Cornell Feline Health Center
The actions taken immediately after a cat has had an accident or suffered from a sudden illness can save its life. Sometimes, illness has been present for a while but it is discovered at the sudden onset of signs that constitute an emergency.
Cats, of course, cannot explain verbally what happened to them or what they feel, but certain signs reveal vital information to help determine a course of action. Is the cat breathing? Is its heart beating? Is it bleeding? Is its temperature normal? Is it behaving abnormally?
Cats in pain are frightened and often try to run away and hide. To administer help, the owner must forcibly restrain the animal with blankets or bags to avoid being bitten or scratched. Speaking softly to the cat, using its name, and handling it with a firm but gentle grip will often calm a pa - -led cat enough to allow treatment.
An understanding of the normal structures and functions of a cat's body is needed for comparison when attempting to determine what is wrong with a cat that is in pain or unconscious.
The key objectives of first aid are the following:
1. To preserve life.
2. To alleviate suffering.
3. To promote recovery.
4. To prevent aggravation of the injury or illness until veterinary assistance can be obtained.
CHECK FOR NORMAL VITAL SIGNS
It is essential to know the normal temperature, pulse, and breathing rate of your cat to accurately judge the severity of illness or injury. Cats vary, as people do, but these are general guidelines:
Pulse 160-240 per minute
Respirations 20-30 per minute
WHAT TO DO IN THE EVENT OF AN EMERGENCY
1. Remove the cause of the injury if possible.
2. Clear airways so the cat can breathe. Remove any collar or harness from the cat's body. Clear the nose and throat of any foreign material, blood, or fluids. Place the animal in the position that makes breathing as easy as possible.
3. Give artificial respiration if the patient is not breathing.
4. Treat cardiac arrest with CPR immediately (see "Cardiopulmonary Resuscitation,"). Often a sharp blow on the side of the chest, just behind the shoulder, will suffice. Continue CPR until the cat's heart is pumping on its own and the cat is breathing
5. Stop or control bleeding as soon as possible. Use pressure bandages, pressure points, or tourniquets as needed.
6. Cover any wounds with clean, dry dressings.
7. Keep the patient warm with blankets, box, or in a warm car, etcetera.
8. Do not move or manipulate the patient unnecessarily. An injured animal will usually assume the least painful position, with the injured part uppermost. When it is necessary to move the patient, support and protect the injured area to prevent further damage and pain. Use blankets, rugs, and boards or boxes to support an animal being transported.
9. Treat for shock If the cat is unconscious, place its head slightly lower than the rest of its body to treat shock and to prevent the patient from inhaling fluids or materials in the mouth. Do not give anything by mouth, not even water or medicines. If the cat is conscious and not seriously injured, give small amounts of drinking water.
10. Promptly transport the cat to a veterinary facility for professional care.
11. If possible, have someone phone the veterinary hospital or surgery, while you are on the way, to alert the staff of your need for emergency care. The person who calls should give a brief description of the injuries, so the hospital
personnel can make preparations for your arrival.
12. Don't speed on the way! A patient that won't survive a few minutes probably can't be saved, and the rough ride to the hospital may aggravate injuries. Risking an additional accident-to yourself or your pet-is not justified by any emergency.
For a reference point, you should determine these rates for your cat when it is healthy, and keep a record in your first-aid kit. Excitement or exercise will increase the normal rates, as in humans, so your most valid measurements will be obtained when the cat is at rest. A good time to measure normal pulse and respiration is when you and your pet are relaxing together in the course of a normal day.
To find the pulse, press your first two fingers against the inside of the upper hind leg, where the large femoral artery is found. Count the pulse for at least sixty seconds. You can also see or feel the heartbeat on the chest wall directly behind the cat's 11 elbow." in an emergency situation, the heartbeat or pulse should be taken and reported to the veterinarian. An extremely fast pulse may indicate a state of shock. A weak pulse indicates a dire situation, which should receive immediate veterinary attention.
To determine the breathing rate or respiration, watch the cat's chest movement. Count either inhalations or exhalations (not both) for one minute. Rapid breathing can indicate shock or lack of oxygen. Labored breathing may be a clue that there is an obstruction or severe chest injury. Shallow breathing is a sign of weakness or chest pain. irregular breathing is a-very serious sign, calling for an immediate veterinary examination. Among the many problems it could indicate are fractured ribs and punctured or collapsed lung.
