Friday, 10 June 2011

CPR in Cats

Despite your best efforts to keep your cat safe, the unthinkable can happen. Your cat could choke on a toy, chew through an electric cord, slip out the door and get hit by a car, or collapse from heatstroke on a hot day. Any number of serious illnesses or injuries could lead to respiratory arrest (failure to breathe) and then rapidly spiral into cardiac arrest (stopped heart) and ultimately death. If your cat fell unconscious and stopped breathing, would you know what to do?

CPR, or Cardiopulmonary Resuscitation, is an emergency procedure used to restore life to an animal (or human) whose breathing or heartbeat has stopped. The goal of CPR is to keep oxygen flowing to the brain and other vital organs until more definitive treatment can be obtained. CPR does not take the place of proper veterinary care. But when conducted appropriately, it can make all the difference for your cat.

The ABC’s of CPR

It is important to confirm that your cat is unconscious and has actually stopped breathing or has no pulse before you attempt to perform CPR. Take a moment to observe the situation before forging ahead. Does your cat fail to respond when you try to rouse her? Is her chest no longer rising and falling as with normal breathing movements? Is there anything stuck in her mouth, any blood or other sign of injury? Are you unable to feel a pulse? If your pet’s breathing or heartbeat has truly stopped, her tongue, lips and gums will soon start to turn blue. If you see these signs, it’s time to act.
CPR in animals and humans has three main components: Airway, Breathing and Circulation, and they must be addressed in that order. There’s no sense trying to restore a pulse (circulation) in an unconscious cat before first trying to remove the toy that is lodged in her throat (airway).

A=Airway

Is your cat breathing?

This can be tricky to determine in an unconscious cat, but it is critical information. Stay calm if you can and take a moment to assess the following:

  • Can you see the normal rise and fall of the chest?
  • Can you feel exhaled breath on your hand?
  • Gently pluck a tuft of hair from your cat’s coat and hold it near the mouth and nose. Is it stirring back and forth with your cat’s breath?
  • Check the tongue and gums. Have they turned blue? If yes, your cat has probably stopped breathing.
If your cat is unconscious and has stopped breathing, first make sure there is nothing blocking her windpipe. In cases where a cat is choking, this may resolve the problem.
What to do:
  1. Lie your cat on her side
  2. Gently extend the neck and incline the head upwards slightly
  3. Look in the mouth for any blood, vomitus, or foreign material and clear it away if possible.
  4. Pull the tongue forward. Sometimes this will dislodge an object.
  5. Perform a “finger sweep” of the back of the throat with your pinky finger to dislodge objects forward onto the back of the tongue.
  6. If all else fails, try the kitty Heimlich maneuver described in our article on Feline First Aid.
  7. Check to see if your cat begins breathing again. If she is breathing effectively, her gums and tongue will start to turn pink and she will slowly come to. If not, proceed to then next step (rescue breathing).
  8. Seek veterinary care immediately, regardless of whether your cat seems to have revived completely. Unforeseen complications can arise minutes to hours after an episode of choking or respiratory arrest.
What not to do:
  1. Take extreme caution not to get bitten. This procedure must only be performed on an unconscious animal.
  2. Don’t confuse the tiny bones in the back of the throat (the larynx) with a foreign body!

B=Breathing

If the airway is clear but your cat is still unconscious and not breathing, it’s time to perform rescue breathing. The goal of rescue breathing is to provide oxygen to the lungs and vital organs until spontaneous breathing can resume. It is analogous to “mouth-to-mouth” resuscitation in people.
What to do:
  1. Gently tilt the head upward to straighten the airway.
  2. Cover your cat’s entire nose and the front of her mouth with your lips. Exhale with enough force to expand your cat’s chest as it would with a normal breath. Inhalation should take about one second.
  3. Relax and let your cat’s lungs deflate normally.
  4. Give 3 to 5 rescue breaths and then pause to see if your cat is breathing on her own.
  5. If she has not resumed breathing, continue rescue breathing, aiming for 8-10 breaths per minute.
  6. Occasionally pause to press down on your cat’s abdomen. This will release air that may have built up in the stomach.
  7. Seek veterinary care immediately, even if your cat resumes breathing normally. Your vet will need to observe for complications and determine why breathing stopped in the first place.
What not to do:
  1. Rescue breathing is for animals who are unconscious. Never attempt rescue breathing on an awake or distressed animal.
  2. Don’t attempt rescue breathing unless you have confirmed that the airway is clear.

C=Circulation

Clearing the airway and performing rescue breaths may be all that’s needed to revive your cat in an emergency. But if you’ve completed these steps and your cat is still not breathing AND has no heartbeat—or if your cat had no pulse even from the start—it will be necessary to provide chest compressions along with rescue breathing. To put things in perspective, the prognosis for a cat who has suffered both cardiac and pulmonary arrest is not favorable. The overall survival rate may be less than 5% for animals who have arrested, and of course this depends on the severity of the reason that the heart and breathing stopped in the first place. But in this rare type of emergency, you may be your cat’s best and only chance.
How to check your cat’s pulse
Checking your cat’s pulse can be a bit tricky even under normal circumstances. Practicing this at home when you’re both relaxed and comfortable will help you be prepared in an emergency. Note that a cat’s pulse rate is typically much faster than that of a human. A cat’s heart may beat up to 180-200 times per minute.
The best place to feel your cat’s pulse is the femoral artery, which runs down the inside of the thigh from the groin to the knee. Place your right hand firmly over the front of your cat’s right upper thigh (or use your left hand on her left thigh) with your fingertips touching the groin area. Move your fingertips back and forth until you feel your cat’s pulse.


feline_femoral_artery_cpr

Performing chest compressions

The principle here is the same as in human CPR courses many of us have taken along the way. Direct compression of the chest wall overlaying the heart can actually force the heart to passively pump blood. This is sometimes enough to sustain life until the heart can be restarted.
What to do:
  1. Cup your palm or fingertips around the area of the chest right behind the elbows
  2. Briskly compress the chest by 1/2 inch at a rate of 120 beats per minute.
Continue doing this until you feel a pulse or arrive at the veterinary hospital. Be aware that an animal who has no pulse and is not breathing despite 20 minutes of CPR is extremely unlikely to survive.

How to coordinate chest compressions with rescue breathing:

It’s best if there are two people to perform CPR. One person can give chest compressions while the other gives rescue breaths. If no one else is available to help, then you must alternate between the two. In this case, give one rescue breath for every 12 chest compressions.
Every savvy cat lover should know the ABC’s of CPR. Hopefully you’ll never need to use them.
Disclaimer: This website is not intended to replace professional consultation, diagnosis, or treatment by a licensed veterinarian. If you require any veterinary related advice, contact your veterinarian promptly. Information is exclusively of a general reference nature. Do not disregard veterinary advice or delay treatment as a result of accessing information at this site.

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