If your pet is experiencing difficulty breathing, profuse bleeding, or any other life-threatening ailment, these are considered “RED” – or true emergencies – on our Fast Track Triage system. We advise you to seek immediate veterinary care. Please call ahead of your arrival so the veterinary team knows to expect you!
As an animal emergency hospital, we understand a pet emergency can be a very scary and overwhelming experience for pet parents – especially if this is their first time visiting a pet ER. To help better prepare pet parents for what to expect when their pet is experiencing a life-threatening emergency, Dr. Schader, one of our emergency veterinarians, joined us on Facebook Live to walk through that process for dog and cat parents.
You can watch the Facebook Live video replay (recorded in January of 2024) here or read a summary of the discussion below.
Disclaimer: This information is for dogs and cats. Exotic pets have a separate set of protocols and procedures for life-threatening emergencies.
Common Life-Threatening Scenarios
When a dog or cat comes to our ER with a life-threatening emergency, the cause is often one of the following scenarios:
- A male cat that gets blocked (also known as a urethral obstruction or an FUO)
- A hemoabdomen (when a pet is internally bleeding into its abdomen)
- Congestive Heart Failure (CHF)
- Respiratory distress (Very common in smush-faced breeds like pugs, bulldogs, and Persian cats)
- Heat stroke (Common during the summer months)
- Exposure to toxins (including human foods, medications, rodenticides, pesticides, antifreeze, and toxic plants such as lilies)
- Trauma (such as a pet that was hit by a car or a pet that was bitten by a dog)
What Happens upon Arrival at the ER
Please keep in mind that not all life-threatening emergencies will require the same procedures discussed in this blog. That being said, when you rush into our ER with an unstable pet, here’s what happens next:
- Our front desk team will make an immediate assessment of your pet. If you called ahead of your arrival, we will be expecting you. If you need help transporting your pet into our hospital, we can bring a stretcher to your car to assist.
- The front desk team member will also ask you for your pet’s CPR code: negative or positive.
- Understand that you will be separated from your pet, and your pet will be brought straight to the treatment area so a veterinary team of five to seven people can begin emergency procedures.
- You will be escorted to an exam room and asked to complete a thorough history on your pet. You’ll want to consider any pre-existing conditions – even if they happened ten years ago. Also think about potential toxin exposures (including medications.)
- While you wait in the exam room, we will provide you with medical updates as frequently as possible.
The first photo is of an emergency “crash cart”. The second photo is of members of our team completing a RECOVER pet CPR training class.
Understanding CPR Codes
CPR, or cardio-pulmonary resuscitation, is performed if your pet’s heart has stopped and they have stopped breathing. At our ER, every pet parent is asked for a CPR code (“positive” or “negative”) – but asking for the code doesn’t mean that we’re going to immediately jump to CPR, or that it’s necessary at the time that we ask. We just need to know your wishes in case your pet’s heart does stop.
- A CPR-positive code means we will do chest compressions and place a breathing tube to try to revive your pet.
- A CPR-negative code means we will not do chest compressions or insert a breathing tube if your pet’s heart stops. A CPR-negative code doesn’t mean that we will let your pet suffer – other medical interventions may still be used – but we will not perform CPR.
Whether you choose a positive or negative CPR code – understand that your decision is valid and our team will not argue with you or judge you. You may even choose to have different CPR codes for different pets within your household – it doesn’t mean you love one pet less, it just means you are considering the individual pet and their quality of life.
The Reality of CPR Success
CPR is meant to revive your pet, but statistically speaking, CPR is typically not a very successful procedure, and the prognosis is often poor. “Successful” CPR is determined by the “return of spontaneous circulation” (ROSC) – meaning a pet’s heart is beating again and the pet is breathing on their own. ROSC still may not translate to a happy, healthy pet that gets to return home with its owner.
What Happens to Your Pet Once in the Treatment Area
As quickly as possible, our front desk staff will bring your pet to the treatment area and share your pet’s CPR code with the rest of the team. The team will drop what they’re doing and immediately assess your pet.
When a pet is CPR-positive and requires immediate CPR, a team of 5-7 people will descend upon your pet. This team will consist of one veterinarian leading the code while technicians and technician assistants fulfill other roles:
- One person is listening to your pet’s heart and breathing. If they don’t hear a heartbeat within five seconds, this person will begin chest compressions.
- A second person is placing an IV catheter, because this is essential to deliver medications and fluids to your pet, intravenously.
- A third person is hooking up your pet to our monitors (ie: an ECG to monitor heart rate, a pulse oximeter to monitor oxygen status, a blood pressure monitor, and so on.)
