Chapter 20: Puppy First Aid

Chances are good that at some point in your dog’s life, he may need first aid or emergency veterinary care. The most important step in first aid is preventing emergencies from happening. However, as you probably already know, puppies are ingenious and have the uncanny ability to get into any and all sorts of trouble—always at the most inopportune times.

Despite having puppy-proofed your home and yard, any number of situations exist in which injuries may occur, be it a bee sting, minor scrape or cut, torn toenail, or something more serious, such as choking, a broken bone or tooth, or poisoning. If your puppy is sick or injured, always err on the side of caution and seek immediate veterinary care, be it with your regular veterinarian or a twenty-four-hour emergency clinic.

Recognizing the difference between a minor situation and a life-threatening medical emergency will help you decide if the situation can be treated at home, coupled with a “wait and see” attitude, or if you need to seek immediate emergency medical attention.

The American Red Cross as well as several other organizations, such as Pet Responder and Wag’N Pet Emergency Management, offer pet first-aid and CPR classes that teach you how to respond to emergencies and provide basic first aid. Knowing what to do in an emergency will help to keep you calm and focused. At the minimum, you should know how to perform the basic procedures, including:

•applying a muzzle

•sliding an injured dog onto a flat board or using a blanket as a makeshift gurney

•transporting an injured dog in a safe and stable manner for both dog and owner

•taking a rectal temperature

•checking a dog’s heartbeat

•taking a dog’s pulse (femoral artery)

•cleaning and dressing, if necessary, a minor wound

While first aid is not a substitute for veterinary care, a little advance preparation may be just enough to relieve your pet’s suffering and possibly save his life until you can get to an emergency clinic.

Life-Threatening Symptoms

Most life-threatening situations involve deterioration of the cardiovascular, respiratory, or central nervous system. If your puppy exhibits any of the following symptoms, or if you suspect something is wrong, seek veterinary assistance right away:

•bleeding that is profuse and/or cannot be stopped

• difficult or labored breathing or no breathing at all

•collapse, coma, depression, extreme lethargy, or lack of consciousness

•uncontrolled or bloody diarrhea or black, tarry stools

•pale bluish or white gums

•pain

•seizures

•temperature above 105°F or 40.5°C (a dog’s average temperature is 101°F to 102.5°F or 38.3°C to 39°C)

•broken, bleeding, or loose teeth

•vomiting blood or uncontrolled vomiting

Puppies that are exposed to trauma, poisoning, or gastrointestinal distress may need immediate emergency veterinary care. Situations that should cause you increased concern include:

•bite from a snake, poisonous spider, toad, or other animal, especially a cat or unvaccinated animal

•burns (hot liquids, fire, electrical blankets)

•electrocution (e.g., from chewing on an electrical cord)

•excessive heat or cold

•frostbite

•overdose of medications

•porcupine quills embedded in the skin

•puncture wounds

•trauma of any kind—hit by a car, kicked by a horse, fell from a deck, and the like

•smoke inhalation

•swallowing foreign objects (toy, marble,

Dog owners need to be prepared for anything.

First-Aid Kit for Dogs and Owners

As a dog owner, a well-stocked canine first aid kit is a must-have. If you travel frequently with your dog, you might consider one kit for your home and one for your vehicle. While many of the supplies in a human first-aid kit can be used for pets, too, you may prefer to have a separate one for your dog. Either way, appropriate first-aid supplies will allow you to more readily deal with any canine medical issue that arises.

First-aid kits vary. Some contain enough medical paraphernalia to perform minor surgeries. Others are small kits that clip on your belt for walking, hiking, and so forth. Home kits should contain basic first-aid necessities. Whether you choose to purchase a colossal preassembled kit, a basic home kit, or customize your own, be sure to include:

•activated charcoal, available from pharmacists, or milk of magnesia (to bind or neutralize certain poisons)

•alcohol or alcohol prep pads for sterilizing scissors and tweezers; not for use on wounds

•eye wash for flushing out eye contaminants

•gauze rolls and gauze pads for wrapping wounds or muzzling an injured dog

•gloves (disposable latex) for protecting hands and preventing contamination of wounds

•hydrogen peroxide 3% USP or Ipecac to induce vomiting if necessary

•instant cold pack/instant heat wrap

•large eye dropper, bulb syringe, or large medical syringe without the needle for flushing wounds

•medications, including antidiarrheal medicine (e.g., Imodium, FortiFlora) and aspirin (not nonsteroidal anti-inflammatory drugs such as acetaminophen or ibuprofen)

•muzzle

•nonstick bandages, towels, or strips of clean cloth to control bleeding or protect wounds

•scissors and tweezers

•styptic pencil or cornstarch (an anticoagulant) to stop bleeding if a nail is broken, torn, or clipped too short

•thermometer designed specifically for dogs (the temperature of regular thermometers does not always go high enough for pets)

•triple-antibiotic ointment/spray to inhibit bacterial growth in cuts and abrasions

These are the basics of most canine first-aid kids. You may also want to consider a few extras, including:

•antiseptic towelettes

•Benadryl 25 mg or Aller-tec (cetirizine hydrochloride tablets 10 mg) for temporary relief of itching and scratching due to allergies

