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Fainting (Syncope)

Author: Dr. med. vet. Gisa Löwe | Last modified: 06.02.2026

Fainting (SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.)
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is a short-term loss of consciousness due to a temporary lack of blood flow to the brain. Common causes include cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems., heart disease, circulatory problems, or severe pain/stress reactions. Any recurring or prolonged fainting must be urgently clarified.

SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., also known colloquially as fainting, is a sudden, short-term and completely reversible loss of consciousness caused by a temporary lack of blood flow to the brain. This neurological phenomenon involves acuteAcute refers to a condition that occurs suddenly and is usually of short duration. In a medical context, it describes symptoms or illnesses that can quickly become serious and require immediate attention. cerebral hypoperfusion, which leads to an abrupt collapse of the animal. In contrast to other disorders of consciousness such as seizures or narcolepsy, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is typically of short duration (usually less than one minute) and is characterized by complete recovery without neurological residues.

The prevalence of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is significantly higher in dogs than in cats. This is due, among other things, to anatomical and physiological differences in the cardiovascular system as well as the different frequency of predisposing underlying diseases. In cats, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is a real rarity, while in dogs, especially in certain breeds with cardiological predispositions, it is observed more frequently.

The pathophysiological basis of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is a reduction in cerebral blood flow of approximately 30–35% or a drop in systemic blood pressure below 60 mmHg. This critical hypoperfusion leads to a lack of oxygen and glucoseGlucose is a simple sugar and the body’s main source of energy. The concentration of glucose in the blood is regulated to meet the energy needs of the cells. in the brain, which means that normal brain function cannot be maintained temporarily.

Causes

Fainting (brief loss of consciousness, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.) occurs when the brain is temporarily not supplied with enough blood, resulting in a lack of oxygen.
In most cases, the loss of consciousness is only brief, but it can be an expression of a serious heart dysfunctionDysfunction refers to an impaired or abnormal function of an organ or system in the body. This can be due to diseases, disorders, or damage and can affect the quality of life.. In most cases, cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems. or diseases of the pericardiumThe pericardium is the sac around the heart, a double-walled membrane that surrounds the heart, protecting it from infection and facilitating its movement within the thorax / chest. Inflammatory conditions of the pericardium can lead to diseases such as pericarditis. are the cause.
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. occurs more often in dogs. They are a rarity in cats.
Loss of consciousness can also occur after a traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries. or fall.

Supplement

The etiologyEtiology is the study of the causes and origins of diseases. It deals with the factors that contribute to the emergence and development of pathological conditions. of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. in small animals is diverse, with cardiovascular causes predominating. In principle, the causes can be divided into the following categories:

Cardiac causes are the main concern in dogs and include cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems. (arrhythmias) such as bradyarrhythmias (e.g. third-degree AV block, sinus node dysfunctionDysfunction refers to an impaired or abnormal function of an organ or system in the body. This can be due to diseases, disorders, or damage and can affect the quality of life.), tachyarrhythmias (e.g. ventricular tachycardiaTachycardia refers to an unusually fast heartbeat with a resting heart rate of over 100 beats per minute. It can indicate physical exertion, stress, illness, or heart problems., supraventricular tachycardiaTachycardia refers to an unusually fast heartbeat with a resting heart rate of over 100 beats per minute. It can indicate physical exertion, stress, illness, or heart problems.) and structural heart diseases such as cardiomyopathies, heart valve diseases or congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. heart defects. Brachycephalic breeds such as pugs, French and English bulldogs are particularly prone to cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. due to their anatomical features and predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases. for heart disease.

In Dobermans, boxers and Cavalier King Charles Spaniels, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. occurs more frequently due to breed-specific heart diseases such as dilated cardiomyopathy or mitral valve endocardiosis. Maine Coon and Ragdoll cats may also be affected due to their genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases. for hypertrophic cardiomyopathy, although syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is generally rare in cats.

