Feline First Aid II ~ Pawprints and Purrs, Inc.

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Any health care links located here are NOT to replace a veterinarian visit; please take your cat to a vet immediately at any sign of odd behavior or any symptoms of illness or injury. Call your vet and describe your cat's symptoms with any of your concerns about the cat's well-being. Your veterinarian may discover changes in your cat's health that you have overlooked. It is always better to err on the side of caution.

Feline First Aid II

"How does one take care of a cat? What do they...do? What am I supposed to...do? The first night with that tiny furry bundle under my roof...well...I slept not a wink." ~ Lilian Jackson Braun, Author of The Cat Who Mystery Novels

The following are tips to learn how to distinguish a minor affliction from a true emergency and how to address the situation. This information is NOT to replace a veterinarian visit; please take your cat to a vet immediately at any sign of odd behavior or any symptoms of illness or injury. Call your vet and describe your cat's symptoms with any of your concerns about the cat's well-being. Your veterinarian may discover changes in your cat's health that you have overlooked. It is always better to err on the side of caution.

Bandages and Splints, Transporting an Injured Cat, and Medicating

Bandages and Splints

It's important to remember one only needs only basic knowledge of applying bandages and splints; these dressings are intended to be temporary until veterinary care is available. Don't feel that your skills are to be expert in an emergency.

Bandages are needed to:

cover open wounds to prevent further contamination during transport to a vet
cover bleeding wounds while pressure is applied to control blood loss during transport to a vet
apply slight pressure to an injury to minimize swelling and the sensation of pain before and after treatment by a vet
prevent the cat from creating further harm by licking his wounds before or after he has received veterinary care
keep healing wounds clean and dry following veterinary care.

Flush away surface debris and disinfect before applying any bandage to an open wound. This may not always be possible in an emergency or even necessary (i.e., in the case of a hemorrhaging wound). Apply a square of gauze or sterile non-stick pad large enough to cover the surface wound; if you have small gauze pads only, use several and overlap them to cover the wound; apply several layers to provide a thick dressing for protection and additional absorption. With one hand, hold the dressing to the wound and place the end of the roll of bandaging material across the dressing. Rolled gauze is preferred for use as the layer over the local dressing, but if not available, use whatever bandage supplies you have on hand.

Wrap the rolled bandage around the dressing, overlapping by about two-thirds of the width of the bandage material. Extend the bandage 1 to 2 inches above and below the edges of the dressing. Do not pull on the bandaging material as you unravel it or the bandage will be too tight (you should be able to easily pass your finger under the edge of the bandage).

Use bandage or surgical tape to secure the end of the bandage. If you have an elastic bandage available, apply it loosely, overlapping edges two-thirds of the width of the bandage; cover the inside layers of gauze and extend it about 1 inch beyond the edges of the gauze layer. Secure the end with tape or safety pins - many bandages now come with fasteners or are self-adhesive, found at the local pharmacy. Use surgical or adhesive tape to cover the top inch of the bandage. This is the key to keeping the bandage in place. The adhesive tape must stick to hair or skin so that it will not slip. Repeat application of the adhesive tape on the bottom edge of the bandage.

If at all possible, call ahead to let your vet know that you are on the way with an injured cat. Remain calm and proceed directly to the vet.

Splints are intended as temporary bindings to stabilize an injury during transport. They are meant to immobilize an injured limb to minimize aggravation of the injury and pain, and to provide support and cushioning. The splint can be made of improvised materials and secured with any type of adhesive tape, safety pins, belt, string, ribbon, bandaging material, etc. Some common objects that can be used for splints include:

Towel - fold it in half, and depending on the size of the towel and the size of the cat's leg, in half again; slide folded towel under leg and wrap towel around toward top of the leg (doesn't need to encircle leg entirely). Or, wrap folded towel snugly but not tightly around the injured limb and secure it in place. It may be most comfortable to simply place a folded towel beneath the injured limb to provide support during transportation.
Any folded garment - use as bandaging material to provide a bulky wrap or fold and secure in the same manner as the towel suggested above.
Newspaper or magazine - fold to provide a groove in which to rest the injured limb, or shaped into a roll and wrapped around the limb.
Sticks/spoons - tie directly to the length of the leg for short periods or use to provide additional support for bandages. Popsicle sticks may work perfectly for kittens.
Boards/cardboard - almost any type of board (paper, wood, plastic, metal, etc.) can be used to support an injured limb as long as there are no sharp edges or splinters.
Cardboard rolls from paper toweling (cardboard rolls from toilet paper for small cats and kittens) - the injured leg can be passed inside the roll and then a towel or cloth wrapped around the leg. The roll can be cut lengthwise to be more easily contoured to the leg and secured with tape.