Unless your cat is unusually docile, you will need a helper to hold it while you take its temperature. Do not attempt to take the temperature of a cat with breathing difficulty.
CREATE A FIRST-AID KIT
The following list does not include common household items, which are assumed to be already available, such as scissors, pliers, blankets, soap, bicarbonate of soda, and mineral oil. Towels or large cloths or blankets should be available to restrain the cat if it is hysterical. The numbers in parentheses indicate quantity.
CONTENTS FOR A CAT FIRST-AID KIT
MATERIALS AND EQUIPMENT
Gauze bandages, 1" and 2" rolls (I each)
Gauze dressing pads, 3" X 3" (8)
Adhesive tape, I" roll (1)
Roll of cotton wool (I)
Triangular bandage (1)
Rectal thermometer (1)
Cotton bails (6)
3% hydrogen peroxide (2 oz)
Milk of magnesia tablets, 5 gin (10)
Activated charcoal tablets (20)
Kaolin mixture (2 oz)
For eye, 1/8 oz: tube ( 1
For skin, 1/8 oz tube (1)
Always replace materials and medications after they have been used.
HOW TO RESTRAIN AN INJURED CAT
Injured cats often do not recognize their owners, whom they normally trust. Nor do they understand the concern and help that people are trying to give them. Cats in pain are afraid and do not understand the source of that pain. Their natural instincts are to escape and hide; if they cannot, they will strike out at anyone who approaches, to avoid a repetition of the incident that caused the pain.
Veterinarians can use medicine (tranquilizers, sedatives, and anesthetics) to alleviate the suffering of a cat. First aid is the process necessary to get the cat to the veterinarian.
In general, the cat is a very independent Creature. Its personality necessitates forcible restraint, or confinement to an area where it thinks it is free but is not. An injured cat may wound anyone offering medical assistance by biting, or by scratching with any of its four feet. it is almost impossible to muzzle a cat, so one must avoid the mouth area. Restraint of the feet is important.
To humanely "disarm" the cat's claws, secure the two front legs together, just above the feet, by winding adhesive tape around them two or three times. Then fasten the rear legs together in a similar manner. Hold the head firmly. The cat can now be examined and treated carefully and effectively.
Actually, the cat is usually a bluffer and will respond well to confident but firm handling. it is also forgetful and forgiving. if a cat becomes angry at forced treatment, release it. Soon it will once again be docile and approachable.
Picking Up or Carrying a Cat
1. Reassure the cat. Talk to it quietly, gently stroke its head and ears, and run your hand down its back.
2. With the cat's tail toward your elbow and its head facing toward your hand, move your hand under its chest (sternum)
and lift, with the cat's lower body resting on your forearm and snuggled against your body. The other hand can either grasp
the scruff of the cat's neck or cradle its chin.
3. Transport a cat in a basket, cat carrier, or cloth bag, such as a pillowcase or burlap bag, tied closed. The cat cannot
see out and will feel snug and secure. If the head is to be examined, or oral medication is to be given, loosen the bag and
expose only the head; this effectively restrains the rest of the patient in the bag.
Restraining Unruly or Aggressive Cats
1. In most instances, an unruly or biting cat can be controlled with a folded blanket or thick towel. Drop the blanket over the cat in its box or cage and pick up the animal inside the blanket. With the cat rolled in the blanket and only a foot or the head protruding, you can apply medication or bandages without danger to either the patient or the handler.
2. Use thick leather or canvas work gloves when handling an aggressive cat. When cats scratch and bite, the wounds are severe. Cats almost always attack the handler's face or hands. Place the obstreperous patient in a strong bag or cat box and take it to the veterinarian, where drugs can be used for restraint. This is safer, wiser, and more humane.
PRINCIPLES OF RESTRAINT
1. Approach the patient with a firm but kind and quiet manner. Use its name if you know it and allow the animal to sniff the back of your closed fist.
2. Do nothing to further injure the patient.
3. Restrain the patient in a way that will not allow it to injure itself.
4. Protect yourself from injury that may be inflicted upon you by the patient.
5. Place the cat in a situation different from its usual secure environment (on the top of a table instead of on the floor, for example). The newness will create uncertainty but not pain, and the patient will be more cooperative and easier to treat.