Non-cardiac causes include neurocardiogenic (vasovagal) syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., which is triggered by a sudden drop in blood pressure as a result of a reflex, orthostatic hypotension with rapid changes in position, and metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. disorders such as hypoglycemiaHypoglycemia is a condition in which blood sugar levels fall below the normal range. Symptoms may include tremors, sweating, Hunger, confusion, and in severe cases, loss of consciousness., severe anemia or hypoxiaHypoxia refers to a condition in which the body or a part of the body is not supplied with enough oxygen. This can lead to various symptoms, including shortness of breath, confusion, and in severe cases, organ failure.. Conditions such as carotid sinus hypersensitivity, situational syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. (e.g. with cough, gagging or defecation) and drug side effects can also lead to syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems..

Traumatic events such as traffic accidents or falls can also lead to temporary loss of consciousness, which, however, is pathophysiologically different from classic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems..

Symptoms

Fainting (syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.) in dogs and cats

Typical Symptoms:

Sudden collapse with brief loss of consciousness
Animal collapsing
Of short duration
Rapid recovery within seconds–minutes
Often related to excitement, cough, exertion
No urination

Alarm signs:

Repeated syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., very slow or extremely fast pulse
CyanosisCyanosis refers to a bluish discoloration of the skin and mucous membranes, caused by an inadequate oxygen supply to the blood. It can be a sign of heart, lung, or blood diseases., dyspneaDyspnea, also known as shortness of breath, is the subjective feeling of breathlessness or difficulty breathing. It can be a symptom of a variety of conditions, including heart disease, lung disease, and anemia., persistentPersistent means lasting or continuing for an extended period. In veterinary medicine, it can refer to chronic diseases or symptoms that do not subside. weakness after event
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. during exertion or without triggerA trigger is a stimulus that elicits a specific reaction or state. In veterinary medicine, this can refer to emotional responses, such as fear or aggression, or medical conditions, such as seizures in dogs and cats.
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. + convulsive movements lasting longer (DD seizure)

Escalation/course:

More frequent episodes in a short time → arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems./heart disease more likely
Recovery not rapid or impaired consciousness remains → critical
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. + dyspneaDyspnea, also known as shortness of breath, is the subjective feeling of breathlessness or difficulty breathing. It can be a symptom of a variety of conditions, including heart disease, lung disease, and anemia. → potentially acute heart/lung problem

The clinical presentation of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is characteristic and usually follows a typical pattern. The loss of consciousness occurs abruptly and leads to the animal suddenly collapsing. This event may be preceded by prodromal symptoms, which, however, are often only recognized retrospectively by the pet owner:

Before the actual syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., signs such as restlessness, weakness, staggering / ataxia, tremors or brief disorientation may occur. During syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., the animal lies flat on its side, shows no reaction to external stimuli and has pale cyanotic mucous membranes. Breathing may be shallow or briefly absent, the pulse is weak or barely palpable. In contrast to epileptic seizures, tonic-clonic seizures, involuntary urination or defecation, and preictal and postictal phases are typically absent.

The duration of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is mostly only a few seconds to a maximum of one to two minutes. Recovery is spontaneous and complete, with the animal appearing normal again immediately after the event or only briefly disoriented. In cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., the episodes can be triggered or worsened by physical exertion, excitement or stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being..

Particularly important for the differential diagnosisDifferential diagnosis is the process of weighing two or more conditions that cause similar symptoms to determine the specific cause of a patient's symptoms. is the differentiation from other disorders of consciousness: In contrast to vestibular syndromeA syndrome is a group of symptoms that occur together and indicate a specific disease or condition. A syndrome can be caused by various factors and is often complex in its diagnosis and treatment. in older animals, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. lacks head tilted to one side and nystagmus. Unlike epileptic seizures, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. does not involve chewing movements, salivation or a postictal phase with confusion. In narcolepsy, on the other hand, the animal is awakened by external stimuli, which is not the case with syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems..

