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

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)

• vocalizing 

 Procedure

1. Place IVC - ASAP, and get a PCV/TP/BG 

   1. 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!

   2. If the dog already has an IVC, draw blood from a different vein to run a PCV/TP/BG

2. Give fluid bolus over 5-15 minutes, or as fast as it will go. 

   1. If in ward ≤ 3 days, give LRS 10mL/lb 

   2. if in ward > 3 days give Hetastarch 10mL/lb 

3. During fluid bolus:

   1. 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.. 

   2. Rectal Temp - alert vet if feverish, 104 or higher (most will be cold), do not remove burrito blankets 

   3. Dextrose 50% - IV repeatedly (3cc/10lb) every 3 minutes (set up a timer) until you hook up patient on pump with dextrose later. 

   4. Position - Sit dog sternal if able. Use towels to help support them. 

4. Assess & call the on-call vet: After fluid bolus is finished, assess gum color and feet temperature (should be warm) 

   1. If still cold feet, gray gums: Repeat Bolus

   2. Do not give a third bolus without doctor advice.

5. Oral Dextrose - Syringe feeding 1mL of oral dextrose on gums. 

6. Pump - Place on IVF at 3x maintenance (3ml/hr/lb) for the next 24 hours. Start regular treatment. 

7. Offer food mixed with water - do not give plain water (more likely to vomit)