The first step in animal CPR (like human CPR), after determining that the animal is non-responsive, is to obtain an open airway.  You should not continue past A until this step has been achieved!

STEP #1:  Carefully pull the tongue straight out of the animal's mouth to open the airway.  WARNING!  EVEN AN UNRESPONSIVE DOG MAY BITE BY INSTINCT!

STEP #2:   Make sure that the neck is reasonably straight;  try to bring the head in-line with the neck.  WARNING: DO NOT OVER-STRAIGHTEN THE NECK IN CASES WHERE NECK/HEAD TRAUMA EXISTS.

STEP #3:   Attempt 2 rescue breaths by closing the mouth, and performing mouth-to-nose ventilations.  If they go in with no problems continue to B - Breathing.

STEP #4:   If not, reposition the neck and try Step 3 again.

STEP #5:   Visibly inspect the airway by looking into the mouth and down the throat for foreign objects occluding the airway.  Unlike human CPR, rescuers may reach into the airway and remove foreign objects that are visible.

STEP #6:   If you still can't breath into the animal, proceed to the HEIMLICH MANEUVER.

A:   HEIMLICH MANEUVER

If you were unable to clear an object from the airway in A, you will need to do the Heimlich Maneuver.

STEP #1:   Turn the animal upside down, with it's back against your chest.

STEP #2:   Hug the animal with your fist in your hand, just below the rib cage (for cats, just squeeze one hand in the same place).

You will be standing HERE with the dog up against you.

STEP #3:   With both arms, give 5 sharp thrusts (bear hugs) to the abdomen.  Perform each thrust as if it is the one that will expel the object.

STEP #4:   Stop.  Check to see if the object is visible in the airway.  If it is, remove it and give 2 mouth-to-nose rescue breaths.  If the breaths do not go in, go back to Step #1.

IMPORTANT!  DO NOT PROCEED WITH CPR EVEN IF THE ANIMAL GOES INTO CARDIAC ARREST! YOU MUST CLEAR THE AIRWAY FIRST!

B:   BREATHING

After achieving a patent airway, you must determine whether the animal is breathing and whether the breathing is effective.

STEP #1:   Carefully pull the tongue straight out of the animal's mouth to open the airway.  WARNING!  EVEN AN UNRESPONSIVE DOG MAY BITE BY INSTINCT!

STEP #2:   Make sure that the neck is reasonably straight;  try to bring the head in-line with the neck.  WARNING:  DO NOT OVER STRAIGHTEN THE NECK IN CASES WHERE NECK/HEAD TRAUMA EXISTS.

STEP #3:   Breathe at 12 breaths per minute - 1 every 5 seconds.  With each breath, just make the chest rise )do not overinflate, especially on a small animal).  IMPORTANT:  If the breaths do not go in, stop and return to A - AIRWAY!

STEP #4:   Proceed to C - CIRCULATION while continuing breathing support as necessary.

C:   CIRCULATION

This is the final step of CPR and should only be started after the A - Airway and B - Breathing steps have been completed.

STEP #1:   Make sure that there are no major (pooling/spurting blood) points of bleeding.  Control as necessary by applying pressure with your hand.

STEP #2:   Check for a pulse in the groin (check carefully on a conscious dog or cat!)

STEP #3:   Lay the animal on its right side.

STEP #4:   Locate your hands where its left elbow touches the chest, approximately the middle of the rib-cage (for cats use 1 hand in a squeezing motion).

STEP #5:   Compress the chest 15 times followed by 2 rescue breaths (3 compressions every 2 seconds).

COMPRESS:   1/2" - SMALL DOGS & CATS, 1" - MEDIUM DOGS, 1.5" - LARGE DOGS

STEP #6:   Repeat as necessary.

During an emergency it is very important that you remain calm!  Animals can sense your unease, but cannot understand what is happening and you can't tell them.

Your body language is very important.  Be calm, yet deliberate in your actions.

When you determine that you either have corrected the life-threatening problem or are unable to stabilize the animal, you should transport to the nearest emergency veterinary hospital.

Notify your emergency clinic that you are coming in with an animal with respiratory arrest with a foreign object airway obstruction and/or cardiac arrest.

Give them the following information via phone if possible:

• Your name
• Your estimated time of arrival
• Steps taken (CPR, removal of object, etc.)
• Breed/size and whether canine or feline
• If a foreign object is in the airway, what the suspected object is
• If a poison or medication has been ingested
• Mechanism of injury (hit by a car, etc.)
• Relevant medical history (diabetic, etc.)

Henry J. Feldman, DVM New York Licensed Physician, NYU School of Medicine