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Christopher Norkus

DVM, DACVAA, CVPP, DACVECC
Christopher Norkus Staff Photo
Medical Director
Anesthesiology, Emergency & Critical Care
Christopher Norkus Staff Photo

At a Glance

Practicing Since:

2011

Board Certified:

Anesthesia and Analgesia
Emergency and Critical Care

Specialties Include:

Critical Care
Emergency Medicine
Anesthesiology
Pain Management

Dr. Norkus began his veterinary career over 20 years ago as a veterinary technician, ultimately obtaining duel Veterinary Technician Specialist (VTS) status in both emergency-critical care and anesthesia. He completed his undergraduate education at the University of Massachusetts-Amherst in 2004 and proceeded to veterinary school at Ross University School of Veterinary Medicine and Tufts Cummings School of Veterinary Medicine, graduating in 2011.

Dr. Norkus completed a prestigious internship at The Animal Medical Center in New York City followed by a residency in anesthesiology at Kansas State University. Following this, Dr. Norkus became board-certified as a Diplomate of the American College of Veterinary Anesthesia and Analgesia and was credentialed as a Certified Veterinary Pain Practitioner in 2015. Dr. Norkus then completed a second three-year residency in emergency medicine and critical care at Allegheny Veterinary Emergency Trauma & Specialty in Pittsburgh, PA and became board-certified as a Diplomate of the American College of Veterinary Emergency and Critical Care in 2018.

To date, Dr. Norkus has published more than two dozen peer-reviewed publications and book chapters and is the editor for the landmark textbook, Veterinary Technician’s Manual for Small Animal Emergency & Critical Care, which is now in its second edition. He lectures regularly for both regional and national audiences. Dr. Norkus’ professional interests include toxicology, acute and chronic pain management, and critical care medicine and anesthesia. Dr. Norkus enjoys cooking, cars, hiking, and traveling in his spare time.
Papers Authored
The influence of quotations uttered in emergency service triage traffic and hospitalization (Quiet)

Abstract: This study aims to determine whether the use of the word, Quiet increases veterinary emergency service triage traffic or hospital admissions. Days were randomized to be a control or test phrase day. On control days, the phrase, Have a nice day! was announced to the entire hospital staff. On test days, the phrase, Have a quiet day! was announced. 
Authored: Norkus C, Butler A, Smarick S
Published: Open Veterinary Journal, 9(1): 99-102

Successful medical management of perinephric abscess and urosepsis following urethral obstruction in a cat

Case Study: A 2‐year‐old intact male domestic shorthaired cat presented to an emergency and referral center for lethargy, vomiting, and hematuria. Severe azotemia and hyperkalemia were observed on a serum biochemistry panel. The patient was diagnosed with urethral obstruction and was treated with urethral catheterization, calcium gluconate, IV fluid therapy, buprenorphine, and prazosin. The patient's azotemia improved, and the hyperkalemia resolved. Urinary catheterization was discontinued. The patient developed pyrexia, worsening azotemia, hypoalbuminemia, hyperbilirubinemia, and dysuria. Urethral catheterization was repeated. Abdominal radiographs showed left renomegaly, and abdominal ultrasound revealed left perinephric fluid. Ultrasound‐guided centesis of the perinephric fluid revealed septic inflammation, and the sample was consistent with urine based upon sample creatinine. Fluid from the perinephric abscess and urine from the bladder both grew Pasturella spp. The patient was treated with perinephric catheterization, saline lavage, and a continuous infusion of cefotaxime for 72 h. The patient's azotemia quickly resolved, and the patient was discharged after 6 days of hospitalization. The patient was reported to have made a full recovery. 
Authored: Norkus C, Keir I.
Published: JVECC, Accepted and In Press

Dexmedetomidine to control signs associated with lisdexamfetamine dimesylate toxidrome in a cat

Abstract: A 5-month-old intact female domestic shorthaired cat had mydriasis, agitation, and increased locomotion after ingestion of lisdexamfetamine, 10.3 mg/kg body weight (BW). Despite treatment with IV fluids, IV acepromazine, oral cyproheptadine and intravenous lipid emulsion the patient’s clinical signs worsened. Dexmedetomidine administered at 2 μg/kg BW and continued at 0.5 μg/kg BW per hour rapidly controlled the patient’s signs. An episode of vomiting and hematuria developed. Follow-up 5 days after discharge revealed that the cat appeared normal.
Authored: Norkus C, Keir I, Means C
Published: CVJ, Mar, 58(3):261-264

