Crashing Puppy/Shock Protocol
This is the medical protocol, created by veterinarians, followed by staff & volunteers when a patient is in shock upon intake or during hospital stay.
Signs of shock:
- comatose, Minimally or non-responsive, lethargic, lateral
- pale, grey, tacky and/or white gums
- thready pulses
- very weak, cannot stand
- cannot swallow
- low temperature (under 97)
- Place IVC - ASAP, and get a PCV/TP/BG
- If unable to do so yourself, get help from a vet or clinic staff member. Do not blow all the veins before having a vet try!
- If the dog already has an IVC, draw blood from a different vein to run a PCV/TP/BG
- Give fluid bolus over 5-15 minutes, or as fast as it will go.
- If in ward ≤ 3 days, give LRS 10mL/lb
- if in ward > 3 days give Hetastarch 10mL/lb
- During fluid bolus:
- Warmth – "burrito" the patient in blankets, covered with a heating pad set on LOW, with only catheter paw sticking out. Do not remove from burrito unless essential because heat must be trapped inside to warm patient..
- Rectal Temp - alert vet if feverish (above 102.5) (most will be cold), do not remove burrito blankets
- Dextrose 50% - IV repeatedly (3cc/10lb) every 3 minutes (set up a timer) until you hook up patient on pump with dextrose later.
- Position - Sit dog sternal if able. Use towels to help support them.
- Assess & call the on-call vet: After fluid bolus is finished, assess gum color and feet temperature (should be warm)
- If still cold feet, gray gums: Repeat Bolus
- Do not give a third bolus without doctor advice.
- Syringe Feed - Once warm, start syringe feeding if patient is swallowing and not vomiting. If not swallowing, try IV dextrose boluses and dextrose on the gums until patient will allow better food.
- Pump - Place on IVF at 3x maintenance (3ml/hr/lb) for the next 24 hours. Start regular treatment.
- Offer food mixed with water - do not give plain water (more likely to vomit)