Basic First Aid
First aid is the emergency care and treatment given to an animal which has
suddenly fallen ill or suffered an injury, before medical/surgical care (veterinary
treatment) can be commenced. The main objectives of first aid are to:
• Keep the animal alive
• Make it comfortable
• Assist in pain control
• Prevent it getting worse
Different situations require a different approach. It is essential to assess the situation
quickly by asking yourself the following questions:
• Is the animal in further danger?
• Will you be in danger if you help?
• Can the animal be restrained?
• Can you move the animal from further risk or harm safely?
In some situations there is plenty of time to attend to the injuries or problems
and the situations will not be life threatening. Other situations may be so severe
that the animal will die if urgent and skilled emergency care is not available.
First aid, which involves only the initial actions of someone attending or witnessing
an accident is very limited. It does not involve diagnosis or medical treatment
of injuries, but is designed to preserve life; temporarily prevent a condition from
getting worse if possible; and allow time to get the animal to the veterinary surgeon,
who can then diagnose the full extent of the condition, which is not always obvious.
EVALUATION
VERY SEVERE – Must act immediately or the animal will die. Examples are:
• The heart has stopped (cardiopulmonary arrest).
• Breathing is obstructed due to an object in the air passages.
• Breathing has stopped.
• Bleeding from a main artery or vein.
• Acute allergic reaction to an insect sting or other substance.
SEVERE – Must act within one hour or the animal may die. Examples are:
• Deep cuts with considerable blood loss.
• Established shock.
• Head injuries.
• Breathing difficulties.
SERIOUS – Must act within 4–5 hours otherwise more serious problems will
develop, which could be life threatening. Examples are:
• Bone fractures that puncture the skin (compound fractures).
• Spinal injuries.
• Early stages of shock.
• Difficulties in giving birth (dystocia).
MAJOR – Must act within 24 hours to prevent further damage. Examples are:
• Fractures with no skin injury (simple fractures)
• Prolonged vomiting and diarrhoea
• Foreign bodies in the eyes or ears
INITIAL MANAGEMENT
(1) Assess the situation and keep calm. Briefly examine the animal and note any
obvious injuries.
(2) Contact the veterinary practice for advice and to let them know that you are
coming.
(3) Ensure your own safety. Make sure the animal is properly restrained before
handling and lifting, so that no one is bitten.
(4) Stop and cover any obvious bleeding. Use sterile dressings if possible to
prevent further contamination.
(5) Make sure the animal is able to breathe. If the airway is obstructed try to
clear it.
(6) Treat for shock by maintaining the body temperature.
HANDLING AND TRANSPORT
If the animal’s life is in danger, then it must be moved. Injured animals are usually
in pain, and they are shocked and frightened. This means they may attack any one
who tries to approach or handle them. To protect both the handler and the animal
from further harm or injury great care is needed at this time:
• Slow, deliberate movements are essential.
• A calm soothing voice will help in approaching the animal.
• Handle the animal as little as possible.
• Muzzle if necessary, but only if the animal has no breathing difficulties.
Transport the animal to the veterinary surgery, supporting any obvious injury,
e.g. a fractured limb. However, before moving the animal, quickly assess the condition.
This is referred to as ‘initial help’, and if it is done as soon as possible, the
chances of survival are greatly improved. Checks that should be made during the
initial help are listed below.
• Check airway – to ensure it is not obstructed; if it is check if can be cleared.
• Check breathing – to ensure that the animal can breathe and to assist with
artificial respiration if required.
• Check heart and pulse – check the beat rate and strength and record these. If the
heart has stopped then proceed with heart massage.
The initial assessment and help given must be reported to the veterinary staff
on arrival at the surgery to reduce delays in the treatment of the injured animal.
Transport
Small dogs and cats
Transport small dogs and cats in a pet carrier or in a cat-sized basket making sure
there are plenty of breathing holes. Many owners nowadays have a cat cage,
which is ideal for small dogs, provided there is plenty of space to stretch out
(Fig. 7.1). Otherwise the animal can be held in the owner’s arms depending on the
injury (Fig. 7.2).
Medium-sized dogs
If these dogs have only minor injuries they may be encouraged to walk slowly. If
they not able to walk, put one arm around the front of the forelegs and the other
arm around the hind legs (provided this is not contra-indicated by the injuries)
and lift and hold close to the handler’s body, with the legs free and hanging
downwards (Fig. 7.3).
Large and giant breeds of dog
These animals should be lifted only by two or more people, one supporting the
head and chest and another supporting the abdomen and hind quarters. If the animal
is too large to be lifted up, with two or more handlers use a stretcher or blanket
lift (Fig. 7.4). Pull the animal onto the blanket, laying it on its side, and lift up
using the corners of the blanket. If there are not enough handlers available, simply
drag the blanket, provided that the surface is smooth. The blanket lift can also be
used for smaller dogs with spinal injuries (Fig. 7.5).
Safe lifting
Whatever the size of the injured animal it is important to always lift in the correct
manner. Bend your knees before lifting, rather than bending from the waist. In
this way, the handler’s own back is less at risk, but if in doubt get more help
(Fig. 7.6). As in human first aid, in animal first aid there is a recovery position
in which the animal should be placed. Unless contra-indicated, this is the safe
position in which the animal should be placed to ensure breathing is assisted and
the heart is exposed for emergency procedures if required (Fig. 7.7). To put the
animal in recovery position:
• Lay the animal on its right side.
• Straighten the head and neck.
• Pull the tongue forwards, behind the canine teeth or to one side of the mouth.
• Remove any collar or harness.