Characteristics of the labor market for veterinary technician specialists in 2013

Objective: To determine characteristics of the labor market for veterinary technician specialists (VTSs) during 2013 and identify characteristics significantly associated with pay rate for VTSs.
Authored: Norkus C, Liss D, Leighton L 
Published: JAVMA, 248:1. 105-109

Evaluation of the pharmacokinetics of oral amitriptyline and its active metabolite nortriptyline in fed and fasted Greyhound dogs

Abstract: This study reports the pharmacokinetics of oral amitriptyline and its active metabolite nortriptyline in Greyhound dogs. Five healthy Greyhound dogs were enrolled in a randomized crossover design. A single oral dose of amitriptyline hydrochloride (actual mean dose 8.1 per kg) was administered to fasted or fed dogs.
Authored: Norkus C, Rankin D, KuKanich B
Published: JVPT, Dec, 38(6):619-622

Pharmacokinetics of intravenous and oral amitriptyline and its active metabolite nortriptyline in Greyhound dogs

Abstract: To evaluate the pharmacokinetics of amitriptyline and its active metabolite nortriptyline after intravenous (IV) and oral amitriptyline administration in healthy dogs.
Authored: Norkus C, Rankin D, KuKanich B
Published: VAA, Nov; 42(6) 580-589

Pharmacokinetics of oral amantadine in greyhound dogs

Abstract: This study reports the pharmacokinetics of amantadine in greyhound dogs after oral administration. Five healthy greyhound dogs were used.
Authored: Norkus C, Rankin D, Warner M, KuKanich B
Published: JVPT, Jun; 38(3):305-308

Labor market characteristics of veterinary technician specialists in 2007

Abstract: To determine labor market characteristics of veterinary technician specialists (VTSs) during 2007 and identify characteristics significantly related to pay.
Authored: Norkus C
Published: JAVMA 235:11, 1303-1306

Anesthesiology

Pet owners are often very anxious about veterinary procedures that involve anesthesia. This handout attempts to alleviate some of these concerns.

The word anesthesia comes from the Greek meaning "lack of sensation". Anesthesia is accomplished by administering drugs that depress nerve function. With general anesthesia, the patient is made unconscious for a short period. During this unconscious state, there is muscular relaxation and a complete loss of pain sensation.

Other types of anesthesia include local anesthesia such as numbing a localized area of skin or a tooth, and spinal anesthesia, such as an epidural block, that results in anesthesia of a particular part of the body.

What are the risks of anesthesia?

There is always risk of an adverse reaction when we use any anesthetic agent, no matter whether it is for a minor, short-term sedation or for a complete general anesthesia lasting several hours.

"It is estimated that approximately 1 in 100,000 animals will have some sort of reaction to an anesthetic agent."

It is estimated that approximately 1 in 100,000 animals will have some sort of reaction to an anesthetic agent. These reactions may range from mild swelling at the site of injection or a mild decrease in cardiac output, to a full-blown episode of anaphylactic shock or death. However, many experts put the risk of anesthetic death as less than the risk of driving to and from the hospital to have the anesthetic procedure.

Another potential danger associated with anesthesia arises if the dog is not properly fasted prior to anesthesia. Anesthetized patients lose the normal reflex ability to swallow; during swallowing, the epiglottis, a cartilage flap that closes over the entrance to the windpipe, prevents food or water from entering the lungs. If there is food in the stomach, the dog could vomit while under anesthesia or in the early post-anesthetic period. If vomiting occurs before the swallowing reflex occurs, the vomited material can be aspirated or enter into the lungs, causing aspiration pneumonia, a potentially life-threatening condition.

Other rare complications of anesthesia include organ system failure such as kidney liver or heart failure, visual impairment, clotting disorders and seizures. We will take every precaution to minimize these risks during your pet's anesthesia. Only when the benefits outweigh the risks will we perform anesthesia on your pet.

Are there things that can be done to minimize the risks?

