RECOVER 2026 · first aid

First aid for dogs and cats

The RECOVER 2026 guidelines are an international, evidence-based consensus on giving first aid to animals before they reach a veterinary practice. They include five "Recognise and Act" algorithms and six instructional illustrations that help owners recognise a threat and take the right action before the animal comes under veterinary care.

Educational material for animal owners — it does not replace veterinary assessment and help. In every case, the animal should be taken to the nearest open veterinary practice.

"Recognise and Act" algorithms

Five algorithms

Algorithm 1 · general

General first aid algorithm

Signs that link recognised problems to a specific action.

Signs that any owner can notice, linked to specific problems where first aid matters. Every reported concern — with one exception — leads to one place: the nearest open veterinary practice.

Assess the safety of the scene

Before you begin, assess the surroundings, your own skills and the availability of other people. An animal in pain, fear or severe stress may be aggressive.

High risk to the rescuer

Do not attempt any intervention. Go straight to transport.

Low risk

Continue with recognition and first aid.

Recognise the signs in the animal

Each of the signs below is linked to a specific first aid action.

Poorly responsive, lethargic

Try to rouse the animal. If it returns fully to normal and you have no further concerns (for example, it was sleeping) — observe; this is the only pathway without a visit to the practice. In animals at risk of hypoglycaemia (insulin, newborns) with weakness, stumbling or collapse — apply a sticky carbohydrate to the lining of the cheek (not during seizures) and go to the practice. Asymptomatic hypoglycaemia confirmed with a glucometer — give food.

Ingestion of a toxin (non-corrosive)

Do not induce vomiting routinely — go to the practice as quickly as possible. Exception: when the practice is unavailable and inducing vomiting is advised by a vet or an animal poison information centre.

Signs of heatstroke

Go to the heatstroke algorithm — passive and active cooling before transport.

Sudden pain / excessive attention to one part of the body

Assess for a burn. Thermal — cool running water for at least 20 min, as soon as possible (within 3 h of the injury). Chemical — running water for at least 15 min, wearing gloves and eye/face protection.

Breathing difficulty, respiratory effort, bluish mucous membranes

Give oxygen during transport if available; if you have a pulse oximeter, aim for SpO₂ 95–97%.

Signs of choking

Go to the choking algorithm — back blows and alternative techniques.

No response, no regular breathing

Start CPR immediately, following the relevant resuscitation algorithm.

Severe external bleeding

Direct pressure. If bleeding from a limb or tail does not stop — a tourniquet (recommended in an unconscious animal, suggested in a conscious one). Head, neck, trunk — pressure only and rapid transport.

Suspected opioid poisoning

Altered consciousness or breathing below 10/min — naloxone intranasally or intramuscularly. No response, not breathing — CPR first, then naloxone as soon as possible.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 2. Educational material — it does not replace veterinary help.

Algorithm 2 · heatstroke

Heatstroke and overheating

Recognising overheating and cooling before transport.

Helps you recognise overheating in a dog or cat and start cooling before the animal reaches the practice. Heatstroke can also occur at moderate temperatures — during running, play or work.

Heavy panting

Constant, heavy panting in a dog (in a cat with or without an open mouth).

A dog reluctant to be active, lying in an unusual position

Withdrawal from activity

Sudden reluctance to play or be active; lying down at an unusual moment during activity.

Disorientation

Disorientation, staggering.

Common signs of overheating

Constant, heavy panting in a dog (in a cat with or without an open mouth)
Sudden reluctance to play or be active
Lying down at an unusual moment during activity
Withdrawing from work
Anxious facial expression, restlessness
Disorientation, staggering
Excessive drooling, vomiting or diarrhoea
Collapse

Recognise the signs of overheating

High ambient temperature or physical exertion + the signs from the box above.

High risk to the rescuer

Do not attempt cooling. Transport to the practice immediately.

Low risk

Continue cooling on the spot.

Passive cooling

Immediately move the animal to a cooler place. Stop running, play, work or hiking.

