Dog CPR:
Learn how to Improve
Your Dog's Chances of Survival


For this article on dog CPR, I had the pleasure of interviewing Dr. Justine Lee, author of the book It’s a Dog’s Life… but it’s Your Carpet.

Dr. Lee is a board-certified emergency critical care veterinary specialist and is currently the Associate Director of Veterinary Services for

Pet Poison Helpline.

For the previous five years, Dr. Lee was on faculty as an Assistant Clinical Professor at the University of Minnesota College of Veterinary Medicine. She is currently one of approximately 240 board-certified veterinary specialists world wide in emergency and critical care, and is a Diplomate of the American College of Veterinary Emergency and Critical Care (DACVECC).

The most important piece of advice that Dr. Lee gives regarding dog CPR is to prevent an emergency from happening in the first place by becoming an astute pet parent. By understanding how to monitor and interpret your dog’s physical and emotional signs, you can often head off a potential tragedy that requires performing dog CPR (now referred to as CPCR (Cardiac Pulmonary Cerebral Resuscitation).

Prevention is especially important with dogs (and all animals) because, unlike humans, once a dog goes into cardiac arrest, there is only a 4.1% chance of reviving him (compared to 21% with a human). This is under the best of circumstances in an animal hospital environment (where oxygen, emergency drugs, etc. are available). Unfortunately, if you are performing dog CPR at home, the chances are even slimmer that he will survive.

When a human requires CPR, it is often due to suffering a heart attack (ventricular fibrillation). This is not the case with animals. Their hearts often time just stop (asystole), usually due to a highly progressed disease such as cancer that has spread throughout the body, end-stage organ disease (like kidney failure or heart failure), or a severe case of internal bleeding. For this reason, it is extremely important to be vigilant about monitoring your pet’s physical symptoms and his behavior for clues to his health, so that you can address issues before it becomes too late.

That said, it is of course any loving pet parents’ natural inclination to want to try to save their dog, and there are instances – such as with a choking dog – that the prognosis is the best, where dog CPR should be attempted.

If you do find yourself in the unfortunate position of having to perform dog CPR, Dr. Lee advises you follow these steps:

Know the location of your nearest emergency clinic, and have its number programmed into your cell phone.
The best chance for your pet’s survival will be to get him immediately to your nearest veterinary hospital for professional treatment. When an emergency is underway is not the time to be frantically searching for your nearest clinic. You should have this information at the ready so that you don’t waste even one second searching for it. More importantly, call to warn them that you are coming, so that the doctors and nurses are prepared to receive you and your pet at the door. I actually tore the page out of my telephone book that lists the nearest animal emergency clinic. Not only does it contain the phone number and address, but a convenient map as well.


Be prepared with the proper equipment.
Always have a leash and blanket handy in your home as well as your car. If you have a large dog, you should also keep a plastic sled in your trunk so that you can lift and transport the dog with as little jostling as possible. In addition, it’s worth purchasing a cloth muzzle in cases of emergency. Even loving dogs will bite from pain, and it’s safest to muzzle before lifting an injured dog.


When performing dog CPR, Dr. Lee advises that you always follow the “ABC”s
(Airway, Breathing, Circulation):

Airway
The first thing you will want to do is determine whether anything is obstructing your dog’s breathing passage. Dogs can choke on a variety of things, ranging from toys to foreign objects to their own vomit. One of the main reasons for a choking dog is that he has gotten a hold of a toy that is inappropriately sized for him. Dr. Lee strongly advises keeping dogs away from undersized toys such as super balls (those hard rubber balls that bounce very high). They can easily become lodged and obstruct the dog’s upper airway. See our article on how to help a choking dog for more on this subject, such as attempting to clear the airway and performing the Heimlich Maneuver.


Breathing
If your dog is not choking, or once you have cleared the airway, check to see if he is breathing. If he is not breathing, you will need to perform rescue breaths, which is the dog version of human mouth-to-mouth resuscitation. With dog rescue breaths, however, you blow directly into the dog’s nostrils, rather than his mouth. In order to make sure that no air leaks out, completely cover your dog’s mouth by wrapping his lips all the way around to create a seal (see photo).

dog CPR closing dog's mouth

You can then put your hand over the dog’s muzzle and cover your lips directly over the nostrils (creating a seal), blowing directly into his nostrils.

