Emergency Vet Triage Questions: What to Ask Before the Consult
A structured triage tool for veterinary nurses and reception staff. Work through the red-flag screen first, then the questions for the presenting complaint, then history. The tool assigns a suggested triage category and builds a printable triage sheet for the consulting vet.
Before an emergency consult, a veterinary nurse should first screen for immediate red flags (breathing difficulty, pale or blue gums, collapse, active seizures, unproductive retching with a bloated abdomen, a blocked bladder, uncontrolled bleeding, toxin ingestion, major trauma), then ask complaint-specific questions, then take a focused history: current medications, appetite, drinking, urination, faeces, vomiting, past illness and preventative care. Any red flag means the pet goes straight through to the vet, not back to the waiting room.
Written by a practising emergency veterinarian and used the way real emergency clinics triage: category by physiology, not by arrival order.
Who this is for: trained veterinary nurses, technicians and reception staff triaging patients that have already arrived at a clinic. It supports, and never replaces, clinical judgement and your clinic's own triage policy. If in doubt, treat the patient as more urgent and tell the vet.
Triage form
Patient and arrival
Enough to identify the patient and time-stamp the triage. Do not let paperwork delay a sick patient: red flags first.
SpeciesRed-flag screen: look first, then ask
Look at the patient across the desk before asking anything: breathing effort, posture, mentation, gum colour if safe to check. Tick anything that applies. Any tick here means the pet goes straight through to the vet now, not back to the waiting room.
ABCDE quick look: what to check in under a minute
The standard primary survey, scaled to a triage glance. Any abnormality here means straight through; the vet repeats this survey in more detail.
A - Airway. Is air moving? Loud breathing means partial obstruction; no air movement means total obstruction or arrest. Look in the mouth only if it is safe.
B - Breathing. Watch the chest from a distance: effort, rate, rhythm. Warning postures are head and neck stretched out, elbows held away from the body, flared nostrils, open-mouth breathing (any cat), and belly and chest moving out of sync.
C - Circulation. Gum colour and CRT if safe, and a femoral pulse. Pale, white, blue or muddy gums, a CRT over 2 seconds, weak pulses or cold paws all point to shock. Tachycardia plus pale gums plus weak pulses is decompensating.
D - Disability. Mentation: alert, quiet, obtunded (dull and slow), stupor (responds only to pain) or coma (no response). Anything below alert, plus seizures, non-stop pacing or an animal that cannot walk, goes through now. Remember shock, hypoxia and low blood sugar also dull mentation.
E - Everything else. A rapid look over the whole body: wounds, punctures, bruising, fractures, a swollen or tight belly, straining to urinate, burns. Ask about toxin access and current medications while you look.
Presenting complaint questions
Pick the complaint that best matches the owner’s reason for coming in. Ask the questions in order; tick or select what the owner reports. Flagged answers feed the triage category automatically.
ComplaintQuick vitals (optional)
Only if your clinic’s triage policy allows it and the patient tolerates handling. Skip entirely for stressed cats and dyspnoeic patients. Out-of-range values are flagged against resting adult dog and cat ranges; small breeds, puppies, kittens and stressed patients run higher, so read flags with judgement.
Normal values for triage (dog and cat)
| Parameter | Dog | Cat | Flagging |
|---|
Resting adult values used by this tool's automatic flagging. Stress, pain, panting, small breeds and young animals push readings up; read every flag with judgement.
Focused history
The standard intake history. For a red-flag patient this is asked after the pet has gone through to the vet, while the owner waits. Record answers briefly; blank answers are simply left off the triage sheet.
Nurse notes
Anything else the vet should know before walking into the consult: owner concerns, temperament, finances discussed, first aid already given.
Triage result
Downgrades are recorded on the triage sheet with your reason. You can always upgrade without a reason.
Emergency triage reference
Everything the tool asks is written out below so it can be read, printed or taught from directly. The interactive tool above and this reference are generated from the same data, and the page checks them against each other every time it loads.
How to use this tool
- Look before you ask. Watch the patient while the owner is still talking: breathing effort, posture, mentation, gum colour if safe. The red-flag screen is a checklist of what you saw and what the owner volunteers first.