First Aid

Lay your pet on its right side, remove the muzzle, open its mouth and gently (!) pull the tongue forward.
If there are no injuries and the animal is breathing, leave it lying on the floor on its side until it wants to get up on its own. Do not carry it onto the couch or the like. It could stagger / ataxia and fall down when trying to get up.
If you are out and about, stop a walk immediately. Give the animal plenty of time to recover on the spot. Loosen the collar.
If your pet does not get up on its own within a minute or has severely bleeding injuries, try to take it to a vet immediately. If necessary, call other people for help.
In the event of very heavy bleeding after a fall or traumaA trauma refers to a physical injury or damage caused by external force. Traumas can range from simple cuts to severe multiple injuries. of another cause (traffic accident), try to stop or reduce the bleeding by compression until you arrive at the vet.
If you do not detect any breathing or cardiac activity, you can also perform cardiac massage and ventilation (see – > resuscitationResuscitation includes measures to revive animals after a cardiac arrest or severe respiratory depression. These may include chest compressions and artificial respiration., Reanimation) on the animal.
Bear in mind that this is sometimes a small organism and you must not use more force than you would, for example, with small children of comparable size.
Apply the pressure to the heart region just behind the elbow on the left side of the body with your animal lying on its right side and possibly hold something against it on the right with your other hand. After approx. 15 pressure pulses, ventilate once. Then follow approx. 15 pressure pulses again, etc.
When ventilating via the nostrils, use a cloth, bend the animal’s head back slightly and do not blow too hard. The chest should only lift slightly. If you do not bend the animal’s head back, you may blow your breath into the animal’s stomach.

Diagnosis

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. requires a systematic approach that begins with a thorough medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits.. Particularly important is detailed information about the exact circumstances of the event, its duration, triggering factors and the behavior of the animal before, during and after the episode. Video recordings of the episodes by the owner can be extremely helpful in differentiating between syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. and other disorders of consciousness.

The clinical examination includes a thorough cardiovascular and neurological evaluation. AuscultationAuscultation is an examination method in which the doctor uses a stethoscope to listen to the sounds in the body, especially in the heart, lungs, and intestines, in order to obtain information about the state of health. to detect heart murmurs, arrhythmias or heart rate changes as well as the assessment of pulse quality and mucous membrane color are necessary. The neurological examination serves to exclude primary neurological causes.

Further diagnostic procedures include:

An electrocardiogramSee ECG. (ECG) is essential for the identification of cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems.. Since many arrhythmias occur intermittently, a long-term ECG (Holter monitoring) over 24–48 hours or an implantable loop recorder may be necessary for rare episodes. The echocardiographyEchocardiography is an ultrasound examination of the heart that assesses the structure and function of the heart valves and chambers. It can provide information about heart size, pumping function, and the presence of heart disease. enables the assessment of the heart structure and function and is particularly important in case of suspected structural heart diseases or congenitalCongenital means "present from birth" and refers to characteristics or conditions that are already present at birth. This can include genetic disorders, developmental anomalies, or infections transmitted by the mother. defects.

Laboratory tests including blood count, serumSerum is the liquid part of the blood that remains after coagulation. It does not contain blood cells or coagulation factors, but many other proteins, antibody and electrolytes. Serum is used in diagnostics for a variety of blood tests. biochemistry, electrolytesElectrolytes are minerals in the body that carry an electric charge and perform vital functions such as regulating fluid balance, acid-base balance, and nerve and muscle activity. The main electrolytes include sodium, potassium, chloride, and magnesium. and thyroid values help to identify metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. causes. A glucose tolerance test is indicated if hypoglycemiaHypoglycemia is a condition in which blood sugar levels fall below the normal range. Symptoms may include tremors, sweating, Hunger, confusion, and in severe cases, loss of consciousness. is suspected. Imaging procedures such as chest X-ray to assess heart size and lung structure as well as advanced imaging (CT, MRI) in selected cases if intracranialIntracranial refers to anything located within the skull. Intracranial conditions in dogs and cats include Tumors, infections, and cerebral edema, which can cause neurological symptoms. pathologies are suspected can supplement the diagnostics.