•canned or dehydrated pumpkin (works as both an antidiarrheal agent and natural laxative); particularly recommended for any dog who carries the MDR-1 gene and may not be able to take certain drugs, including antidiarrheal medications

•EMT gel (applied to a wound to reduce bleeding, seal off nerve endings to reduce pain and itching, and form a protective barrier over the wound to reduce infection)

•Famotidine (available from a veterinarian or over the counter as Pepcid AC 10 mg) to remedy stomach upset/vomiting by reducing the amount of stomach acid being produced

•flexible cohesive wrap for securing wound wraps

•hydrocortisone cream

•list of emergency numbers for poison-control center, veterinarian, and twenty-four-hour emergency clinic

•rehydrating solution, such as Pedialyte, to replace lost electrolytes

•Rescue Remedy (Bach Original Flower Essences), a natural stress-reliever for calming dogs.

•sterile saline wound flush

•wound-healing spray, such as tea tree oil, formulated for cuts, scrapes, abrasions, and hot spots

"An ounce of prevention…" goes the saying. While minor wounds can be treated at home, a canine first-aid class will go a long way in preparing you for minor or very serious emergencies. When in doubt, always seek veterinary care immediately. For more information about first-aid kits or classes, contact your local veterinarian or the American Red Cross.

There’s an App for That

The American Red Cross has a pet first-aid app that puts veterinary advice for everyday emergencies in the palm of your hand.

Common First-Aid Emergencies

Unexpected emergencies can happen in an instant, whether due to health problems, accidents, or even everyday household items.

Antifreeze (Ethylene Glycol) Ingestion

Dogs are attracted to antifreeze, supposedly because of its appealing taste. All dog owners should be highly aware of its danger, as damage caused by very small amounts is irreversible and life-threatening. As little as a single tablespoon of antifreeze can result in acute kidney failure; about 5 tablespoons can kill a medium-sized dog.

Symptoms can occur within thirty minutes to twelve hours and include, but are not limited to:

•uncoordinated movement, staggering, depression, seizures (usually within the first hours)

•nausea, vomiting

•excessive urination

•diarrhea

•panting

•rapid heartbeat

•weakness

•fainting

•coma

A dog may appear to feel better in a day or two, but more severe internal damage is still occurring. Recovery depends on how quickly your dog is treated by a veterinarian. Once your dog ingests antifreeze, a small window of time for treatment exists. The sooner your dog is treated, the better his chance of survival. Once kidney failure has set in, dogs can occasionally be saved with aggressive treatment. Unfortunately, kidney damage caused by antifreeze poisoning is usually severe, irreversible, and, in many cases, life-threatening.

Cardiac Arrest

If you realize your dog is not breathing, you should immediately get him to the closest veterinary or twenty-four-hour emergency clinic. Unfortunately, the outcome is usually not promising. According to the American Veterinary Medical Association (AVMA), less than 6 percent of dogs who experience cardiopulmonary arrest while in a veterinary clinic survive. If your dog stops breathing, cardiac arrest will soon follow. Only attempt cardiopulmonary resuscitation (CPR) in extreme emergency, as this emergency procedure can cause fatal damage if not done correctly or if performed on a dog that is not in need of the procedure. Here is the basic CPR procedure:

•Lay the dog on his side on a flat, hard surface that will not bend when the chest is compressed.

•A dog’s heart is located just behind his front legs (right around the point of the flexed elbow). Apply pressure with the flat part of your hand directly over the heart area with a force that is appropriate for the size of the dog at a rate of about 80 to 100 compressions per minute, again depending on the size of the dog. (A small, fragile dog or puppy cannot sustain the same pressure as a large, heavy-boned dog without injury.)

•If you are the only person available, breathe into your dog’s nose once for every five compressions that are done. If you have someone to help you with compressions, give artificial respiration after every two or three compressions.

•Continue with the CPR and artificial respiration until the dog begins breathing on his own and the pulse becomes steady.

No strict rules apply as to how long you should continue CPR. If the heart has not begun to beat within five to ten minutes, it may not be helpful to persist. It is worth noting that this is a basic CPR outline. A pet first-aid class will give you firsthand experience at performing CPR, which will help you remain calm and effective.

Choking

Dogs can choke on any number of items from doll parts to safety pins to pieces of dog bones. Dogs who wolf down their food too quickly can choke, too. Any obstruction in your dog’s airway is a life-threatening emergency and requires immediate medical attention to prevent brain damage or death.

Symptoms vary, but the most common signs include an acute onset of vigorous breathing efforts and may also include coughing, gagging, or a retching noise, and pawing at the side of the face. The coloring of the dog’s gums and tongue will change rapidly (in as little as sixty to ninety seconds), and he may collapse. Seek immediate veterinary attention.

The dog’s airway needs to be cleared immediately. Time is of the essence because once a dog goes unconscious, you may have less than one minute before his heart stops beating. You can attempt a modified Heimlich maneuver by following these steps: Position yourself behind the dog. Wrap your arms around his body, just behind his rib cage. Wrap one hand around the other to make a double fist, placing the double fist on his abdomen beneath or behind the rib cage, and apply a brisk compression. It may take several attempts to dislodge or expel the object.

