Emergencies and First Aid for Dogs and Cats. Part I: General Recommendations from the Veterinarian

Checklist for Calling the Vet in an Emergency

An unforeseen emergency with your dog or cat can suddenly affect any pet owner. In such moments, quick and structured action is crucial to provide your pet with the best possible help. This is precisely where a well-prepared checklist comes in, offering valuable guidance during the initial phone contact with the veterinarian. By noting down relevant information in advance and providing it in an organized manner, you support the treating veterinarian in quickly assessing the situation and increase the chances of successful initial care.

In a serious emergency, it is helpful to inform your veterinarian by phone (no email, no SMS) before you arrive. This allows them to make preparations and provide you with instructions on how to proceed.

You should be able to answer these questions if possible:

  • What kind of emergency is it? What do you notice?
  • When did the emergency occur?
  • Is the animal responsive and can it still stand?
  • What has been done so far?
  • What do the mucous membranes look like? If possible, what are the values for:
  • Body temperature (BT), respiratory rate (RR), heart rate (HR), and capillary refill time (CRT)? —> see “Normal Values”

What are Emergencies?

  • Respiratory or cardiac arrest
  • Difficulty breathing, gasping for air
  • Unconsciousness, temporary (collapse, syncope) or persistent (coma). Lateral recumbency. Pallor or bluish discoloration of mucous membranes (cyanosis)
  • Bleeding, Severe
  • Diarrhea, persistently bloody
  • Vomiting, bloody
  • Severely enlarged bladder
  • Altered heart rhythm (HR significantly increased – tachycardia, HR significantly decreased – bradycardia, HR irregular – arrhythmia)
  • Heatstroke
  • Capillary refill time (CRT) over 2 seconds
  • Body temperature elevated/decreased (above 41 °C – hyperthermia, below 35 °C – hypothermia). Seizures (epileptiform seizures)
  • Paralysis, sudden
  • Weakness, sudden
  • Severe trauma (accident, fall)
  • Poisoning
  • Eye injury
  • Injuries, severe (abdominal cavity injured, sternum injured). Burns

Table of Contents

Normal Values for Dogs and Cats Body Temperature – Respiratory Rate – Heart Rate – Capillary Refill Time

To detect critical changes in your pet, it is helpful to know what is “normal” or “still within normal limits”.

Observing bodily functions such as body temperature, respiratory rate, heart rate, and capillary refill time provides pet owners with initial insights into the health status of their dog or cat. These values should therefore be monitored in critical situations or when an illness is suspected.

Most physiological data are subject to fluctuations due to:

Animal’s age: higher values in younger animals than in older ones

Body size: higher values in smaller animals than in larger ones

Time of day: higher values in the evening than in the morning

Physical activity: higher values during physical activity

Ambient temperature: higher values at higher ambient temperatures

Nevertheless, there are reference values that can be used to assess health status.

Body Temperature

Measured rectally (rectal temperature, RT). Normal for dogs, cats: 37.5–39.0 °C.

Elevated temperature: increase of 0.5 °C compared to normal. Fever: from 40 °C Respiratory Rate

Normal for dogs: 15–25 breaths (BR)/min, Normal for cats: 20–40 BR/min.

Breathing should be easy and without abnormal sounds.

Heart Rate

Normal for dogs: 60–100 beats/min

Small breeds: 60–180 beats/min. Puppies: 60–200 beats/min

Normal for cats: 140–180 beats/min.

In dogs, there is a respiration-dependent rhythm. The heart rate increases during inhalation and decreases during exhalation.

Capillary Refill Time (CRT)

measured in seconds (s)

Normal for dogs and cats: 1–2 sec

CRT is a very sensitive and reliable parameter for assessing the animal’s hydration status. Only in specific cardiovascular diseases can the significance of CRT be impaired.

How to Measure Heart Rate: (HR); Measured in Beats/Minute

The pulse, which corresponds to the heartbeat, can be felt on the large artery of the hind leg of a lying or standing animal, high up on the inner thigh, near the hip joint, using the index, middle, and ring fingers with light pressure (see fig.).

The heart rate (HR) can be felt on the left chest wall just behind the left elbow. For dogs, it’s best to place your flat hand, and for cats, use 2 to 3 fingers (see fig.).

