NAVLE

NAVLE Emergency Medicine: Shock, GDV, Urethral Obstruction, and Critical Care

April 6, 2026 5 min read 25 views

Emergency questions on the NAVLE reward knowing which intervention comes first, which drugs are contraindicated, and the species-specific differences in shock presentation. GDV, urethral obstruction in cats, and Addisonian crisis are the most frequently tested conditions.

Shock Classification and Treatment

TypeMechanismSignsTreatment
HypovolemicBlood/fluid lossTachycardia, pale MM, weak pulsesIV crystalloids 10–20 mL/kg bolus; pRBC if PCV <20%
Distributive (septic)Vasodilation, maldistributionEarly: brick-red MM, bounding pulses; Late: pale MM (cats go directly to late)Aggressive IV fluids + broad-spectrum antibiotics + vasopressors
CardiogenicPump failureDyspnea, pulmonary edema, muffled soundsDobutamine/pimobendan; diuretics; NO aggressive fluids
ObstructivePhysical obstruction (tamponade, pneumothorax)Beck's triad: muffled heart sounds, JVD, hypotensionPericardiocentesis (tamponade); chest tube (tension pneumothorax)

Gastric Dilatation-Volvulus (GDV)

Large, deep-chested breeds (Great Dane #1, Standard Poodle, German Shepherd, Weimaraner). Gastric volvulus 270–360° → gastric ischemia + shock + death within hours. Signs: unproductive retching, tympanic abdominal distension, hypersalivation, cardiovascular shock.

Priority order (this is tested):

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