for bradycardic arrest or bradycardia from high vagal tone (e.g., GDV, severe vomiting, ocular manipulation). RECOVER advises against routine repeated atropine dosing during non-shockable arrest. Lidocaine is for ventricular arrhythmias, and high-dose epinephrine is no longer routinely recommended.

8Which ECG abnormality is most consistent with severe hyperkalemia in a blocked cat?

A.Tall tented T waves, wide QRS, absent P waves

B.Deep Q waves with ST elevation

C.Inverted T waves with U waves

D.Delta waves with short PR interval

Explanation: Hyperkalemia causes a progressive ECG sequence: tall tented T waves, shortened QT, flattened or absent P waves (sinoatrial arrest), and widened QRS that eventually resembles a sine wave. These changes reflect altered cardiac cell repolarization and are common in urethrally obstructed cats. Emergency treatment includes calcium gluconate for cardioprotection plus regular insulin with dextrose to drive K+ intracellularly.

9What is the recommended calcium gluconate dose for cardioprotection in a hyperkalemic patient?

A.0.5 to 1.5 mL/kg of 10% calcium gluconate IV slowly over 5-10 minutes with ECG monitoring

B.10 mL/kg of 10% calcium gluconate rapid IV push

C.0.1 mg/kg of 10% calcium gluconate IV

D.5 mL/kg of 23% calcium chloride rapid IV

Explanation: 10% calcium gluconate 0.5-1.5 mL/kg IV administered slowly over 5-10 minutes with continuous ECG monitoring stabilizes the cardiac membrane potential in hyperkalemia. Calcium does not lower serum potassium but restores the resting-to-threshold gradient, narrowing the QRS and allowing normal conduction. Rapid administration can cause bradycardia or cardiac arrest, so the infusion must be slowed or stopped if arrhythmias worsen.

10A dog presents with pericardial effusion and pulsus paradoxus. What is the classic ECG finding of cardiac tamponade?

A.Electrical alternans with small-amplitude QRS complexes

B.ST elevation in all leads

C.Wide complex tachycardia with right bundle branch pattern

D.First-degree AV block with Wenckebach phenomenon

Explanation: Electrical alternans — beat-to-beat variation in QRS amplitude — is the classic ECG finding of pericardial effusion with cardiac tamponade, caused by the heart swinging within the pericardial fluid. QRS complexes are also small because the fluid dampens the electrical signal. Definitive diagnosis is echocardiographic, and treatment is pericardiocentesis.

About the VTS (ECC) Exam

Advanced specialty credentialing exam for credentialed veterinary technicians pursuing Veterinary Technician Specialist status in Emergency and Critical Care. Administered by AVECCTN under NAVTA's Committee on Veterinary Technician Specialties.

Questions

200 scored questions

Time Limit

4 hours

Passing Score

Set annually by Examination Committee

Exam Fee

$325 exam + $75 application (AVECCT / NAVTA CVTS)

VTS (ECC) Exam Content Outline

12%

Cardiovascular

CPR/RECOVER guidelines, arrhythmias, ECG, CHF, pericardial effusion, FATE

12%

Fluid/Electrolyte/Acid-Base

Shock resuscitation, crystalloid/colloid selection, blood gas interpretation, Kmax

12%

Gastrointestinal

GDV, parvo, pancreatitis, hepatic failure, septic peritonitis, AHDS

11%

Respiratory

ARDS, pleural effusion, mechanical ventilation, capnography, asthma, BOAS

Anesthesia/Analgesia

MLK/FLK CRIs, multimodal pain, pain scales, inhalant management, blood pressure

Hemolymphatic/Immunologic

Transfusion medicine, IMHA, sepsis/SIRS, DIC, oncologic emergencies

Urinary

Urethral obstruction, AKI/IRIS, uroabdomen, ethylene glycol, post-obstructive diuresis