Active cooling

Pour cool running water over the animal from the nape of the neck downwards, paying particular attention to areas with the thinnest coat (for example, the belly), so that the water soaks through to the skin. Avoid the mouth — risk of aspiration. Running water works better than a single dousing. Do not cool only the paws.

Breathing without rasping or high-pitched noises

Cool to a rectal temperature of 39,7–40°C, then stop active cooling — even if the animal is still panting. Without a thermometer — cool for 15 min.

Rasping breathing (stertor) or high-pitched noisy breathing (stridor)

Continue cooling until panting clearly improves or until 38,6°C — whichever comes first.

Dry the animal

After cooling is finished, dry the coat with a towel.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 4. Educational material — it does not replace veterinary help.

Algorithm 3 · choking

Choking — foreign body in the airway

Back blows, alternative techniques and CPR.

Complete airway obstruction is fatal within minutes, so a rapid response by a bystander is decisive.

Pawing at the mouth

Agitation, pawing at the mouth.

Head and neck extended

Head and neck extended.

Signs of choking

Agitation, pawing at the mouth
Head and neck extended
Weak or absent cough sound when trying to cough or gag
High-pitched, squeaky sound when trying to breathe
Pale or bluish mucous membranes
Excessive drooling

Recognise the signs of choking

Especially with quiet or "squeaky" breathing.

High risk

Do not intervene. Transport immediately.

Low risk

Intervene.

Animal conscious

Up to 5 back blows

On one or both sides, over the upper, rear part of the chest, to the side of the spine — do not strike along the spine itself.

✓

Foreign body removed

The animal still needs veterinary assessment — go to the practice.

Not effective — try an alternative technique

A position with the head lower than the trunk (± further back blows), chest thrusts or abdominal thrusts. Abdominal thrusts can injure small, thin animals or those with enlarged abdominal organs. Do not put your fingers into the mouth of a conscious animal.

↻

Repeat the cycle

Return to back blows until the foreign body is removed or the animal loses consciousness.

Animal unconscious

30 chest compressions

Rate 100–120/min. Start with compressions — not with checking the airway.

Check the airway (< 10 s)

Remove any visible foreign body. Never do a blind finger sweep.

2 mouth-to-nose breaths (< 5 s)

Head and neck in line with the spine so as not to block the airway. If there is a second rescuer, they can keep trying to remove the foreign body while the first returns to compressions.

↻

Repeat the A–B–C cycle

Until the foreign body is removed or help arrives.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 8. Educational material — it does not replace veterinary help.

Algorithm 4 · CPR

CPR away from the practice — first responder with equipment

Resuscitation with a self-inflating bag and mask.

For helpers and first responders equipped with a self-inflating bag and a mask that fits tightly over the animal's muzzle. The procedure is analogous to the bystander algorithm, with one key difference: how the breaths are delivered.

The animal does not respond, no normal breathing

Confirm that the scene is safe and call for help.

Begin chest compressions within 10 s

No initial airway check — compressions first.

30 compressions at a rate of 100–120/min

A short pause, then 2 breaths in < 5 s.

Breaths via a self-inflating bag with mask

Instead of the mouth-to-nose method, breaths are delivered through a face mask fitted tightly over the animal's muzzle and connected to a self-inflating bag. As with the mouth-to-nose method, the head and neck should be in line with the spine.

↻

Repeat the 30:2 cycle

Until return of spontaneous circulation, arrival of further help, or the end of resuscitation.

If the equipment (self-inflating bag, mask) is not available or does not fit the animal's muzzle, use the bystander algorithm with mouth-to-nose breaths.

Editorial note from the practice: in resuscitation, the most important thing is uninterrupted chest compressions — interrupt them only for breaths and, if there is a second person, swap roughly every 2 minutes, because fatigue quickly reduces the effectiveness of compressions. During opening hours, phone the practice before you set off so that we can prepare the team; outside opening hours, on Sundays and on public holidays, go to the nearest 24-hour animal hospital (addresses on the Contact page). If another veterinary facility is closer than we are, go there — travel time is what counts.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 9. Educational material — it does not replace veterinary help.

