Most animal medical treatments are initially modeled from the therapies developed for humans.
We have found this to be a good starting point but as every veterinary student is taught, “animals are not small people,” those developed specifically for animals are better.
The techniques and benefits of cardiopulmonary resuscitation are well documented and described for people. As veterinarians, we have adopted these human recommendations for CPR for our patients, and they have provided us with a good starting point.
Fortunately, a group of veterinarians put together the RECOVER (Reassessment Campaign on Veterinary Resuscitation) initiative to develop the first veterinary specific recommendations for dog and cat CPR, with the plan to update these findings every five years.
These were recently published in the June issue of the Journal of Veterinary Emergency and Critical Care.
As pet owners, you should be aware of what these recommendations are since the sooner CPR is started, the better chance of survival.
Dr. Carrie Davis, the director of Emergency Medicine, at Veterinary Specialty Care in Mount Pleasant, stressed in a recent presentation to pet owners, the first thing to know is when to start CPR.
To do this, you must be able to identify cardiopulmonary arrest (CPA) or, simply put, when your pet has stopped breathing and its heart has stopped beating.
Here, Davis stressed using the ABCs as for humans.
A means quickly assess the airway. Is there a foreign body that could be preventing air passage?
B means breathing. Place a hand on their chest to feel for movement or your cheek next to their nose.
C means circulation. This one is more difficult to assess even for us. A pulse can be difficult to feel sometimes even in healthy patients. The best quick method is to place a hand over their heart and feel for beating.
All of these should be checked as quickly as possible, as the longer CPR is postponed, the greater chance of permanent injury or death. Davis explained that since the risk of injury from CPR is low (less than 2 percent of people receiving CPR experience any serious injuries), it is better to start and be wrong than to wait.
The RECOVER initiative made specific recommendations for how CPR should be performed in pets.
Once cardiopulmonary arrest has been identified, chest compressions should be started. To be affective, they must be high quality with minimal interruptions.
Place your pet on their side, feet away and their back against your body. Place one hand on top of the other and compress 1/3 to ˝ chest width 100-120 times a minute.
The hand location for large breeds is at the widest portion of their chest, and for deep chested dogs (greyhounds), directly over the heart.
CPR in small dogs and cats can be done similar to greyhounds or by wrapping your hand around the sternum and squeezing the chest between your fingers and thumb.
Recent recommendations in human CPR stress compressions and to not be as concerned with breathing. However, for pets, breathing is still felt to be important. The difference arises from the fact that people primarily require CPR for cardiac reasons while for animals this is rare.
To give a breath, hold your pet’s mouth shut and place your mouth over both of their nostrils. Breathe out and inflate their lungs until you see a normal chest rise.
The cycle should be done at 30 compressions, then two breaths. Ideally there are two people: one compressing and one breathing. When done properly, the person compressing will fatigue quickly, resulting in poor quality compressions. For this reason the RECOVER initiative recommends the breather and compressor alternate every two minutes.
You stop CPR when they are breathing, and their heart is beating. While still administering CPR, or once they recover, get them to a veterinarian as soon as possible. The initiative also covered areas of advanced life support that your veterinarian can initiate once you arrive.
Do not drive and administer CPR. You can do neither effectively at the same time.
In an ideal situation, there would be four people involved, one to compress, one to breathe, one to time cycles and one to drive.
This many people may not be quickly available. Dr. Davis recommends if you are alone and cannot quickly get help, get your pet to the ER. If there are only two people, one should perform CPR and the other drive.
Unfortunately, CPR even when performed in a veterinary hospital, does not provide outcomes as well as those seen in people. Less than 6 percent of dogs and cats that need CPR while in the hospital go home. This is partly because the diseases they succumb too are often not reversible as in humans. However, things like choking and drowning that occur at home may have a better outcome if CPR is initiated sooner.
Knowing how to perform CPR on your pet may save his life.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.