Breathing Emergencies

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What To Do In Breathing Emergencies

This is advice on what to do in specific emergencies. It’s meant to be read at leisure, before, not during an emergency.

Choking

Dogs in particular taste life. They examine the world with their mouths much as we do with our hands. As world-class scavengers some will try to eat almost anything. Both cats and dogs can get bones stuck in the mouth without it causing choking. Bones get stuck between or on teeth or against the hard palate causing the dog or cat to paw at its mouth. If a bone or any object blocks the windpipe choking follows. If your dog is choking, don’t wait for veterinary help. Your dog risks suffocating to death. Choking is frightening. An otherwise calm dog is liable to box and bite. Take extra care to avoid getting injured.

If the pet is choking or unconscious and you can’t see the object

*1. Hold a cat or a small or medium-sized dog by its thighs and gentle shake it for up to ten seconds. Swinging allows gravity to assist. If this does not dislodge the object the pet is choking on, or the dog is too large to lift do the following

*2. Lay the dog on its side.

*3. Using one hand to support its back, grab the abdomen just behind the ribs and sternum and squeeze upwards and forwards twice, towards the throat.

*If a large dog, lay it on its back and place both hands in centre of belly just under rib cage. Thrust in and up twice.

These are variations of the Heimlich maneuvre you would use on a person choking. Take care. Extreme pressure can damage the liver and cause internal bleeding. A sharp squeeze produces pressure in the windpipe. This helps dislodge the blockage.

*4. Sweep your fingers through the mouth and remove the dislodged object.

*5. Give two breaths of artificial respiration (see below) then two more thrusts to see if further debris remains in the windpipe. Check the pulse every few sequences and give heart massage if necessary (see below). Repeat until the pet coughs out the obstruction and breaths.

6. If artificial respiration or heart massage is necessary get immediate veterinary attention.

If a choking pet is conscious

*1. Restrain a cat or small dog by wrapping it in a towel with only its head visible.

*2. Restrain a large dog by backing it into your legs.

*3. Open the mouth by grasping the upper jaw with one hand and pressing the upper lips over the upper teeth.

*4. Draw the lower jaw down with your other hand.

*5. Use the blunt end of a spoon to pry the object off the teeth or from the roof of the mouth. Do not pull on visible thread, string or fishing line. It may be attached to an object further down.

Monitor Breathing

Large dogs normally breath about 10 times a minute while the smallest individuals and cats may breath 30 times a minute. Breathing rates increase with pain, shock, lung and heart problems. Breathing and panting are different. Panting increases with exercise, anxiety and pain. It is the natural way for dogs in particular to eliminate excess heat. Calculate breathing, not panting, by timing chest movements for 15 seconds and multiplying by four. Of course, if your pet is unconscious and not breathing, artificial respiration will be necessary.

If your dog has a dense coat or breathes so lightly you can not see chest movement, hold a piece of tissue in front of his nose and count the number of times the tissue moves in 15 seconds. Multiply by four to find the rate per minute. Alternatively, place your hand on your dog’s chest and feel for each breath taken over 15 seconds and multiply by four.

Check The Pulse To Assess The Heart

Your dog’s pulse varies from as slow as 50 beats a minute in large breeds up to 160 beats a minute in small individuals and cats. A kitten’s or puppy’s heart may beat up to 200 times a minute. Your pet’s heart rate will increase with fever, pain, heart conditions and in the first stages of shock. To monitor the heart of a large dog, press the fingers of your hand firmly against the left side of the chest just behind the elbow. On smaller dogs and cats, grasp the chest with fingers and thumb on both sides, just behind the elbows and squeeze gently until you feel heart beats. This may be difficult to do on fat pets. Alternatively feel the pulse by placing your fingers inside the hind leg where it meets the body. A large artery, the femoral artery, passes through here close to the surface of the skin. Move your fingers around until you pick up the pulse. Count for 15 seconds then multiply by four to calculate the heart rate. Naturally, if your pet is unconscious and the heart is not beating, heart massage becomes your priority.

Examine The Gums For Signs Of Shock

Shock is a potential killer. A pet may look fine after an accident, then die a few hours later of clinical shock. Treating for shock takes precedence over first aid for other injuries such as broken bones. The colour of your pet’s gums give a firm clue to shock. Normal gums are a healthy pink. During shock they become dull pink or even white. In healthy pets when you press your finger against the gums, blood is squeezed out. The gums whiten but immediately refill when you remove your finger. The more advanced the state of shock, the longer it takes for the capillaries in the gums, the microscopic blood vessels, to refill. If you have a dog such as a Shar Pei with naturally black pigmented gums, check for shock by gently parting and examining the inner lining of the vagina or by retracting the prepuce and examining the colour of the penis.

