CPR on Dogs: A Guide to Emergency CPR for Your Pet

An emotional video showing a man rescuing a dog who had stopped breathing went viral, prompting both praise and criticism for the techniques used. Ultimately, the pup was saved and made a full recovery, but it is difficult to watch the video and not imagine your own best friend lying there helpless. Cue the waterworks!

It is important to be prepared for emergency situations like these, especially for those of us who love to explore the outdoors with our pups. CPR could someday make the difference in your dog’s chances of survival, so here is a quick guide outlining some important observations, techniques, concerns, and prevention.

Many of you who are trained in CPR and other first-responder techniques will notice the overlap between CPR procedures for dogs and humans.
Like with humans, if you notice your dog seems to be unresponsive, quickly check your ABC’s. ABC stands for: Airway, Breathing, and Circulation. You can recognize a dog in Cardio-Pulmonary Arrest by observing any of the following three things:

1. Responsiveness: does your dog respond to you?

If you notice something off about your dog, immediately check if the dog is responsive to voice or touch. You can try calling them, blowing on their faces or in their ears, and tapping on them. If the dog does not respond, immediately begin chest compressions while you look to determine whether your dog is breathing. 

2. Breathing: is your dog breathing? Is there anything obvious that might be obstructing the airway?

To check your dog’s breathing, use your eyes, ears, and touch. Can you see the chest rising and falling at all? Can you hear anything if you place your ear near their nose and mouth? Can you feel air movement around the nose and mouth? If not, immediately begin the process of CPR with chest compressions while you assess whether your dog could be choking on something. Is there anything obvious that is restricting your dog’s airways?

3. Pulse: does your dog have a heart beat?

Look, listen, and feel for a pulse. 

*Note; if your dog is unresponsive or not breathing, immediately begin CPR. Most vets recommend not wasting valuable time by actively checking for a pulse because it can be difficult to detect and those extra seconds would be better spent performing chest compressions. 

That said, there are a few ways you can feel for a pulse on a dog, some more difficult to detect than others. Practice on your healthy dog to give you an idea for how to do it. You can try by placing your hand and ear over your dog’s heart on the left side of their chest, feeling and listening for a pulse. Another reliable technique is to slide your fingers inside your dog’s thigh above their knee and feel for the femoral artery, which should have a steady and noticeable pulse in a healthy dog. 
If you cannot detect a pulse and the dog is not responsive, begin CPR. 
It is important to make these observations quickly. Do not spend more than 10-15 seconds on the ABC’s.

When do I need to start CPR on my dog?

If you notice any of these three signs, immediately start CPR. You might ask: how do I know for sure if my dog is in Cardio-Pulmonary Arrest? According to my veterinarian and other supporting research, it is best to begin CPR as soon as possible. If you perform CPR correctly, it is a fairly safe procedure, and the various steps involved will take you through the steps of determining your dog’s condition anyway. Therefore, if you notice any of the three previously mentioned symptoms, immediately begin CPR regardless. Time is a critical factor, especially in dogs, so a few seconds saved could make the difference.
Before beginning, remember that if you find yourself in this situation, it is extremely important to remain calm and cerebral—your dog’s life might depend on your ability to stay lucid and work your way through these steps.
If there is anyone around to help, be sure to call for help. CPR is physically exhausting and having extra hands there will be a huge help.
When recruiting help, it is more effective to delegate tasks to specific people. Rather than asking for “someone” to help you, or for “someone” to call the emergency response line, look and point at a specific person and tell them directly to either help you or to call the emergency team. This helps to prevent the bystander effect where everybody assumes someone else is already helping.