Give four to five rapid rescue breaths into the dog’s nostrils, then check to see if he is breathing (his chest will rise on its own). If the dog does not begin to breathe on his own, continue performing 20 rescue breaths per minute (preferably while someone else is driving you to the nearest veterinary emergency hospital). Bear in mind, however, that if you (or your veterinarian) cannot revive your dog within two minutes, he will have suffered brain damage from oxygen deprivation.


Circulation
To determine your dog’s circulation, you will need to check for a heartbeat. An efficient way to know if your dog’s heart is beating is to put your hands under the dog’s left or right front leg at the point where the elbow hits the chest and feel for the heart beat (see photo).

dog CPR checking for a heartbeat

Alternately, you can feel for a femoral pulse on the inside of your dog’s thigh – this takes a lot of practice and is often hard to find with a lot of fur or fat! It is a good idea to practice checking your dog’s heartbeat and pulse in advance, so you are familiar with this practice in case of an emergency.

To see how good your dog’s circulation is, you can also check the color of his gums. To do this, lift up his gum and check the color (see photo).

dog CPR checking dog's gums

Use your finger to lightly press on the gum to blanch the color out of the gum. If the color does not return to pink in less than two seconds, something is wrong! If the dog’s gums are pink, it means that his heart is beating and providing circulation. If the gums are very pale, it may you’re your dog is anemic.

If there is no heartbeat or pulse, you will need to apply chest compressions as part of your dog CPR.

Where you will apply CPR chest compressions will depend upon the size of your dog. For dogs less than 35 pounds (15 kgs), perform the chest compressions directly over the heart, with your hands folded together (see photo). Make sure that your arms are extended and your elbows locked while you compress the chest ½ -- 1 inch with each compression.

dog CPR chest compressions less than 35 pounds

For dogs that weigh more than 35 pounds (15 kgs), perform the compressions directly over the last rib, with your two hands folded together (see photo).

Again, keep your arms extended and your elbows locked, compressing the chest approximately ¼ of the overall width, which may be 1 – 2 inches with each compression. You should be performing approximately 60-100 compressions per minute (more frequent the smaller your dog).

If you are performing dog CPR by yourself, you will need to alternate rescue breaths and chest compressions at the following rate:

  • Small Dogs: 20 breaths followed by 100 compressions
  • Medium Dogs: 20 breaths followed by 80 compressions
  • Large Dogs: 20 breaths followed by 60 compressions

Some dogs that stop breathing might also have fluid coming out of the nose. This is often times a sign of congestive heart failure or severe lung disease, and unfortunately it is highly unlikely that even CPR performed by a professional will save him.

Again, vigilance and astute monitoring of your dog’s health are essential to preventing a dog CPR emergency.

Some warning signs that require medical attention:

  • Restlessness and panting at night (your dog should be peacefully sleeping)
  • Coughing
  • Lethargy or malaise
  • Unproductive retching (note that this can be an urgent sign of stomach bloat, requiring immediate medical and surgical attention)
  • Weakness
  • Collapse
  • Pale gums
  • Strange howling
  • Dilated pupils
  • Loss of appetite (if a Labrador stops eating, for example, he should be rushed immediately to your veterinarian or the nearest emergency veterinary hospital)

Unlike people, dogs are very stoic, and often don’t let on that they have a health problem until it is very far along – perhaps even too late. For this reason, Dr. Lee stresses that it is up to us as responsible pet parents to watch for any changes in our dog’s physical or emotional condition. The key is to be astute so that you are never in a position where you have to perform dog CPR.

Knowing the basics of

dog first aid , including CPR, is very important for every pet parent. And, when in doubt, contact a veterinary clinic. It is better to err on the side of caution and prevent a possible tragedy. Your dog will thank you for your vigilance!

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