Splints are recommended if there is an obvious or suspected closed fracture, an open fracture or a large gapping wound on a limb. Do not touch any open would with your bare hands.

An open fracture is one in which bone fragments protrude at the skin surface. If there is an open fracture or wound, disinfect the surface, place a clean dressing and if possible, cover with a sterile dressing and light bandage before splinting the leg. If the wound is bleeding profusely, tightly bandage an ice pack in place at the site of the hemorrhage and the limb immobilized with a splint.

A closed fracture should be suspected if your cat has pain and difficulty on attempts to walk using the injured leg. The fractured limb may be dragged, held off the ground, or simply held in awkward positions not bearing the cat's weight. Some fractures are stable - the bone fragments are still held together and the cat gingerly may bear weight on the limb. In general, however, the pain of broken bones will deter voluntary movement of the limb. Please note: some severe sprains and other soft tissue injuries can be painful enough initially to disable a limb.

Though splints are helpful, they should be considered optional first aid. If the cat is able to bear weight on the leg or to control the injured limb, it is probably not worthwhile to make a splint. A splint can help minimize pain, bone displacement or other complications while transporting him for medical treatment. Open fractures rank high in the list of urgent injuries and should be seen by your veterinarian immediately.

Transporting an Injured Cat

There are many methods of lifting an injured animal. You will need to consider the location of the emergency (e.g., in a ditch, yard, lake, etc.) in addition to the nature of the cat's injuries (unconscious, broken leg, bleeding wound). The size of the cat and his temperament are also important factors that will affect how he may be carried. Before attempting to lift any cat, be sure that you understand how to approach a frighted/injured cat set forth in Article 1. Always remember to protect yourself from injury. You cannot help an injured cat if you are hurt in an attempt to rescue him.

If the cat is able to walk but has an injured limb or other obvious injury, you may need to lift and carry him to your vehicle. Regardless of whether the cat is able to walk, avoid bending his body or making abrupt movements. Some injuries are undetectable at the accident scene. The method of lifting the cat will depend greatly on his size and the extent of his injuries.

To lift a small kitten, cup his body in your palm and use your other hand to prevent him from rising or bouncing away by petting him or applying slight downward pressure. If the kitten is fighting you, it may be necessary to scruff his neck but support his hind legs so that he does not dangle or swing about.

To lift an adult cat, place one arm along the length of his abdomen and chest and cradle his body close to yours. Grasp both his front legs between the fingers of your hand to prevent him from breaking free or from scratching you. With your other hand, hold the cat's head and neck close to you to give him a sense of security in your arms. Some cats are better carried tucked under your arm and held close to you by pressing the cat's body between your arm and your side, especially if they are fighting against you.

To lift a more agitated or aggressive cat, scruff the back of the cat's neck to lift and hold him with his paws facing away from you. With your other hand, support the cat's weight and grasp the back legs between your fingers to provide further control.

It is often helpful to use a towel or blanket to cover a struggling cat to minimize your own injury and give him a comforting sense of being hidden from additional harm.

Reassure the cat as you lift and carry him. He may struggle to get free because of pain and/or panic. Keep your hold firm but do not grip tightly unless it is absolutely necessary to prevent further injury to yourself or him.

If the cat is unconscious or unable to walk, he maybe suffering from serious internal injuries or head and spinal cord trauma. For these cats, and for a very over-weight cat who is too awkward or heavy to lift, it might be best to transport on a stretcher. Depending on the size and weight of the cat, use a box. You can also use the lid of a garbage can, a laundry basket, a gym bag with a solid bottom, a desk drawer or anything else that is appropriate and available. If you are unable to locate an item for a stretcher, don't waste time constructing a makeshift stretcher. It is far more important to get the cat to the nearest emergency facility as quickly as possible. More than likely, a coat or jacket, blanket or sheet, mat or area rug, will be the easiest and best stretcher. Cover the injured cat with a blanket or any article of clothing to preserve body heat. Place the cat's back against the back of the seat or on the floor of your vehicle so that he won't be unnecessarily jostled during transport. He already has enough problems without rolling off the car seat.

Drive carefully, concentrating on traffic, road obstacles, and the shortest route to your destination. Sucessful transportation to the emergency facility is a critical aspect of first aid. Speak to the cat in a calm and soothing voice as you drive.