In complex cases, electrophysiological studies for more accurate characterization of cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems. or a tilt table test for the evaluation of neurocardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. may be necessary. However, these specialized procedures are only available in cardiologyCardiology is the branch of medicine that deals with diseases and disorders of the heart and circulatory system. Cardiologists diagnose and treat heart conditions such as coronary artery disease, heart failure, and arrhythmias. reference centers.

The differential diagnosisDifferential diagnosis is the process of weighing two or more conditions that cause similar symptoms to determine the specific cause of a patient's symptoms. includes epileptic seizures, narcolepsy/cataplexy, vestibular syndromeA syndrome is a group of symptoms that occur together and indicate a specific disease or condition. A syndrome can be caused by various factors and is often complex in its diagnosis and treatment., collapse due to orthopedic problems, weakness due to metabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. disorders and transient ischemic attacks.

Further veterinary measures

SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. can have many causes. In most cases, however, they are caused by reduced cardiac output, so more detailed examinations of cardiac function are advisable. ElectrocardiogramSee ECG., echocardiographyEchocardiography is an ultrasound examination of the heart that assesses the structure and function of the heart valves and chambers. It can provide information about heart size, pumping function, and the presence of heart disease., X-rayX-ray is an imaging technique that uses X-rays to create images of the inside of the body. It is often used to diagnose bone fractures, lung diseases, and other conditions. and certain laboratory tests are in the foreground.
In some cases, neurological examinations are necessary.
Only after clarifying the cause is appropriate therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. possible.

Supplement

The treatment of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is primarily based on the underlying cause and follows an individually adapted therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. concept. In cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., the treatment of the heart disease is the main focus.

In bradyarrhythmias such as third-degree AV block or sinus node dysfunctionDysfunction refers to an impaired or abnormal function of an organ or system in the body. This can be due to diseases, disorders, or damage and can affect the quality of life., the implantation of a permanent pacemaker may be indicated. This therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. option is now available in specialized veterinary centers and shows good long-term results with careful patient selectionSelection refers to the process of natural or artificial selection of specific individuals for reproduction, based on desired genetic traits. In breeding, this is applied to promote specific characteristics in dogs and cats.. Alternatively, drugs such as theophylline or terbutaline can be used to increase the heart rate, although their effectiveness is limited.

In tachyarrhythmias, antiarrhythmics are used. Sotalol, mexiletine or amiodarone are often used for ventricular tachycardias, while beta blockerBeta blockers are a class of medications used to lower blood pressure, treat cardiac arrhythmia, and reduce the heart's workload. They work by reducing the effect of epinephrine on the heart. (e.g. atenolol), calciumCalcium is a mineral that is essential for building and maintaining strong bones and teeth. It also plays a role in blood coagulation, nerve transmission, and muscle contraction. channel blockers (e.g. diltiazem) or digoxin are used for supraventricular tachycardias. The choice of medication is based on the specific arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems., comorbidities and potential side effects.

Structural heart diseases are treated according to their type. In heart valve diseases, ACE inhibitorACE inhibitors are medications that inhibit angiotensin-converting enzyme, thereby lowering blood pressure. They also have a protective effect on the kidneys. They are used in dogs and cats to treat heart disease, high blood pressure, and certain kidney diseases., diureticsDiuretics are medications that increase urine production in the kidneys to rid the body of excess salt and water. They are often used to treat high blood pressure, heart failure, and certain types of edema. and pimobendan are used, while cardiomyopathies are treated with beta blockers, calciumCalcium is a mineral that is essential for building and maintaining strong bones and teeth. It also plays a role in blood coagulation, nerve transmission, and muscle contraction. channel blockers or heart failure therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., depending on the type.