CHECKS AND OBSERVATIONS
• Any signs of bleeding from the animal’s surface or from a body opening, e.g.
the mouth, rectum, vulva, prepuce or ears.
• ‘Colour check’ by looking at the lining of the lower eyelid and the mucous
membrane of the mouth and gums.
‘Colour check’ of mucous membranes
• Pale: Indicates shock or serious bleeding (internal or external)
• Blue: Also referred to as cyanotic and indicates lack of oxygen to the tissue cells
• Yellow: Also referred to as jaundice, can be caused by an excess of bile pigment in
the bloodstream and usually involves the liver in some way
• Red/congested: Indicates over-oxygenation after exercise, a heat stroke or a feverous
condition
• The capillary refill time. The upper lip is lifted, and the gum over an upper
canine tooth is pressed (Fig. 7.8). This squeezes the blood out of the surface
capillaries, causing the area to go temporarily white. The refill time is the time
it takes to become the normal pink colour again as the capillaries again fill up.
Normal refill time is 1–1.5 seconds. Any time longer than this is considered as
‘slow’ and is reported; it may indicate a degree of shock.
• Rate and quality of the pulse. This is normally checked in the groin area of the
hind leg on the femoral artery. Rate refers to the speed of the pulse which is a
reflection of the heart beat. The pulse should be taken for a full minute for a true
recording. The quality of the pulse refers to descriptions such as strong,
thready, weak or normal. In order to describe this, the handler must have some
experience of pulse taking.
• The rate of breathing is recorded and noted whether it is normal speed, slow,
fast or shallow.
• Body temperature is checked by feeling the extremities of the body such as
the feet and tail end. If the temperature is higher or lower than it should be the
handler will be aware of the warmth or chill of the extremity being held.
• Record the animal’s level of consciousness. In other words, can the animal
respond to any stimuli like its name, a noise or sudden movement?
• Record any unusual odours from the animal’s body and whether it is coming
from the animal’s mouth, anus or coat.
When assessing a sick or injured animal, the pulse recordings, a general idea of
body temperature and the breathing rate will provide information about the:
• Body’s ability to control body temperature.
• Heart’s ability to pump the blood in the circulation to reach all body cells.
• Circulation’s ability to transport the blood efficiently.
• Respiratory system’s ability to supply the body oxygen requirement.
Temperature
A fall in temperature may be seen in:
• Shock and severe bleeding
• Impending death (moribund animal)
• Immediately before parturition
The temperature can be assessed with a thermometer, or by touching the
extremities (feet), or by noting the body position (curled up or spread out).
Normal body temperature as checked by thermometer is:
• Dog: 38.3–38.7°C (100.9–101.7°F)
• Cat: 38.0–38.5°C (100.4–101.6°F)
Pulse
Pulse is a means of checking the heart (cardio) and blood (vascular) function.
With each heart beat, the walls of the arteries expand and contract in size to allow
the created wave of blood to pass and to maintain its speed of flow – this is called
the pulse. If there is a change in the heart function or in the volume of blood
flowing in the blood vessels, there will be a corresponding change in the pulse
rate (speed) or character. It is essential for the operator to spend some time practising
feeling pulses, both normal and abnormal, to improve their skill. This will
also dramatically decrease the time it takes the operator to find the animal’s pulse.
Descriptive words that are used to describe the pulse include:
• Intermittent
• Thready – slow, soft pulse
• Irregular
• Strong
• Weak
A normal pulse is described as regular, strong or firm. The pulse is taken where
an artery runs close to the body surface. Each pulsation corresponds with the contraction
of the right and left ventricles of the heart. The sites include the:
• Femoral artery located in the groin region on the medial aspect of the femur of
the hind leg.
• Digital artery located on the cranial or anterior surface of the hock region of the
hind leg.
• Coccygeal artery located on the ventral aspect (under-side) of the base of the
tail just above the rectum.
The commonest site for taking the pulse is the femoral artery (Fig. 7.9) on the
hind leg. Before taking the pulse the animal must be suitably restrained, therefore
two people make the task much easier.
Taking the pulse
(1) Wait for the animal to get used to being restrained.
(2) Once the animal is settled, take the pulse by placing the fingers over the
chosen artery.
(3) When properly located, using a watch with a ‘second’ hand, count the pulse
for one minute. Never shorten this period because the pulse can change
quickly and a reading of less than one minute could be inaccurate and
therefore useless.
(4) Write down the pulse count at the end of the minute.
(5) Relax the restraint of the animal and praise it.
Normal pulse rates are:
• Dog*: 60–180 beats per minute
• Cat: 110–180 beats per minute
*The wide pulse range in dogs is due to the variation in size from toy breeds
(nearer the upper (180) end of the range) to giant breeds (nearer the lower (60) end
of the range).
Terms to describe the pulse are:
• Dysrhythmia: This indicates that the pulse and heart rate are not synchronised.
The pulse is lower due to the heart pumping blood inefficiently.
• Sinus arrhythmia: This refers to the increase in pulse rate on breathing in
and decrease in the rate on breathing out; this is often considered to be
normal.
• Fast pulse: This occurs when the tissues are not getting enough oxygen and the
heart is compensating by speeding up to meet the body’s needs. A fast pulse is
normal after exercise.
The pulse increases because of:
• Exercise
• Excitement or stress
• Heart/heart valve disease
• Shock or loss of blood
• Pain
• High temperature/fever
The pulse decreases because of:
• Sleep
• Unconsciousness
• Heart disease
Respiration
Normal breathing is almost silent, although air flow may be heard in the airways.
