Managing cardiopulmonary arrest (CPA) requires professionals to assess their patients as quickly as possible, with cardiopulmonary resuscitation (CPR) being performed immediately on dogs and cats, stated Noah Jones, RVT, of Today’s Veterinary Practice, a peer-reviewed clinical information in veterinary medicine.
The success of CPR depends on a number of factors such as the underlying cause of the arrest, the effort’s timeliness and effectiveness, and the team’s preparedness of the team administering CPR, explained Andrew Linklater, DVM, DACVECC, of MSD Veterinary Manual, a trusted source of animal health information for students and practicing veterinarians. The prognosis of recovery from cardiopulmonary arrest (CPA) with CPR is between 35% to 44%, but sadly, only less than 10% of animals survive to discharge.
An Evaluation of CPR in Dogs and Cats Following the RECOVER Guidelines (2019)
Published in Frontiers In Veterinary Science, a global, peer-reviewed, open-access journal, 177,125 dogs and cats were presented to the hospital and 46, 874 were admitted as inpatients, wrote Sabrina N. Hoehne, Kate Hopper, and Steven E. Epstein. 18,726 dogs and cats were presented to the small animal emergency service and 17, 997 small animal cases were anesthetized. There were a total of 219 CPR episodes recorded (0.12%) in 172 dogs and 47 cats. Among those that underwent CPR, 44% of canines and 55% of cats achieved ROSC (return of spontaneous circulation).
17% of dogs and 21% of cats had ROSC ranging from 30 seconds to <20 minutes. 26% of canines and 34% of felines had survived events (sustained ROSC that continued for ≥20 min). A smaller percentage of dogs (7%) and cats (19%) survived to hospital discharge. Of those that achieved ROSC for <20 minutes, 57% of dogs and 80% of cats were euthanized. Among the 17 dogs euthanized within 20 minutes of ROSC, 71% were euthanized due to poor prognosis and 12% due to financial concerns, 12% due to a combination thereof.
However, the reasons for euthanasia were not clear for one dog (6%). Among the eight cats euthanized within 20 minutes of ROSC, 50% were euthanatized due to poor prognosis while another 50% underwent euthanasia due to a combination of poor prognosis and owner financial constraints.
At the time of CPA (cardiopulmonary arrest), 43% of dogs that did not achieve ROSC had no supportive, basic life support (BLS), or advanced life support (ALS) measures in place at the time of CPA. In 85% of dogs that did achieve ROSC, one or more CPR measures were already in place. Cats that did not achieve ROSC did not have any CPR measures in place at the time of CPA (33%). However, one or more CPR measures were already in place in 77% of cats that did achieve CPA. 5% of dogs that did not achieve ROSC and 5% of dogs that achieved ROSC had medication constant rate infusions to support cardiovascular function in place, as well as norepinephrine in 3 dogs and dobutamine, vasopressin, and dopamine in one dog each not achieving ROSC, and norepinephrine dopamine (thee canines) in dogs achieving ROSC.
With the exception of two dogs, hand positioning during chest compressions was reported in all animals. Multiple chest compression techniques were reported in 9% of dogs and 15% of cats. Chest compressions were most commonly performed with both hands positioned over the heart in dogs with (55%) and without ROSC (45%). Another most commonly performed technique was compressions over the widest part of the thorax (33% and 74%). Alternatively, a one-handed compression technique was most commonly done in cats (60%) followed by two hands circumferential technique (47%).
How to Give CPR to Your Dog?
Respiratory arrest may take place if your dog becomes unconscious, which usually happens before cardiac arrest, said Pet Coach, whose mission is to help owners provide the best care and attention to your pet. Your dog’s heart may beat for several minutes after it stops breathing. CPR should be done immediately to save your dog’s life. It is recommended to have two individuals performing CPR.
One is responsible for continuing artificial respiration while the other performs chest compressions. Be sure that the instructions for artificial respiration are followed, alternating with chest compressions. Alternate 30 chest compressions with two breaths. If your dogs weigh less than 30 pounds, lay your pet on its side on a flat surface. Put the palm of your hand on its rib care directly above the heart. Place your other hand on top of the first.
If your pet is a puppy, put your thumb on one side of its chest. The rest of your fingers should be placed on the other side. Compress your dog’s chest for about one inch. Squeeze and release at a rate of 100 to 120 compressions per minute. Continue performing CPR until your dog can breathe on its own and if its heart starts beating steadily. If your dog weighs above 30 pounds, lay it on its side on a flat surface. Place one hand above the other over the widest portion of your dog’s rib cage rather than the heart. Straighten your arms with one hand on top of the other and push down on the rib cage. Ensure that you compress your dog’s chest 1/3 to ½ of its width. Squeeze and release at a rate of 100 to 120 compressions per minute. Continue performing CPR until your dog can breathe on its own. Check if your dog has a steady heartbeat after CPR.
How to Give CPR to Your Cat?
On a flat surface, lay your cat on its side, said Pet Coach. Check if its heart has stopped beating. If so, perform CPR immediately. Have two people perform this procedure, as much as possible. One does artificial respiration and the other does chest compressions. Have them alternate one breath with three compressions.
However, if you are the only one performing CPR, alternate one breath with five compressions. After laying your pet, place your palm on its ribcage over the heart. Then, place your hand on top of the first. Similar to puppies, performing CPR on a kitten involves putting your thumb on one side of its chest while the rest of your fingers is positioned on the other side. Compress your cat’s chest for about one inch. Squeeze and release at a rate of 80 to 100 compressions per minute.
The success of CPR depends on the team’s preparedness and the timeliness of the procedure. Managing the complications after the arrest should be monitored by your veterinary for early diagnosis and treatment of pre-existing medical complications.