Canine CPR: Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary resuscitation (CPR) is the treatment required to save an animal (or human) life when he or she has suffered respiratory and/or cardiac arrest. CPR consists of two parts: Rescue breathing and chest compressions.
These two techniques combine to keep the lungs supplied with oxygen and keep blood circulating, carrying oxygen to the other parts of the body. Basic CPR is CPR performed by trained bystanders at the scene of the arrest. Advanced CPR is CPR performed by trained teams of professionals. Basic CPR is the most important, and will be described in this section.
All tissues require a steady source of oxygen. If the source is interrupted for only a few minutes, irreversible damage may be done. If an arrest occurs, basic CPR must be initiated at the scene.
Basic CPR: Rescue Breathing
Make Certain the Animal is Actually Arrested and Unconscious
Talk to the animal first. Gently touch and attempt to awaken the pet. You could be seriously injured should you attempt to perform CPR on a pet who was only sleeping heavily and was startled awake.
Ensure an Open Airway
- Extend the head and neck and pull the tongue forward.
- Look in the mouth and remove any saliva or vomitus. If it is too dark to see into the mouth, sweep your finger deep into the mouth and even into the throat to remove any vomitus or foreign body. Be aware of a hard, smooth, bone-like structure deep in the throat. This is likely to be the hyoid apparatus (Adam’s apple). Serious injury could result if you pull on the hyoid apparatus.
Observe for Effective Breathing
Sometimes an animal will begin to breathe spontaneously when the head is put in the position discussed above (head and neck extended, tongue pulled forward). Watch for the rise and fall of the chest while listening closely for sounds of breathing. If no breathing is evident in 10 seconds, begin rescue breathing.
Begin Rescue Breathing
Rescue breathing is performed by covering the animal’s nose with your mouth and forcefully blowing your breath into his lungs. In cats and small dogs, you must hold the corners of the mouth tightly closed while you force the air in.
In larger dogs, the tongue should be pulled forward and the mouth and lips held shut using both hands cupped around the muzzle. Force the air into the lungs until you see the chest expand. Take your mouth away when the chest has fully expended. The lungs will deflate on their own. Air should be forced into the animal’s lungs until you see the chest expand.
Give 3 to 5 Full Breaths
After several breaths are given, stop for a few seconds to recheck for breathing and heart function. If the pet is still not breathing, continue rescue breathing 20-25 times per minute in cats or small dogs, or 12-20 times per minute in medium or large dogs. Push down on the stomach area every few seconds to help expel the air that may have blown into the stomach. If the stomach is allowed to distend with air, the pressure will make the rescue breathing efforts less effective.
If Breathing is Shallow or Non-existent and the animal is still unconscious, continue rescue breathing 10 to 15 times per minute and transport the animal to the nearest veterinary facility.
Basic CPR: Chest Compressions
- After Giving 3 to 5 Breaths, Check for a Pulse
- If no pulse is detectable, begin chest compressions.
In Small Dogs or Cats
Squeeze the chest using one or both hands around the chest. Depress the rib cage circumferentially. Do this 100 to 150 times per minute.
In Large Dogs
Compress the chest wall with one or two hands, depending on the size of the dog (and the size of the rescuer). If the dog is on her side, place the hand(s) on the side of the chest wall where it is widest. If the dog is on her back, place the hand(s) on the sternum (breastbone). Depress the rib cage or sternum 1.5 to 4 inches, depending on the dog’s size. Do this 80 to 120 times per minute.
Coordinate Rescue Breathing and Chest Compressions
Give breaths during the compressions, if possible. If it is not possible to give breaths during the compressions, give two breaths after every 12 compressions.
When Two or More Rescuers are Working Together
Rescue breathing should be given during every second or third heart compression.
Continue CPR Until
- You become exhausted and can’t continue.
- You get the animal transported to a veterinary facility and professionals can take over. The pulse is palpable or heartbeats are felt and they are strong and regular. In the vast majority of cases, artificial ventilations will continue to be required for a period of time, even though heart function has returned. This is due to nervous system depression secondary to the arrest.
All resuscitated animals should be transported to a veterinary facility for further examination and care!
Secondary Survey
The secondary survey is performed once resuscitation measures have been successfully performed or when it is decided that resuscitation measures are not required. In some circumstances (because of ongoing resuscitation), the secondary survey is never completed and the animal is transported directly to the veterinarian or emergency hospital during resuscitation.
