(A Veterinarian's Perspective)

First Aid

Definition of First Aid For Your Pet:  First Aid is the immediate care given to a pet who has been injured or suddenly taken ill. 

In an emergency, first aid is not a substitute for veterinary treatment.  However, knowing basic first aid could save your pet's life.  Here in this section of my webpage, I will try to cover some basic emergency situations and how to handle them.  If you have any questions, or would like me to add a something about a particular emergency requiring first aid,  feel free to contact me.

The First Aid Kit:

My first aid kit contains the following items:

	1" and 2" adhesive tape
	2" roll gauze (which can serve as a muzzle)
	Newspaper and plastic food wrap (for a splint)
	Thermometer
	Nolvasan (Chlorhexidine) or Betadine (Povidone) antiseptic
	E-collar
	Eye wash (saline in a squirt bottle)
	Alcohol
	Hydrogen peroxide
	2" and 4" gauze and gauze pads
	Scissors
	Blanket with a heat pack (if possible)
	K-Y jelly
	Ice pack
	Tweezers or Hemostats
	Veterinarian's phone number (and emergency number)
	Poison Control's phone number

 

Bleeding: Pets often suffer blood loss as a result of trauma. If bleeding is severe or continuous, the animal may lose enough blood to cause shock (loss of as little as 2 teaspoons per pound of body weight may cause shock). Emergencies may arise that require you, the owner, to control the bleeding, even if it is just during transport of the animal to the veterinary facility.  You should know how to stop hemorrhage (bleeding) if your pet is injured.

Techniques to Stop External Bleeding 

1. Direct Pressure:  Gently press a  pad of clean cloth or gauze over the bleeding absorbing the blood and allowing it to clot.  Do not disturb blood clots after they have formed. If blood soaks through, do not remove the pad; simply add additional layers of cloth and continue the direct pressure more evenly. The compress can be bound in place using bandage material which frees the hands of the first provider for other emergency actions. In the absence of a compress, a bare hand or finger can be used.
                            Direct pressure on a wound is the most preferable way to stop bleeding.
    
2. Elevation:  If there is a severely bleeding wound on the foot or leg, gently elevate the leg so that the wound is above the level of the heart.  Elevation uses the force of gravity to help reduce blood pressure in the injured area, slowing the bleeding.  Elevation is most effective in larger animals with longer limbs where greater distances from wound to heart are possible. Direct pressure with compresses should also be maintained to maximize the use of elevation.
    
3. Pressure on the Supplying Artery:  If external bleeding continues following the use of direct pressure and elevation, finger or thumb pressure over the main artery to the wound is needed. Apply pressure to the femoral artery in the groin for severe bleeding of a rear leg; to the brachial artery in the inside part of the upper front leg for bleeding of a front leg; or to the caudal artery at the base of the tail if the wound is on the tail. Continue application of direct pressure.
    
4. Pressure Above and Below the Bleeding Wound:  This can also be used in conjunction with direct pressure. Pressure above the wound will help control arterial bleeding. Pressure below the wound will help control bleeding from veins.
    
5. Tourniquet:  Use of a tourniquet is dangerous and it should be used only for a severe, life-threatening hemorrhage in a limb (leg or tail) not expected to be saved. A wide (2-inch or more) piece of cloth should be used to wrap around the limb twice and tied into a knot. A short stick or similar object is then tied into the knot as well. Twist the stick to tighten the tourniquet until the bleeding stops. Secure the stick in place with another piece of cloth and make a written note of the time it was applied. Loosen the tourniquet for 15 to 20 seconds every 20 minutes. Remember this is dangerous and will likely result in disability or amputation.

   Use of a tourniquet should only be employed as a last-resort, life-saving measure!

    

Internal Bleeding

Internal bleeding is a life-threatening condition, but it is not obvious like external bleeding. Any bleeding which is visible is external. Internal bleeding occurs inside the body and will not be seen. There are, however, external signs of internal bleeding:

	The pet is pale (check the gums or eyelids).
	The pet is cool on the legs, ears, or tail.
	The pet is extremely excited or unusually subdued.

