Understanding Your Pet's CPR Status
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Why We Ask About CPR Status
When your pet is hospitalized, you may be asked to choose a CPR status. We understand that this can be a difficult question, especially when you are already worried about your pet.
A CPR status tells our medical team what you would like us to do if your pet's heart stops beating or they stop breathing. Knowing your wishes ahead of time allows our team to respond immediately and appropriately in an emergency.
There is no universally right or wrong choice. Your veterinary team can help you consider your pet's medical condition, prognosis, and your goals for their care.
CPR Status Exemption for Healthy Patients Under Anesthesia or Sedation
As in human medicine, it is very common for healthy patients to stop breathing and for their heart to slow down, pause or occasionally stop when anesthesia or sedative drugs are administered. When this happens, our team will correct these normal physiological responses to drugs by helping patients’ breath and we will administer medications to correct their heart rate and blood pressure.
What Is Cardiopulmonary Arrest?
Cardiopulmonary arrest (CPA) occurs when a pet's heart stops effectively pumping blood, they stop breathing, or both. Without immediate intervention, cardiopulmonary arrest results in death.
If your pet experiences cardiopulmonary arrest while hospitalized, the medical team will follow the CPR status documented in your pet's medical record.
What Is CPR?
Cardiopulmonary resuscitation (CPR) is an emergency attempt to restore circulation and breathing after cardiopulmonary arrest.
Under the 2024 RECOVER veterinary CPR guidelines, Basic Life Support is the immediate foundation of CPR. Advanced Life Support is added while Basic Life Support continues. For this reason, Full CPR generally includes both BLS and ALS interventions as medically appropriate.
Basic Life Support (BLS)
Basic Life Support focuses on immediately providing circulation and ventilation after cardiopulmonary arrest. BLS is started as soon as arrest is recognized.
- Chest compressions to circulate blood
- Placement of a breathing tube when possible
- Assisted ventilation to provide breaths and oxygen
- High-quality CPR performed in cycles with interruptions kept as brief as possible
Advanced Life Support (ALS)
Advanced Life Support begins after Basic Life Support has been initiated and is performed while chest compressions and assisted ventilation continue. ALS uses additional treatments and monitoring to attempt to restore spontaneous circulation and address the cause of the arrest.
- IV or other emergency vascular access
- ECG and other CPR monitoring
- Emergency medications
- Defibrillation for shockable heart rhythms when indicated
- Treatment of contributing or reversible problems when identified
What Does Full CPR Mean?
Choosing Full CPR authorizes the veterinary team to begin Basic Life Support immediately and add Advanced Life Support interventions as medically appropriate if your pet experiences cardiopulmonary arrest.
Full CPR is an intensive medical response. The exact interventions used depend on your pet's condition, heart rhythm, response to CPR, and the suspected cause of the arrest.
What Does DNR Mean?
DNR stands for "Do Not Resuscitate." Choosing DNR means that if your pet experiences cardiopulmonary arrest, CPR - including Basic Life Support and Advanced Life Support - will not be initiated.
A DNR status does not mean that we stop caring for your pet. Unless you and your veterinarian have made other decisions about the treatment plan, previously authorized medical care, monitoring, medications, oxygen, pain management, comfort care, and other treatments continue.
DNR applies specifically to what happens if cardiopulmonary arrest occurs.
What Happens During CPR?
CPR is an intensive emergency procedure. Chest compressions must be performed firmly enough to circulate blood through the body, and emergency procedures may need to happen very quickly.
Although every effort is made to provide appropriate and compassionate care, CPR can result in complications. Successfully restarting the heart also does not always mean that a pet will recover enough to leave the hospital.
- Broken ribs or other injuries from chest compressions
- Injury related to emergency airway or vascular access
- Recurrence of cardiopulmonary arrest
- Organ or neurological injury caused by inadequate oxygen or blood flow during the arrest
How Successful Is CPR?
CPR outcomes depend greatly on why the arrest occurred, your pet's underlying health, how quickly CPR is started, and how your pet responds to treatment.
Some pets have conditions in which successful resuscitation is more likely, while pets with severe or advanced disease may have a much lower likelihood of meaningful recovery.