WHAT TO DO ABOUT CHOKING
Warning: Choking is one of the signs of rabies if a strange cat appears to be choking but has no obvious injury, rabies is a possibility. The same is true of any cat that has not been vaccinated. If you do not know the cat, stay away from it and call the nearest animal control center
If the cat is one you know and you believe that an object, such as a bone, might be in its throat and obstructing the cat's breathing, reach in with your fingers or tweezers and try to remove it. if the blockage is further down, lay the cat on its side, place the heel of your hand just behind the last rib, angling slightly upward, and push firmly, but not so firmly as to break the ribs. Four quick thrusts should dislodge the obstruction; if not, try again. If unsuccessful, take the cat to a veterinarian.
COPING WITH BREATHING DIFFICULTIES
Any foreign object in the nasal passages, throat, trachea, or bronchi can physically prevent the flow of air into the lungs. Penetrating chest wounds can result in collapsed lungs. Any tearing of the diaphragm, which normally acts to expand the lungs, can also interfere with effective breathing.
Look for these signs to determine if the cat is in respiratory distress:
1. Mucous membranes (gums and lining of the eyelids) may be pale or blue in color (osmotic), indicating poor circulation or
inadequate oxygenation of the blood.
2. Labored respiration may occur: gasping, openmouthed breathing, or slow, shallow breathing. A cat in sudden respiratory
distress, as from choking, may paw at its face.
3. The cat may be unconscious, with dilated pupils.
If the respiratory problem is caused by something other than simple obstruction, you must resort to artificial respiration.
Remove the cat's collar, open the mouth, and pull the tongue forward so that it does not block the throat. Pull the head and neck forward, then put your hands on the ribs, push down suddenly, and release. This drives the stale air out of the lungs, and an elastic recoil mechanism will allow them to refill. Repeat about once every five seconds.if the chest cavity has been punctured, the elastic recoil mechanism will not be working, and you will have to actually blow air into the lungs. Hold the cat's mouth and lips closed, put your mouth over its nose, and blow firmly into the nostrils for about three seconds. Watch the chest carefully. Blowing too hard can cause lung damage. After a two-second rest, repeat. Keep this up for thirty minutes or more, or until the animal has begun breathing on its own, or until it has been pronounced dead by a veterinarian. The cat's progress can be monitored by checking the color of its gums. If it begins to fight the procedure, breathing is improving.
WHEN BREATHING AND HEARTBEAT STOP
Cardiopulmonary Resuscitation (CPR)
CPR is an important lifesaving technique that has become widely accepted for humans through classes offered by the Red Cross and other groups. These same techniques may "breathe" life back into a seemingly lifeless pet.
CPR provides short-term, artificial breathing and heart contractions for an unconscious animal whose breathing and heartbeat have stopped. CPR sustains the animal until it can perform these functions again on its own. An animal can suffer respiratory and heart failure from a traumatic experience, such as being hit by a car, ingesting a toxic material, or from shock.
An animal is considered unconscious if it is unresponsive to stimuli, such as pinching and shaking. Do not perform CPR on an animal that has a heartbeat. Do not perform artificial breathing on an animal that is already breathing unless the breathing is very shallow. These techniques could injure the animal if it is breathing normally or has a heartbeat.
Breathing can be determined visually as the chest rises and falls during inhalation and exhalation. Feel the heartbeat by placing your fingers on the left side of the chest wall, above the point of the elbow. Visual signs of an absence of heartbeat include fully dilated eyes and cool, grayish-blue gums. Feel the heartbeat on a healthy cat to become familiar with the sensation,
Artificial breathing: If the animal is not breathing but has a heartbeat, then only artificial breathing is needed.
Heart contractions. If there is no heartbeat or respiration, cardiopulmonary arrest has occurred and CPR must be administered. It consists of compressing the heart while administering artificial breathing. Both therapies are applied, one immediately following the other. A rhythm must develop between continual heart compressions and artificial breathing technique.
1. With one hand, place the thumb on the cat's chest at the point of the elbow and your fingers on the opposite side of the chest cavity for compression.
2. Squeeze gently, but firmly, at a rate of one compression per second.
3. After five cardiac compressions, follow with artifi cial breathing, without breaking the rhythm of the cardiac compressions.
Another variation is to place the animal on its right side on a firm surface. Place one hand under the body and the other hand above it, so the entire upper chest area is enclosed. Use both hands to compress. Compress the chest five times, then move one hand to the nose and mouth and administer respiration once; then repeat.
Continue CPR for a few minutes, while observing the animal for signs of life, such as spontaneous respiratory efforts or a heartbeat. If breathing and heart rate are not restored, continue CPR up to fifteen minutes. After fifteen minutes, revival is unlikely. if at all possible, have someone drive you to the veterinarian while you continue giving CPR.