If any of these signs are evident, the pet should be immediately transported to a veterinary facility for professional help. Remember: internal bleeding is not visible on the outside

 

Diarrhea and Vomiting:

What to Do:

  Remove all food and water.
  Check for signs of dehydration.
  If the diarrhea and/or vomiting continues or the pet acts ill, seek veterinary attention. Diarrhea and vomiting can quickly lead to serious fluid loss and electrolyte imbalance, especially in the very young and the very old. 
  If no vomiting occurs for 6 to 8 hours, begin to give small amounts of clear liquids (water, Gatorade, Pedialyte, or other electrolyte solution) frequently. A rule of thumb is to give 1 teaspoon per pound of body weight every 2 or 3 hours throughout the day and night. 
  Isolate the sick pet from other pets.

What NOT to Do

  Do not medicate your pet without talking to your veterinarian. 
  Do not allow the pet to eat or drink anything until there has been no vomiting for 6 to 8 hours.

Vomiting and diarrhea are associated with a host of problems which are referred to collectively as gastroenteritis. Some cases are quite severe (e.g., poisoning, or GI obstructions), and some are not (e.g., dietary indiscretion).  If fever is present, infection may be a cause.

If your pet is not feeling well and has vomiting and/or diarrhea, he should see a veterinarian.

 

Poisons:  If you suspect that your pet has consumed a substance that is poisonous, look for evidence (i.e., an open container or RAT POISON, a pool of ANTIFREEZE, etc.). Call your veterinarian or a poison control center and be prepared to answer the following questions:

	What product caused the poisoning and how much was ingested?
	When did the poisoning occur?
	What symptoms are your pet exhibiting?
	Can you retrieve a container or label from the poisonous substance to determine the active ingredient?

Follow the instructions of the veterinarian or the poison control center.

If you cannot get in touch with a veterinarian or a poison control center, then induce vomiting:

Give full strength (3%) hydrogen peroxide by mouth at a dosage of 1 tablespoon (15cc) per 15 to 20 pounds of body weight, or syrup of ipecac (follow label directions)

Do not induce vomiting if:

	The animal is unconscious, semi-conscious, or seizuring.
	There is evidence that the poison was: a strong acid or an alkali (such as bleach -- this would cause more damage coming back up), a petroleum product (these would increase the risk of aspiration if vomiting is induced), a cleaning product, the substance was ingested more than 3 hours ago.

If the pet is going to be transported to a veterinary facility, search for containers of the poison to take with the animal. Transport the pet immediately: don't wait until vomiting commences (if you induced vomiting). Cleaning out your car is a small price to pay for a successful outcome in a serious poisoning case.

If you have any doubts as to whether a substance is poisonous, call a veterinarian or a poison control center.

 

Fractures / Injuries:

Fracture: a break or crack in a bone.
Closed fracture: fractures in which there is no related external wound.
Open (compound) fracture: fractures associated with open wounds (the bone may be visible through the wound).
Dislocation: injury to connective tissues holding a joint in position resulting in displacement of a bone at the joint.
Sprain: an injury to a joint, ligament, or tendon in the region of a joint. It involves partial tearing or stretching of these structures without dislocation or fracture.

What to Do:

  Muzzle and or cover the head of the pet before treatment to prevent biting injury to the first aid provider.
  Open fractures should be dressed with a wet, clean dressing applied over the opening and bone. 
  If possible, the limb should be immobilized with a splint to prevent further injury.
  Carefully transport him to a veterinarian.

Splints can be fashioned out newspapers or magazines or coat hangers.  You can also make a splint out of sticks of wood supporting the fracture, fixed in place with tape or cloth.

Any splint should extend past at least one joint above and one joint below the fracture site.

What NOT to Do

  If the splint is difficult to apply or the animal objects, do not attempt splinting.
  Never attempt to set or reduce a fracture or try to push a protruding bone back into position.

A fracture or dislocation or severe sprain may be suspected when the animal suddenly appears lame on a leg, or picks up a leg and won't use it. They may also be suspected following any major fall or blunt injury. Obvious findings of a bone protruding from a wound are rare. What is more common is the unusual angulation or deformation of the fractured area, and swelling. Accurate diagnosis requires the use of x-rays.