- A fourth person is recording everything that the team is doing. This person also has a timer to remind whoever is doing chest compressions to switch out with someone else every two minutes. (Chest compressions are tiring!)
- As the veterinarian determines which drugs are necessary and shouts out doses, a fifth person is drawing up these does from the emergency crash cart and getting them into the IV catheter (or into a vein or muscle if we don’t have a catheter yet.)
- A sixth person will place a breathing tube if your pet is having difficulty breathing.
Other Diagnostics
Sometimes, we can perform quick diagnostics to help figure out what’s going on with your pet. However, imaging and a thorough physical exam aren’t the priority if your pet’s heart has stopped or your pet isn’t breathing. Once able, the veterinarian may perform an overall physical exam and a “point of care” ultrasound. This isn’t a thorough ultrasound that a radiologist would do – this is a quick check with an ultrasound probe on your pet’s abdomen or chest to look for problems, such as:
- Obvious masses
- Air in the chest
- Fluid around the heart or in the belly
- If there is a large amount of fluid, we may be able to put a needle into the abdomen to collect a sample. That sample’s contents will also help the team determine what is the matter with your pet.
Other diagnostics, including x-rays, aren’t a priority until your pet is stable. Even if your pet was hit by a car and has an open fracture, we’ll want to address getting your pet breathing and their heart beating before assessing the broken bone. Broken bones are not imminently life-threatening, while cardiac and respiratory issues are.
Conversations with the Pet Parent
Once your pet is stabilized or while the team is performing CPR, the veterinarian may take a moment to briefly speak with you about what’s going on in the treatment area, as well as to ask you about your pet’s history or if you know what happened. The veterinarian will also discuss your pet’s condition and prognosis based on what we know so far. This conversation will lead to:
Once your pet is stabilized or while the team is performing CPR, the veterinarian may take a moment to briefly speak with you about what’s going on in the treatment area, as well as to ask you about your pet’s history or if you know what happened. The veterinarian will also discuss your pet’s condition and prognosis based on what we know so far. This conversation will lead to:
- Deciding if we should continue CPR (if pet requires CPR).
- Discussing various diagnostics, hospitalization, and a variety of treatment options with associated costs.
- With emergency scenarios, we will mention humane euthanasia as an option. It doesn’t mean the veterinarian believes this is the only next step. Instead, our veterinarians are presenting all options available to you. If you do choose humane euthanasia due to financial reasons or due to your pet’s poor prognosis, we will support you in that decision.
- Treatment approval
- One of the biggest ways animal ERs differ from human ERs is that most people do not have health insurance for their pets. Pet emergencies can incur significant costs – sometimes reaching $1000 in the first ten minutes of treatment, for CPR, medications, fluids, and ultrasound. We understand that discussing finances can be uncomfortable, but it’s necessary to ensure that your pet receives treatment that is in step with your budget.
- Note: When asked for a CPR code upon arrival, our team will also likely inquire about your willingness to spend $500-$1000. Emergencies are unpredictable, and quick decisions are essential. As for total costs, it’s important to consider that your pet probably won’t just return home after receiving CPR. Instead, you will likely incur substantial long-term costs for diagnostics, hospitalization, imaging, surgery, medications, and so on.
- We will always respect your treatment decisions and financial constraints without judgement.
- Seek advice
- Many pet parents come to our ER after experiencing a trauma with their pet. It’s hard to think rationally in this state of mind. After speaking with the veterinarian about your pet’s care options, we encourage you to take the time to process the situation and talk to a level-headed family member or friend for guidance. A neutral perspective helps ensure decisions are made in the best interests of you and your pet.
An ER vet tech monitoring a patient in our ER utilizing the “Tree of Life” – a term used in emergency veterinary medicine to refer to the use of multiple machines needed to save a patient’s life. The “Tree of Life” includes a continuous ECG monitor to track the patient’s heart rate, two fluid pumps running two different IV fluids, and three syringe pumps running three different continuous medications!
Now, tuck this information away in the back of your head. We hope your pet never has to visit our ER and you won’t ever need to recall it! We recognize pet emergencies, CPR codes, and costly treatment options can all be overwhelming, but they are crucial to consider even before a real emergency occurs – despite how uncomfortable they may be to contemplate! If your pet does experience an emergency, know that we are here to help!
More Reading:
- Transporting Pets to the Animal Emergency Hospital
- 5 Most Common Reasons for Pets to Require Emergency Surgery
- Top 10 Reasons For Veterinary Emergency Room Visits
- What to Expect at an Animal Emergency Clinic Part I
- Emergency Prevention: Four Tips to Help Prevent a Pet Emergency
Content provided by Sarah Schader, DVM.