The breathing, heart and circulatory system are very closely linked therefore
a change in one is mirrored by a change in the other. If the blood gas levels of
oxygen or carbon dioxide become abnormal this will be seen in the animal’s
colour, its pulse rate and character and in the breathing. Some breeds of dog and
cat (short-nosed breeds), because of the anatomy of the airway, may make considerable
breathing sounds; this is normal.
There should be a rhythm to the breathing, i.e. the time between breathing in
and out should be equal. The breathing can be varied by use of the voluntary or
skeletal muscles of the chest (thorax). It is because of the voluntary ability to alter
breathing that the pulse should only be taken once the animal has settled. Any
obvious restraint will probably cause the breathing to increase as a response.
The reading is taken either on breathing in or when the animal breathes out. It
should not be taken when the animal:
• Is panting (cause for concern when seen in a cat)
• Has recently exercised
• Has been stressed by restraint
• Is asleep
Normal rates of breathing are:
• Dog: 10–30 breaths per minute
• Cat: 20–30 breaths per minute
It is timed using a watch with a second hand for one minute, also making note
of the depth of the breathing.
Breathing may increase because of:
• Shock or bleeding
• Recent exercise
• Pain
• Excitement
• Heat stroke
Breathing may decrease because of:
• Unconsciousness
• Sleep
• Poisons
• Low body temperature (hypothermia)
Terms to describe breathing are:
• Tachypnoea: This refers to rapid, shallow breathing.
• Hyperpnoea: This means panting.
• Apnoea: This means no breathing is taking place.
• Cheyne-Stokes: This is irregular breathing (deep breaths, then fast shallow
breaths) seen shortly before death.
• Dyspnoea: This means difficulty breathing in or out and is often painful.
Signs of difficulty breathing include:
• Forced breathing out
• Flaring of nostrils
• Extended head and neck
• Elbows are rotated away from the chest
• Breathing through the mouth
• Exaggerated movements of the chest and abdomen
• Sounds
• Unable to settle
LIFE SAVING TECHNIQUES
• The heart has stopped – cardiac arrest
• The breathing has stopped – respiratory arrest
The two situations listed above are jointly referred to as cardio-pulmonary
arrest (pulmonary is the term used for the vessels that take the blood to the
lungs and back to the heart). The objective of cardio-pulmonary resuscitation is to
restore heart and lung action and to prevent irreversible brain damage, which will
occur if the tissues are deprived of oxygen for any length of time. Damage to body
cells is thought to occur after 3–4 minutes following cardiac arrest. Therefore, it is
important to be adequately prepared for the management of these emergencies
and to recognise that time is short if permanent damage to body tissues is to be
avoided.
In veterinary practice resuscitation methods do include the use of drugs that stimulate the
heart and the breathing, but these are administered only by a veterinary surgeon and
therefore are not a first aid procedure.
Cardiac compression
Small dogs or cats
• Place the animal in recovery position (on its right side, head and neck extended,
and tongue pulled forwards.
• Take hold of its chest between the thumb and fingers of the same hand over the
heart and just behind the elbows.
• Support the body of the animal with the other hand on the lumbar spine area.
• At all times keep the head and neck in a straight line to assist breathing.
• Squeeze the thumb and fingers of the hand over the heart together, this will
compress the chest wall and the heart which is squeezed between the ribs.
• Repeat this action approximately 120 times per minute.
• Keep a watch for the heart contractions re-starting.
Medium-sized dogs
• Place the animal in recovery position.
• Put the heel of one hand on the top of the chest, just behind the elbow and over
the heart (Fig. 7.10).
• Place the other hand either on top of the first hand or under the animal to
support the heart as it is compressed.
• Press down onto the chest with firm, sharp movements.
• Repeat this action about 80–100 times per minute.
• Keep a watch for the heart contractions re-starting.
Large, barrel-chested or fat dogs
• Place the animal on its back, with its head slightly lower than its body.
• Put the heel of one hand on the abdominal end of the sternum.
• Place the other hand on top of the first.
• Press firmly onto the chest, pushing the hands forwards towards the head of
the animal.
• Keep the head and neck straight during the procedure at all times.
• Press down in this way for 80–100 times per minute.
• Keep a watch for the heart contractions re-starting.
Fig. 7.11 shows the hand position for cardiac massage for a large, non-barrel
chested breed dog. Whatever the size of the animal, stop at 20-second intervals to
check the heart beat or pulse and then continue.
Respiratory arrest
Whatever the cause, if the breathing has stopped then it must be urgently restarted.
There are two methods for re-starting the breathing:
(1) Artificial respiration – manual method
(2) Mouth-to-nose technique
Artificial respiration
• Place in recovery position
• Clear airway of any blocking material
• Place a hand over the ribs, behind the shoulder bone (Fig. 7.12).
• Compress the chest with a sharp downward movement.
• Allow the chest to expand and then repeat the downward movement.
• The compressions are repeated at approximately 3–5-second intervals, until
breathing re-starts.
• Keep head and neck straight at all times to assist airway.
Mouth-to-nose technique
• Place the animal in recovery position.
• Clear the airway.
• Place a tissue or thin cloth over the animal’s nose (for personal safety).
• Hold the animal’s neck straight at all times.
• Keep its mouth closed by holding the upper and lower jaws together.
• Breathe down its nose to inflate the lungs (Fig. 7.13).
• Repeat this at 3–5-second intervals.
• Keep a watch for the breathing re-starting.
This technique provides the animal with the unused oxygen in the handler’s
breath and their exhaled carbon dioxide, which help to stimulate the breathing
reflex or gasp reflex in the animal.
BLEEDING (HAEMORRHAGE)
Bleeding or haemorrhage is the escape of blood from damaged blood vessels and
can cause serious problems. Heavy bleeding can decrease the circulating blood
volume enough to cause shock. Even small losses of blood over a period of time
can potentially put the animal at risk.
