Introduction:
What would you do if:
...your dog was hit by a car?
...your cat had a bleeding injury from a fight?
...your dog fell down the stairs and started limping?
...your cat was overheating on a hot summer day?
To avoid the feelings of panic that may accompany these situations, the following steps are recommended to better prepare you for a pet medical emergency. Always remember that any first aid administered to your pet should be followed by immediate veterinary care. First aid care is not a substitute for veterinary care, but it may save your pet's life until it receives veterinary treatment.
A. Common Conditions Requiring First Aid
1. Can’t Breathe
Difficulty breathing is also called dyspnea and is a medical emergency. Respiratory distress is recognized by increased effort to breathe; noisy or squeaky breathing; cyanosis (a bluish tinge to the lips and mucous membranes); and an inability to inhale or exhale. In cats, breathing with the mouth open (panting like a dog) is a sign of severe distress and should be evaluated by a veterinarian right away.
It is imperative to get the pet examined to determine the cause. Diagnostic tests (such as x-rays, blood tests and ultrasound) will be needed, but the pet must be stabilized (often with oxygen or by removing fluid from the chest) before they can withstand the rigors of testing if respiratory distress is severe.
What to Do
Brachycephalic (short-nosed) breeds (e.g., English bulldog, Pekingese, and Pug) warrant a special mention. Because of the short nose, the soft palate can interfere with breathing. On hot days or in hot environmental conditions these dogs try to cool off by panting vigorously, and the soft palate interferes even more. This cycle continues until the dog is severely dyspneic and overheated. Cooling these dogs is imperative. Move them to a cool environment and seek immediate veterinary care. This syndrome is manageable only by protecting these breeds from heat or by surgically reconstructing the soft palate.
What NOT to Do
Choking is interference with breathing caused by foreign material in, or compression on, the trachea (windpipe). Thankfully, true choking is a very rare occurrence. Many pet owners will seek veterinary care because they believe their pet has something stuck in its throat, and this is rarely the case. It is far more likely that your pet has something mild and infectious such as tracheobronchitis (commonly called kennel cough) and is coughing rather than choking.
Frequently, coughing is confused with choking. Both cause the pet to forcefully exhale. With choking, the pet has difficulty inhaling. When coughing, the pet can inhale almost normally. Be careful to distinguish the two: attempting to give first aid to a pet who is merely coughing can cause injury.
If you are in any doubt, have your pet evaluated by a veterinarian. To evaluate the throat, most pets will require sedation and some will require evaluation with a fiber-optic endoscope or X-rays to look for foreign material.
If the Pet is Unconscious
Perform a Finger Sweep. Open your pet's mouth and do a finger sweep by placing your finger along the inside of the mouth, sliding it down toward the center of the throat over the base of the tongue, and gently "sweeping" toward the center to remove any foreign material. Warning: there is a structure deep in the throat (the Adam's apple) that feels like a smooth bone. Do not attempt to pull it out!
Begin Rescue Breathing. Rescue breathing is performed by covering the pet’s nose with your mouth and forcefully blowing your breath into the lungs. In cats and small dogs, you must hold the corners of the mouth tightly closed while you force the air in. In larger dogs, the dog’s tongue should be pulled forward and the mouth and lips held shut using both hands cupped around the muzzle. Force air into the lungs until you see the chest expand. Take your mouth away when the chest has fully expended. The lungs will deflate without help. Air should be forced into the lungs until you see the chest expand. If air is not entering the lungs, slap the chest wall firmly or perform the Heimlich maneuver by putting the pet on his back, placing your hands over the abdomen near the bottom of his rib cage, and gently but firmly thrusting toward the spine. Perform a finger sweep and begin rescue breathing. Repeat until the foreign body is clear and the lungs can be inflated. Transport to the veterinarian.
If the Pet is Conscious
Stay calm and try to keep the pet calm. If the pet is overheated, cool them with cold water applied to their extremities (ears and feet) and belly, and transport them to the nearest veterinarian. Perform a finger sweep only if it will not excite the pet. Do not perform a finger sweep if you believe your pet will bite you.