In neurocardiogenic (vasovagal) syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., the focus is on avoiding triggering factors. In addition, fludrocortisone can be used to increase blood volumeBlood volume is the total amount of blood circulating in an organism's circulatory system. Changes in blood volume can indicate various health conditions, including dehydration or cardiovascular disease. or beta blockers to dampen the cardiac reflex response.

MetabolicMetabolic refers to metabolism, i.e. the entirety of chemical processes that take place in a living organism to enable life processes. Metabolic disorders can cause a variety of Diseases in Dogs and cats. causes require specific therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. of the underlying disease, in particular the treatment of hypoglycemiaHypoglycemia is a condition in which blood sugar levels fall below the normal range. Symptoms may include tremors, sweating, Hunger, confusion, and in severe cases, loss of consciousness. by adjusting the feeding or insulininsulin is a hormone produced by the pancreas. It regulates blood sugar levels by promoting the entry of glucose into cells. insulin deficiency or impaired insulin action are key features of diabetes mellitus. therapy in insulinomasInsulinomas are rare Tumors of the pancreas that produce excessive insulin and can lead to low blood sugar levels. They occur in dogs and cats and require careful diagnosis and treatment..

In addition to drug therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions., adjustments to lifestyle habits are important. These include avoiding excessive physical exertion in cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. reduction and the use of chest harnesses instead of collars in predisposed animals. In brachycephalic breeds, weight loss can help improve cardiorespiratory function.

Prognosis and aftercare

The prognosis for syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. varies considerably and depends largely on the underlying cause. In general, syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. of cardiogenic origin has a more guarded prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. than those with non-cardiac causes.

In the case of cardiac arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems., the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. depends on the type of arrhythmiaAn arrhythmia is a heart rhythm disorder in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Arrhythmias can be harmless or a sign of serious heart problems. and the treatment options. Patients with third-degree AV block who receive a pacemaker show a significantly improved life expectancy with survival rates of 85–90% in the first year after implantation. In the case of malignantMalignant means "cancerous" and is used to describe tumors or neoplasms that grow invasively and have the ability to metastasize. Malignant tumors can cause serious health problems in dogs and cats. ventricular arrhythmias, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is more reserved, but it can be improved with appropriate antiarrhythmicAntiarrhythmic medications are substances used to treat and provide prevention of irregular heartbeats. They work by stabilizing the electrical activity of the heart. therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions..

Structural heart diseases such as dilated cardiomyopathy or advanced mitral valve endocardiosis are associated with a poorer prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. because they are often progressiveProgressive describes a condition or disease that worsens over time. This term is often used to characterize the course of an illness that causes increasingly severe symptoms or damage.. Here, the median survival time after the onset of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is often only 6–18 months, despite optimal drug therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions..

In neurocardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally good, provided that triggering factors can be identified and avoided. These patients often have a normal life expectancy with adequate management.

Follow-up plays a crucial role in the management of patients with syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.. Regular check-ups are necessary to monitor the response to therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. and make adjustments if necessary. In the case of cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., cardiological check-ups with ECG and, if necessary, echocardiographyEchocardiography is an ultrasound examination of the heart that assesses the structure and function of the heart valves and chambers. It can provide information about heart size, pumping function, and the presence of heart disease. are generally recommended every 3–6 months.

In patients with pacemakers, special checks are necessary to check the pacemaker function and battery capacity. Some modern devices allow telemedical monitoring.

For pet owners, documenting the frequency and severity of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. episodes is important. A diary can help to identify patterns and assess the success of the therapy. In addition, owners should be trained to recognize warning signs that could indicate a deterioration.

Summary

Syncope in dogs and cats is defined as a sudden, brief, and completely reversible loss of consciousness due to temporary cerebral hypoperfusion. They occur much more frequently in dogs than in cats and can indicate various underlying diseases, with cardiovascular causes dominating.

