Veterinary teams have new evidence-based guidance to help them advise owners on what to do in the minutes before an animal reaches veterinary care.
The 2026 RECOVER First Aid Guidelines for Dogs and Cats were published in the Journal of Veterinary Emergency and Critical Care on 25 August. They are the first small-animal first-aid guidelines to have been developed using a systematic evidence review and consensus process, and are intended specifically for the prehospital period — in other words, that slightly awkward bit between an owner realising something is badly wrong and getting the patient through the practice door.
The main guidelines address 10 clinical questions and contain 38 treatment recommendations covering emergencies including heatstroke, choking, hypoglycaemia, toxin ingestion, severe limb haemorrhage, opioid exposure and cardiopulmonary arrest. An accompanying publication covers acute allergy and anaphylaxis.
What has changed?
Some of the recommendations are likely to be particularly useful when reviewing the advice given over the phone.
For suspected heatstroke, RECOVER recommends active cooling before arrival at the veterinary clinic. Cool running water should be applied to the trunk, with particular attention to areas with a thinner haircoat such as the ventral abdomen. For most patients, the guidelines suggest stopping active cooling once rectal temperature reaches around 39.7–40°C, rather than continuing until the patient is normothermic.
For conscious dogs and cats that are choking, the guidelines recommend starting with up to five firm back blows over the caudodorsal thorax. If these fail, alternative techniques such as abdominal or chest thrusts can be considered. In an unconscious animal, however, RECOVER recommends starting chest compressions rather than performing a blind finger sweep of the mouth. Any animal requiring intervention to clear an airway obstruction should then receive immediate veterinary assessment.
There is also a strong recommendation against routinely advising owners to induce vomiting following toxin ingestion. Prehospital emesis may still be appropriate where immediate veterinary care is unavailable, but only following advice from a veterinarian or animal poison-control service.
For suspected symptomatic hypoglycaemia where the animal is not actively seizuring, a viscous simple carbohydrate such as glucose syrup can be applied to the buccal mucosa, provided doing so does not delay veterinary treatment. Nothing should be placed in the mouth of an actively seizuring patient.
Evidence is still limited in places
Perhaps unsurprisingly, running controlled trials on first aid in choking dogs or cats with heatstroke isn't especially easy. Although the RECOVER process was rigorous, many individual recommendations are therefore based on very low-quality evidence or expert opinion.
So, these aren't 38 interventions suddenly proven to improve survival in dogs and cats. Instead, RECOVER has taken the evidence that is available — including relevant human and experimental evidence — and used a transparent consensus process to turn it into practical recommendations.
For practices, the guidelines may be particularly useful as an opportunity to revisit emergency telephone protocols, owner first-aid information and the advice routinely given for situations such as heatstroke, poisoning and choking. Having the whole team giving the same evidence-informed advice before the patient arrives seems a sensible place to start.
