Today’s article is inspired by an unfortunate event that occurred this morning: I nearly lost one of my dogs to a choking incident. Problems arose while I was feeding my disabled dog Kota. She requires hand-feeding due to an MS-like condition that has damaged the nerves in her jaw and face, leading to a condition called Trigeminal Neuritis (also known as “TN” or “drop jaw.”) She also has megaesophagus, which is a condition that affects the muscles in her esophagus. Normally, the muscles in the esophagus pull the food down and into the stomach (as a result, we must keep her vertical so gravity pulls the food down instead.)
Due to her conditions, Kota’s food must be made to a milkshake consistency. But today, I made it a bit too thick and it backed up in her esophagus, as gravity wasn’t pulling it down into her stomach fast enough. Once it reached the point where her trachea (windpipe) branches off, it blocked her airway and she was unable to breathe.
Kota exhibited the classic symptoms of a choking dog or cat — she stopped breathing entirely and she did not attempt to cough. She immediately started panicking; she started squirming around and moving her head in a manner that made it appear as though she was attempting to regurgitate (but without success.)
Within about 30-45 seconds, she went completely limp and lost consciousness. Her tongue had turned white — also classic symptoms of choking. I tried to clear her airway by hand, but I quickly realized the blockage was in her esophagus and beyond my reach.
You can perform the Heimlich maneuver on dogs, cats and other animals, but it’s not all that effective if the victim is choking on liquids. So to clear her airway, I called upon my dog midwifery skills. Often, puppies are born with fluid in their airway; you must clear this fluid from their airway to allow them to breathe. To clear the puppy’s airway, you hold it upside down over your head and swing the puppy downward, stopping abruptly when the puppy is near your knees. This “jerking” motion of the sudden stop causes the fluid to be expelled from the airway. It’s called a “shake down.”
I performed a “shake down” on Kota and fortunately, it brought up the food that was obstructing her airway. But she had already stopped breathing by this point, so I performed CPR using the following method:
- Ensure the obstruction has been removed from the victim’ airway. CPR will not be successful if the airway is still blocked.
- Feel for a heart beat at the center of the pet’s chest, in the area between the front legs. If the heart is beating, you do not need to perform chest compressions. This is potentially harmful to the dog; you may counteract the heart beats with compressions or you may cause an arrhythmia. (Fortunately, Kota’s heart was still beating.)
- Ensure the pet is not breathing. Look for the chest rising and falling or place your ear and the snout and listen for breath.
- Position the pet on the ground for CPR. For large dogs, you must place them on their side and you should kneel beside them to perform CPR. For cats and small dogs like Kota (under 45 lbs.), place the animal on her back and kneel behind the pet with your knees facing the animal’s head.
- Interlace your fingers and place them over the rib cage, over the heart (located at the center of the chest, between the front legs.) Perform five compressions in quick succession.
- Press for a count of 2, then release for a count of one, then press down for a count of 2, release for a count of 1 and repeat.
- Close the pet’s mouth and place your mouth over the snout, covering both the mouth and nose.
- Take a deep breath and breathe into the animal’s body. Stop blowing once the chest stops rising.
- Perform five chest compressions, followed by one breath and repeat this pattern. Every few cycles, stop and feel for a heart beat and look for signs of breathing. If there is a heart beat, only breathing will be required; you will not need to perform compressions. In this case, give one breath every three seconds.
Continue CPR until the pet regains consciousness or until you arrive at the veterinary clinic.
When performing CPR on a pet or human, you must place them on the floor. If you attempt to perform compressions on a couch, bed or other soft surface, you’ll just be pushing the body down into the cushion; you won’t compress the heart effectively.
There is a risk of injury during CPR; you may break ribs while performing chest compressions, but unfortunately, this is something that is unavoidable. Broken ribs are a CPR-associated risk for pets and humans alike, but at the end of the day, it’s better to be alive with a broken rib vs. being dead with intact ribs.
Fortunately, it took just a few breaths to revive Kota. It took about two minutes for her color to return to normal. So this time, it was a happy ending and we will take precautions to ensure this doesn’t occur again in the future. In Kota’s case, we’ll water down her food a bit more so it passes down her esophagus faster; we’ll slow down her feedings; and we’ll ensure she remains upright during feedings (she had slid down slightly during the course of the feeding, resulting in a slightly more horizontal body position.) We’ll also keep suctioning equipment on-hand to make it easier to clear her airway.
This situation illustrates the importance of knowing how to clear a pet’s airway and how to perform CPR, especially if your pet suffers from megaesophagus or another condition that makes her more prone to choking. This potentially deadly situation unfolded in a matter of seconds; there wasn’t time to “Google” an article or call the vet’s office. You have to be prepared to act immediately.
That said, it’s helpful to examine your pet before a problem arises. Feel your pet’s chest and familiarize yourself with the best location to feel her heart beat. Put your ear up to your pet’s nose and listen to the sound of her breathing, so you know what it sounds like. Examine your pet’s gums and tongue so you know what they look like when the animal is healthy. And, of course, take the time to read up on pet CPR and the Heimlich maneuver. It’s knowledge that may very well save your pet’s life one day! I’ve owned animals my entire life, and I’ve never had to perform CPR before today, but I’m really thankful I had this knowledge, as it saved my best friend.
See our related article on How to Clear an Airway and How to Perform CPR on a Cat, Dog or Another Pet.