The symptomatologySymptomatology refers to the entirety of symptoms associated with a particular disease or condition. It describes how a disease manifests itself externally. is characterized by a sudden collapse of the animal with brief loss of consciousness without typical seizure activity and with complete recovery within a short time. The differentiation from other disorders of consciousness such as epileptic seizures or vestibular syndromeA syndrome is a group of symptoms that occur together and indicate a specific disease or condition. A syndrome can be caused by various factors and is often complex in its diagnosis and treatment. is clinically significant.

A diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. requires a systematic approach with thorough medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits., clinical examination, and targeted cardiological diagnostics. Electrocardiography, long-term ECG, and echocardiographyEchocardiography is an ultrasound examination of the heart that assesses the structure and function of the heart valves and chambers. It can provide information about heart size, pumping function, and the presence of heart disease. are central diagnostic procedures.

The therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. depends on the underlying cause and, depending on the findings, includes antiarrhythmicAntiarrhythmic medications are substances used to treat and provide prevention of irregular heartbeats. They work by stabilizing the electrical activity of the heart. medication, implantation of a pacemaker in certain bradyarrhythmias, or the treatment of structural heart diseases. In addition, adjustments to lifestyle habits and regular check-ups are necessary.

The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. varies considerably depending on the underlying disease. While neurocardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. often has a good prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop., cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. due to advanced heart disease is associated with a more guarded prognosis.

Outlook on current research

Research in the field of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. in small animals is constantly evolving and focuses on several promising areas. Current studies are investigating genetic predispositions for cardiac arrhythmias in various dog breeds. In particular in boxers, Dobermans and German Shepherds, genetic markers are being identified that are associated with an increased risk of arrhythmogenicArrhythmogenic refers to factors or substances that have the potential to cause or promote cardiac arrhythmia. syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.. These findings could lead to targeted genetic screenings in the future to identify at-risk animals early on.

In the field of diagnostics, miniaturized implantable long-term ECG recorders are being developed that are specially optimized for veterinary use. These devices enable continuous monitoring over months and can automatically detect and store arrhythmias. Initial clinical studies show promising results with significantly higher detection rates for intermittentIntermittent refers to something that occurs at intervals or starts and stops temporarily, such as intermittent Pain that comes and goes. arrhythmias compared to conventional Holter monitors.

The technology of pacemaker implantation for small animals is also constantly being improved. Newer devices are smaller, longer-lasting, and have more advanced programming options that allow for more individualized adaptation to the patient’s needs. In addition, wireless monitoring systems are being developed that enable telemedical monitoring of patients with a pacemaker, which means that complications can be detected earlier.

In the field of pharmacotherapy, new antiarrhythmicAntiarrhythmic medications are substances used to treat and provide prevention of irregular heartbeats. They work by stabilizing the electrical activity of the heart. substances with a more favorable side effectA side effect is an unwanted reaction to a medication or treatment. In animals, side effects can range from mild and temporary to severe and potentially life-threatening. profile are being investigated. Particularly promising are selective ion channel blockers that specifically act on certain cardiac ion channels and could thereby achieve a more targeted antiarrhythmicAntiarrhythmic medications are substances used to treat and provide prevention of irregular heartbeats. They work by stabilizing the electrical activity of the heart. effect with fewer systemic side effects.

Last but not least, interventionalInterventional describes medical procedures that are invasive to make diagnoses or treat diseases. Interventional techniques in veterinary medicine include surgeries, catheter procedures, and image-guided therapies. electrophysiology is gaining importance in veterinary medicine. Catheter ablationCatheter ablation is a minimally invasive procedure in which abnormal heart tissue that causes arrhythmias is destroyed using a catheter. This procedure is rarely used in dogs and cats and is reserved for specialized veterinary centers. procedures for the treatment of focalFocal refers to a limited or specific area. In medicine, this may concern a localized area where a disease or pathological process is active, such as a focal seizure that affects only part of the brain. arrhythmias, which have so far mainly been used in human medicine, are increasingly being adapted for selected veterinary patients. InitialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. experience reports show encouraging results in the treatment of supraventricular tachycardias in dogs.

