shih tzu cprHopefully, your puppy will never need cardiopulmonary resuscitation (CPR), but just in case it does, you'll need to be ready to respond immediately.

First, determine if your puppy needs CPR. Check for breathing by placing your hand in front of your puppy's nose and mouth. Check for a heartbeat by listening with your ear on the left side of your puppy's chest directly behind the elbow.

If your puppy isn't breathing and has no heartbeat, follow the instructions below in the order given. If your puppy isn't breathing, but has a heartbeat, follow the instructions below, omitting the heart massage.

1. Clean the airway

Carefully pull your puppy's tongue forward and look for obstructions in the mouth or throat. If you see an obstruction, remove it with tweezers. Be careful not to push the obstruction further into the throat. If you can't reach the obstruction, place your hands on both sides of the chest and push firmly and quickly. Repeat until the obstructing object is dislodged.

2. Position

Lay your puppy on its right side. Move its head forward to extend the neck, which will straighten the airway and make it easier to get air into the lungs.

3. Start rescue breathing.

Close your puppy's mouth. Place your mouth over your puppy's nose and exhale through your mouth until your puppy's chest expands. If the chest doesn't expand, check again for obstructions, then reposition your puppy and try again. Administer 12 to 15 breaths per minute.

4. Start heart massage.

Place the thumb and fingers of one hand on either side of the chest, then compress the chest by gently squeezing your thumb and fingers together. Compress the chest 100 to 150 times per minute, alternating compressions with breaths.

5. Continue

Keep administering breaths and chest compressions until your puppy starts breathing on its own and you can hear a heartbeat. Then call your veterinarian. Your puppy will need evaluation and possibly further treatment. If you are unable to revive your puppy, have someone drive you to the veterinary clinic while you continue CPR.

Note: It's possible to perform CPR by yourself, but it's easier if you have someone to help you. If you have an assistant, ask them to call your veterinarian while you start CPR. The assistant can then massage the heart (if necessary) while you take care of rescue breathing.

Unfortunately, CPR is often unsuccessful, even when administered by well-trained veterinary professionals. There's nothing to lose by trying, however, and everything to gain if you're able to revive your puppy.

- Karla S. Rugh, VM, Ph.D.
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