Algorithm 5 · CPR

CPR away from the practice — bystander

Resuscitation without equipment: compressions and mouth-to-nose breaths.

For owners, handlers and helpers without medical equipment who have found a dog or cat unconscious and not breathing normally.

The animal does not respond, no normal breathing

Confirm that the scene is safe. Do not start CPR if the scene is dangerous or the owner has a do-not-resuscitate decision in place.

Call for help

Use the phone on speaker; do not hold it to your ear — your hands must be free to help the animal.

Begin chest compressions within 10 s

No airway check and no breaths at the start — this is a change from earlier RECOVER guidelines (compressions first, not the airway).

30 compressions at a rate of 100–120/min

A short pause (a few seconds), then 2 mouth-to-nose breaths in < 5 s. Head and neck in line with the spine.

Risk to the rescuer (infectious disease, narcotics)

Perform chest compressions only, without breaths.

No risk

Continue the cycle of 30 compressions : 2 breaths.

↻

Repeat the cycle

Until return of spontaneous circulation, arrival of help, or the end of resuscitation.

When transporting a small dog or cat, a passenger wearing a seat belt can continue compressions with one hand and mouth-to-nose breaths while a second person drives to the practice.

Editorial note from the practice: in resuscitation, the most important thing is uninterrupted chest compressions — interrupt them only for breaths and, if there is a second person, swap roughly every 2 minutes, because fatigue quickly reduces the effectiveness of compressions. During opening hours, phone the practice before you set off so that we can prepare the team; outside opening hours, on Sundays and on public holidays, go to the nearest 24-hour animal hospital (addresses on the Contact page). If another veterinary facility is closer than we are, go there — travel time is what counts.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 10. Educational material — it does not replace veterinary help.

Instructional illustrations

Six illustrations

Illustration 1 of 6

Applying carbohydrate to the mucous membrane

First aid for hypoglycaemia.

First aid for hypoglycaemia: a sticky, simple carbohydrate (corn syrup, glucose gel, honey) applied to the mucous membrane between the premolar teeth and the cheek.

Hypoglycaemia

How to do it

Give 0,2–10 ml — an amount scaled to the size of the animal (up to about 2 teaspoons).
Apply the carbohydrate to the mucous membrane between the upper premolar/molar teeth and the cheek.
Aim: to coat a large area of mucous membrane, not to make the animal swallow the liquid.
Do not give anything by mouth or onto the mucous membrane if the animal is having an active seizure.
Do not do this if it poses a risk to the owner (for example, risk of being bitten).

Who is at risk of hypoglycaemia

Animals receiving insulin (most common)
Puppies and kittens in the neonatal period (most common)
Insulinoma; paraneoplastic syndromes
Xylitol ingestion in dogs
Pregnancy and birth

Applies to at-risk animals with symptoms (weakness, stumbling, drowsiness, collapse) — provided it does not delay transport to the practice. For asymptomatic hypoglycaemia confirmed with a glucometer, giving food is recommended.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 3. Educational material — it does not replace veterinary help.

Illustration 2 of 6

Methods of cooling an overheated dog

Three variants of active cooling in the field.

Three variants of active cooling available in different settings — choose the method to suit the conditions you are in.

Water from a hose

Home or industrial setting.

Immersing the hindquarters

Recreational / wilderness setting.

Ice water from a cool box

Urban / recreational setting.

What to watch for

Avoid the mouth — risk of accidental aspiration or drowning.
Cooling is most effective where the coat is thinnest.
Running water or repeated dousing works better than still water.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 5. Educational material — it does not replace veterinary help.

Illustration 3 of 6

Cooling a burn with running water

20 minutes of cool running water on the burn.

Cool running water on a burn to a dog's limb — as soon as possible after the injury.