Bleeding is not always visible; it may be internal, especially after a fall or road
traffic accident. Therefore, look out for the general signs of bleeding:
• Colour – pale.
• Attitude – dull or listless.
• Appears thirsty.
• The pulse and breathing rate are fast and may appear feeble.
• Feet and tail (extremities) are cold to touch (Fig. 7.14).
• Body temperature if taken is sub-normal.
• Capillary refill time is slow.
If blood loss is severe the signs will include those of reduced blood flow to vital
organs such as:
• Animal becomes restless and will not settle
• It has difficulty breathing
• It may have fitting-type episode
• Animal unable to stand and becomes unconscious
Which blood vessel is damaged?
• Artery: The blood is bright red (oxygenated) in colour and comes out in spurts which
are synchronised with the heart beat.
• Vein: The blood is dark red (de-oxygenated) in colour and it flows steadily.
• Capillary: The blood is bright red, involving small arteries and veins, and comes out
as a steady ooze.
Methods of arresting bleeding
Whichever method is used, it must not interfere with the ability of the animal to
breathe, preferably in a normal manner via the nose. Therefore, in the case of a
nose bleed (epistaxis), while attempting to slow the blood loss no first aid treatment
should interfere with the airway. The methods described below are meant
for temporary relief and can be used for only a limited amount of time, until the
veterinary surgeon takes over.
Digital or finger pressure
This method is used on a surface wound. A sterile or clean pad of absorbent material
is pressed onto the area to control the blood loss. Care must be used with this
method in case there is a piece of metal, glass or wood imbedded in the wound
tissues, because pressing would push it deeper, and it would be harder to locate
or may cause damage to internal structures. The time limit for this method is
about 5–15 minutes after which the tissues beyond must receive a reviving flow of
blood. After this the pressure can be applied again.
Pressure points
In several locations around the body, major arteries are positioned near the body
surface, many passing over a solid structure such as bone. These tend to supply
blood to the extremities, i.e. limbs and tail. Pressure on an artery where it crosses
a bone can slow or even stop the blood supply reaching the area beyond. If
the wound is on the extremity, these points can be used to apply pressure as a
temporary measure to stop blood loss.
• Fore limbs – Pressure is put on the inside on the medial elbow area to slow the
brachial artery (Fig. 7.15).
• Hind limbs – Pressure is put on the same site used for taking the pulse in the
groin area on the femur to slow the femoral artery.
• Tail – Pressure is applied to the ventral or under-side of the base of the tail to
slow the coccygeal artery.
The time limit for application of pressure in these locations is about 5–10 minutes.
After this allow the blood flow to restore tissues. Re-application of pressure or use
of another method may be required before the veterinary surgeon takes over.
Pressure bandages
These may be used initially or after one or both of the previous methods have
been used if the bleeding has not stopped prior to arrival of veterinary help.
Pressure bandages can be applied only to extremities, i.e. the limbs (below elbow
or knee) and tail. They are applied tightly to constrict and slow the blood flow in
the surface vessels supplying the area, thus limiting blood loss.
The bandage is applied with plenty of padding material backing the dressing
over the wound. It is tightly bandaged in place to include the foot area. If blood
seeps through this bandage then more padding is applied and bandaged in place.
If the foot is not included swelling will occur below the bandaged area due to the
obstruction caused to the tissue fluid return to the trunk from the extremity. This
is again only a temporary measure until arrival at the veterinary surgery. It can
be put on for about an hour before the tissues must be released from the tight
bandage and flow restored.
SHOCK
Shock is a term used to describe a complex and potentially fatal clinical syndrome
which always involves insufficient blood to the tissues, with resulting lack of
oxygen to the cells. This lack of oxygen to the cells is called tissue hypoxia and can
be fatal if not corrected.
When blood is lost because of bleeding from a damaged blood vessel, the body
tries to compensate by re-distributing blood to vital structures such as the brain
and heart at the expense of other organs like the kidneys, skin, intestines and
muscles. The resulting tissue hypoxia can cause severe damage to the organs.
There are various causes of shock. Some examples are:
• Blood loss from damaged vessels
• Pain or stress in highly strung animals
• Heart problems that interfere with the normal pumping action of the heart
The signs of shock include:
• Pale colour
• Cold extremities
• The animal becomes weak, slipping into an unconscious state
• Increase in the heart rate and breathing
• Slow capillary refill time of longer than 2 seconds
Until the animal can be treated by the veterinary surgeon, the handler must
start the preventive shock procedure. Probably the single most useful thing that
can be done is to maintain the body temperature. If the body is not allowed to shut
down the surface (peripheral) blood vessels to the limbs and tail then established
shock will at least be delayed, possibly even prevented.
Shock has three forms:
(1) Impending: It is expected to happen bearing in mind the events or injuries suffered
by the animal.
(2) Established: If it is in place, the animal must receive urgent medical treatment
involving whole blood transfusion or use of plasma expanders.
(3) Irreversible: Treatment is unlikely to save the animal’s life as the body systems
are too severely damaged.
Treatment is aimed at not allowing shock to move on beyond the impending
stage. To achieve this:
• Maintain the body temperature by wrapping the animal in blankets or towels
(Fig. 7.16) and keep massaging or rubbing the extremities (feet and legs) to
stimulate the blood flow. Never use artificial heat as the animal’s temperature
may get too high.
• Position the head slightly lower than the body to encourage the flow of blood to
the brain.
• Stop any further blood loss.
• Help the animal to breathe by placing in recovery position, and if required give
artificial respiration if breathing stops.
• Record the pulse.