Misc. Triage/Emergency Care

Primary survey, POCUS/AFAST/TFAST, heatstroke, envenomation, Rule of 20

Neurologic

Status epilepticus, modified GCS, TBI, ICP management, IVDD

Toxicology/Pharmacology

Chocolate, xylitol, NSAIDs, rodenticides, organophosphates, antidotes

Endocrine/Metabolic

DKA, Addisonian crisis, thyroid storm, hypoglycemia

Musculoskeletal

Open fractures, rhabdomyolysis, trauma triage

Reproductive

Dystocia, pyometra, eclampsia

How to Pass the VTS (ECC) Exam

What You Need to Know

Passing score: Set annually by Examination Committee
Exam length: 200 questions
Time limit: 4 hours
Exam fee: $325 exam + $75 application

Keys to Passing

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

VTS (ECC) Study Tips from Top Performers

1Master the RECOVER CPR guidelines (2012 + 2024 update) cold — compression rate, epinephrine 0.01 mg/kg, defib 2 J/kg then 4 J/kg — they are tested heavily

2Memorize common CRI doses (MLK, FLK, lidocaine 25-75 mcg/kg/min dog, ketamine 2-10 mcg/kg/min)

3Know canine vs feline differences cold (lidocaine in cats, shock fluid dose 50 vs 90 mL/kg, blood types)

4Use Silverstein & Hopper's Small Animal Critical Care Medicine as your primary reference

5Take the RECOVER online BLS/ALS certification early — it is required for the application and teaches core content

Frequently Asked Questions

What is the VTS (ECC) exam?

The VTS (ECC) certifying examination is a 200-question multiple-choice exam administered annually by the Academy of Veterinary Emergency and Critical Care Technicians and Nurses (AVECCTN). It is the final step in earning the Veterinary Technician Specialist (Emergency and Critical Care) credential, granted under NAVTA's Committee on Veterinary Technician Specialties (CVTS).

How much does the VTS (ECC) exam cost in 2026?

The 2026 AVECCTN examination fee is $325, set annually by the Board of Directors. A $75 non-refundable application fee is also required when submitting Part A of the application. Candidates should also budget for RECOVER CPR certification, continuing education, IVECCS travel (if desired), and study materials.

Who is eligible to sit for the VTS (ECC) exam?

Candidates must (1) be legally credentialed as a veterinary technician (RVT, LVT, CVT, or equivalent) in a US state, Canadian province, or equivalent credentialing body, (2) have at least 6,000 hours of veterinary emergency/critical care work experience over 3 or more years within the five years prior to application, (3) complete at least 25 hours of ECC continuing education in the past five years, (4) submit 50 case logs and 4 case reports, (5) complete the AVECCTN Skills List with RECOVER CPR certification, and (6) have two letters of recommendation. The application is submitted in two parts (Part A by March 31, Part B by October 31).

When and where is the VTS (ECC) exam held?

The AVECCTN certifying exam is held once per year in September, the day before the International Veterinary Emergency and Critical Care Symposium (IVECCS) begins. The exam is delivered online with remote proctoring — candidates take it from home or office rather than traveling to a test center.

What is the passing score for the VTS (ECC) exam?

The passing score is set each year by the AVECCTN Examination Committee and approved by the Board of Directors based on the difficulty of that year's exam. The minimum passing score is not publicly published as a fixed percentage. Candidates are notified of their pass/fail result within 60 days of the exam, with written deficiency feedback available on request for those who do not pass.

How should I study for the VTS (ECC) exam?

Focus your study on the 13 domains of the AVECCTN blueprint, weighted by percentage. Core references include the RECOVER 2012 / 2024 CPR guidelines (free from VECCS), Small Animal Critical Care Medicine (Silverstein and Hopper), Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care, and the Manual of Veterinary Transfusion Medicine and Blood Banking. Complete the RECOVER online BLS/ALS certification. Expect 6-12 months of dedicated preparation.

Can I become a VTS without attending a formal school?

Yes. AVECCTN is not a school — it is a certifying body. VTS (ECC) status is earned entirely through work experience, case documentation, continuing education, and passing the exam. You must already be a credentialed veterinary technician (which does require a formal AVMA-accredited program for most US states) before you can begin accumulating VTS experience hours.