Burn

How to do it

Cool the burn with cool running water (from a hose or tap) for at least 20 minutes.
Start as soon as possible — ideally within 3 hours of the injury; the sooner, the better.
Cool water is preferred over ice water.
Do not use water around the mouth — risk of drowning.
When running water is not available (for example, on the way to the practice), use a cool, damp towel or a gel pack, likewise for at least 20 minutes.

Chemical burns: the rescuer puts on gloves, long-sleeved clothing and eye and face protection — a corrosive substance is also a risk to people. Safely brush any loose or thick deposit of the substance off the coat, then rinse with running water for at least 15 minutes (away from the mouth). If the animal licks the contaminated area, fit a protective collar.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 6. Educational material — it does not replace veterinary help.

Illustration 4 of 6

Recognising breathing difficulty in a dog

Body posture and signs of respiratory failure.

Body posture and signs by which respiratory failure (orthopnoea) can be recognised in a dog or cat.

Dyspnoea

Features to recognise

Anxious facial expression
Head and neck extended
Open mouth, lips drawn back
Elbows held away from the ribs
Increased, exaggerated chest movements
Position with the sternum towards the ground and the back up — a dog or cat with breathing difficulty rarely lies on its side

An animal showing these signs may need oxygen during transport to the practice — see the oxygen therapy recommendations in the general algorithm.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 7. Educational material — it does not replace veterinary help.

Illustration 5 of 6

Giving a medication intranasally

Naloxone in an unconscious animal using an atomiser.

Giving a medication (for example, naloxone in suspected opioid poisoning) intranasally using an atomiser on a syringe, in an unconscious, long-nosed dog.

Intranasal administration

When to use

Altered consciousness or a breathing rate below 10/min when opioid exposure is suspected.
If the animal is unconscious, apnoeic or agonal — start CPR first, following the resuscitation algorithm, then give naloxone intranasally or intramuscularly as soon as possible.
Do not give it if this poses a risk to the rescuer.

Signs of opioid poisoning and how to give the antidote

Signs: loss of balance, drowsiness progressing to collapse, constricted pupils in a dog / dilated in a cat, vomiting, slow or shallow breathing, apnoea.
Intranasally: atomiser on a syringe; the medication disperses best when it is given as the animal breathes in.
Intramuscularly: the paraspinal muscles of the lumbar area or the lateral part of the quadriceps muscle of the thigh. Avoid the back of the thigh and the rump (sciatic nerve).
Reasonable dose: 0,1–0,2 mg/kg (intranasally or intramuscularly).
The animal needs veterinary assessment even after improving — the effect of the opioid may return.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 11. Educational material — it does not replace veterinary help.

Illustration 6 of 6

Improvised tourniquet

Stopping severe bleeding from a limb.

A tourniquet tightened firmly on a small animal's limb, above the wound (closer to the trunk) — for severe limb bleeding that does not stop with direct pressure.

Tourniquet

How to do it

Apply a tourniquet when arterial or severe bleeding from a limb or tail does not stop with direct pressure alone. Do not apply a tourniquet to the head, neck or trunk — there, use only pressure and rapid transport.
Use material at least 5 cm wide (a scarf or tie is easier to tighten than a belt).
Wrap it around the limb above the wound (closer to the trunk), tie a simple knot and tighten only until the bleeding clearly slows.
If the tourniquet slips down, loosen it, move it higher and tighten again. Secure it with an extra knot or tape. It may need tightening again on the way.
In an unconscious animal a tourniquet is recommended; in a conscious one, suggested (risk of being bitten).
Do not remove the tourniquet yourself — the vet will do it after assessment at the practice. Pressing on the artery with your fingers alone is ineffective.
Do not do this if it poses a risk to the rescuer.

Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026. — Figure 12. Educational material — it does not replace veterinary help.

Compiled by HOŁDOWAŃSCY Veterinary Practice on the basis of Mandell DC, Thawley VJ, Burkitt-Creedon JM, Fletcher DJ, Boller M, Fausak E. "RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines." Journal of Veterinary Emergency and Critical Care, 2026.