Count the pulse or heartbeats for half a minute and then double the number of beats counted. This will give you the current HR, measured in beats/minute (beats/min).

How to Measure Capillary Refill Time (CRT), Measured in Seconds (S)

If you apply firm pressure with your finger to the mucous membrane of the lip or the gums near the canine tooth, a temporary

blanching occurs, visible as a white area where the finger pressure was applied. In an animal not suffering from dehydration, blood flow returns within one to two seconds, and the white area on the mucous membrane disappears. The time span from blanching to the return of blood flow is called the capillary refill time (CRT). The time it takes for even blood flow to return is the CRT in seconds.

Transporting an Injured Animal

Not only first aid, but also safe and appropriate transport of an injured animal to the vet is important. Improper transport can not only cause unnecessary pain, severe secondary damage to the animal, but also endanger people. Gentle transport of an injured animal requires not only empathetic handling but also basic knowledge of first aid measures and suitable aids. In a stressful situation, even an otherwise calm animal can react unpredictably.

First Aid

  • Leash your animal. It might panic and run away, becoming unretrievable.
  • Move it as little as possible.
  • Remove any constricting items if possible.
  • Protect yourself. Even otherwise friendly animals might bite when in severe pain.
  • Apply a muzzle, but without obstructing breathing. If necessary, a temporary (!) muzzle loop will also suffice.
  • It’s best to transport small dogs and cats in a carrier (cardboard box).
  • If possible, it should open from the top.
  • Lay your animal on its side if possible, but do not force any specific position to prevent additional pain or discomfort (difficulty breathing). If a spinal injury is suspected, use a flat surface (board) for transport if possible. If necessary, use a blanket and have an assistant hold the ends.
  • Do not carry your animal vertically in your arms. This will worsen the pain and can lead to secondary damage due to compression.
  • Do not press on the stomach to avoid inducing vomiting. Stomach contents could enter the airways.
  • Do not bend the head towards the chest. It should lie as straight as possible in a natural body posture or as the non-unconscious animal prefers.
  • If the animal vomits, lift its pelvis and abdomen so that its head and neck point downwards, allowing fluid to drain and preventing it from entering the airways.
  • If you are carrying a small dog or cat, hold the animal tilted downwards when it vomits so that its head is the lowest point. This prevents vomit from entering the airways.
  • Cover your pet with a blanket to calm it down and keep it warm. In a serious emergency, don’t forget to inform the veterinary hospital of your arrival.

First Aid Kit

First aid kits (at home, in the car) help you react quickly in emergencies. Ready-made kits for dogs and cats are available commercially. Your veterinarian will also be happy to help you assemble a kit. Proactive preparation saves valuable time in an emergency and ensures that your animal can receive appropriate care immediately.

You should consider the following:

  • Non-stick sterile bandages and rolled gauze in various sizes
  • Antiseptic solution (chlorhexidine 0.5%, ethanol-water mixture) or antiseptic ointment
  • Bandages for muzzling or a suitable muzzle (“restraint muzzle”). Disposable examination gloves
  • Elastic wrap bandages
  • Rubber tubing for tourniquet (tourniquet)
  • Large cloth
  • Hand disinfectant (alcoholic solution)
  • Towel
  • Adhesive tape
  • Cold packs
  • Plastic bags in various sizes
  • Scissors and tweezers
  • Superglue
  • Safety pins in various sizes
  • Syringes for suction or flushing
  • Thermometer
  • Petroleum jelly or similar for covering
  • Cotton balls, swabs, and cotton buds
  • Wound compresses

Additions:

For chronic illnesses of your animal and for longer trips (“travel kit”), medications such as antibiotic ointment or anti-diarrhea medication are a useful addition. Your veterinarian will certainly advise you.

You should regularly check your first aid kit, replenish it if necessary, or replace single-use items whose expiration date has passed. Veterinary medicines and your personal medications should be stored strictly separately. Many medications, some of which are available over-the-counter, are highly toxic to dogs or cats and must under no circumstances be used on these animals. This includes various pain relievers in particular.