Pre-surgical physical examination, preoperative blood and urine tests and radiographic examination may detect clinical and sub-clinical problems. Certain medical conditions will increase the risk of having an anesthetic complication. These conditions include heart, liver or kidney disease, diabetes mellitus, anemia, dehydration, and certain infectious diseases such as heartworm disease.

"Blood tests will increase the chance of detecting a hidden problem that could prove to be life threatening."

Blood tests will increase the chance of detecting a hidden problem that could prove to be life threatening. In older animals, chest radiographs are recommended to ensure there is no pre-existing pathology in the heart or lungs that might increase the risk of an adverse reaction.

Immediate intravenous access for emergency drug administration is one of the most important factors in the successful treatment of cardiovascular or respiratory failure in either the awake or the anesthetized patient. By placing an intravenous (IV) catheter and line before anesthesia, your veterinarian can ensure that this lifeline is already in place, should the need arise. Anesthetics, fluids and emergency drugs can be administered through the IV line.

Intravenous fluids help maintain blood pressure in the anesthetized patient and will replace lost fluids (during surgery, fluids are lost through evaporation from body cavity surfaces, through bleeding, and in any tissues that are being removed). Upon completion of the procedure, intravenous fluid therapy speeds the recovery process by diluting the anesthetic agents circulating in the blood stream and by enhancing their metabolism and elimination through the liver and kidneys. Patients that receive IV fluid therapy generally wake up faster than those that do not. Additionally, studies have shown that 0.9 - 2% of all patients that receive general anesthesia will develop kidney dysfunction or failure 7-14 days after anesthesia. This risk is significantly reduced in patients that receive peri-operative intravenous fluid therapy. Although 98% of all pets will have no problem, your veterinarian's goal is to eliminate that unknown 2%.

"All surgery patients should receive intravenous catheterization and fluid therapy."

For these reasons, all surgery patients should receive intravenous catheterization and fluid therapy.

You should ensure that your pet's complete medical history is available to your veterinarian, especially if your pet has been seen at another veterinary clinic. Before anesthetizing your dog, your veterinarian needs to know about any medications or supplements that your dog has received in the past few weeks, any pre-existing medical conditions, any known drug reactions, the results of previous diagnostic tests, and whether the dog has undergone any anesthetic or surgical procedures in the past. Other useful information includes the pet's vaccine status and reproductive status, (i.e. when was its last estrus or heat cycle).

Why do I have to sign an anesthetic consent form?

It is important that you fully understand what will happen to your pet, and that you acknowledge that you understand the risks. Usually, the form will also include consent to perform surgery or other specified diagnostic testing, and will provide an estimate of the expected costs of the procedures. In many areas, the veterinarian is required by their regulatory organization to obtain written consent from the client prior to performing anesthetic procedures.

Can you describe a typical anesthesia?

All anesthesia patients are weighed on admission and are given a thorough pre-anesthetic examination. This includes an examination of the chest, palpation of the abdomen, and assessment of the gums (checking for hydration status and evidence of good circulatory status. The medical history will be reviewed, and additional diagnostics such as blood or urine testing, blood pressure, electrocardiogram (ECG) or x-rays of the chest or abdomen may be performed prior to administration of any anesthetic drugs.

"With balanced anesthesia, the patient receives a combination of sedatives and anesthetic agents..."

In the great majority of cases, a technique called 'balanced anesthesia' is used. With balanced anesthesia, the patient receives a combination of sedatives and anesthetic agents that is based on its body weight and best suited to its individual needs. The most common combination is a pre-anesthetic sedative and analgesic combination that is administered by injection, followed by an induction agent that is also administered by injection, and maintenance of the anesthetized state with an anesthetic gas mixed with oxygen. In order to ensure accurate delivery of the gas anesthetic, a breathing tube, called an endotracheal tube, is inserted into the windpipe or trachea. In addition to delivering the gas to the lungs, the endotracheal tube seals off the airway so that the patient does not accidentally aspirate fluids or other foreign material while s/he is unconscious and unable to swallow.

VCA Veterinary Specialists of CT

993 North Main Street

West Hartford, CT 06117

Main: 860-236-3273

Fax: 860-236-3275

Hospital Hours:

    Mon-Sun: Open 24 hours

Specialty Appointment Hours::

Monday - Friday: 8:00am - 6:00pm Saturday & Sunday: ER only

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