• Transfer to the veterinary surgery as soon as possible.
HEART CONDITION
A correctly functioning heart is essential for the supply of oxygen, nutrients and
other elements to all body cells. It is also required for the removal of waste and
by-products from the body tissues. If anything should disrupt the function of
the heart, the entire body is affected. Heart disease may develop slowly or may have
been present from birth. Often the animal copes quite well but in the case of serious
heart disease progression to heart failure may become inevitable and any stressful
situation for that animal must be managed carefully. Signs to watch for are:
• Breathlessness
• Coughing after rest
• Fainting
Treatment (if the animal is unconscious) will involve cardio-pulmonary resuscitation
if the heart beat and breathing stop. Keep the animal warm to avoid shock
and seek veterinary help urgently.
POISONING
A poison or toxin is any substance, which on entry to the body in sufficient
amounts, has a harmful effect on the individual concerned. Dogs are likely to eat
almost anything and therefore become poisoned more frequently than cats.
However, primary poisoning can also occur in a cat that has licked a poisonous
substance attached to its coat. The cat has a poorly developed liver enzyme
system for detoxification. Therefore the effects of poisoning can be very serious.
Secondary poisoning can also occur in cats, in particular, after a cat has eaten
baited mice, rats and other pests.
Poison can gain entry to the body by various means:
• Through the mouth (eaten or during self-grooming)
• Breathing in
• Absorption through the skin surface
• Through a cut
Animals can be poisoned by any of a multitude of potentially toxic substances,
a lot of which are ordinary household products. The source may be poisonous
plants or toxic chemicals including:
• Pesticides for the garden, e.g. slug bait, path clear, moss killer, etc.
• Rodent killers, e.g. warfarin
• Paint and cleaning solutions for brushes
• Disinfectants, e.g. bleach and toilet cleaners
• Drugs, e.g. aspirin, blood pressure tablets and sleeping tablets
Aspirin is a poison for cats since as a result of their metabolism the effect of this
drug can last for up to 30 hours (approximately 12 hours in a dog), and this can
lead to overdose if the owner re-medicates too soon. Cats can become poisoned
when self-grooming, in particular from products such as paint brush cleaners,
creosote-type paints and oils.
If a cat’s coat hair is contaminated by any product, remove the contaminant as
soon as possible, wearing gloves to avoid contact with the product on the coat.
Use washing-up liquid on a dry coat and lubricate the affected hair area working
the liquid soap with fingers into individual hair bundles until the contaminant
starts to come away. Wash off with warm water and use a cat-approved shampoo
on the now wet coat. Rinse thoroughly and dry the cat. Treat for shock and seek
veterinary help if required. Do not use any liquid soap other than washing-up
liquid (or cat-approved shampoo) which is produced sufficiently dilute to cause
no harm to human hands, whereas detergents could act like a poison for the cat.
Very few poisons result in distinct signs. Most cause non-specific signs such
that initially all that the owner notices is that the animal is behaving differently,
and only later becoming aggressive, excited or depressed and/or unsteady on its
feet, salivating, vomiting and or having diarrhoea, abdominal pain and fittingtype
episodes. It may also be pale, have a lowered body temperature and slow
capillary refill time.
The owner knows best about what is normal and what is unusual in their pet,
therefore record all reported information and get in touch with the veterinary surgeon
as soon as possible for advice on what to do next. If the owner knows which
chemical was involved and has the container or packet take that to the veterinary
surgery too. Unless instructed, do not make the animal sick, as this may cause more
harm, particularly if the poison is corrosive. Until the veterinary surgeon takes over:
• Place the animal in recovery position.
• Provide support for any breathing problems.
• Keep it warm to reduce shock.
• Record pulse and heart rate.
• Comfort and do not leave unattended.
• Transfer to the veterinary surgery as soon as possible.
INSECT STINGS
Stings are usually more painful than they are harmful. However, it is possible that
an animal may have an allergic reaction to the insect venom, or that the sting
is close to the animal’s airway and could obstruct breathing. If the venom sack
is imbedded in the skin, never squeeze it as this may inject more venom into
the animal. Remove carefully if possible, or leave it in place for the veterinary
surgeon to remove in the safety of the practice.
• Wasp stings: These are alkaline. Treatment therefore consists of an acid solution
like household vinegar in the form of a pad or compress.
• Bee stings: These are acidic. Treatment therefore consists of an alkaline such as
bicarbonate of soda mixed with water and soaked into a pad or compress.
The aim of the treatment is to neutralise the situation. It is not always possible to
know which insect is involved unless someone has seen the sting happen. If you
are not sure what the insect was, apply a cold compress or face flannel filled with
ice cubes to the area to reduce the swelling and give some pain control prior to any
veterinary treatment.
FRACTURES
A fracture is a crack in the surface of a bone or a complete break in a bone. The
objectives of first aid for fractures are to prevent the situation getting worse and to
make the animal comfortable for safe transportation to a veterinary surgery. The
causes of bones fracturing are varied and include:
• Road traffic accidents.
• The animal landing badly after jumping.
• Uncontrolled fall from a high surface or table.
Types of fracture
• Simple: The bone is broken but there is no connecting skin injury.
• Compound: The bone is broken and there is a wound connecting to the skin or
the bone is protruding through the skin. A badly handled simple fracture can
become a compound fracture.
Fig. 7.17 shows a fractured right femur and extent of tissue swelling. The signs
of a fracture include:
• Loss of use of affected limb, which will not weight bear.
• Pain on handling, or the animal will not allow handling.
• Unusual position, shape or movement of the limb.
• Swelling and bruising.