Applying a Bandage

Applying a correct bandage can significantly influence the healing process of injuries in dogs and cats. This requires not only clean and careful wound preparation but also optimal fixation of the material. This prevents dirt from entering and irritating the wound, while also protecting the animal from further damaging the area by licking. What you should pay attention to:

  • Always pad bandages well and do not apply them too tightly! For a paw bandage, it is important to pad all spaces between the “toes”. Don’t forget the dewclaw either! If this is not done, wounds will quickly develop in these areas.
  • In a second step, the entire area to be covered should be well padded with cotton wool or a padding bandage. This means never wrapping a bandage directly onto the paw/leg without padding. This is only acceptable if the covering bandage is to be applied for a short time only, for example, on the way to the vet.
  • You will certainly manage better with padding bandages than with cotton wool. You can buy them at the pharmacy or from your veterinarian and keep them in your first aid kit as a precaution.
  • Finally, a simple gauze bandage is sufficient to cover the padding for a short time. A moisture barrier placed over the gauze bandage is quite useful but should not be continuously on the bandage. It is very important when using elastic, slightly adhesive bandages for this purpose to ensure they are not too tight. Simply pulling the bandage off the roll leads to a more or less significant stretching of the bandage material. Under no circumstances apply it over the gauze bandage in such a stretched state. A bandage that is too tight impairs or cuts off the blood supply to that area and quickly leads to severe pain for the animal and even to the death of skin and tissue. Your animal may only indicate the impairment by not putting weight on the paw and by gnawing at the bandage.

It’s best not to use elastic bandages at all, even if your bandage doesn’t look as professional.

Resuscitation (Reanimation)

The need for resuscitation represents an extremely critical emergency where every second counts. If a dog’s or cat’s heart stops pumping blood or breathing ceases, quick and correct action can determine the life or death of your animal. Knowledge of resuscitation measures and their correct procedure can be crucial to give the animal the necessary chance of survival and to minimize secondary damage. Resuscitation in the sense of first aid refers to ventilation and chest compressions performed by a person on a patient (dog, cat) who no longer has their own respiratory and cardiac function.

It is performed according to the so-called ABC method.

This method is applied when no aids or medications are available. Under clinical conditions, other measures are naturally taken.

  • A stands for Airway
  • B stands for Breathing
  • C stands for Cardiac Resuscitation (cardiac – pertaining to the heart)

A structured approach according to this ABC scheme should be practiced.

First Aid

Before You Begin, Check if the Animal is Responsive. If so, No Resuscitation is Necessary.

A Airway Control

First, apply a single pressure to the chest to simulate an exhalation and thereby re-check whether vomit or other foreign bodies are obstructing the airways and need to be removed.

Before you begin, re-check if your animal is responsive. If so, no resuscitation is necessary.

Please pay attention to the depth of breathing and the RR (breaths/min) of your animal. In case of convulsive breaths, known as gasping, immediately begin chest compressions. Breathing is checked by observing the movements of the chest or by checking exhalation by holding the back of a hand in front of the nostrils.

Procedure:

  • Place the dog in right lateral recumbency
  • Opening the oral cavity
  • Check the oral cavity for visible foreign bodies obstructing the airways; gently pull the tongue out and to the side
  • Extend the head
  • If possible, pull the lower jaw slightly forward

B Breathing

If no breathing is detected, begin ventilation

  • The tongue is moved back into the oral cavity and the mouth is closed. Cup the animal’s mouth and gently bend the animal’s head backward before starting ventilation.
  • If possible, also pull the lower jaw slightly forward.
  • If you do not bend your pet’s head backward, the air blown in might go into the stomach instead of the lungs.
  • Keep the animal’s mouth closed.
  • Place a clean cloth over the nostrils and blow so that the chest only rises slightly.
  • Firmly grasp the animal’s muzzle with one hand and perform mouth-to-nose ventilation, initially at 1–2 BR/min.
  • Overall, 20 BR/min should be performed for large dogs and 24 BR/min for small dogs or cats.
  • Allow time for exhalation between each breath.
  • Keep in mind that your tidal volume is most likely significantly larger than that of your animal.
  • Therefore, you must not blow a full, strong breath into your animal. This would overstretch the animal’s lung elasticity and cause the alveoli to burst. The chest should only rise slightly.
  • If the chest does not rise during ventilation, you must bend the head a little further back and try ventilation again.
  • For very small animals, it may be sufficient to slowly transfer only the air volume from your mouth into the animal using the force of your cheeks. Here too, the chest should rise slightly.

