6.1 Hospitalization Care and Kennel Management

Hospitalization Care and Kennel Management

Hospitalized veterinary patients require a clean, safe, and comfortable environment to facilitate recovery and minimize stress. As a veterinary assistant, you play a vital role in maintaining kennel hygiene, selecting appropriate housing, managing waste, and ensuring patient comfort. Adhering to strict sanitation protocols prevents the spread of nosocomial (hospital-acquired) infections and promotes healing.

Cage and Run Selection

Selecting the correct housing is the first step in hospitalization care. Cage and run selection depends on the patient's size, species, behavior, and medical status.

Sizing and Space Requirements

A cage or run must be large enough to allow the animal to stand fully upright, turn around completely, and lie down in a fully extended recumbent position. For dogs, runs are preferred for larger breeds (typically those over 50 pounds) or active individuals to prevent confinement distress. For cats and small dogs, cages are suitable. In feline housing, the cage should be wide enough to allow the litter box to be placed as far away from the food and water bowls as possible.

Species and Behavioral Considerations

Cats are highly sensitive to their environment and should be housed in a quiet, dedicated feline ward away from barking dogs. A visual barrier, such as a towel draped over the cage door, helps reduce stress. Hiding boxes should be provided for cats and fearful small dogs. Dogs that are highly anxious or dog-aggressive should be placed in cages that do not face other dogs directly.

Medical Condition Adjustments

• Recumbent Patients: Animals that cannot stand or move (e.g., neurological or post-operative orthopedic patients) require large, easily accessible cages or runs. They must not be placed in upper-level cages due to the risk of falling during handling or transport.
• Infectious Patients: Patients exhibiting signs of contagious disease (e.g., canine parvovirus, feline panleukopenia, upper respiratory infections) must be housed immediately in a dedicated isolation ward with a separate ventilation system, rather than the general ward.
• Post-Anesthetic Patients: Cages for patients recovering from anesthesia should be highly visible to staff (close to the treatment area), dry, and free of heavy water bowls that could present a drowning hazard if the animal is still obtunded.

Bedding Management and Patient Comfort

Appropriate bedding is crucial for maintaining body temperature, preventing pressure sores, and keeping patients clean and dry.

Types of Bedding

• Towels and Blankets: Standard for active, continent patients. Easy to launder and versatile.
• Fleece and Synthetic Sheepskin (VetBed): Highly recommended for recumbent or geriatric patients. These materials wick moisture away from the skin, keeping the animal dry even if minor elimination occurs, and provide superior cushioning.
• Disposable Puppy Pads: Placed over fabric bedding to absorb fluids from draining wounds, surgical sites, or incontinent patients. They allow quick changes and help keep the underlying fleece or blanket clean.
• Newspaper: Used as a base layer in cages for ease of cleanup, but should never be the sole bedding for patients, as it offers no orthopedic support or thermal insulation.

Care for Recumbent and Geriatric Patients

Recumbent patients are at high risk for decubital ulcers (pressure sores) and atelectasis (collapse of the lungs) due to prolonged pressure on bony prominences (like the elbows, hocks, and hips).

• Bedding Requirements: These patients need thick, padded bedding such as egg-crate foam, specialized air mattresses, or heavy sheepskin.
• Recumbency Care: The veterinary assistant must turn recumbent patients from side to side (lateral recumbency to sternal, then to the opposite lateral side) every 2 to 4 hours. This rotation must be documented in the treatment chart to prevent lung congestion and pressure sores.
• Hygiene: Incontinent patients must be checked frequently. Soiled bedding must be removed immediately, and the animal's skin must be cleaned and dried to prevent urine scald (chemical burns on the skin from contact with ammonia in urine).

Environmental and Emotional Comfort

• Thermoregulation: Neonates, geriatric patients, and those recovering from anesthesia have compromised thermoregulation. Heat sources must be safe; use warm-water circulating pads, heated air blankets (e.g., Bair Hugger), or incubator cages. Never use electric heating pads directly on an animal, as they can cause severe thermal burns, particularly if the patient is sedated or unable to move away from the heat.
• Photoperiod and Noise: Maintain a normal day-night light cycle. Minimize loud noises, slamming cage doors, and barking. Soothing classical music or species-specific pheromones (e.g., Feliway for cats, Adaptil for dogs) can be used to lower stress levels.

Sanitation Protocols and Disinfectants

Sanitation is divided into cleaning, disinfecting, and sterilizing. As a veterinary assistant, you will primarily perform cleaning and disinfection.

1. Cleaning: The physical removal of organic matter (feces, urine, blood, saliva, hair) using soap or detergent and water. Disinfectants will not work if organic debris is present.
2. Disinfection: The application of a chemical agent to destroy or inhibit the growth of pathogenic microorganisms on inanimate objects.
3. Sterilization: The complete destruction of all forms of microbial life, including spores (typically achieved via autoclaving).

Key Disinfectants Used in Veterinary Clinics

The veterinary assistant must understand the properties, dilutions, and safety hazards of common disinfectants.

The Five-Step Kennel Cleaning Protocol

To ensure effective disinfection, follow this precise order:

1. Remove the Patient: Place the patient in a clean, secure holding area. Never clean a cage with the animal inside.
2. Remove Organic Matter: Scoop out feces, wipe up urine, and remove food bowls, water bowls, and bedding.
3. Wash and Rinse: Scrub the cage walls, floor, and ceiling with a detergent/soap solution to remove remaining organic film, then rinse thoroughly.
4. Apply Disinfectant: Spray the disinfectant at the correct dilution. Ensure the surface remains wet for the full contact time recommended by the manufacturer (usually 10 minutes for bleach or quaternary ammoniums).
5. Rinse and Dry: Rinse away any chemical residue (especially important with bleach and phenols) and dry the cage completely before returning the patient and putting in clean bedding/bowls.

Waste Management and Safety

Veterinary clinics generate different types of waste that must be segregated for safety and compliance with OSHA and local regulations.

Regular Waste

Non-hazardous materials such as clean paper, plastic packaging, food wrappers, and unsoiled bedding are placed in standard trash cans.

Biohazardous / Medical Waste

Waste contaminated with blood, body fluids, or infectious agents (e.g., parvovirus-contaminated feces, tissues from surgery, necropsy waste) must be placed in designated red biohazard bags. These bags are collected by licensed waste disposal companies for autoclaving or incineration.

Sharps Disposal

Any sharp object capable of puncturing skin must be placed in a rigid, puncture-proof sharps container.

• Examples: Needles, syringes with needles attached, scalpel blades, glass slides, cover slips, and broken glass vials.
• Safety Rule: Never overfill a sharps container (fill only to the indicated line, usually 2/3 or 3/4 full). Never recap a needle using a two-handed technique; if recapping is absolutely necessary, use the one-handed "scoop" method.

Personal Protective Equipment (PPE)

When cleaning runs, handling waste, or mixing concentrated disinfectants, you must wear appropriate PPE, including gloves, protective eyewear, and a waterproof apron. This protects you from zoonotic pathogens (diseases transmissible from animals to humans, such as leptospirosis) and chemical exposure.