Chest Compressions:

Dogs of different sizes will have different average resting heart rates. Smaller dogs tend to have faster heart rates than larger dogs. However, the goal of CPR is not to mimic a regular heartbeat directly, but rather to assist the patient’s circulatory system in cycling the de-oxygenated blood. The build up of carbon dioxide in the blood stream helps to trigger the nervous system into operation, so it is important to cycle the blood throughout the body by compressing the heart and then allowing the chambers of the heart to refill before compressing again. 
The recommended rate of chest compressions during CPR on dogs is around 110 to 120 beats per minute, which is also what is generally taught for CPR on humans. You might have heard it before: you can time your chest compressions to the beat of “Stayin’ Alive” by the Bee Gees, or to Queen’s “Another One Bites the Dust.” This will help you stay on track administering about 2 chest compressions per second. 
To administer chest compressions on most dogs, make sure the dog is lying on its side. Do NOT role the dog onto its back the way you would with a human. There can be exceptions to this rule for extremely flat and wide chested dogs like French Bulldogs, but for most dogs, the dog should be on its side. You can perform CPR on either side of the dog, so it does not matter whether the dog lies on its left or right side.

For round-chested dogs like Labradors: perform compressions on the highest area of the barrel/chest. For keel-chested dogs, like Boxers or Dobermans, perform compressions directly over the heart. You can locate the heart by following where the dog’s elbow would naturally touch their chest. Place your hands over that area for compressions. 
If you are performing compressions on a flat-chested dog and need to lie the dog on its back, place your hands directly over the sternum for compressions.

CPR on Flat-Chested French Bulldog

Performing compressions is tiring. It is important to use proper technique both to control the amount of force used and to maintain endurance. Place one hand behind the other, lock your elbows so that your arms are straight, do not roll your back, and begin chest compressions. Movement should engage your core and you will bend at the waist. Do not bend your elbows. Remember that it is important that the heart compresses, then has a chance for the chambers to refill. Be sure you do not lean with steady pressure on the dog because that could impede chamber refill.
The amount of force you need to use will vary for different sizes and builds of dogs. The general rule of thumb is to compress the chest 1/3 to 1/2 the width of their chest.
Perform 30 chest compressions, then administer two breaths.

Administering Breaths:

Administering Breaths to a dog during CPR

Provided intubation is not possible, you will need to administer breaths to the dog. Ensure the dog’s mouth is closed, then wrap your hand along the dog’s lips to help seal the mouth and prevent air from leaking out. Be sure the dog’s nostrils are exposed. Sometimes, the dog might have liquid coming out of the nostrils. Wipe away any excess liquid that might obstruct your breaths, then place your lips around both nostrils of the dog. Perform two deep exhales into the dog’s nose. You should see the dog’s chest rise with the breaths and the air should pass without obstruction. After two breaths, immediately recommence chest compressions. 
It is important to perform CPR for a cycle of two minutes uninterrupted. Remember to administer two breaths after every 30 chest compressions. Once you have performed two uninterrupted minutes of CPR, take 5 seconds to check your ABC’s again. If there is no sign of responsiveness yet, immediately begin another round of CPR, substituting out with someone if you have the help.

To Recap: 

Step 1: Stay calm and lucid
Step 2: Call for help
Step 3: Quickly assess the ABC’s
Step 4: Begin chest compressions at 120 beats per minute
Step 5: Give 2 breaths after every 30 chest compressions
Step 6: After 2 minutes of CPR, quickly check ABC’s again
Step 7: Begin another cycle of CPR
Step 8: Repeat until help arrives or the dog becomes responsive and capable of sustaining its breathing and a regular pulse
That is the general process for performing CPR on a dog who might be in Cardio-Pulmonary Arrest. Cardio-Pulmonary Arrest can occur for any number of reasons. Listing possible causes and their prevention could and has filled whole books dedicated to the subject. Many causes can be more common in certain breeds of dogs, or dogs with certain pre-existing conditions. Be sure to discuss these with your vet so you can better prepare yourself to prevent a future situation where you might need to use CPR on your pup. Once a dog falls into Cardio-Pulmonary Arrest, their chances of survival drop drastically. If you ever do find yourself in the unfortunate situation of needing to administer CPR to your pup, I hope the contents of this article will help you in that scary situation. Be prepared, be preventative, and keep enjoying the outdoors with your best friend!
Take a look here for some helpful commands to teach your pups before you go hiking with them: 5 Less Common Commands for Hiking with your Dog

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