Cardiopulmonary Resuscitation in Exotic Animals

Key Points

  • The basic principles of cardiopulmonary resuscitation are the same for all animals. Guidelines and drug doses in non-traditional species are extrapolated from dogs and cats, however there are differences related to patient temperament, anatomy, physiology, and size.
  • Preparation is essential. A “crash cart” with emergency supplies should be readily available, as well as a dosing chart for resuscitation drugs. Calculate drug doses, particularly for tiny patients that will require dilution for safe and accurate delivery. Emergency and reversal drugs can be drawn up ahead of time.
  • Atropine may not be effective in the rabbit due to the presence of atropinase or high doses may be required.
  • Endotracheal intubation of rabbits and many rodents is challenging. Ideally, the veterinary professional should be proficient in multiple techniques prior to presentation of the patient, however forced mask high flow oxygen ventilation may be the most successful technique in some small herbivores.
  • Lower levels of oxygen or even room air delivered via a bag valve mask can be preferable in the reptile patient to stimulate respiration.
  • Due to the presence of the sternal plate or keel, direct compression of the heart is impossible in birds, however sternal compression does serve to push air through the bellows-like air sac system.
  • Birds and reptiles lack a diaphragm, therefore closed-chest compressions cannot utilize the thoracic pump mechanism to increase negative intrathoracic pressure.
  • Small patient size means that supplemental heat and warmed fluids are required during resuscitation. Hypoglycemia is also a concern.

There is little empirical information available on cardiopulmonary resuscitation in most exotic animals. Fortunately, the basic principles of CPR are the same for all species, however there are important species-specific considerations. This review article explores techniques for establishing airway control, ventilation and cardiac compression recommendations as well as considerations for emergency drug selection . . .


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Further reading

Costello MF. Principles of cardiopulmonary cerebral resuscitation in special species. Semin Avian Exotic Pet Med 13(3):132-141, 2004.

Huang L, Well MH, Cammarata G, et al. Nonselective beta-blocking agent improves the outcome of cardiopulmonary resuscitation in a rat model. Crit Care Med 32(9):S378-S380, 2004.

Kohlhauer M, Darbera L, Lidouren F, et al. Comparative effect of hypothermia and adrenaline during cardiopulmonary resuscitation in rabbits. Shock 41(2):154-158, 2014.

Lamoureux L, Radhakrishnan J, Gazmuri RJ. A rat model of ventricular fibrillation and resuscitation by conventional closed-chest technique. J Vis Exp. (98). doi: 10.3791/52413, 2015.

Rezende-Neto JB, Rizoli SB, Andrade MV, et al. Rabbit model of uncontrolled hemorrhagic shock and hypotensive resuscitation. Braz J Med Biol Res 43(12):1153-1159, 2010.

Zhang YM, Gao B, Wang JJ, et al. Effect of hypotensive resuscitation with a novel combination of fluids in a rabbit model of uncontrolled hemorrhagic shock. PLoS One 8(6):e66916, 2013.

To cite this page:

Pollock C. Cardiopulmonary resuscitation in exotic animals. LafeberVet Web site. Available at https://lafeber.com/vet/cardiopulmonary-resuscitation-in-exotic-animals/