Caution: Severe cardiopulmonary complications may result if you attempt CPR on a conscious, breathing animal.
HOW TO CONTROL BLEEDING
Injuries to the soft tissue include cuts, lacerations, abrasions, and abscesses. To control bleeding, first try the direct-pressure technique. Place a clean, preferably sterile, gauze pad directly over the wound and apply firm, even pressure. if blood soaks through the gauze, do not remove it, or you may disrupt any clot that has begun to form. just place another pad on top and continue to apply pressure. If a limb is injured, it may help to elevate it, but do this with care to avoid causing further damage to possible fractures.
If direct pressure does not stop the bleeding, try indirect pressure on the arteries supplying the area. The useful pressure points on a cat are inside the upper surface of the forelimb and hindlimb, and at the underside of the base of the tail. Very firm pressure to these areas will reduce the amount of bleeding from those respective extremities.
if neither type of manual pressure controls the bleeding from a leg or tail wound, you may apply a tourniquet as a last resort. Avoid this step unless absolutely necessary, for gangrene (death and decay of tissue) may result if a tourniquet is left on too long. Never apply a tourniquet around the neck. The procedure for applying a tourniquet is the following:
1. Use a one-inch-wide gauze bandage roll; wrap twice around. the limb or tail, between the wound and the body, about two
inches from the wound. Do not use a narrower bandage or a string. it will cut into the underlying skin.
2. Tie a half hitch (one tie of the line) in the bandage, put a pencil or stick on top, and tie a square knot above.
3. Twist slowly until the bleeding slows to a trickle. Fasten the stick in place by tying or taping gently. The tourniquet should be
released briefly every ten to fifteen minutes.
4. Cover the wound lightly with sterile gauze.
Once a tourniquet is in place, take the cat to a veterinarian without delay. If the tourniquet must remain in place over fifteen minutes, release it for one minute for every fifteen minutes it is in place, then retighten. Watch for shock. (See "Shock")
Closed or internal wounds are harder to detect and therefore harder to treat. They may appear as contusions (bruises) or hematomas (swollen areas filled with blood). internal wounds may be suspected if the cat is bleeding from the mouth or anus, if it vomits or defecates blood, or if it is in a coma or state of shock with no signs of external injury. Emergency treatment consists of keeping an airway open, treating for shock, immobilizing fractures, and seeing a veterinarian as soon as possible.
Less serious wounds can be treated as follows: Wash hands thoroughly and restrain the cat. First smear a bit of ointment or petroleum jelly around the wound area (not in the wound itself), so the hair will stick together and not fall into the wound as you clip the fur away with scissors. Next, clean the wound carefully with clean or sterile water. Wet a cotton swab or gauze pad and clean the wound by washing gently from the center of the injured area, working outward. When a cotton swab becomes soiled, throw it away and use a fresh one to prevent contaminating the antiseptic with dirt from the wound.
Safe antiseptics for cats include hydrogen peroxide, Bactine, and dilute Betadine. After cleaning, blot away any excess water gently with a sterile gauze pad and apply a suitable antibiotic, such as Neosporin or bacitracin. Cover the ointment with a sterile gauze pad and bandage. Be sure the dressing is taped carefully in place so the cat cannot easily reach the loose-ends and untie it. Keep the bandage clean and dry, changing it daily so that you can monitor the healing process. See a veterinarian as soon as possible. The sooner the veterinarian sees the wound, the better the chances for a surgical closure if stitches are required.
Wounds, especially bite or puncture wounds, are very prone to infection and formation of abscesses. Often, the first evidence that a cat has been in a fight is the hard, hot, painful swelling of an abscess appearing some time after the fact; the initial bite may have caused a small undetected hole.
Clip the fur around an abscess and clean the skin as described above. "Hot-pack" the area with a clean towel soaked in a solution made from a pint of hot water with two teaspoons of salt added. The water should be as warm as possible without being uncomfortable. Hold the compress on for ten to fifteen minutes as often as possible, the ideal being every two hours. Reheat the solution each time. The abscess may open, and pus should drain from the area within a day or two. When it does, rinse the wound with the salt solution, apply an antibiotic, and bandage the area loosely so as not to prevent drainage. It is always wise to take any cat with an abscess to the veterinarian; the abscess may have to be opened surgically and drained, and systemic antibiotics may be prescribed to prevent significant loss of tissue.