A general examination (from the tip of the nose to the end of the tail) should be performed. Determine and record:
- pulse rate and character
- respiratory rate and character
- mucous membrane color
- capillary refill time
- rectal temperature
Examine the eyes, ears, nose, neck, mouth (if possible), chest, abdomen, back, pelvis, legs, and tail. First aid treatment should be performed as necessary during transport to the veterinarian.
Taking and recording your pet’s pulse is an important part of the secondary survey.
When to call your vet
The following information may help you decide which conditions are absolute emergencies, and which ones may let you take a “wait and see” attitude. If your dog is sick or injured and you are unsure of the severity of the condition, it is always best to err on the side of caution, and contact your veterinarian (or emergency clinic) right away.
Contact your veterinarian immediately if your dog:
Has signs of heart or respiratory disease including:
- No pulse or heart beat
- No breathing or severe difficulty breathing
- Bluish or white gums or tongue
- A near drowning
Has been exposed to a toxin or poison or has had trauma including:
- A broken bone, or a cut that exposes a bone
- Heavy bleeding that cannot be stopped
- An eye injury, the eye is out of the socket, or appears enlarged or protruding
- A fight, especially if it was with a cat or a wild, or unvaccinated animal
- A wound from a bullet or arrow
- Being hit by a vehicle or other large fast-moving object
- Puncture wounds to the abdomen or chest
- Any trauma to the head
- A bite from a snake, scorpion, or poisonous spider; or has bitten a toad
- Porcupine quills imbedded in the mouth, face, or body
- A broken tooth, or the loss of a healthy tooth, including the root (keep the tooth in a small jar of milk)
- A severe laceration, or an incision that has opened and the skin is gaping
- Falling or jumping from an open window, balcony, etc.
- Swelling of the face and/or hives
Has had heat or cold related injuries including:
- Chewing on an electrical cord and receiving a shock or burn
- Burns or inhaled smoke
- Heat stroke or a fever over 105°F (normal is less than 102.5°F)
- Frostbite or hypothermia
Has signs of gastrointestinal distress including:
- Straining continually, but unable to produce feces
- Bloat (abdomen appears large or dog attempts to vomit, but cannot bring anything up)
- Choking
- Vomiting blood or uncontrolled vomiting
- Swallowing a foreign body (e.g., toy)
- Diarrhea with blood, a foul smell, or that is uncontrolled
- Black, tarry stool
- A protruded rectum or bleeding from the rectum
- An overdose of medication or suspected poisoning
Has signs of nervous system or muscular disease including:
- Extreme lethargy or depression, unconsciousness, collapse, or coma
- Seizures
- A head tilt, nystagmus (eyes move rapidly from side to side), staggering, walking in circles, knuckling over (walking on the top of the foot), unable to use hind limbs, or other problems moving
- Severe or continuous pain
- Sudden inability to bear weight on one or more limbs
Has signs of urinary or reproductive problems including:
- Difficulty giving birth: no puppy after 24 hours of beginning labor; no puppy after 1 hour of active straining; over 4 hours between deliveries; weak or infrequent contractions once labor has started; failed to start delivery within 24 hours of the temperature dropping below 99°F; crying or licking the genital area excessively; abnormal bleeding or vaginal discharge; weakness
- A male in whom the penis is exposed and cannot be withdrawn back into the sheath (the hair-covered area that usually encloses the penis)
- Straining continually but unable to pass urine, or the urine has blood in it
- Crying while trying to urinate
- Bleeding from the urinary or genital area
Contact your veterinarian the same day if your dog:
Has signs of heart or respiratory disease including:
- Some difficulty breathing, shallow breathing, or breathing at a faster rate (unassociated with physical exercise or environmental temperature)
- Continuous sneezing or coughing
Has signs related to digestion or food and water consumption including:
- Not eating or drinking for 24 hours
- Vomiting or diarrhea for more than 24 hours and acting depressed
- Drinking water excessively, unrelated to activity or environmental temperature
Has signs of nervous system or muscular disease including:
- Sudden change in behavior
- Crying when touched or picked up
- Cloudy eyes, squinting, or appears to be unable to see
- Sudden, severe lameness
Has signs of urinary or reproductive problems including:
- A retained afterbirth for over 8 hours
- A female who has had an unwanted breeding
