Improvements in Pet CPR
My pet sitter recently took a training course in pet CPR (cardiopulmonary resuscitation). I think it’s great that she’s trying to do more to protect the pets under her care, but the pragmatist in me wonders if she’s wasting her time. The unfortunate truth is that performing CPR on a dog or cat that has stopped breathing and doesn’t have a heartbeat is almost always ineffective.
Take a look at this depressing stat: Only 6-7% of dogs and cats that stop breathing and don’t have a heartbeat while in the veterinary hospital survive to return home to their families. And this is when doctors, technicians, and drugs that can make a huge difference in life and death situations are all within arm’s reach.
Also, I assume this 6-7% figure includes cases of cardiopulmonary arrest that occur while pets are under anesthesia. These cases have the highest chance of a successful outcome because some of these pets are relatively healthy (e.g., not suffering from diseases that are the underlying cause of their cardiopulmonary arrest and that will still be present even if they are revived), are already intubated, have an IV catheter in place, and are being closely monitored so that intervention occurs more or less immediately. Take the anesthetic cardiopulmonary arrests out of the equation, and I suspect the picture for CPR "success" in pets is even bleaker. I seem to remember 2% being what I was taught in veterinary school, but don’t quote me on that.
In an effort to improve these dismal stats, more than 100 veterinary specialists in emergency and critical care have collaborated to develop standardized, evidence-based guidelines on how to best perform CPR on dogs and cats. The initiative goes by the acronym RECOVER (Reassessment Campaign on Veterinary Resuscitation) and involved the review of over more than 1,000 clinical and/or experimental papers, resulting in recommendations falling under five categories: Preparedness and Prevention, Basic Life Support, Advanced Life Support, Monitoring, and Post-Cardiac Arrest Care.
- Perform 100-120 chest compressions per minute over one-third to one-half of the chest width, with the animal lying on its side.
- Ventilate intubated dogs and cats at a rate of 10 breaths per minute, or at a compression to ventilation ratio of 30 to 2 when performing mouth-to-snout ventilation.
- Perform CPR in 2-minute cycles, switching the person performing compressions each cycle.
- Administer vasopressors (i.e., medications that constrict blood vessels) every 3–5 minutes during CPR.
The special issue of the Journal of Veterinary Emergency and Critical Care that contains all of the initiative’s findings is available at no charge online. A standardized training course that implements these guidelines is in the works.
RECOVER’s objective is to raise the pet CPR success rate to what is currently achieved in human medicine — around 20%. It’ll take some time to retrain veterinarians, veterinary technicians, and the public as to how to perform pet CPR most effectively, but it will be worth the effort if we can more than double its chances of success.
Dr. Jennifer Coates