The best treatment for an animal with fractured bones is to get it to the
veterinary surgery quickly, while taking care not to cause any further injuries
by careless handling. Some fractures are also complicated by damage to other or
surrounding tissues such as blood vessels, nerves or organs. Depending on the
fracture, first aid consists of:
• Stopping any bleeding.
• Cleaning and covering any wounds.
Immobilise the fracture site if possible. This is only possible if the joints above
and below the site can be immobilised by a splint. If splinting is possible, always
apply the splint to the limb in the position in which it was found. For example, if
the foot of the fore leg is positioned sideways instead of facing the front do not
correct the position – splint it as you find it. Materials used for splinting are:
• Rolled-up magazine or newspaper
• Ruler or piece of wood
Which parts of the body can be splinted?
• Fore limb – from elbow to toes
• Hind limb – from stifle to toes
• Tail
If splinting is not possible:
• Confine the animal on plenty of bedding.
• Comfort and do not leave unattended.
• Treat for shock.
• Handle with care so as not to move the fracture unnecessarily.
• Take to the veterinary surgery urgently.
DISLOCATION
Dislocation is the displacement of one or more bones that form a joint. A dislocation
differs from a fracture because displacement occurs only between joints
and not along the length of a bone. Signs of a dislocation are similar to those of a
fracture:
• Pain
• Abnormal joint function
• Shortening or lengthening of the limb involved
• Deformity and abnormal joint position or angle
The commonest simple dislocation involves the patella (knee cap). It can occur
as a result of trauma in a road traffic accident, but it can also be a hereditary defect,
particularly in small breeds of dog. Knee dislocation varies from very mild (an
occasional medial slip of the patella) to very severe (the patella permanently out
of position). A temporary limp is seen if the patella is capable of returning into the
normal position after a dislocation. In this case on lifting the leg the patella will
slip back into position and the leg can be placed back on the ground once more. If
the patella is more permanently out of position:
• Do not attempt to place it back ino position.
• A cold compress on the knee may help with pain.
• Treat for shock.
• Seek veterinary help.
SOFT TISSUE INJURY
• Sprain: This always involves a joint with damage to the surrounding ligaments
and other tissues. Recovery is slow as the torn and stretched tissue repairs.
Common sites are fore and hind feet.
• Strain: This involves a muscle with tearing or stretching of the tissue. It can
happen anywhere in the body; however, common sites are lower front leg, neck
and shoulder muscles.
These injuries may require veterinary treatment depending on the amount of
muscle damage, pain and inability to use the affected area.
WOUNDS
Wound refers to damage to the continuous structure of any tissue in the body,
most commonly the surface of the skin.
Healing of wounds
Healing by first intention takes place in wounds that:
• Are not contaminated with grit, soil and micro-organisms.
• Have clean-cut edges that can be held together.
• Have been cleaned within one hour of injury.
• Heal, as the edges re-join, by 10 days after the injury.
Healing by second intention or granulation takes place in wounds that:
• Are contaminated with grit, soil and micro-organisms.
• Have jagged edges and possibly sections of skin missing.
• Have not been cleaned within two hours of injury.
• Have edges that gape open.
• Are infected.
• Take weeks or months to heal.
Wounds are described as being open or closed. A closed wound is one which
does not penetrate the whole thickness of the skin, such as bruises or blood
blisters (haematoma) or pockets of blood from a small damaged blood vessel.
Treatment of these wounds involves use of a cold compress, such as ice cubes held
in a face flannel, immediately after the injury to reduce the swelling of local tissues
and help control pain. This treatment is useful only immediately after the
injury.
Open wounds are those with damage to surface tissue and some bleeding. They
are named according to the type of damage and whether or not tissue is missing:
• Incised wounds: These have clean-cut edges, are painful due to damage to the
surface nerve endings and tend to bleed freely. They are caused by objects with
sharp edges like scissors or a knife blade.
• Lacerated wounds: These have jagged flaps of skin, and sometimes skin
sections are missing (avulsed). However because tissue is torn and stretched
they are less painful than incised wounds and do not bleed much. They are
caused by bite injuries, clippers or combs.
• Puncture wounds: These wounds have a long narrow tract going deep into the
tissues, with only a small opening on the skin over the tract which is covered
by scab. (Fig. 7.18). The scab traps microbes in the tract. The wound is caused by
sharp-pointed objects like teeth (bite wounds) or scissors. They may also
be caused by an in-growing toe nail or cork screw nail (although the tract
is not that deep, these still provide a site for infection to develop). All such
wounds are contaminated with the microbes trapped in the damaged tract. The
microbes multiply, causing a localised infection to develop, which, if allowed to
increase in size, becomes an abscess. Abscesses are very painful, often causing
loss of limb function if located in the nearby tissues.
• Abrasions and scratches: These are seen as bits of torn, ragged surface skin,
with contaminants imbedded in the damaged areas. They are caused by friction
and overheated or damaged clipper blades. The damage due to tearing is seen
as oozing of serum from damaged capillaries in the surface layers of the skin
only. These injuries are painful, bruised, and often inflamed.
• Fly strike (myiasis): This is seen when blow-flies lay eggs around the edges of
an open wound. On hatching, the fly larvae crawl into the wound and burrow
into the damaged tissues. The larvae feed on the wound fluids and living tissue,
causing pain to the host animal. A reddish-brown fluid is usually seen on the
coat hair and the area can be foul smelling.
Wound care
The sooner an open wound is cleaned using water-based antiseptic solution, the
more chance there is that infection will not develop. Solutions used for wound
cleaning must not cause any further inflammation or damage to the wound, and
therefore should not contain any soap or detergent. Prevention of multiplication
of micro-organisms in the wound can mean all the difference between the wound
healing within ten days (first intention) and delayed healing (second intention or
granulation).