- Any red flag: stop and move. The pet goes straight through to the vet or treatment area. Finish the questions with the owner afterwards.
- No red flags: ask the complaint questions. Pick the presenting complaint and work down the list. Flagged answers automatically raise the suggested triage category.
- Finish with history, confirm the category, print the sheet. The printable triage sheet carries everything the vet needs to walk into the consult informed.
Which symptoms are red flags at an emergency vet?
Any one of these, seen or reported, means the patient is triaged RED and taken through immediately. Do not wait for the full history first.
| Red flag (seen or reported) | Why it cannot wait |
|---|---|
| Struggling to breathe, choking, or open-mouth breathing in a cat | Airway and breathing problems can be minutes from arrest; stress makes them worse. |
| Pale, white, blue or grey gums or tongue | Pallor or cyanosis means shock, blood loss or hypoxia until proven otherwise. |
| Collapsed, unresponsive, or unable to stand | Collapse has a short list of causes and almost all of them are time-critical. |
| Seizing now, more than one seizure today, or a seizure lasting over 5 minutes | Clusters and prolonged seizures cause hyperthermia and brain injury; they need to be stopped. |
| Bleeding that will not stop, or blood from mouth, nose or any wound in volume | Ongoing external bleeding is controllable in a treatment room, not a waiting room. |
| Trying to vomit with nothing coming up, plus a swollen or tight belly | Classic bloat (GDV) presentation; survival falls with every hour to surgery. |
| Straining to urinate with little or nothing coming out, especially a male cat | A blocked bladder causes potassium rises that stop the heart; male cats block most often. |
| Ate or may have eaten a poison, bait, toxic food or human medication | Early decontamination changes outcomes; many toxins have a narrow treatment window. |
| Major trauma: hit by a car, a fall from height, a dog attack, or a penetrating wound | Serious internal injury hides behind a normal-looking patient after major trauma. |
| Suspected heatstroke: hot day or exertion, heavy panting, weakness or collapse | Heatstroke keeps cooking organs until active cooling starts. |
| Possible snake bite or other envenomation | Envenomation progresses unpredictably; antivenom decisions are urgent. |
| Birthing trouble: strong straining with no puppy or kitten, or hours between births | Obstructed labour risks mum and every unborn puppy or kitten. |
| Severe pain: crying out, unable to settle, or will not be touched | Severe pain is inhumane to leave waiting and often marks a surgical problem. |
| Sudden facial swelling or hives with vomiting, weakness or breathing changes | Anaphylaxis can shut the airway and circulation within minutes. |
| Eye out of its socket, sudden blindness, or a chemical splashed in the eye | A prolapsed globe, acute blindness or a chemical burn can cost the eye within the hour. |
| A diabetic on insulin that is wobbly, flat or refusing food | Insulin overdose relative to intake causes hypoglycaemia that progresses to seizures. |
| Suddenly dull, confused, unresponsive or not moving (altered mentation) | Altered mentation means the brain is not being perfused, oxygenated or fuelled properly, or is itself injured. |
| Cat suddenly unable to use its back legs, crying out, legs cold (possible arterial clot) | A saddle thrombus cuts blood supply to the hind legs; it is agonising and signals serious heart disease. |
| Drowning or near-drowning, electrocution, smoke inhalation, or burns | Drowning, electrocution, smoke and burns all cause injuries that progress for hours after the pet looks stable. |
What do the four triage colours mean?
The tool uses a four-colour system adapted for veterinary practice. The suggested category is deterministic: any red flag or red answer suggests RED, any amber answer suggests ORANGE, and a patient with no flags is suggested GREEN for the nurse to confirm or upgrade on judgement. The tool never argues a patient down: nurses can upgrade freely, and a downgrade below the suggested category is recorded with a reason.
| Category | Meaning | Vet seen | While waiting |
|---|---|---|---|
| RED | Immediate. Straight through to the vet or treatment area | Now |
|
| ORANGE | Urgent. Vet within 15 minutes; recheck every 5 to 10 minutes | Vet within 15 min |
|
| YELLOW | Semi-urgent. Vet within 30 to 60 minutes; recheck every 15 to 30 minutes | Vet within 30-60 min |
|
| GREEN | Routine. Standard queue; re-triage if anything changes or the wait passes an hour | Standard queue |
|
What questions does a vet nurse ask for each emergency?