These research approaches promise significant advances in the coming years in the understanding, diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients., and therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. of syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. in dogs and cats, which could ultimately lead to an improved quality of life and prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. for affected animals.

Frequently asked questions (FAQs)

What is the difference between syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. and an epileptic seizure in my pet?
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. involves a brief loss of consciousness without seizure activity, followed by immediate complete recovery. An epileptic seizure typically shows seizure activity (twitching, chewing movements), often urination or defecation, and a subsequent phase of confusion (postictal phase).
Are certain dog breeds particularly susceptible to syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.?
Yes, certain breeds have an increased risk. Brachycephalic breeds (pugs, bulldogs) due to their respiratoryRespiratory refers to breathing or the process of breathing. Respiratory diseases affect the respiratory tract and can impair the ability to breathe effectively. problems, Dobermans and boxers due to predisposing heart diseases, and Cavalier King Charles Spaniels due to frequent mitral valve diseases are particularly at risk.
Can a one-time syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. be an emergency, or should I wait?
Any first syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. should be considered an emergency and should be followed by a timely veterinary examination. Even if the animal recovers quickly, there may be a potentially life-threatening underlying disease.
How can I, as a pet owner, distinguish between syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. and simple stumbling or slipping?
In syncope, the animal completely loses consciousness and does not react to speech or touch for a short time. When stumbling or slipping, the animal remains conscious and reacts normally to its environment.
Can syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. be triggered by stress or excitement?
Yes, especially neurocardiogenic (vasovagal) syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. can be triggered by emotional stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being., anxiety or excitement. StressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. can also lead to a deterioration of cardiac function and thus to syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. in animals with heart disease.
What first aid measures should I take if my pet suffers syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.?
Lay your pet on its right side, ensure clear airways (stretch the head slightly, carefully pull the tongue forward), keep it warm and calm. Avoid hectic movements and carefully transport the animal to the vet after recovery.
Can an animal with recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. syncope lead a normal life?
With appropriate diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and treatment, many animals can lead a good life. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. depends on the underlying disease. Adjustments in everyday life (e.g. avoiding overexertion, stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being.) may be necessary.
Are pacemakers a realistic option for pets?
Yes, pacemakers are used successfully in dogs and less frequently in cats. The technology has been adapted for small animals and shows good long-term results. However, this option is only available in specialized centers and involves considerable costs.
How do syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. in cats differ from those in dogs?
SyncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems. is generally much rarer in cats than in dogs. When they occur, they are more often associated with severe structural heart diseases such as hypertrophic cardiomyopathy. The clinical presentation is similar, but diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. in cats can be more difficult due to their more hidden behavior.
Can dietary supplements or special diets prevent syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems.?
In primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. cardiogenic syncopeA syncope is a sudden, temporary loss of consciousness, usually due to a brief drop in blood pressure and reduced blood flow to the brain. Syncopes can be triggered by various factors, including stress or heart problems., there are no specific dietary supplements for preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring.. However, in heart diseases, sodium-reduced diets and certain supplements (e.g. taurine, omega-3 fatty acids) can have a supportiveSupportive refers to supportive treatments that aim to alleviate symptoms and improve quality of life without directly treating the underlying cause of the disease. effect. However, the basic treatment should always be drug-based.

Literature

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Killich, M. (ed.): Small animal cardiology, diagnosis and therapy of heart diseases in dogs, cats and domestic animals, part 2 diagnostics. Thieme Verlagsgruppe, Stuttgart, New York, Delhi, 2019, DOI: 10.1055/b-0038-163915
Löwe, G. and Löwe, O. (2021). Emergencies in dogs and cats – A veterinary Guide. Kynos-Verlag. 208 pp.
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