Even if the cat doesn't seem badly injured, he will be in a state of high anxiety and could progress into a state of shock. Your cat is always attuned to your verbal cues, facial expressions, and body language and will be even more responsive in a crisis.

Medicating a Cat

Medicating a sick or injured cat can be one of the greatest challenges of pet ownership. Even the most passive and gentle cat can become downright ornery when it comes to being medicated or manipulated in order to receive medication. The administration of prescribed drugs can be important in preventing emergencies. For example, your cat may be on a course of prescribed drugs to treat a serious illness. Although the administration of medication will rarely be required of a cat owner in an emergency, you might be instructed to do so by your veterinarian.

Never administer any type of medication or treatment to your cat without first consulting your veterinarian. Do not assume that a remedy in the past for a particular symptom will again be appropriate should the same or similar symptoms occur. Many medical conditions resemble one another, but their treatments may be very different. An accurate diagnosis must be made. You should not guess at what treatment is right for your cat without your veterinarian's input.

How to Give Oral Medication

Medicines that are taken by mouth (oral) come in tablet (chewable or nonchewable), capsule, gel capsule, and liquid forms.

To administer medication in pill form (tablet or capsule) directly into the cat's mouth:

Place your cat in your lap or preferably, on an elevated surface.
Encircle the top of your cat's head with one hand between your thumb and fingers.
Gently elevate the head so that his nose is pointing upward; in this position, the lower jaw will drop down slightly.
With your other hand, use your pinkie finger to gently press downward on the lower jaw and quickly drop the tablet or capsule to the very back of the tongue so that the medication is more likely to be swallowed. Some animals become very adept at holding onto a pill without swallowing. Be sure that the medication is introduced far back on the tongue so that this trick is less successful. If you are very quick, use your index finger to push the pill deeper into the throat.
Release the lower jaw, but maintain your hold on his head and slide your thumb under his jaw to gently hold the mouth closed with your fingers. To encourage swallowing, gently rub his nose with your finger (he will swallow and try to lick his nose) or stroke his throat.

To give a tablet or capsule, it is generally not recommended to crush the medicine in food. Most drugs have an unpleasant taste when the pill's coating is unsealed.

If you're unable to give a pill directly into the mouth, you may need to hide it in food or a treat. Always be sure that the tablet is swallowed. Your cat might eat around it, leaving it in his dish or carry the pill elsewhere and spit it out. For that reason it is preferred to hide the medication in a small portion of food - a piece of soft cheese, peanut butter, luncheon meat, etc. - and stay to watch as your cat consumes the treat and its hidden cargo. Similarly, you can dip the tablet in margarine or butter to help lubricate its passage and hide the taste. Another tip is to freeze the pills with a ¼ teaspoon of water or broth; these will slide easily past the tongue and if tasted, won't be unpleasant.

Some solid oral medications are prepared as chewable tablets that are specially flavored to appeal to your cat. Most cats find these very palatable, but if your cat refuses them, mix the chewable tablet with the cat's food or favorite treat.

To administer liquid oral medication, gently place the dropper at the corner of the cat's mouth where the top and bottom lips meet. Deliver the liquid onto the back of the tongue by placing the tip of the dropper between the back teeth. If your cat resents the flavor the liquid medication (spits up, drools heavily or foams at the mouth), try mixing it into his food or hiding it in a special food treat or as a frozen treat as mentioned earlier.

Avoid giving oral medication far back in the throat with the head elevated in line with the neck. This posture increases the risk of aspirating (inhaling into the lungs) the liquid or tablet. A 45º angle of elevation is safe, effective, and need not be exceeded.

If your vet has instructed you to remove food and/or water from your cat, do not administer medication in food treats unless you consult with him.

If you have difficulty medicating your cat despite great efforts, do not hesitate to seek help from your veterinary clinic. Gadgets called "pill poppers" are available through veterinarians and pet supply stores. Unfortunately, some cats can be very determined and refuse any attempt to be medicated or treated. Some can become aggressive or unintentionally injure their owners during attempts to treat them. In this case, bring your cat to the clinic for his daily treatment, or an alternative medication or route of administration (e.g. injectable) may be advised. It may be necessary to hospitalize or board your cat at the clinic until all the necessary treatments have been completed.

