Brain cells have an enormous need for oxygen; if they are deprived, even for a few minutes, they are quickly damaged and can die completely. If a dog’s heart has stopped beating, oxygen is no longer being supplied to the brain. The heart must be restarted within a few minutes if a dog is to survive. If you act quickly you can save a dog’s life: giving heart massage can restart a stopped heart, and artificial respiration can transfer the oxygen you breathe out into your dog’s lungs, until it starts breathing again. The combination of heart massage and artificial respiration is known as cardiopulmonary resuscitation or CPR.

Life-threatening situations
CPR may be needed in any of the following circumstances:

  • Blood loss;
  • Choking;
  • Concussion;
  • Diabetic coma;
  • Electric shock;
  • Heart failure;
  • Near-drowning;
  • Poisoning;
  • Shock;
  • Smoke inhalation.

When to give CPR
If your dog is unconscious, quickly assess whether the heart is still beating . If it has stopped, CPR hould be performed immediately. If the heart is beating but the dog is not breathing, give artificial respiration.

How to check if the heart is beating
Only give heart massage if your dog’s heart is not beating. There are several ways to check if the heart has stopped. Feel or listen for a heartbeat or pulse. Check the eyes: they dilate when the heart is no longer beating. Check the gums: if, when you press your finger against normal pink gums, they blanch then return to pink, the heart is still beating. If the gums do not refill with blood, the heart has stopped.

How to check if a dog is breathing
Artificial respiration should only be performed if a dog is not breathing. An unconscious dog sometimes breathes so gently it is difficult to see. If you are not sure, hold a mirror close to your dog’s nose and look for condensation: this is visible either as fogging or tiny water droplets on the surface of the mirror. If this is present, your dog is breathing. Alternatively, hold a small piece of tissue or cotton wool in front of the dog’s nostrils and watch carefully – any movement indicates shallow breathing.

Giving Artificial Respiration
If a dog has stopped breathing, but its heart is still beating, give artificial respiration until the dog starts breathing again or until veterinary help arrives. Place the dog on its side, clear any debris from its nose and mouth and pull the tongue forward. Close its mouth and, with the neck in a straight line, place your mouth over the dog’s nose and blow in until you see the chest expand. If you find this offensive, use your hand to form an airtight cylinder between your mouth and the dog’s nose, and blow through this. Take your mouth away. The dog’s lungs will naturally deflate. Repeat this procedure 10 to 20 times a minute until it breathes on its own. Check the pulse every 15 seconds to ensure the heart is still beating. If it stops, integrate heart massage with artificial respiration (see below. Get emergency veterinary help as soon as possible.

Giving CPR to Large Dogs
CPR is the combination of heart massage and artificial respiration. If you have a medium or large dog, use the procedure below; you will need a different technique if your dog is small. Do not worry about bruising a rib or applying too much pressure when giving heart massage to a large dog – this is a life-or-death situation. If a dog is not breathing, press your ear firmly to its chest: if the heart is still beating, start to give artificial respiration (see above). If you cannot hear the heart, start to give heart massage immediately. Place the dog on its side, if possible with its head lower than the rest of its body. Put the heel of one hand on the dog’s chest just behind its left elbow, then the heel of the other on your first hand. Press downward and forward at a rate of 100 times a minute, pushing towards the neck.
After 15 seconds of heart massage, give artificial respiration for 10 seconds. Continue alternating until a pulse returns, then give artificial respiration alone. If two people are present, one gives heart massage for five seconds, then the other a breath of artificial respiration. Seek immediate emergency veterinary attention.

CPR for small dogs
Place your dog on its side, if possible with the head lower than the rest of its body. Grasp its chest, behind the elbows, between your fingers and thumb. Support the dog’s back with your other hand.

  • Squeeze firmly, compressing the rib cage, squeezing up towards the neck; repeat this action using quick, firm pumps at a rate of 120 times a minute.
  • After 15 seconds of heart massage, give artificial respiration for 10 seconds. Continue alternating until a pulse returns, then give artificial respiration alone. Get immediate emergency veterinary attention

Treating a Bleeding Dog
Heavy bleeding or slow, continuous, lighter bleeding can lead to dangerous clinical shock. While internal bleeding is difficult to manage, external bleeding can often be controlled by applying pressure. If blood is spurting from a wound, an artery has been damaged; this type of bleeding will be more difficult to stop because arteries carry blood at a higher pressure (carrying blood away from the heart) than do veins (carrying blood back to the heart). Watch carefully for any signs of shockand treat if necessary.

Shock is a silent killer: a dog may look fine after an accident, then die a few hours later of clinical shock. Treating shock takes precedence over treatment for other non-life-threatening injuries. The colour of a dog’s gums gives a good clue to shock. Normal gums are a healthy pink, but during shock they become dull pink or even white. In healthy dogs, if you press your finger against the gums, blood is squeezed out of tiny blood vessels called capillaries. The gums whiten, but the capillaries immediately refill when you remove the finger. As shock advances, the time the the capillaries take to refill increases.

If you have a dog with black pigmented gums, such as a Chow Chow or Shar Pei, it is difficult to assess shock in this way. In these breeds, examine the inner lining of the vagina of a female dog – a pale colour indicates shock. For a male, retract the prepuce and examine the colour of the penis.

Signs of early shock

  • Faster than normal breathing;
  • Faster than normal heart rate;
  • Pale gums;
  • Anxiety or restlessness;
  • Lethargy and weakness; Subnormal rectal temperature;
  • Capillaries in the gums take more than two seconds to refill.

Signs of late shock

  • Shallow, irregular breathing;
  • Irregular heart beat;
  • Very pale or blue gums;
  • Extreme weakness or unconsciousness;
  • Very cool body temperature �less than 98�F (36.7�C);
  • Capillaries in the gums take more than four seconds to refill.