Each set below is what the tool asks for that complaint. Answers marked RED send the patient straight through; AMBER raises the suggestion to ORANGE (vet within 15 minutes).
Breathing problems
Laboured breathing, noisy breathing and open-mouth breathing in cats are among the most time-critical presentations an emergency clinic sees. Dyspnoea has a short differential list (airway obstruction, pleural space disease, heart failure, pneumonia, asthma in cats) and almost all of it deteriorates with stress, which is why these patients skip the waiting room and go straight to oxygen.
- Working hard to breathe right now (effort, noise, or belly heaving) RED
- Cat breathing with its mouth open at any point RED
- Tongue or gums looked blue, grey or very pale RED
- May have something stuck in the throat (was chewing a toy, ball or bone) RED
- When did it start?
- Suddenly, within the last few hours AMBER
- Known heart disease or a heart murmur AMBER
- Coughing (note how long and whether anything comes up)
- Honking cough but otherwise bright, after recent boarding, daycare or the groomer
- Is it there even at rest?
- Yes, even resting AMBER
- Any patient with genuine breathing difficulty is RED regardless of the answers above. Minimal handling, no restraint, straight through to oxygen.
Vomiting or diarrhoea
Most vomiting dogs and cats are stable, but three patterns are genuine emergencies: unproductive retching with a swelling belly (bloat or GDV, minutes to hours matter), significant blood in vomit or stool, and the flat, unvaccinated puppy or kitten where parvovirus is on the list and the patient needs isolating on arrival.
- Trying to vomit but nothing comes up, or the belly looks swollen or tight RED
- How many vomits in the last 24 hours?
- More than five, or ongoing AMBER
- Any blood in the vomit or stool?
- Streaks of fresh blood AMBER
- A lot of blood, or vomit like coffee grounds RED
- Black, tarry stool AMBER
- Cannot keep even water down AMBER
- Quiet, weak or flat between episodes AMBER
- Puppy or kitten, or not fully vaccinated, with vomiting or diarrhoea AMBER
- Could have swallowed a toy, bone, corn cob, sock, string or similar AMBER
- Could have gotten into food, rubbish, compost or anything toxic AMBER
- How long has it been going on, and when was the last episode?
Toxin or swallowed object
Poisonings are won or lost on timing: within roughly two hours of ingestion the vet can often decontaminate before the toxin is absorbed, so what was eaten and when are the two questions that matter most. Chocolate, rat bait, snail bait, grapes and raisins, xylitol, human medications, lilies for cats and dog flea products applied to cats make up most of the caseload.
- What did they get into?
- Chocolate AMBER
- Rat or mouse bait RED
- Snail or slug bait RED
- Human medication RED
- Overdose of a pet medication RED
- Sugar-free gum or lollies (xylitol) RED
- Grapes, raisins or sultanas RED
- Lily (any part, cats) RED
- Paracetamol and the pet is a cat RED
- Dog flea product on a cat RED
- Onion, garlic, leek or chives AMBER
- Cannabis or edibles AMBER
- Antifreeze or coolant RED
- Cleaning product or chemical AMBER
- Non-food object (toy, sock, string, bone) AMBER
- Not sure or something else AMBER
- When?
- Under an hour ago RED
- One to two hours ago RED
- Two to six hours ago AMBER
- Unknown AMBER
- Already showing any symptoms (vomiting, wobbliness, tremors, drooling) RED
- Roughly how much, and the pet's weight if known?
- Owner has the packaging, label or a photo of it
- Ask the owner to keep the packaging with them. Never advise inducing vomiting at home or in reception; that is the vet's call.
Collapse or weakness
A collapsed dog or cat has a short and serious differential list: internal bleeding, heart rhythm problems, heatstroke, low blood sugar in diabetics, and seizures that were not witnessed. Even a pet that seems fully recovered has earned a same-day vet exam, and one that is still down, pale or distended is seen immediately.