First of all clip away the hair around the wound to expose the site, and then
clean the area if possible. Solutions to use for cleaning are:
• Tap water
• Dilute antiseptic and water
Once the wound has been cleaned always cover it to prevent contamination
and the animal aggravating the area further, and seek veterinary assistance.
EYE INJURIES
Any animal with eye injuries will have impaired sight and will be in pain. It is
very important to approach the animal slowly and talk to it so that it is warned of
your approach. The animal will be frightened and could injure the handler unless
precautions are observed and correct handling techniques are used.
The types of injury seen include:
• Injuries caused by chemicals: These can cause serious injury to the eye structures.
Always irrigate as soon as possible using tap water to remove any chemical.
Do not leave unattended and seek medical help.
• Prolapsed eye ball: This means that the eye is now in front of the lids, and the
optic nerve cord is being stretched as the lids swell. Never touch the eye ball.
The treatment is as follows:
(a) Keep the eye moist at all costs. Use tap water soaked into a pad and squeeze
onto the eye to moisten.
(b) Once moistened, soak the pad again in tap water and place gently over
the eye.
(c) Hold or bandage in position.
(d) Do not leave unattended and stop any attempts at self-mutilation.
(e) Keep warm and quiet and treat for shock.
(f) Seek veterinary assistance urgently.
The important point to remember is that the eye must not be allowed to dry
out. Some breeds of dog are prone to eye prolapse due to their short faces, such as
Pug, Pekinese and Boxers. Therefore always use extra care when handling these
breeds.
If the handler is present when the prolapse happens, return the eye to its place
by holding the upper and lower eye lids and pulling them gently over the eye ball.
This is possible only immediately after the injury. Do not attempt to do this if the
eye has been prolapsed for longer than ten minutes and follow the above mentioned
steps.
• Perforating injury: These are seen when a sharp object or instrument becomes
imbedded in the structure of the eye. Never pull the foreign body out of the
eye even if it is large enough to grasp. If it is removed non-surgically the
fluid in the front chamber of the eye (aqueous humour) can leak, causing
the back chamber to prolapse forward, thereby destroying the structure of the
eye. Management involves keeping the eye moist (see eye prolapse above),
preventing self-mutilation, and taking the animal to the veterinary surgery
urgently.
PARAPHIMOSIS
Paraphimosis is the inability of an engorged penis to retract back into the prepuce
following erection and or mating. Treatment is aimed at protecting the exposed
penis, attempting to replace it into the prepuce. The animal may inadvertently
self-mutilate this tissue further by licking. This causes considerable damage to the
mucous membrane covering the penis followed by development of a substantial
swelling. Keep the exposed tissue wet using water, as it is essential that the tissue
is not allowed to become dry. Cold packs may be helpful in reducing the swelling
sufficiently to replace the penis in the prepuce. Veterinary help must be sought if
reduction is not possible by this method.
METABOLIC PROBLEMS
The following conditions can become first aid situations.
• Diabetes mellitus
• Epilepsy
Diabetes mellitus
There are several forms of the disease but they all cause the same problem, which
is too much glucose in the blood. Diabetes is controlled by the animal’s owner by
(i) giving insulin injections, which moves the glucose out of the blood and into
cells of the body, and (ii) controlling dietary intake to reduce glucose absorption
from the intestine. These two actions help to reduce circulating blood glucose
concentrations.
You should also be aware of the signs associated with low blood sugar (hypoglycaemia).
This can occur in a diabetic animal when insulin is being given but the
animal is not eating, resulting in an insulin overdose. At the same time, it is
important not to allow the blood glucose to fall too low. This can be prevented by
ensuring correct timing of feeding in relation to insulin administration.
Diabetic coma (hyperglycaemia) can develop if insulin has not been given,
because of excess glucose in the blood. The signs of diabetic coma include:
• Lowered exercise tolerance
• Drowsiness
• Aggression
• Unwillingness to eat
• Staggering gait
These signs will be followed by muscle weakness, collapse and coma. If the
animal becomes unconscious, oral glucose should not be given and the animal
should be taken to a veterinary practice as quickly as possible.
Epilepsy
Epilepsy is also referred to as convulsion, fit or seizure. The animal appears to lose
control of its body during a seizure-like episode. The cause is very difficult to
determine due to the wide variety of occurrences and is linked to alteration of the
electrical activity within the brain, which leads to loss of consciousness. Possible
causes of epilepsy in animals include:
• Low blood sugar (hypoglycaemia)
• Stress in highly strung animals
Based on severity, epilepsy can be:
• Petit mal: This lasts a few seconds known as an absence, and it affects only a
part of the brain. The signs include inattention, staring into space and apparent
confusion.
• Grand mal: This is severe, lasting minutes to hours and affecting the entire
brain. The animal is seen to have muscular twitches and contractions followed
by a loss of consciousness, paddling of limbs, shivering and incontinence.
• Status epilepticus: This refers to repeated fitting episodes, one after another.
The episode cannot be shortened by first aid but can be prolonged by continued
stimulation from loud noises (radio, music or TV) bright lights or rough
handling. Therefore management of the situation is important to prevent other
injuries occurring while the animal is convulsing.
Prior to examination by a veterinary surgeon, one should take note of the
following:
• Do not attempt to restrain.
• Subdue light, reduce noise.
• Partly open a window or door for fresh air.
• Remove as many objects (e.g. furniture) as possible from the room or push them
back out of the animal’s way.
• Do not leave unattended for long and ensure that the airway is not obstructed
(e.g. by vomit or its tongue).
• Only handle when the animal begins to recover, checking to see if it is able to
respond to its name.