Here is some information about all the options:
- Cherry: offers flexible payment plans that allow you to split the cost of your pet’s care into manageable monthly payments. With a quick application and fast approval process, it’s designed to help you move forward with recommended treatment without delay. Visit withcherry.com/veterinary
- All Pet Card: The All Pet Card is a credit card that can be used only at participating veterinary hospitals. We accept 6- or 12-month terms without interest. There are also options to pay a set amount each month for 24 months or 36 months. The monthly payment options are not interest free, but the interest rate is less than if you choose the no interest option and are unable to pay it off in the 6- or 12-month term. All Pet Card is provided by Comenity Bank. Visit allpet.com for more information. You can submit your information online and pre-qualify for an account. If approved, you can use your account right away for payment of services.
- CareCredit: Care Credit is a credit card that can be used in other locations including dentists, doctors, and veterinary care facilities. We offer 6- or 12-months terms without interest. There are also options to pay a set amount each month for 24 months or 36 months. The monthly payment options are not interest free, but the interest rate is less than if you choose the no interest option and are unable to pay it off in the 6- or 12- month term. Care Credit is provided by Synchrony Bank. Visit carecredit.com for more information. You can submit your information online and pre-qualify for an account. If approved, you can use your account right away for payment of services. If you already have an existing account but the limit will not cover the total amount, we can submit a credit limit increase on your behalf if requested.
- Scratch Pay: Scratch Pay is a company that will pay on your behalf, and you pay Scratch Pay back. Scratch Pay is a one-time payment, without establishing an on-going credit account. Scratch Pay may approve you with lower credit scores than required for a revolving credit card account. Think of Scratch Pay as borrowing from a friend or relative and paying them back over time. Visit scratchpay.com for more information.
- VetBilling: VetBilling is a third-party billing company that will manage accounts so that you can make monthly payments. We require that the examination is paid for plus a 30% down payment. You can pay off the balance in up to 9 monthly payments. The fees for utilizing VetBilling include a $25.00 payment arrangement set up fee and a $3.00 per payment processing fee. Visit vetbilling.com for more information.
Financial Responsibility for CPR and Emergency Care
CPR is an intensive emergency procedure that requires the immediate attention of multiple members of the veterinary medical team, medications, supplies, monitoring, and specialized equipment.
If you choose Full CPR, you are authorizing the veterinary team to begin BLS immediately and add ALS interventions as medically appropriate if cardiopulmonary arrest occurs. Charges associated with CPR are in addition to the cost of your pet's other medical care and hospitalization.
If spontaneous circulation returns, your pet may require additional diagnostic testing, medications, oxygen therapy, mechanical ventilation, intensive monitoring, or continued hospitalization. These treatments may result in additional costs beyond the initial CPR procedure.
Because cardiopulmonary arrest requires an immediate response, the veterinary team may not be able to contact you for additional financial authorization before beginning CPR.
Choosing a DNR status means CPR will not be performed and CPR-related charges will not be incurred. Other previously authorized medical care and associated charges will continue unless you and your veterinary team change the treatment plan.
Please ask a member of our team if you have questions about anticipated costs or financial authorization related to your pet's care.
Choosing a CPR Status
When making this decision, consider your pet's current illness or injury, overall health and age, whether the underlying condition is reversible, expected prognosis, likelihood of meaningful recovery after CPR, quality of life, your goals for your pet's care, and the potential financial cost of CPR and continued intensive care.
It is okay to ask questions. Your veterinary team can help you understand what each option would mean for your individual pet.
- Your pet's current illness or injury
- Overall health and age
- Whether the underlying condition is reversible
- Expected prognosis and likelihood of meaningful recovery
- Quality of life
- Your personal wishes and goals for care
- Potential costs of CPR and continued intensive care
You Can Change Your DecisioN
A CPR status does not have to be permanent. Your pet's medical condition may change during hospitalization, and you may reconsider your decision at any time. Please speak with your veterinary team if you would like to discuss or change your pet's CPR status.
We Are Here to Help
We recognize that making decisions about emergency resuscitation can be difficult. Our goal is to provide clear information so that you can make the decision that is right for you and your pet.
Please ask us any questions you have about CPR, your pet's prognosis, or what these choices may mean for your pet.
CPR Status Documentation
The veterinary team will document the CPR status selected for your pet in the medical record.
CPR – RESUSCITATE MY PET
If my pet experiences cardiopulmonary arrest, I authorize the veterinary team to initiate Basic Life Support and Advanced Life Support interventions as medically appropriate.
DNR - DO NOT RESUSCITATE
If my pet experiences cardiopulmonary arrest, I do not authorize CPR. I understand that CPR, including BLS and ALS, will not be initiated and that other authorized treatment and comfort care will continue unless the treatment plan is changed.