If your animal performs normal movements, discontinue emergency measures and observe it. Seizures are not normal movements.

C Cardiac Resuscitation in case of cardiac arrest

  • Cardiac resuscitation refers to all measures aimed at ending cardiopulmonary arrest.
  • First, a single so-called “precardial” thump is performed (a term from human medicine, “precardial” means “located in front of the heart”). For dogs, this is done on the dog lying in right lateral recumbency, laterally in line with the elbow joint, as a short, strong pressure impulse.
  • If no heartbeat is still palpable thereafter, chest compressions should be started at the highest point of the chest behind the elbow (see fig.).

Chest Compression

  • Place your pet on a smooth, firm surface on its right side, not on its back as with humans.
  • Kneel in front of your pet on its belly side.
  • Place the palm of your hand in the region behind the left elbow. You can support the pressure with your other palm. Keep your arms straight.
  • For very large dogs, you can extend the chest compression to 3 to 4 cm. You may also use the weight of your upper body to achieve the compression. 60–80 chest compressions/min are performed.
  • For small dogs and cats, use only one hand or even just your fingers for compression. Grasp the sternum from below and perform compressions in the elbow region on both sides between your thumb and the remaining 4 fingers. A frequency of 120 to 140 compressions/min should be aimed for.
  • Try to achieve a steady rhythm between ventilation and chest compression. After two ventilations, perform 15 chest compressions, then ventilate twice again, and so on.
  • In between, check whether your efforts have been successful and if a heartbeat or pulse is palpable.

If possible, learn these measures in an appropriate course before an emergency occurs. For small animals, the possibilities for resuscitation (reanimation) and their execution are often unknown, and untrained individuals may also cause additional harm.

It begins with being sure that the animal is indeed no longer breathing and/or has no heartbeat or pulse.

Nevertheless, it is often better to do something than nothing, even if you are unsure.

If blood is no longer transported to the brain, brain damage can occur within a few minutes. After 8–10 minutes without oxygen supply, the animal dies.

If you are inexperienced, limit yourself to lateral chest compressions in rapid succession (one to two times per second!). This ensures blood flow and thus oxygen transport to the brain, heart, and other vital organs.

Be careful to consider the small size of your pet when applying force. The chest should be gently compressed, but the ribs should not be injured. Disregard your pet’s breathing.

See a veterinarian as soon as possible.

Continue resuscitation efforts if possible until you can hand your pet over to a veterinarian. Your veterinarian has specialized equipment to stimulate the heart to pump and to precisely adjust the ventilation volume to the patient’s lung capacity.

Obstructed Airways – Heimlich Maneuver

If the airways are obstructed by a foreign body, the regular gas exchange of oxygen and carbon dioxide through the lungs can no longer occur or is severely restricted. The oxygen supply to the brain and other vital organs is limited, and death by suffocation can occur within a few minutes (see ➞ Choking).

One measure to clear the airways is the so-called Heimlich maneuver.

If your pet is able to cough vigorously, applying the Heimlich maneuver is usually not necessary. However, if your pet’s cough is atypical, quiet, or gurgling, if the oral mucous membranes turn bluish, and if the suspected foreign body cannot be seen or removed from the oral cavity, then begin the Heimlich maneuver.

The pressure in the abdominal cavity is temporarily increased by the following measures:

  • Grasp your pet from behind/above, immediately below the ribs, and clasp your hands together over your pet’s abdomen.
  • Apply short, quick pressure to your pet’s abdomen, upwards and forwards towards the chest. This exerts pressure on the diaphragm, which leads to a forceful expulsion of air from the lungs. The airflow thus generated can dislodge the foreign body.
  • This maneuver is repeated in quick succession.
  • Small dogs and cats can be held securely in your arms, with the animal facing downwards. The head should hang lower than the chest. Repeated, measured tapping on the back can lead to the loosening and expulsion of the foreign body.

It is sometimes recommended to apply brief pressure with the arm to the upper abdominal region synchronously with tapping on the back. However, there is a risk that stomach contents may be pushed upwards and enter the trachea.

If your pet becomes unconscious, begin resuscitation.

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