The RECOVER Initiative: Updated CPR guidelines for pets

AAHA will release an extended summary of new CPR guidelines in November. Read about them in advance here.

By Maureen Blaney Flietner

The RECOVER Initiative has released major changes to its 2012 CPR guidelines for basic life support, advanced life support, and monitoring that will give veterinary professionals at all levels a more informed opportunity to save patients suffering cardiac arrest. 

The June 26 update was needed because of scientific advancements, feedback, and new evidence, said Daniel Fletcher, PhD, DVM, DACVECC, co-chair of the RECOVER Executive Committee. The committee also wanted to use a different process for making the recommendations rather than just tweak the earlier guidelines.  

That process, the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system, is used by many human healthcare organizations around the world to provide a standardized approach for grading the quality of evidence and strength of recommendations. 

Among the changes: 

  • A better approach to chest compression in cats and small dogs less than 15 pounds. 
  • Added emphasis on early ventilation since dogs and cats have more respiratory arrests than humans.  
  • Removing high-dose epinephrine from the guidelines. 
  • Changed dosing of electrical defibrillators 

In addition, there are three new areas of guidelines:  

  • for newborn resuscitation for kittens and puppies, which will be published this fall.  
  • for first aid 
  • for large animals such as horses, sheep, and cattle.  

The latter two are to be published within the year. 

Why RECOVER? 

RECOVER grew out of a 2010 meeting of veterinary emergency and critical care specialists who saw the need to develop and distribute evidence-based CPR guidelines, which are still missing today from American Veterinary Medical Association educational accreditation and certification programs. 

According to Bobbi Conner, DVM, DACVECC, President, of the American College of Veterinary Emergency Critical Care (ACVECC), the RECOVER collaboration, a nonprofit program within ACVECC and Veterinary Emergency & Critical Care Society (VECCS), provides the guidelines. Certification training for RECOVER instructors became a joint effort between ACVECC and Cornell University College of Veterinary Medicine.  

Online and in-person training offload the burden from local practices that don’t perform CPR on a regular basis but want their teams ready to provide up-to-date care, explained Conner. Veterinary hospitals then can support employees completing RECOVER training and maintenance of certification every two years. 

Response continues to be positive for the RECOVER Initiative. According to Fletcher, with the 2012 guidelines, 90,000 took the online courses, 20,000 attended in-person rescue labs, and there were 70,000 downloads of the guidelines. With the recent release of the 2024 guidelines, there were nearly 40,000 downloads in the first month. 

“We’re now updating our online course materials, rescuer certification workshop, and instructor certification process with the new information for the rest of the year,” said Kenichiro Yagi, MS, RVT, VTS (ECC) (SAIM), who serves as program director for the RECOVER CPR Initiative. “We also plan to translate the guidelines and course materials into several major languages to better support our global community of veterinary professionals. I am looking forward to the day RECOVER CPR certification is considered a must-have for every corner of veterinary medicine around the world.”  

Details, including downloadable algorithms, drug charters, and the list of RECOVER instructors, are available at the RECOVER Initiative website 

Photo credit: © Panupong Piewkleng + via Getty Images Plus 

Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors. 

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