Pet CPR basics: a refresher

A dog or cat in cardiac arrest has minutes to live. The brain starts to suffer irreversible damage after 4-6 minutes without oxygen. The owner is the only person who can act in that window. The vet is at least 10 minutes away, often longer. The owner is the only one who can do anything that will help.

Pet CPR is the bridge between the collapse and the vet. Done correctly, it can buy 20-40 minutes of effective circulation. Done incorrectly, it can cause harm. The key is to know the difference before you need to know it.

This is the refresher. Read it now. Practice on a stuffed animal tonight. File it in the back of your mind. If you ever need it, you will be glad you did.

The first ten seconds

The animal has just collapsed. Your job in the first ten seconds is to assess, not to act. Do not start CPR on an animal that does not need it.

The assessment sequence:

Is the animal breathing? Look at the chest. Watch for 5-10 seconds. Normal breathing is obvious. Agonal breathing (gasping, irregular, open-mouth with no chest movement) is not effective breathing - it is a sign of cardiac arrest.

Is there a pulse? Feel for the femoral pulse on the inside of the thigh, in the groin area. A normal pulse is easy to feel. A very slow or absent pulse in an unconscious animal is a sign of cardiac arrest.

Are the gums pink or pale/blue? Lift the lip. Pink gums indicate circulation. Pale, white, gray, or blue gums indicate poor or no circulation.

The combination of unconsciousness, no breathing (or agonal breathing), no pulse, and pale gums is cardiac arrest. Start CPR.

The sequence: ABC

The same as human CPR, adapted for pets.

A: Airway

Open the mouth. Check for any visible obstruction - a ball, a piece of food, a toy. If something is visible and easily reachable, remove it. Do not blindly sweep the throat with your finger - you may push the obstruction further down.

Extend the head and neck slightly. In a dog, pull the tongue forward. The airway should be straight.

B: Breathing

If the animal is not breathing, give 2-3 rescue breaths. For a dog, close the mouth and breathe into the nose. For a cat, cover the mouth and nose with your mouth and breathe gently.

The breath should make the chest rise visibly. Do not over-inflate. A small dog's or cat's lungs are much smaller than a human's. A gentle puff is enough. Too much air can damage the lungs.

C: Circulation

If there is no pulse, start chest compressions. The technique depends on the size of the animal:

Small dogs and cats (under 7 kg): One-handed compression. Wrap your hand around the chest just behind the elbows and squeeze the chest between your thumb and fingers. Compress 1/3 to 1/2 of chest width.

Medium dogs (7-18 kg): Two-handed compression around the chest. Both hands wrap around the chest, compress 1/3 to 1/2 of chest width.

Large dogs (over 18 kg): Compress directly over the widest part of the chest, hands stacked, elbows locked, compress 1/3 to 1/2 of chest width.

The compression rate: 100-120 per minute. This is faster than most people think. The beat of "Stayin' Alive" by the Bee Gees is approximately 100 bpm and is a useful mental metronome. The compression depth: 1/3 to 1/2 of the chest width, allowing full recoil between compressions.

The cycle: 30:2

The CPR cycle is 30 compressions followed by 2 breaths. The cycle takes about 18-20 seconds. Repeat for 2 minutes (about 5-6 cycles), then check for a pulse. If no pulse, continue CPR. If a pulse returns, stop compressions and monitor breathing.

Do not stop CPR for more than 10 seconds. The moment compressions stop, blood pressure drops to zero, and the brain starts to suffer. If you need to move the animal, do it during a compression cycle, not between cycles.

Single rescuer vs two rescuer

If you are alone, you do the 30:2 cycle. If there is a second person, the second person can do rescue breaths every 6-8 compressions (about every 4-5 seconds) while the first person does continuous compressions at 100-120 per minute. The two-rescuer technique is more efficient but requires coordination.

What CPR can and cannot do

CPR is a bridge, not a cure. The goal is to maintain enough circulation to keep the brain alive until the underlying cause can be treated. The success rate of CPR in dogs and cats is low - studies suggest 5-20% of animals that receive CPR survive to hospital discharge. The success rate depends heavily on the cause of the arrest, how quickly CPR was started, and the underlying health of the animal.

CPR is most likely to succeed in:

Anesthesia-related arrests (caught immediately, cause is reversible)

Drug overdose or toxin exposure (cause can be addressed)

Drowning or electrocution (respiratory cause, CPR supports while cause is treated)

CPR is least likely to succeed in:

Long-standing cardiac disease with chronic heart failure

Multi-organ failure

End-stage cancer

Cardiac arrest with prolonged downtime before CPR was started

The honest framing: CPR is a low-probability, high-stakes intervention. The owner who starts CPR is giving the animal a chance. The owner who does not start CPR has guaranteed a bad outcome. The math is easy.

Common mistakes

1. Starting CPR on an animal that does not need it

A collapsed animal that is still breathing and has a pulse does not need CPR. CPR on a beating heart is harmful - the compressions can cause arrhythmias and trauma. The 10-second assessment is the safeguard.

2. Compressing too shallow or too deep

Shallow compressions do not generate effective circulation. The compression depth of 1/3 to 1/2 of chest width is a real number, not a guideline. On a medium dog, that is 4-5 cm. On a cat, that is 1.5-2 cm. Practice on a stuffed animal to get the depth right.

3. Compressing too fast or too slow

Slower than 100/min does not generate enough circulation. Faster than 120/min does not allow the heart to fill between compressions. The metronome is the safeguard.

4. Not allowing chest recoil

The chest must fully recoil between compressions. The hands come up but do not leave the chest. The recoil is what allows the heart to fill. Compressing constantly without recoil is ineffective.

5. Stopping too early

Once you start CPR, do not stop until the animal is breathing and has a pulse, or until you are physically at the vet clinic. The vet takes over. Do not give up at 5 minutes because the animal "looks dead." The animal is dead if you stop. The animal has a chance if you do not.

6. Forgetting the call for help

CPR alone is not enough. Someone needs to call the vet, get the car, drive to the clinic. If you are alone, the call for help comes after the first 2 minutes of CPR. Then back to CPR. Then drive.

The post-CPR vet visit

CPR is not a substitute for veterinary care. Even if the animal has a pulse and is breathing by the time you get to the clinic, the underlying cause of the arrest needs to be diagnosed and treated. The vet will:

Stabilize the animal with oxygen, IV fluids, and monitoring

Run diagnostics to identify the cause (ECG, bloodwork, imaging)

Treat the underlying cause

Monitor for re-arrest (common in the first 24 hours)

The owner who has done CPR is not "the one who saved the dog." The owner is the one who bought the dog the time for the vet to do the saving. Both are needed. Both matter.

The bottom line

Take a pet first aid and CPR class. The Red Cross, the ASPCA, and many local veterinary offices offer them. They are 2-4 hours, they cost $50-150, and they are the single most useful preparation you can have for a pet emergency. Reading this article is a refresher, not a replacement. The class is the foundation.

If the class is not available, read this article, watch one of the reputable online videos, and practice on a stuffed animal. Have the vet clinic's emergency number on the fridge. Have a plan for who drives. Have a plan for what to do with the other pets. The plan matters because the emergency will not wait while you figure it out.

About the author

Sofia Martinez is an emergency and critical care veterinarian based in Madrid with a DVM from the Universidad Complutense de Madrid and a residency in emergency medicine. She has spent 11 years in emergency practice, including 6 years at a 24-hour emergency and trauma center, and has personally performed or supervised hundreds of CPR events in dogs and cats. See her full profile at [authors/Sofia Martinez/](../Sofia%20Martinez.md).