If you are unsuccessful, and your dog is still not breathing, work on clearing the airway. Many veterinarians are adamantly opposed to sticking your fingers in the mouth of a choking dog. Instead, pull his lower jaw open and tilt his head upward. If an object is visible, try to remove it with your finger without pushing it deeper. Use extreme caution to avoid being bitten. Regardless of how friendly your dog might be, a panicked, choking dog is likely to bite as a reflex mechanism.

Once you have cleared the dog’s airway, have him examined by a veterinarian as soon as possible. As with most medical issues, a first aid-class (or your veterinarian) can show you how to perform the maneuver well in advance of needing it.

Brachycephalic breeds like the Dogue de Bordeaux have more difficulty in hot weather. Provide your dog with shade, lots of cool water, and a place to take a dip!

Heat-Related Issues

The average dog’s temperature is 101.5°F or 38.6°C, with a normal range between 101°F and 102.5° F or 38.3° and 39°C. These are core temperatures, based on rectal thermometer readings. While temperatures can vary throughout a dog’s body, the core temperature is one of several constant (homeostatic) internal conditions, which also include blood pressure and blood chemistry.

Anytime a dog’s body temperature goes above normal, it is a cause for concern. Heatstroke is associated with a marked elevation in a dog’s body temperature. It is a serious, life-threatening emergency, yet it is almost always preventable. The most common causes include exposure to high temperatures, high humidity, or poor ventilation. While all dogs are susceptible, brachycephalic (short-nosed) breeds like the Pekingese, Bulldog, and Pug heat up faster than others.

Unlike people, dogs do not sweat. The only sweat glands they have are on the pads of their feet. Their primary cooling mechanisms are panting and conduction. When overheated dogs pant, they breathe in and out through their mouths. They inhale cool air and, as the air moves into their lungs, it absorbs heat and moisture. When they exhale, the hot air passes over their wet tongues and evaporation occurs, enhancing and maximizing heat loss and cooling their bodies.

Conduction, which is the second method of cooling, occurs when a dog lies down on a cool surface, such as a title floor, grass, or concrete. You may have seen your puppy do this, but you were not aware that the heat from his body was being transferred to the cool surface.

Of the four types of heat-induced illnesses (heat cramps, heat exhaustion, heat prostration, and heatstroke), you should be most concerned with heat prostration and heatstroke.

Heat prostration is considered a moderate case of heatstroke, with a dog's body temperature at 104°F to 106° F or 40°C to 41°C. Many experts do not differentiate between heat prostration and heatstroke, as both are serious medical issues. Symptoms include rapid panting, red or pale gums, weakness, vomiting, confusion, and dizziness. Seek immediate medical veterinary attention. Dogs with heat prostration can often recover without complicating health problems.

Heatstroke is the most severe form of heat-induced illnesses and occurs when a dog's body temperature is above 106° F. Symptoms are often overlapping but are generally more severe than those of heat prostration and can include rapid panting, inability to stand up, collapsing, red or pale gums, thick and sticky saliva, weakness, vomiting (with or without blood), diarrhea, shock, fainting, or coma.

Cell damage begins to occur at body temperatures above 108° F, resulting in multiple organ-system dysfunction, including the respiratory, cardiovascular, gastrointestinal, renal, and central nervous systems. Immediate veterinary attention is paramount.

Effective cooling of a dog can be accomplished by getting him to a cool environment immediately and lowering his temperature by submerging his body in cool (not cold or iced) water or applying cool water to his body with a shower or hose. When submerging a dog in cool water, always keep his head elevated above the water. If possible, use a fan to keep air moving over the body surface. Check his rectal temperature every five minutes. Once his body temperature reaches 103ºF, you can stop the cooling measures; even though he appears to be recovering, take him to your veterinarian or a twenty-four-hour emergency clinic to be checked.

The best prevention is to monitor your dog and his activities and never place him in a situation where he can become overheated. Limit exercise, such as playing, running, and games, to the cooler parts of the day.

When you invest the time, energy, and love into the proper care and training of your puppy, the rewards never end.

Hot Cars

Did you know that a parked car acts like a greenhouse, trapping the sun’s heat? That’s why you should never leave your dog unattended in any vehicle. Despite a zillion public-service announcements, this point cannot be overemphasized because many people simply do not realize how quickly a car can overheat—yes, even with the windows cracked! Consider that on a sunny day, the internal temperature of a parked vehicle can quickly reach 134°F or 56°C, with the majority of the temperature rise occurring within the first fifteen to thirty minutes. Leaving the windows opened slightly does not appreciably slow down how fast the car heats up or even reduce the maximum temperature possible. A dog can suffer irreparable brain damage or death if his body temperature rises above 107°F or 41.7°C. In the amount of time it takes you to run into the grocery store, your dog could be exposed to life-threatening temperatures.

Nonexertion Heatstroke

Nonexertion heatstroke most commonly occurs when dogs are confined in an overheated enclosure, such as an automobile, or when they are confined outdoors during warm weather or high humidity and deprived of water or shade.