HEAT STROKE
A heat stroke results from an excessive rise in body temperature caused by high
environmental temperatures. Dogs and cats do not lose body heat through the
skin due to their dense coats and lack of sweat glands. Therefore to eliminate
excess body heat they use the respiratory system, inhaling cool air through the
nose and exhaling the hot air through the mouth. The faster this exchange occurs
the faster their body will cool down – which is why dogs pant after exercise. The
normal range of body temperature range is given earlier in the chapter.
Heat stroke is rarely seen in cats, and in dogs it usually occurs because the
animal has been confined, on a hot day with no access to shade, in the drying
area of a salon or in a car/vehicle with insufficient ventilation. N.B. On a hot
day the temperature in a car soon becomes higher than the environmental
temperature even if windows are left open. Never leave an animal unattended
in a car.
When the environmental temperature exceeds the animal’s body temperature
it ultimately becomes impossible for that animal to maintain its body temperature
within normal limits for that animal. Heat stroke affects all dogs, but most at risk
if exposed to excess heat are:
• Those with thick dense coats
• Over-weight animals
• Short-nosed breeds
• Animals with heart conditions
• Elderly animals
• Those with medical conditions that affect breathing
In heat stroke, panting becomes ineffective and the body temperature rises
rapidly, Death follows quickly if the body temperature is not immediately
reduced. Signs of heat stroke include:
• Excess panting and salivation
• Bright red mucous membranes (check the gums)
• Vomiting
• Excitement/anxiety
• Disorientation
• Collapse/unable to stand
• High body temperature (41–43°C)
It is essential to reduce body temperature urgently as follows:
• Remove the animal from the hot environment.
• Cool it, using a pack of frozen vegetables held on the neck area.
• Wrap in towel/blanket soaked with cold water, and continue to hose water
over the soaked wrapping, keeping clear of the face.
• Monitor the animal’s body temperature.
• If it has collapsed, put in recovery position to assist breathing.
• If it is conscious, encourage it to drink small amounts of water continuously (if
unrestricted the animal may swallow too much too fast and vomit).
• Treat for shock if the temperature goes below the normal temperature.
• Even if the body temperature is restored, it is essential to have the animal
checked by a veterinary surgeon as soon as possible in case of a repeat rise in
temperature.
BANDAGING
Reasons for bandaging include:
• Protection of a wound.
• Prevention of self-mutilation and interference.
• Support for soft tissues (muscle or ligament) in sprains and strains.
• Stopping bleeding (pressure bandage).
• Prevention of contamination.
Layers of a bandage
• Dressings: These are placed against the wound to provide a sterile contact
material that will prevent further contamination of the site.
• Padding: This provides the means of absorption and padding, e.g. cotton wool
(Fig. 7.19).
• Bandage: This secures the padding and dressing and protects them from the
environment and the patient (Fig. 7.20).
The bandage must be comfortable. If the bandage is applied too tightly the
animal will try to remove it or the surface tissues will be damaged by the animal’s
constant chewing and licking. The bandage prevents the animal from interfering
with the area under the bandage and limits movement in the case of broken bones
or tissue damage, and therefore limits pain. The bandage should stay on for the
required amount of time. Watch out for:
• Discomfort.
• Interference or self-mutilation (to try to remove the bandage).
• Bandage getting wet or dirty.
Rules for bandaging
• Wash hands before starting to prevent introducing infection.
• Collect all the materials together before restraining the animal.
• Never stick adhesive tape onto the animal’s coat or hair, as it is hard to remove.
• Do not use safety pins or elastic bands to secure the ends of any bandage. Use
narrow adhesive tape on the bandage surface.
• In the case of a leg bandage, include the foot otherwise it will swell.
• If unsure of the animal’s temperament, muzzle for safety.
Applying a bandage
Limb bandage
It is important to apply the bandage in a spiral fashion (Fig. 7.21) to a leg to prevent
development of pressure rings on the skin. A pressure ring forms when a bandage
is applied in a circular manner or the bandage has slipped from its original position
on the limb to lie as rings over one area.
A tight bandage can cause fluid to build up in the tissues, preventing it from
flowing properly. To make sure a bandage is not applied too tightly, it should be
possible to easily slip two fingers under the edge of the bandage (Fig. 7.22).
ANATOMICAL DIRECTIONS
These are words in the language of medicine used for rapid communication for
location of injury/or site description. Many of these words have originated from
Greek or Latin, but are still in use today. Anatomical directions are used to
describe areas of the animal’s body and their direction and are useful if reporting
an accident or injury case (Fig. 7.23).
The following four words are another way of saying above, below, front and
back, respectively:
• Dorsal: Towards the top or the back surface of the body.
• Ventral: Towards the underside, below surface or nearer the ground.
• Cranial or anterior: Situated at the front of the body or towards the head end.
• Caudal or posterior: Situated towards the back end of the body or towards
the tail.
Words that mean the side, middle of the body, or near the nose are:
• Lateral: To the side (left or right) or away from the middle of the body.
• Medial: The midline of a body structure or the body.
• Rostral: In the head but towards the nose.
Words that mean near or far from a named body structure (especially limbs)
are:
• Proximal: Nearer to the body trunk or closer to a named structure.
• Distal: Away from the body trunk or further from a named structure.
Words which indicate the surface of a limb, especially the lower limb surfaces are:
• Palmar: Also called volar, indicating the caudal or back surface of the forelimb,
below the carpus or wrist area.
• Plantar: Indicating the caudal or back surface of the hind limb, below the tarsus
or hock area.
Words meaning inside or outside the body are:
• Internal: Inside the body.
• External: Outside or surface of the body.