2. Bleeding
Pets often suffer blood loss as a result of trauma or poisoning. Some bleeding is visible, and is a result of a cut or laceration, while internal bleeding occurs inside the body (such as in the chest or abdomen) and is not be visible to the naked eye. If bleeding is severe or continuous, the pet may lose enough blood to cause shock; loss of as little as 2 teaspoons per pound of body weight may cause shock, which doctors usually detect as a high heart rate and low blood pressure. Emergencies may arise that require you to control the bleeding, even if it is just during transportation to the veterinary facility. Pet owners should know how to safely stop hemorrhage (bleeding) if their pet is injured.
Techniques to Stop External Bleeding
The following techniques are listed in order of preference. The first rule when dealing with an injured pet is to avoid injury to yourself, so take appropriate precautions (such as the use of a muzzle) to avoid being bitten. For all techniques below, seek veterinary attention immediately after stopping the bleeding, or on the way to the veterinary hospital.
Direct Pressure
Gently press a
compress (a pad of clean cloth, feminine sanitary product or gauze) over the
bleeding area, so it can absorb the blood and allow it to clot. Do not disturb
blood clots after they have formed. If blood soaks through, do not remove the
pad; simply add additional layers of cloth and continue the direct pressure
more evenly. The compress can be bound in place using loosely applied bandage
material, which frees the hands of the first provider for other emergency
actions. If you don’t have a compress, you can use a bare hand or finger.
Direct pressure on a wound is the most preferable way to stop bleeding.
Elevation
If a severely bleeding wound is on the foot or leg, gently elevate the leg so
that the wound is above the level of the heart.
Elevation uses the force of gravity to help reduce blood pressure in the injured area, slowing the bleeding. Elevation is most effective in larger animals with longer limbs where greater distances from the wound to the heart are possible. Direct pressure with compresses should also be maintained to maximize the benefits of elevation.
Elevation of a limb combined with direct pressure is an effective way to stop bleeding.
Pressure on the Supplying Artery
If external bleeding continues after you have used direct pressure and
elevation, use your finger or thumb to place pressure over the main artery to
the wound. Apply pressure to the femoral artery in the groin (on the inside of
the thigh) for severe bleeding of a rear leg; to the brachial artery in the
inside part of the upper front leg for bleeding of a front leg; or to the
caudal artery at the base of the tail if the wound is on the tail. Continue
application of direct pressure. Seek veterinary attention
immediately.
Tourniquet
Use of a tourniquet is potentially dangerous and it should be used only for a
severe, life-threatening hemorrhage in a limb (leg or tail) not expected to be
saved. If you see blood spurting or pumping from a wound, which is a rare
occurrence, consider the use of a tourniquet. Use a wide (2-inch or more) piece
of cloth and wrap it around the limb twice and tie it into a knot. Then tie a
short stick or similar object into the knot as well. Twist the stick to tighten
the tourniquet until the bleeding stops. Secure the stick in place with another
piece of cloth and write down the time it was applied. Every 20 minutes loosen
the tourniquet for 15 to 20 seconds. Remember this is potentially dangerous and
can often result in disability or amputation.
A tourniquet should only be used as a last-resort, life-saving measure!
Internal Bleeding
Internal bleeding is a life-threatening condition, but it is not obvious like
external bleeding. In internal bleeding, blood pools in the stomach or chest
but does not result in blood in the stool or bleeding from the rectum. There
are, however, some external signs of internal bleeding:
If you see any of these signs, immediately transport your pet to a veterinary facility for professional help. Most cases of internal bleeding will require intensive therapy in a veterinary hospital. Remember: internal bleeding is not visible on the outside.
3. Fractures
A fracture refers to a break or crack in a bone. There are several different types of fractures, and each type has different complications and methods of repair. Your veterinarian can help you decide how best to fix the fracture and if referral to a specialist is in your pet’s best interest. Although splinting will allow a small number of fractures to heal, most will require surgery to ensure the best outcome. Toy breeds of dogs (such as Pomeranians, rat terriers and similar small, long-legged dogs) always require surgery on foreleg fractures due to the high failure rate of splinting.
