Knowledge Award Audio Overview: auditing fluid therapy for dogs with acute haemorrhagic diarrhoea

Hello, my name is Lucy Leicester and I’m part of the team at Vets Now which provides out of hours emergency care for companion animals from more than 60 sites across the UK. Our quality improvement project focused on emergency caring dogs with acute haemorrhagic diarrhoea syndrome or AHDS.

This is a common emergency presentation at Vets Now and patients can deteriorate quickly because of severe fluid loss with the risk of hypovolemic shock. The topic was chosen by our clinical teams. We asked colleagues across the organisation to identify areas they felt would benefit most from review and AHDS emerged as the clear priority.

Our teams were also involved in selecting the audit criteria, helping to ensure that the project focused on the aspects of care that mattered most in day-to-day clinical practice. Our aim was to explore and support clinical decision-making in canine AHDS patients, particularly around fluid therapy and antimicrobial prescribing. To achieve this, we combined a large-scale clinical audit with the development of a structured care framework.

The audit identified opportunities for improvement while the care framework helped embed those improvements in everyday practice.

To help ensure the project addressed real clinical and operational challenges, we gathered feedback from teams about their experiences managing AHDS cases during emergency shifts.

We relied a lot on the RCVS Knowledge resources, especially around evidence-based contextualised care, human factors and systems thinking. We used VetMed resource for our literature review and used published veterinary guidelines on fluid therapy and antimicrobial stewardship as our audit standards.

The audit was carried out by a large team of volunteer auditors. We provided training and completed a pilot audit to refine the methodology before launching the full audit cycle. We extracted data from 1,100 AHDS cases seen across all our sites.

Having input from clinical teams throughout the process helped ensure the resources we developed were genuinely practical and useful to use during emergency shifts.

Our re-audit identified measurable improvements in fluid therapy prescribing and antimicrobial stewardship across the organisation. Something that particularly stood out during the project was the level of engagement from colleagues across the business, the willingness of teams to contribute ideas, participate in audit activity, and help shape the final resources became one of the project’s greatest strengths.

Clinical teams were involved at every stage from selecting the audit topic and extracting audit data to designing interventions and testing new tools, which was key to achieving sustainable change across such a large organisation.

Overall, this project demonstrated how combining clinical audit with structured evidence-based interventions can support animal welfare by delivering meaningful improvements in patient care. The biggest lesson from this project was the importance of involving clinical teams at every stage. From choosing the topic to developing solutions, their input was essential.

For practices considering their own quality improvement projects, I’d encourage them to involve teams from the outset, build interventions around the best available evidence and develop resources that support clinicians to apply the evidence within the context of each individual patient. For us, that combination was key to achieving meaningful and sustainable change.