- Still down, unresponsive, or unable to stand now RED
- Lost consciousness at any point RED
- Gums looked pale or white at the time RED
- Belly looks swollen or distended RED
- Happened during or after heat or heavy exercise RED
- Diabetic, and insulin was given today RED
- How are they now?
- Up, but quiet or wobbly AMBER
- Still down RED
- Has this happened before?
- First time AMBER
- What did it look like? (paddling, stiffening, went floppy, how long)
Seizures or tremors
A single short seizure in a known epileptic can usually wait for its vet; an active seizure, a cluster of seizures in one day, or any seizure over five minutes cannot, because prolonged seizing overheats the body and injures the brain. Toxins (snail bait, chocolate, cannabis, mouldy food) are a common cause the owner will not volunteer unless asked.
- Seizing right now RED
- How many seizures in the last 24 hours?
- Two or more RED
- A seizure lasted more than 5 minutes RED
- Not back to normal 30 minutes after the seizure ended AMBER
- First ever seizure AMBER
- Could have gotten into snail bait, chocolate, cannabis, mouldy food or medications RED
- Known epileptic on medication (note the drug and any missed doses)
- Describe it: how long, what it looked like, time of the last one
Trauma or wounds
The mechanism of injury outranks how the patient looks: dogs hit by cars and cats that fall from height can walk in bright with a ruptured bladder, bleeding spleen or bruised lungs, and bite wounds are icebergs, with small punctures over crushed tissue underneath. That is why major trauma keeps its red flag even when the pet seems fine.
- What happened?
- Hit by a car or bike RED
- Fell from height (window, balcony, arms) RED
- Attacked by another animal AMBER
- Found injured, cause unknown AMBER
- Still actively bleeding RED
- Breathing looks different since the injury RED
- Can they walk?
- Limping AMBER
- Dragging or unable to use the back legs RED
- Cannot get up RED
- Wound over the chest or belly, or anything penetrating RED
- Bite wounds over the chest, belly or neck, even if small AMBER
- When did it happen, and what first aid has been given?
- Hit-by-car and fall patients can look bright with serious internal injuries. Mechanism keeps its flag even when the pet looks fine. Handle painful patients cautiously; ask the vet before muzzling anything with breathing or facial problems.
Urinary problems
A male cat straining in the litter tray with little or nothing coming out is a possible urethral obstruction, one of the true hour-by-hour emergencies: a blocked bladder pushes potassium high enough to stop the heart. Blood in the urine or frequent small trips without systemic signs is urgent but usually not immediately life-threatening.
- Straining with little or nothing coming out RED
- Male cat with any urinary signs RED
- When did they last pass a normal amount of urine?
- 12 to 24 hours ago AMBER
- Over 24 hours ago RED
- Blood in the urine AMBER
- Also vomiting, flat or off food RED
- Crying in the litter tray, licking the back end, or frequent small trips
- Any previous urinary problems or blockages?
Not eating or lethargic
How worrying inappetence is depends on the species and the clock: a dog skipping one meal is rarely urgent, a cat off food for more than a day risks hepatic lipidosis (especially if overweight), and a rabbit, guinea pig or ferret not eating for even half a day is an emergency because their guts and blood sugar fail fast.
- How long off food?
- 24 to 48 hours AMBER
- Over 48 hours AMBER
- Overweight cat that has stopped eating AMBER
- Rabbit, guinea pig or ferret not eating for 12 hours or more RED
- Puppy or kitten under 6 months refusing food AMBER
- Drinking?
- More than usual AMBER
- Not drinking at all AMBER
- Also vomiting or diarrhoea (switch to that question set too)
- How flat are they?
- Very dull, barely interested in anything AMBER
- Reluctant or unable to get up RED
- Noticeable weight loss recently
- Anything else changed? (behaviour, hiding, breathing, toileting)
Eye problems
Eyes fail fast and quietly: a prolapsed globe, sudden blindness, a chemical splash or a bulging painful eye (possible glaucoma) can cost the eye within hours, and a squinting, tearing eye usually means a painful corneal ulcer that needs same-day care. Eye problems are never a wait-and-see triage.