Fracture Types
Closed fracture: Fractures in which there is no related external wound.
Open (formerly known as compound) fracture: Fractures associated directly with open wounds (the bone may or may not be visible through the wound).
Dislocation: An injury to the connective tissues holding a joint in position that results in displacement of a bone at the joint.
Sprain: An injury to a joint, ligament, or tendon in the region of a joint. It involves partial tearing or stretching of these structures without dislocation or fracture.
Other types of orthopedic injuries can involve torn ligaments, particularly in the knee. Many athletic, large breed dogs will tear the cranial cruciate ligament in their knee, which results in a sudden loss of use of the leg, and joint pain and swelling in the knee. Surgical stabilization is the best means to repair this injury.
What to Do
What NOT to Do
4. Lacerations/Open wounds
A wound is any break in the continuity of the tissues of the body, either external or internal. Injured pets can act in unusual and unpredictable ways. When dealing with an injured pet, remember to protect yourself from being bitten by using a muzzle or heavy towel as needed to gently restrain your pet.
Many wounds will require pain control and sedation or general anesthesia for cleaning and closure once your pet has been evaluated by a veterinarian. Some wounds, like those inflicted by another animal, can become worse before they get better as dead tissue is removed by the body’s immune system. This process can take many days or weeks and may require repeated bandaging, repeated surgeries or skin grafting for severe wounds.
What to Do
Deep Wounds (generally those that are bleeding or have exposed muscle, fat, or bone)
Superficial Wounds (wounds that do not penetrate all the way through the skin)
What NOT to Do
The tape should be in contact with the skin (hair) at the bandage margins, anchoring the bandage so it will not slip. The outer layer of a bandage should be applied smoothly and snugly, but not tight enough to cut off blood circulation.
5. Heatstroke
Body temperature may be elevated because of an infection (fever), but it may also increase because of hot and/or humid conditions outside. An increased body temperature caused by environmental conditions is commonly referred to as hyperthermia, heatstroke, and heat prostration.
Hypothermia may be a life-threatening condition, and does require immediate treatment. A dog’s normal body temperature is 101.5°F plus or minus 1 degree Fahrenheit, and any time the body temperature is higher than 105°F, a true emergency exists. Heatstroke generally occurs in hot summer weather when dogs are left with inadequate ventilation in hot vehicles. However, heatstroke may also occur in other conditions, including:
Initially the pet appears distressed, and will pant excessively and become restless. As the hyperthermia progresses, the pet may drool large amounts of saliva from the nose and/or mouth. The pet may become unsteady on his feet. You may notice the gums turning blue/purple or bright red in color, which is due to inadequate oxygen.
What to Do
What NOT to Do
Severe hyperthermia is a disease that affects nearly every system in the body. Simply lowering the body temperature fails to address the potentially catastrophic events that often accompany this disorder. A pet suffering from hyperthermia should be seen by a veterinarian as soon as possible.
6. Transporting an Injured Pet
The first aid provider must not only identify and treat injury or illness, but must also safely transport the patient to the veterinary facility for further treatment. Improper technique when transporting a patient can result in further injury or complications, and risks a bite injury to the person transporting the injured pet. Although this article cannot fully prepare you for all specific examples, it can provide the following general recommendations.
Handle the Pet as Little as Possible
Try to make the pet comfortable by encouraging him to lie down and stay. Smaller dogs and cats can most effectively be transported in commercially available carriers or in a cardboard box with a lid.
Handle the Pet Gently
Rough handling may cause further internal bleeding, more damage to the soft tissues around a fracture, and many other complications.
Lie the Pet on its Side if Possible
If the pet seems to resent this or has more difficulty breathing on its side, it may indicate the pet has an injury to the chest or lungs. In this case, it is better to leave the pet in a comfortable position of his choosing.
Minimize Movement
If possible, gently tie or tape the pet to a flat surface such as a large board or piece of plywood. This is imperative when handling an unconscious patient or the patient with a suspected back injury to ensure that they do not thrash about – this could potentially make any internal or spinal injuries worse.