The signs of early shock are:

  • Faster than normal breathing
  • Faster than normal heart rate
  • Pale gums
  • Cool ear flaps and paws
  • Anxiety or restlessness
  • Lethargy and weakness
  • Normal or subnormal rectal temperature
  • Slow capillary refill time to the gums - more than two seconds

The signs of late shock are:

  • Shallow, irregular breathing
  • Irregular heart beat
  • Very pale or blue gums
  • Extreme weakness or unconsciousness
  • Very cool body temperature - less than 98 degrees F (36.7 C)
  • Very slow capillary refill time to the gums - more than four seconds

Gum colour

  • Yellow -liver problems (jaundiced)
  • Blue - lack of oxygen (cyanotic) - shock
  • White - shock or blood loss
  • Pale - early shock, anemia, blood loss
  • Pink - normal
  • Red - carbon monoxide poisoning, hemorrhaging

Monitor Dehydration

The 'elasticity' of the skin on your pet’s neck is a good indicator of its state of hydration. In a healthy pet, when you pull on or “tent” the skin on the top of its neck it snaps back into its normal position almost immediately.

A delay in snapping back may be caused by:

  • Dehydration
  • Malnourishment
  • Old age
  • Obesity

In elderly or fat animals feel the gums. Dehydrated individuals have dry, sticky gums.

Anaphylactic Shock Can Kill

Anaphylactic shock is a serious, potentially life-threatening allergic reaction with different signs from those of clinical shock. It occurs particularly in cats exposed to allergens they have been previously sensitised to. The signs of anaphylactic shock are:

  • local redness, swelling, irritation and itchiness
  • anxiety, difficulty breathing, vomiting and diarrhoea
  • weakness, collapse, coma and death

These signs may develop slowly over several hours or almost immediately. Insect stings and therapeutic drugs are possible causes. Immediate veterinary treatment with corticosteroids, adrenalin, intravenous fluids and oxygen is vital for acute anaphylactic shock.

Treat shock

If your pet shows signs of shock don’t let it wander about or give it anything to eat or drink. Do the following.

*1. Stop any bleeding, check the airway and give heart massage or artificial respiration as necessary.

*2. Wrap it in a blanket to prevent further heat loss.

*3. Use pillows or towels to elevate its hindquarters, allowing more blood to travel to the brain.

*4. Keep its head extended and transport to us or after hours to Elizabeth Street.

Give Artificial Respiration

Only give artificial respiration if your pet has stopped breathing. Check the gums. If they are pink it usually means that oxygen is being carried around the body. If blue or white, artificial respiration may be necessary. If your pet has stopped breathing do the following.

*1. Place it on its side, clear any debris from its nose and mouth and pull its tongue forward.

*2. Close its mouth and with its neck in a straight line, place your mouth over its nose and blow in until you see its chest expand. If you find this offensive, use your hand to form an airtight cylinder between your mouth and your dog’s nose. Blow through this.

*3. Take your mouth away. Its lungs will naturally deflate. Repeat this procedure 10 to 20 times a minute until she breathes on its own.

*4. Check the pulse every 15 seconds to ensure the heart is still beating. If it stops integrate heart massage with artificial respiration.

5. Get emergency veterinary help as soon as possible.

If two people are present, one gives heart massage for five seconds then the other gives a breath of artificial respiration. Continue this alternating procedure until it is safe for one to leave to arrange transportation to the veterinarian.

Give Heart Massage

Every living cell in your pet’s body needs oxygen to survive. Oxygen is breathed into the lungs, picked up by red blood cells and pumped by the heart around the body. Brain cells have an enormous need for oxygen, which is why 20 percent of the blood pumped by the heart goes to such a relatively small organ. If brain cells are deprived of oxygen, even for a few minutes they are damaged or die. In emergencies, heart massage can restart a stopped heart while artificial respiration puts your breathed out oxygen in your pet’s lungs, to be carried to its brain until it starts breathing again on its own. The combination of heart massage and artificial respiration is called cardiopulmonary resuscitation or CPR.

Only give heart massage if your dog’s heart is not beating. Check the eyes. They dilate when the heart stops. Feel for a heartbeat or pulse. Check the gums. It when you press your finger against pink gums they blanch then return to pink the heart is still beating. If there is no pulse and the gums do not refill with blood, the heart has stopped.

CPR may be needed in these circumstances:

  • Blood loss
  • Choking
  • Concussion
  • Diabetic coma
  • Electrocution
  • Heart failure
  • Near-drowning
  • Poisoning
  • Shock
  • Smoke inhalation

Small dogs and cats

*1. Place your pet on its side, if possible with its head lower than the rest of its body.

*2. Grasp its chest, behind its elbows, between your fingers and thumb. Support its back with your other hand.

*3. Squeeze firmly, compressing the rib cage, squeezing up towards the neck repeating this action using quick, firm pumps 120 times a minute.

*4. After 15 seconds of heart massage, give artificial respiration for 10 seconds.

*5. Continue alternating until a pulse returns, then give artificial respiration alone.

6. Get immediate emergency veterinary attention. Note the time when you began. It is rarely possible to maintain adequate cardiac output for longer than 15 minutes on a heart that does not restart.

Medium and large dogs

*1. Place your dog on its side, if possible with its head lower than the rest of its body.

*2. Put the heel of one hand on its chest just behind its left elbow then the heel of the other on your first hand.

*3. Press downwards and forwards 100 times a minute, pushing towards the neck. This is energy draining work when applied to a large dog. Do not worry if you crack a rib. The circumstances are literally life and death.

*4. After 15 seconds of heart massage, give artificial respiration for 10 seconds.

5. Continue alternating until a pulse returns, then give artificial respiration alone.

6. Get immediate emergency veterinary attention.

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