- Eye pushed out of its socket RED
- Suddenly bumping into things or appears blind RED
- Chemical, cleaning product or plant sap in the eye RED
- Eye looks bigger, bulging or cloudy compared with the other RED
- Eye held shut, tearing, or pawing at it AMBER
- Red, weepy or discharging but open and comfortable
- When did it start, and was there any known knock or scratch?
- Eyes are unforgiving: a painful or changed eye is never a wait-and-see. Do not let owners apply old eye drops from home.
Lameness or back pain
Most limps can wait a day; two cannot. A dog dragging its back legs may have a spinal cord problem such as a slipped disc (IVDD), where hours change the odds of walking again, particularly in dachshunds and other long-backed breeds. An open fracture or a limb at a strange angle also needs immediate care and pain relief.
- Dragging the back legs or unable to use them RED
- Cat with sudden hind leg weakness or paralysis, crying out, legs cool to touch RED
- Bone visible, limb at a strange angle, or an open wound over the injury RED
- Weight bearing?
- Not putting the leg down at all AMBER
- Cries when picked up or touched over the back, or reluctant to move the neck AMBER
- Long-backed breed (dachshund, corgi, basset, shih tzu) with sudden back pain or wobbliness AMBER
- Hot, swollen joint or limb AMBER
- Known trauma caused it (switch to the trauma set too)
- Which leg, since when, better or worse?
Swelling or allergic reaction
A puffy face or hives after a sting looks dramatic and is usually treatable, but allergic reactions can escalate to anaphylaxis within minutes: any breathing change, vomiting or weakness after a sting, bite or new medication moves the patient to the front of the queue, and even comfortable swellings are rechecked every few minutes.
- Any change in breathing or noisy breathing since the swelling started RED
- Vomiting, diarrhoea, weakness or collapse since the sting, bite or new drug RED
- Facial or muzzle swelling, or puffy eyes AMBER
- Hives or lumpy raised skin over the body AMBER
- Known or likely trigger?
- Vaccine or medication today AMBER
- When did it start, and is it spreading?
- Allergic reactions can escalate over minutes. Even a comfortable-looking facial swelling is rechecked every 5 to 10 minutes while waiting.
Birthing trouble
Dystocia risks the mother and every unborn puppy or kitten at once. The working thresholds: strong straining for 20 to 30 minutes with nothing delivered, more than two hours between babies with more expected, green or black discharge before the first arrival, or a visibly stuck puppy or kitten all mean the vet is needed now, not after another hour of waiting at home.
- Strong straining for over 20 to 30 minutes with no puppy or kitten RED
- More than 2 hours between births with more expected RED
- Green or black discharge before the first baby has arrived RED
- A puppy or kitten visibly stuck RED
- Mum weak, flat or trembling RED
- Past the due date (over 65 to 70 days from mating) with no labour AMBER
- How many born so far, how are they, and when did labour start?
- First litter
Something else
For anything that does not fit a set, the same principles hold: how long, how fast it is changing, whether the pet is still eating, drinking and bright, and a spoken re-run of the red-flag screen. A problem that is progressing quickly earns a higher category than the same problem that has been stable for a week.
- Describe the problem in the owner's words
- How long has it been going on?
- Getting better or worse?
- Worse, or changing quickly AMBER
- Eating and drinking normally
- Demeanour?
- Quiet AMBER
- Flat or weak RED
- Re-run the red-flag screen out loud for anything that does not fit a set: breathing, gums, ability to stand, toxins, pain.
What are normal vitals for dogs and cats at triage?