Deep Puncture Wounds
Deep puncture wounds to the chest are extremely hazardous. The great danger is that air or blood will enter the chest cavity through the wound, replacing the normal vacuum with a positive pressure that will collapse the lungs and cause the cat to suffocate within minutes. Try to cover this type of wound with an airtight seal, such as plastic or gauze. Do not try to remove the penetrating object (such as a garden stake), or you may allow more air to enter. Leave the object in place and treat for shock until you can get the cat to your veterinarian. Prompt attention is mandatory.
Eyes are very delicate organs. Any injury to them should receive veterinary attention. The most important things you can do are the following:
1. Stop any bleeding. Use direct pressure with a gauze pad placed over the eye.
2. Keep the surface of the eye moist with contact lens solution, or artificial years.
3. Cover the eye lightly with sterile gauze.
4. Take the cat immediately to the veterinarian.
Shock is often difficult to recognize because it may not appear until after an accident, as much as eight to ten hours later, when the cat is no longer being watched closely. in shock, the volume of circulating blood is decreased or the blood vessels collapse, and the heart loses much of its ability to pump blood. This decreases the oxygen supply to the tissues. The body tries to compensate by speeding up the blood flow, and by reducing or shutting off blood flow to nonvital organs. The signs of shock, listed below, reflect these changes:
1. Decrease in or loss of consciousness
2. Pale mucous membranes (e.g., gums, rims of the eyes)
3. Body feels cold to touch
4. Feeble and rapid pulse (greater than 240 per minute)
5. Shallow but rapid breathing (greater than 40 per minute)
6. Inability to stand (sometimes, but not always)
7. Involuntary passage of urine and/or feces (not always)
Prompt supportive therapy must begin immediately if the cat is to recover from this collapse of the circulatory system. First stop the bleeding and give artificial respiration if breathing has stopped. Provide a warm, quiet environment and use cardiopulmonary resuscitation if needed. (See "Cardiopulmonary Resuscitation.) Make sure the cat is positioned on its side, with head lower than the rest of the body, so that gravity can assist blood flow to the brain. If the heart seems to be working on its own, massage the leg and trunk muscles to encourage blood return from these areas.
A cat in shock is frequently thirsty, but giving it water could be dangerous. In severe shock, the digestive tract does not efficiently absorb water. A semiconscious cat may accidentally inhale rather than swallow water. The most effective way of treating circulatory shock is by intravenous fluid administration and other intravenous medications, which must be administered by a veterinarian. Shock is a medical emergency that requires prompt veterinary attention.
INURIES TO BONES
Fractures and dislocations usually are not life threatening, unless they cause severe bleeding, interfere with breathing (as broken ribs may do), or crush a vital part of the spinal cord or brain. However, prompt immobilization of a fracture is important to prevent a simple break from turning into a compound fracture (one that breaks through the skin) and to reduce damage to the surrounding soft tissue. A severe fracture also may cause shock, and the complication of infection can lead to blood poisoning.
Recognizing a broken bone can be difficult. A cat with a broken leg will show pain and inability to use the leg. There may be swelling around the fracture site, or the cat might hold its leg at an unusual angle or show an unusual range of motion in the middle of a leg rather than at a joint. A sensation called crepitus, a suggestion of grating or scraping, can be felt when the leg is moved gently. With spinal injuries, the cat will often be unable to use its legs. It is crucial to avoid aggravating the damage with movement or manipulation. if a break is suspected, do not try to verify it by physical manipulation. immobilize the affected area, if possible, and quickly, gently, transport the cat to a veterinarian.
The most direct method of immobilizing a fractured leg is to apply a splint. Almost any long, stiff object can be used in an emergency. A simple cylinder of newspaper or a towel wrapped around the leg may suffice. When using sticks, there must be two, one on the inside and one on the outside of the leg. Any hard object used should b e padded so that it does not chafe the leg. A splint will be effective only if it extends past and immobilizes the joints above and below the injury. Tape the support in place, taking care not to make it so tight that it cuts off the circulation.
Fractures of the vertebral column and skull are serious, but these areas cannot be splinted. Place the cat in a padded box to avoid any unnecessary movement of the cat's body and head and take it to a veterinarian promptly.
Additional care is needed to prevent bacteria from entering the wound of a compound fracture. Do not push the broken edges of bone back together just cover the injury with a sterile cloth and apply the splint as previously described. Your veterinarian will do a more thorough cleanup once the cat's condition has stabilized.