Introduction

- These clinical practice guidelines (CPGs) apply to deployed human healthcare providers (HCPs) in combat or austere areas of operations. Veterinary care is established at multiple locations throughout theater, and the veterinary health care team is the MWD’s primary provider. However, HCPs are often the only medical personnel available to MWDs that are critically ill or injured. The reality is that HCPs will routinely manage working dogs in emergencies before they are ever seen by veterinary personnel.
- Care by HCPs is limited to circumstances in which the dog is too unstable to transport to supporting veterinary facilities or medical evacuation is not possible due to weather or mission constraints; immediate care is necessary to preserve life, limb, or eyesight; and veterinary personnel are not available. HCPs should only perform medical or surgical procedures – within the scope of their training or experience – necessary to manage problems that immediately threaten life, limb, or eyesight, and to prepare the dog for evacuation to definitive veterinary care. Routine medical, dental, or surgical care is not to be provided by HCPs.
- Emergent surgical management of injured MWDs may be necessary by HCPs to afford a chance at patient survival. This should be considered only if:
  - The provider has the necessary advanced surgical training and experience.
  - The provider feels there is a reasonable likelihood of success.
  - The provider has the necessary support staff, facilities, and monitoring and intensive care facilities to manage the post-operative MWD without compromising human patient care.
  - Emergent surgical management should be considered only in Role 2 or higher medical facilities and by trained surgical specialists with adequate staff. Direct communication with a US military veterinarian is essential before considering surgical management, and during and after surgery, to optimize outcome.