These are the resting adult values the tool flags against, shown in the vitals step as a reference dropdown. Anything outside them earns at least a caution; the thresholds in the right-hand column earn a red flag on their own.
| Parameter | Dog | Cat | How the tool flags it |
|---|---|---|---|
| Temperature | 37.7 to 38.6 C | 37.7 to 38.6 C | Above 40 C or below 36.5 C is flagged red |
| Pulse / heart rate | 80 to 120 bpm | 180 to 200 bpm | Red: dog over 200 or under 60; cat over 250 or under 150 |
| Respiratory rate | 10 to 40 brpm | 20 to 40 brpm | Count at rest; panting and stress raise it |
| Gum (MM) colour | Pink | Pink | White, blue or brown gums are flagged red |
| CRT | 1 to 2 seconds | 1 to 2 seconds | Under 1 s or over 2 s is abnormal; over 3 s is red |
| Mentation | Alert | Alert | Obtunded, stupor, coma or uncontrolled excitability is red |
| Pulse quality (femoral) | Strong, regular | Strong, regular | Weak or absent pulses are red; bounding is a caution |
| Systolic blood pressure | Over 90 mmHg | Over 90 mmHg | Under 90 mmHg is flagged red (shock until proven otherwise) |
| Lactate | Under 2.5 mmol/L | Under 2.5 mmol/L | 2.5 and above suggests poor perfusion; 5 and above is red |
Reading abnormal vitals. Gum colour is the fastest circulation check there is: white or pale means blood loss, anaemia or shock; blue means the patient is not oxygenating; brown suggests methaemoglobinaemia from toxins such as paracetamol in cats; brick red goes with heat, sepsis and hyperdynamic shock; yellow is jaundice; and pinpoint bruising points to a platelet or clotting problem. CRT abnormality runs in both directions: over 2 seconds means poor perfusion, and under 1 second can mean a hyperdynamic state such as early sepsis or heatstroke. Mentation below alert (obtunded, stupor, coma) is a red flag in its own right, and shock, hypoxia and low blood sugar must be excluded before blaming the brain. Weak or absent femoral pulses, systolic blood pressure under 90 mmHg and lactate at or above 2.5 mmol/L all say the same thing from different angles: the tissues are not being perfused.
The cat exception. Shocky cats often break the textbook: instead of racing hearts they present bradycardic, hypothermic and dull. A cold, slow, quiet cat should be treated as shock and have a blood pressure checked before anyone reaches for a heat pad, because warming a shocked cat before addressing perfusion makes things worse.
What history does the vet nurse take before the consult?
Once the patient is stable enough to wait, or has already gone through, the nurse completes a short structured history. This is the same ground a written intake form covers, asked out loud: who the regular vet is and whether the pet was referred, current medications and doses, known conditions, past surgeries and any previous drug reactions, then the systems review: appetite and any recent food change, drinking, urination (colour and amount), faeces, vomiting (how often and what colour), demeanour, breathing, and pain. Preventative care rounds it out: vaccination status, heartworm prevention, flea and tick control, and worming, each with when it was last given. Finally lifestyle: indoors or outdoors, housing type, other animals at home, whether the pet has travelled or came from overseas, and whether the owner has had the pet since it was young.
Two history questions punch above their weight in emergency practice: "Does your pet tend to eat things it shouldn't?" and "Could they have gotten into any baits, poisons, medications or toxic plants?" Owners rarely volunteer these unprompted, and they change the differential list completely.
What should happen in the waiting room?
- Nothing to eat or drink until the vet says otherwise. Many emergency patients need sedation, anaesthesia or imaging, and a full stomach complicates all three.
- Cats up high, in carriers, facing away from dogs. A stressed cat's heart rate, breathing and temperature can all rise enough to muddy the exam, and stress alone can tip a fragile cat over.
- Dyspnoeic patients never wait. Breathing difficulty is RED by definition. Minimal handling, no forced restraint, straight through to oxygen.
- Keep the packaging. For any toxin case, the box, blister pack or bait tray is often worth more than the history. Ask the owner to keep it on them, not in the car.
- Recheck on schedule. ORANGE every 5 to 10 minutes, YELLOW every 15 to 30, GREEN if anything changes or the wait passes an hour. Any deterioration is re-triaged from the top.
- Suspected infectious patients are isolated, not seated in the shared waiting room: unvaccinated puppies with vomiting or diarrhoea (parvovirus risk), coughing dogs fresh from boarding or daycare (kennel cough), and similar. The tool flags these automatically.