An x-ray is the only way to accurately diagnose a fracture 

 

Heat Stroke -- Hypethermia:  The significant elevation of body temperature above normal. It is sometimes indicative of a fever, but it can also be associated with severe conditions such as heat stroke.  Any time the body temperature is higher than 106 degrees, a true emergency exists.

What to Do

	Remove the pet from the environment where the hyperthermia occurred.
	Move the pet to the shade and direct a fan on him.
	If possible, determine rectal temperature and record.
	Begin to cool the body by wetting with cool (not cold) water on the trunk and legs. It is helpful to use rubbing alcohol on the skin of the stomach and allow the fan to speed evaporation.
	Transport to a veterinary facility.

What NOT to Do

	Do not use cold water or ice for cooling.
	Do not overcool the pet.
	Do not attempt to force water orally.
	Do not leave the pet unattended for any length of time.

In the summertime, other than fever, the most frequent cause of hyperthermia is heat stroke.  Keep in mind that prolonged seizures, eclampsia (milk fever), poisonings, and many other conditions may also cause hyperthermia.  The bracycephalic (short-nosed) breeds (Pekingese, Chinese Pug, Lhasa Apso, Boston Terrier, etc.) may suffer from ineffectual panter syndrome  which results in an increased body temperature that can be fatal.

The most common sign of heat prostration or heat stroke is vigorous panting. The pet is likely to be lying on its side, unable to stand, although some are restless and agitated.  There may be a thick, ropy saliva in the mouth, or froth coming from the mouth and/or nose. Often the pet seems to be rigid, extending its head, neck, and limbs. The mucous membranes are often red but may be pale or "muddy." The pet may show signs of shock.

Rapidly cooling the pet is extremely important. While ice or cold water may seem logical, its use is not advised. Cooling the innermost structures of the body will actually be delayed, as ice or cold water will cause superficial blood vessels to shrink, effectively forming an insulating layer of tissue to hold the heat inside. Tap water is more suitable for effective cooling.

Severe hyperthermia is a disease that affects nearly every system in the body. Simply lowering the body temperature fails to address the potentially catastrophic events that often accompany this disorder. A pet suffering from hyperthermia should be seen by a veterinarian as soon as possible.

 

Seizures / Convulsions:  A seizure is any sudden and uncontrolled spastic type of movement of the animal's body caused by abnormal brain activity.  Seizures may be very severe and affect all of the body, or quite mild, affecting only a portion of the pet.  The pet may or may not be conscious, and may urinate or have a bowel movement

What to Do

  Protect the pet from injuring itself during or after the seizure. Keep him from falling and especially keep him away from water.
  Remove other pets from the area.
  Record the time the seizure begins and ends.
  If the seizure or convulsion lasts over 5 minutes, wrap the pet in a cool, wet towel and seek veterinary attention at once. 
  If the pet loses consciousness and is not breathing, begin CPR.

What NOT to Do

  Do not place your hands near the pet's mouth. They do not swallow their tongues and you are at risk of being bitten.
  Do not slap, throw water on, or otherwise try to startle your pet out of a seizure -- it will end when it ends, and you cannot affect it by slapping, yelling, or any other action.

 

Snakebite:  When your pet is "struck" by a snake, it is best to assume it is a poisonous bite.

What to Do:

	Immobilize the part of the animal that has been bitten by the snake. Try to keep it at or below the level of the heart.
	Keep the pet calm and immobile; carry if necessary.
	Seek veterinary attention as soon as possible.
	Try to retrieve the snake if it can be done without risk.  It is sometimes helpful to identify the type of snake.

What NOT to Do

	Do not cut over the fang marks.
	Do not manipulate the bitten area any more than needed.
	Do not allow the pet to move about freely.
	Do not ice pack or tourniquet the area.
	Do not administer any medications except on a veterinarian's advice.
	Do not use electric shock on the area.

Snakebite is a complex problem. The severity and type of damage done by venom depends on the type of snake involved.  If your pet is bitten by a snake, assume the bite is poisonous and seek veterinary attention quickly.