How to Give Eye Medication

Eye (ophthalmic) medications come in liquid or ointment form. Eye drops may be slightly easier to apply than ointments because they can be delivered more quickly. Some cats will feel uncomfortable when the drops fall onto the surface of the eye. Ointments may take a bit more control to deliver to the eye, but usually remain in the eye longer for greater benefit of healing.

Wrap your cat in a towel with only his head exposed to protect yourself from being scratched. To administer ophthalmic drops or ointment to your cat:

Encircle his head in your hand and use your fingers to slide the skin of the upper eyelid toward the top of the head; your cat will naturally move his eye downward and away from you.
With your other hand, hold the medication bottle or tube and rest the side of your palm on the side of your cat's face, just off to the side of the eye being medicated. This will also help to steady the cat's face to minimize further injury to the eye in case he struggles.
Instill the required number of drops or the recommended amount of ointment onto the outside corner of the eye's surface and release the upper eyelid as you allow the eyelids to blink.

Unless your cat is on a rigid diet, give him a treat for his tolerance of your manipulation.

How to Give Ear Medication

Ear (otic) medication is available in liquid and ointment form. Your vet will prescribe the medication that is appropriate for your cat's ear problem. An ear culture may be necessary if your cat's ears do not respond to the first medication selected for use. Treatments will be easier if you place your cat waist level high. You may need to roll a towel around his body so only his head is exposed to facilitate medication and minimize your risk of being scratched.

To administer otic medication to your cat:

Grasp the ear between your thumb and a bent index finger - to avoid pinching the ear, do not use your fingertip. Visually locate the entrance to the ear canal. Most ear infections originate deep inside the ear canal, and medication must be instilled directly into the canal to be effective.
Gently place the nozzle of the tube or bottle as deep as possible into the canal (these containers are designed to deliver otic medications into the cat's ear canal) and instill the recommended dosage of medication. You will not injure your cat's ear because the canal turns at a right angle and the container tip can't reach the eardrum. Don't release your hold on the cat until you are done.
Release the ear but hold his head while you gently massage the base of his ear to help distribute the medication inside the ear canal. You'll hear it squishing inside his ear.

Unless your cat is on a rigid diet, give him a treat for his tolerance of your manipulation.

How to Give CPR

Cardiopulmonary resuscitation (CPR) is the popular name given to two distinct emergency procedures: artificial respiration, which allows oxygen to be delivered when breathing has stopped, and heart massage (cardiac massage), which maintains blood flow when the heart has ceased to beat on its own. In many cases, breathing and heartbeat will stop together and both artifical respiration as well as heart massage will be necessary. Sometimes, the heart will continue to beat for a few minutes even when respiration has stopped and breathing may continue briefly when the heart has arrested. It is very important to determine three things before CPR is attempted:

Make sure that the cat is unconscious. Call the cat's name loudly, clap your hands above his head, rub your knuckles across his ribs, and pinch the skin between the toes to see if he pulls his paw away. If the cat responds to any of the above, delay performing CPR.
Verify the presence or absence of a heartbeat. The beating heart will be felt most strongly on the left side of the chest just behind the bent elbow. Place your palm over the cat's chest and press down slightly for better contact with the heartbeat. This is especially important with cats who have a thick coat or are very overweight.
Verify the presence or absence of breathing. Watch for even a faint movement of the ribs (place your hands lightly on the cat's chest wall if you are unsure). Put your hands just in front of the nostrils to detect warm air as it is expelled.

Note: If either artifical respiration or cardiac massage or both are required, call for help and transport your cat immediately to the nearest veterinary clinic. If possible, call ahead to notify the staff of the nature of your emergency and approximately when you'll arrive.

To give artificial respiration:

Make sure the cat is unconscious and not breathing.
Place the cat on his right side. (Should you need to administer cardiac massage, the left side of the chest will be already accessible - an important exception to this is when there is an obvious chest wound on the left side. In this case, place the cat on his left side, despite the injury, so that the healthy lung on the right side is free to breathe more easily.)
Examine the mouth and back of the throat to remove any foreign matter. If the cat is not breathing and his chest does not inflate when you begin artificial respiration, check the inside of the mouth and throat. Open the mouth by parting the upper and lower jaws. Pull the tip of the tongue forward and downward toward the cat's chest to dislodge any obstructing material and to get a clear view. Scoop away solid debris and wipe any heavy mucus, saliva, blood, vomit, or foreign object thay you find. If necessary, reach your fingers into the back of the throat to feel for any obstructing object or material. If you see but can't reach an object, use a spoon or tweezers, being very careful not to push it farther into the airway. Begin CPR immediately following removal of the obstruction.
Encircle the cat's muzzle with one hand and support his neck with your other. Avoid unnatural neck positions that could interfere with the flow of air or aggravate any hidden injury.
Keeping his mouth closed firmly, place your mouth over the cat's nose and exhale deeply but without real force for about one to two seconds to bring about a moderate rise of the cat's rib cage, signaling adequate inflation of the lungs.
Remove your mouth from the cat's nose to allow for the lungs to deflate and the cat to exhale - do not let go of the muzzle; keep your face close to the cat for efficient technique but your eyes on the chest to monitor the rise and fall of the rib cage and lungs.
Repeat each assisted breath every two seconds.
Check for the presence of a heartbeat at least three times every minute by placing one hand on the chest wall just behind the cat's bent left elbow. If there is no heartbeat, you will need to begin heart massage. To avoid permanent brain injury, do not stop artifical respiration for longer than 30 seconds; continue CPR during transport as needed.

Note: If the gum color doesn't return to a more normal pink, or if the chest doesn't rise and fall when you perform artificial respiration, the airway may be obstructed. In an effort to expel whatever solid or liquid matter might be obstructing the flow of air, suspend the cat upside down by holding each thigh in one hand or by encircling his hips; swing him from side to side in a wide arc. Repeat the swing method as necessary. The chances of reviving the cat are, unforunately, very remote if there is a deep airway obstruction. Check the mouth and throat again to remove or wipe anything that has been expelled and return to CPR.

If he coughs or seems to move in any way, suspend CPR and check to see if he has begun to breathe independently and if the heartbeat is present. Do not continue CPR if he is breathing and the heart is beating. Observe him for any changes in case you need to resume CPR and transport to the nearest veterinary clinic immediately.

To give cardiac massage:

Place the cat on his right side, with the left side facing up, as the base of the heart is closest to the surface in this position. If he has an obvious injury to the right side of the chest, place him on his left side (cardiac massage might be less efficient, but you need not risk puncturing a lung or heart with broken ribs during CPR).

An alternative position for very obese cats or those with obvious chest injuries requires the cat to be placed slightly on his back; place one hand on either side of the cat's chest about one third of the way between the sternum and the elbow. Compress the chest between both your hands. See #3 and 4.
If possible, elevate the hips to facilitate the flow of blood returning to the brain and vital organs.
For small and medium sized cats, place your thumb and fingers on either side of the chest just behind and slightly below the bent elbow. For very large or obese cats, place the heel of one hand just behind and slightly below the bent elbow. Use two fingers for very young kittens.
Compress the chest wall over the heart and release between each compression without removing your hand. Press just enough to depress the chest lightly at a rate of 120 compressions per minute - count aloud to keep the rhythm: " 1 and 2 and 3 and 4 and 5 and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 15"; compress on each digit, release on "and". Don't worry about pressing too hard but avoid compressing too roughly.
If you are alone and both artificial resuscitation and cardiac massage are required (unassisted CPR), perform one quick breath after every five cardiac compressions. For greater efficiency, keep one hand on the cat's head and your head close to his face as you continue chest compressions between respirations.

If you have an assistant, one person should perform artificial resuscitation and the other should perform cardiac massage. Synchronize your efforts at a rate of one breath per three to five compressions.

Stop CPR every three to five minutes, or before if any movement is detected, to check for the presence of a pulse or heartbeat and for independent respiration. If the cat's pupils remain fixed and dilated despite CPR, a good prognosis is unlikely.

Do not stop artificial respiration for longer than 30 seconds to avoid permenant brain injury. Continue performing CPR during transport as needed.

Note: If either artifical respiration or cardiac massage or both are required, call for help and transport your cat immediately to the nearest veterinary clinic. If possible, call ahead to notify the staff of the nature of your emergency and approximately when you'll arrive.

Additional First Aid Articles:

Article   1: First Aid Kit, Approaching a Frightened or Injured Cat, Breathing, Heartbeat, Shock, Temperature, and Disinfecting Wounds
Article   2: Bandages and Splints, Transporting an Injured Cat, Medicating, and CPR
Article   3: External Wounds: Abscesses, Laceration, Applying Tourniquets, Scratches and Punctures, Burns and Scalds

Also see Emergencies and First Aid for related information.

Page URL: http://www.sniksnak.com/cathealth/firstaid2.html

Resource References:
1. Practical Kitten Care DeBitetto, James, DVM
2. The Cornell Book of Cats Cornell Veterinary School