Common triage mistakes
- Taking the full history before looking at the patient. The form can wait; the airway cannot. Look first, screen for red flags, then ask.
- Trusting "he's always like that". Owners normalise slow changes. "When was the pet last completely normal?" cuts through better than "what's wrong?".
- Treating unproductive retching as vomiting. A large-breed dog trying to vomit with nothing coming up and a swelling belly is a possible GDV, one of the most time-critical emergencies in the building.
- Sitting a straining male cat in the queue. Straining with little or nothing coming out is a possible urethral obstruction until proven otherwise: hours matter.
- Restraining a breathless cat for a gum check. The information is not worth the risk. Observe through the carrier and move them to oxygen.
- Downgrading on appearance. Hit-by-car patients and bite wounds can look fine over serious internal injury. Mechanism of injury keeps its flag even when the pet looks bright.
- Letting a waiting patient go unwatched. Triage is a category at a point in time, not a verdict. Recheck on schedule and re-triage any change.
Frequently asked questions
What questions should a vet nurse ask at emergency triage?
Start with a red-flag screen: breathing difficulty, gum colour, ability to stand, seizures, unproductive retching with a bloated belly, straining to urinate, toxin exposure, major trauma, birthing trouble and severe pain. Any red flag means the pet goes straight through. Then ask complaint-specific questions (when it started, how often, blood, toxin access), and finish with a focused history: medications, appetite, drinking, urination, faeces, vomiting, past illness and preventative care.
What counts as a genuine veterinary emergency?
Breathing difficulty, pale or blue gums, collapse, repeated or prolonged seizures, uncontrolled bleeding, suspected bloat (GDV), a blocked bladder (especially male cats), toxin ingestion, snake bite, heatstroke, major trauma such as being hit by a car, birthing trouble, an eye out of its socket, and severe pain. These are seen immediately, ahead of the queue.
Why does the nurse take some pets straight through ahead of others?
Triage orders patients by how quickly they could deteriorate, not by arrival time. A dog with bloat or a cat that cannot urinate can become unsalvageable in hours, while a limping but stable dog can safely wait. Being taken through first is about physiology, not favouritism.
Should I feed my pet while we wait at the emergency vet?
No. Keep them off food and water until the vet advises, because many emergency patients need sedation, anaesthesia, imaging or surgery, and a full stomach adds risk and delay. Exception: only if the veterinary team specifically instructs otherwise, for example some diabetic patients.
What should I bring to an emergency vet visit after a poisoning?
The packaging, label, bait tray or a photo of whatever was eaten, plus an estimate of how much is missing and when it happened. Do not induce vomiting at home unless a vet has told you to; with some toxins and in some patients it makes things worse.
How are triage categories decided in this tool?
Deterministically. Any red flag or red-flagged answer suggests RED (immediate). Any amber answer suggests ORANGE (vet within 15 minutes). With no flags the tool suggests GREEN and the nurse confirms or upgrades on judgement. The nurse can always upgrade; downgrading below the suggestion requires a recorded reason.
Is my dog vomiting an emergency?
Once or twice in a bright dog that keeps water down can usually be monitored or seen routinely. It becomes an emergency with any of: trying to vomit with nothing coming up plus a swelling belly (possible bloat or GDV), a lot of blood or vomit like coffee grounds, repeated vomiting that will not stop, a flat or weak dog, or an unvaccinated puppy, where parvovirus is a real risk.
What are the signs of bloat (GDV) in dogs?
Unproductive retching (trying to vomit with nothing coming up), a swollen or tight belly, restlessness and pacing, drooling, and then weakness or collapse, most often in large deep-chested breeds after eating. GDV is immediately life-threatening: survival falls with every hour to surgery, so it is a straight-through RED at any clinic.
How quickly does a blocked cat need to be seen?
Immediately. A cat straining to urinate with little or nothing coming out may have a urethral obstruction, which pushes blood potassium high enough to stop the heart, usually within 24 to 48 hours of blocking but sometimes faster. Male cats are affected most. This is never a wait-in-the-queue presentation.