Do Not Put Pressure on the Stomach
This is most important for the pet who is having difficulty breathing, has been vomiting, or has pain in the abdomen.
Use a Backboard
If the pet seems paralyzed or unable to get up, a spinal injury is suspect and the pet must be firmly immobilized to prevent further damage to the nerves. Get a firm, flat support (an ironing board, a piece of plywood, a collapsed cardboard box, a table leaf -- think of one in your house before you need it). Grasp the skin over the back of the neck and over the small of the back and gently slide the pet on to the support. Try to keep the back and neck straight. Gently tie or tape the pet to the support. As stated above, if this causes the pet to struggle, you will need to find another method of transport, such as a large blanket to use as a stretcher.
Position the Head
If the pet is unconscious, position the head in normal alignment with the body. It should not flex abnormally downward nor extend excessively upward. Improper flexing or extending can cause decreased blood drainage from the brain and cause serious damage. If the pet has vomited or appears likely to vomit, put the head down below the level of the heart. This will allow the vomitus to run out of the mouth and not down into the windpipe and the lungs. Be aware that pets with severe head injuries are likely to vomit, even while they are unconscious.
Cover the Patient with a Blanket
Covering an injured pet has a calming effect. More importantly, it prevents heat loss. A blanket can also be used as a transport device. In this case, the animal can be gently lifted with the blanket. Gently slide the pet into the center of the blanket. Roll the edges of the blanket to provide a better grip. Gently lift the blanket and the pet into the transport vehicle. This is usually a two-person procedure.
Know the Route to the Veterinary Facility and Call Ahead
Get precise directions and drive directly to the facility. This will result in the fastest delivery of the pet for professional care. Call them to let them know you are on the way.
Drive Carefully!
Driving out of control or in a panic may result in delays (while the officer writes a ticket) or injuries if you are involved in an accident.
Emergency situations require prompt and safe transport of the sick or injured pet. If done properly, this will give your pet a better chance for recovery. If delayed or done carelessly, the outcome may be less favorable. As with most first aid principles, prior planning and awareness of proper techniques will prevent many problems.
First Aid: A Final Note
Most veterinary hospitals are not open around the clock. Some may provide emergency service (meaning someone will meet you there if you call first). If you do not call first, you may arrive to find that a doctor is not available. To avoid wasting time in a crisis, ask your veterinarian ahead of time about emergency services available, and learn the shortest route to your veterinarian and to a 24-hour emergency facility, if one is available in your area.Health Benefits of Pet Ownership
The company of a pet relaxes and entertains people, but the benefits of pet ownership go beyond simple joy. Studies have shown that keeping a pet improves the health and well-being of the people in the household. During stressful times, the comfort of a pet protects against depression and loneliness. Animal companions ward off depression and loneliness among people with AIDS and Alzheimer’s disease. Stressful situations have less of an impact on elderly pet owners and visit their physician less frequently.
Pets allow their owners to feel needed as nurturers, while also nurturing their owner. An animal’s unconditional affection often increases the owner’s ability to cope with personal setbacks and depression and can reduce loneliness. Individuals who live “alone” with a pet are actually part of a family; they can look forward to being greeted and recognized when they walk in the door. Caring for a pet can make its owner feel needed and provide reasons for living and staying healthy.
Pets motivate people to be more active and social. Pets are conversation-starters, help to make new acquaintances. Walking the dog provides not only physical exercise but also an opportunity to interact with humans living and more vulnerable to depression. Dog-walking and being outdoors where social contact is possible are healthful effects of dog ownership.
The comfort, social interaction, and motivation provided by pets improve cardiovascular health and lower blood pressure. Physical and verbal interaction can lower blood pressure. One study of hypertensive patients showed those who were given pets handled stressful tasks better than those who relied on blood pressure medication alone. Research shows people are more likely to survive the year after a heart attack if they have both a companion dog and a human social support network. Animal companionship is commonly linked to lower death rates and better long-term health.