- A female who is pregnant or nursing her young and develops a red, swollen, or painful breast
- A male with swollen testicles or scrotum
Has signs associated with the skin including:
- A rash, excessive shedding, excessive head shaking, or persistent scratching or chewing at spots on the body
- Abnormal lumps or bumps that are painful, red, and/or hot to the touch
- Maggots
- A nosebleed for no apparent reason, bruising easily, or tiny red dots on the skin
Contact your veterinarian in 24 hours if your dog has signs including:
Has signs related to digestion or food and water consumption including:
- Not eating, but no other signs of illness
- A soft stool, but there is no pain, blood, fetid odor, green or black color, mucus, or straining
- Occasional vomiting (2 or 3 times), but no abdominal pain or blood
- Foul breath
- Sudden weight gain or loss
- Drooling
Has signs of nervous system or muscular disease including:
- Lameness for more than 24 hours
- Swollen joints
- Lethargy, depression, sleeping more than usual, unwillingness to play or exercise
Has signs associated with the skin including:
- Moderate itching or an unpleasant odor from the coat
- A discharge from the eye, ear, or other body opening
At one time or another every dog has a bout of vomiting or diarrhea. Usually they have eaten something disagreeable, eaten too much, too fast or exercised too soon after eating, are overly excited or nervous, or their body is reacting to any of a number of other non-serious conditions.
If your dog is not showing other signs of illness, you can save yourself a trip to the vet if you wait 12 hours and do the following:
Take away all food and water so that the irritated intestinal tract can settle down. Nothing makes a vomiting dog vomit more than a big drink of water or a large meal. You may allow the dog to drink very small amounts, and in this short time, if your dog is otherwise healthy, you do not have to worry about dehydration. If the diarrhea resolves, after 24 hours, you may give your dog very small amounts of a bland food, such as drained, cooked hamburger mixed with an equal amount of cooked rice.
Observe your dog closely. Is behavior and activity otherwise normal? Think about and try to identify the cause of the problem. Could your dog have eaten something (like grass, garbage, or a dead animal) that upset its digestive system? Has your dog been wormed lately? Watch how your dog vomits or eliminates so you can describe it to your vet if symptoms persist. Examine the stool or vomit. Collect samples if you believe you will need to take your dog in. Monitor the dog’s weight for possible weight loss.
When you should call your veterinarian
Vomiting:
- blood in vomit
- vomiting accompanied by diarrhea
- vomit looks and smells like stool
- vomiting is projectile
- vomiting is sporadic and there is no relationship to meals
- multiple bouts of vomiting occur over a short period of time
- ingestion of a poison (like antifreeze or fertilizer) is suspected
- vomiting persists more than a day or two
- stomach bloating occurs or your dog tries to vomit but can not
- dog also appears listless
- there is weight loss
- dog is showing other signs of illness such as labored breathing or pain
Diarrhea:
- bloody diarrhea
- diarrhea accompanied by vomiting
- multiple bouts of vomiting occur over a short period of time
- ingestion of a poison is suspected
- fever and other signs of toxicity are present
- diarrhea persists more than a day or two
- dog also appears listless
- there is weight loss
- dog is showing other signs of illness such as labored breathing or pain
Q. How does a veterinarian assess if a pet is dehydrated?
A. Testing dehydration on this Beagle pupOne way to assess hydration in an animal is to lift the skin over the animal’s shoulder and watch how fast it goes back to its normal position. In a normal, healthy animal, if the skin between the shoulders is lifted up and then released, the skin will pop back to its normal position immediately.
In dehydrated animals, there is less fluid in the skin and it is less elastic. When lifted off the back, the skin of a dehydrated animal will not immediately fall back to its normal position. If a pet has lost 6-8% of its normal fluid, there will be a definite delay in the skin returning to its normal position. If the pet is 10-12% dehydrated, the skin will actually look like a tent and not go back to its normal position. Signs of shock may be evident. If a pet is over 12% dehydrated, it is an extreme emergency.
Other ways to assess dehydration are to examine the mucous membranes (gums); they should be moist. In a dehydrated animal, the eyes may appear sunken in. In very dehydrated animals the heart rate may be increased, but the pulse would be weak.