What should I tell the vet nurse when I arrive at an emergency clinic?
Lead with the main problem and when your pet was last completely normal. Then: any chance of poisons, baits or medications (bring the packaging), current medications, known conditions, and whether the problem is getting worse. Short, specific answers help the nurse triage accurately; everything else can follow once the pet has been assessed.
Why was my pet seen after animals that arrived later than us?
Emergency clinics run on triage, not arrival order. Patients are seen in order of how quickly they could deteriorate: a breathing crisis or a blocked bladder goes ahead of a stable limp, whatever the queue order. If your pet gets worse while you wait, tell the team immediately and they will re-triage on the spot.
Can veterinary nurses perform triage assessments?
Yes. Triage is a core nursing skill: a trained veterinary nurse screens for red flags, takes a focused history, records vitals where appropriate, and assigns a waiting category under the clinic's triage policy, escalating to the veterinarian anything urgent or unclear. Structured question sets like this one keep that process consistent between staff and shifts.
Using this tool for nurse training
Because the question sets, red flags and category rules are written out in full above, this page doubles as a training reference: new nurses and reception staff can learn the red-flag screen before their first emergency shift, and teams can standardise what gets asked so triage does not depend on who happens to be on the desk. The printable sheet also creates a consistent written record for case reviews and clinical audits, and the recorded-reason rule on downgrades builds the habit of documenting triage decisions.
Triage terms explained
Triage. Sorting patients by how quickly they need a vet, not by when they arrived. The word comes from battlefield medicine and works the same way in a veterinary waiting room.
Red flag. A sign or piece of history that by itself means the patient cannot safely wait: it is taken straight through regardless of everything else.
GDV (gastric dilatation-volvulus, bloat). The stomach fills with gas and twists, cutting off its own blood supply. Presents as unproductive retching with a swelling belly, mostly in large deep-chested dogs. Surgical, and survival falls by the hour.
Urethral obstruction (blocked bladder). Urine cannot leave the bladder, most often in male cats. Potassium rises until the heart slows and stops, so the presentation is straining with little or nothing produced.
Dyspnoea. Difficulty breathing: increased effort, noise, belly heaving, or open-mouth breathing in cats. Handled with minimal restraint and oxygen first, questions second.
Mentation. How awake and aware the patient is, from bright and alert through quiet and dull to unresponsive. A change in mentation is one of the fastest ways to spot a patient in trouble.
CRT (capillary refill time). How long a pressed gum takes to go pink again. Under two seconds is normal; longer suggests poor circulation.
Post-ictal. The disoriented recovery period after a seizure. Common; but a pet still abnormal 30 minutes after a seizure ends needs the vet's attention.
Decontamination window. The first roughly two hours after eating a toxin, when the vet can often make the patient vomit or bind the toxin before it is absorbed. This is why "when did they eat it?" changes everything.
Nil by mouth. No food or water until the vet advises, protecting the option of sedation, anaesthesia or imaging without added risk.
Isolation. Keeping a possibly contagious patient (parvovirus suspects, kennel cough) physically separated from the shared waiting room to protect other patients.
Sources and further reading
The red flags, timing thresholds and waiting-room practice in this tool reflect mainstream emergency and critical care practice as taught in current veterinary emergency references and used in emergency clinics daily. For the broader evidence base and professional guidelines, see:
- RECOVER Initiative: evidence-based veterinary CPR and emergency care guidelines
- Veterinary Emergency and Critical Care Society (VECCS): the specialty body for veterinary emergency and critical care
- WSAVA: global veterinary guidelines, including pain recognition and vaccination
Thresholds such as the two-hour decontamination window, dystocia straining times and anorexia windows are deliberately conservative triage prompts, not treatment rules: the vet on duty makes the clinical decisions.
About the author
Related veterinary tools
Professional use. This tool is written for trained veterinary staff performing in-clinic triage. It is a structured prompt sheet, not a diagnostic instrument: it never rules out an emergency, and a calm-looking patient can still be critically ill. Follow your clinic's triage policy, escalate anything you are unsure about, and treat borderline patients as the more urgent category. Designed by Dr Duncan Houston.