Shock is a life-threatening medical emergency in which the circulatory system fails to provide enough blood flow to supply sufficient oxygen and nutrients to vital organs and tissues. Cats can go into shock for a variety of reasons, including blood loss, heart failure, severe infection, anaphylaxis, trauma, severe dehydration, and more. Recognizing the signs of shock early and promptly administering emergency first aid and veterinary treatment is critical for the cat’s survival. This article will discuss the three most common clinical signs of shock in cats.
One of the first and most obvious signs of shock in cats is an increased heart rate, known as tachycardia. The normal heart rate range for an adult cat at rest is between 140-220 beats per minute. In shock, the heart will often beat at a rate exceeding 220 beats per minute as it tries to circulate blood more rapidly to compensate for falling blood pressure and inadequate perfusion.
Tachycardia occurs because the body’s sympathetic nervous system kicks in during shock, releasing catecholamines like epinephrine and norepinephrine that accelerate heart rate and constrict blood vessels. The tachycardia helps maintain cardiac output and blood pressure temporarily but also increases the heart’s demand for oxygen.
To check for tachycardia, gently feel your cat’s pulse on the inside of the hind leg near the groin or paw pads and count the beats for 15 seconds. Multiply this number by 4 to get the beats per minute. You can also listen for an abnormally rapid heartbeat with a stethoscope if one is available. Cats in shock often have a pulse rate over 220 bpm.
Pale or Grey Mucous Membranes
Another very common clinical sign of shock is pale or greyish mucous membranes in the gums, lips, nose, and ear flaps. Mucous membranes losing their normal pink color is a reflection of reduced blood flow and oxygen delivery.
In a normal, healthy cat, mucous membranes like the gums will be moist and bubblegum pink. This pink color comes from the blood circulating through capillary beds just under the surface tissue. In shock, these blood vessels constrict, and blood is shunted away from peripheral circulation towards vital organs like the brain, heart, and lungs. With less blood flowing to the mucous membranes, they take on a pale, greyish, or blueish discoloration.
To check your cat’s mucous membranes, gently lift the upper lip to examine the color of the gums. Press your finger gently on the gums for a few seconds and then release – the gums should briefly blanch white but then quickly return to normal pink color once pressure is released. If the gums remain pale, grey, or blueish even after pressure is released, this indicates poor perfusion and probable shock. The membranes of the nose, lips, and ear flaps can also be examined for similar discoloration.
Prolonged Capillary Refill Time
Closely related to the pale mucous membranes sign, prolonged capillary refill time is another hallmark clinical indicator of shock in cats. Capillary refill time is a measurement of how quickly blood reflows into tissue after pressure is applied. It is an indirect way to assess peripheral circulation and perfusion.
To measure capillary refill time in a cat, gently press your fingertip on the cat’s gum or lip to blanch the tissue. Hold gentle pressure for 2-3 seconds then release. In a healthy cat, the normal capillary refill time is 1-2 seconds before pink color returns. Cats in shock usually have a prolonged refill time exceeding 2 seconds. A refill time of 3 seconds or longer is considered abnormal and indicative of poor perfusion.
Prolonged capillary refill time along with pale/grey mucous membranes signal the body’s circulatory system is failing and vital organs are not receiving enough oxygenated blood flow. Rapid veterinary intervention is vital at this stage.
Other Common Signs of Shock
In addition to the three major clinical signs described above, cats in shock may exhibit an array of other symptoms including:
- Weakness, lethargy, or loss of consciousness
- Hypothermia (subnormal body temperature)
- Rapid, shallow breathing (tachypnea)
- Weak, thready, or absent peripheral pulse
- Cool extremities (ears, paws, tail)
- Painful abdomen (in cases of internal bleeding)
- Dilated pupils
- Vomiting or diarrhea
- Seizures or convulsions in late stages
Not every cat in shock will display all the above signs. Individual symptoms will also vary in severity depending on the underlying cause and stage of shock. But in general, abnormal heart rate, pale mucous membranes, and prolonged capillary refill time are considered the three most consistent and prominent clinical manifestations of shock in cats.
Causes of Shock in Cats
There are a wide variety of potential causes for a cat to go into shock, including:
- Traumatic injury such as being hit by a car
- Bite wounds or abscesses leading to sepsis
- Ruptured bladder from urinary obstruction
- Gastric dilation and volvulus (bloat)
- Severe dehydration or heat stroke
- Anaphylaxis or severe allergic reaction
- Blood loss from injury or internal bleeding
- Heart failure
- Toxic snake or spider bite
- Electrocution injury
- Endocrine disorders like Addison’s disease
Identifying and promptly treating the underlying cause of shock is vital for the cat’s survival and recovery.
First Aid for Cats in Shock
If you suspect your cat is in shock, quick first aid steps should be taken while transporting the cat to emergency veterinary care. Try to stabilize the cat and minimize further harm before and during transport. Key first aid measures include:
- Keep the cat restrained, quiet, and warm – prevent exertion
- Administer oxygen therapy if available
- Bandage any bleeding wounds
- Start IV fluids if possible
- Give glucocorticoid drugs like dexamethasone to treat anaphylaxis
- Perform CPR if the cat is unconscious and not breathing
Avoid giving oral medications or fluids as vomiting may occur. Also do not give analgesics like opioids that could suppress respirations. The goal is to stabilize blood pressure, respiration, heart rate, and prevent further shock while en route to the vet clinic or animal ER. Even a delay of minutes could be life-threatening so seek professional emergency veterinary care immediately if shock is present.
Emergency Treatment for Shock
At the veterinary hospital, cats in shock will receive rapid emergency therapy to restore adequate blood circulation and oxygenation. This intensive treatment may include:
- IV catheter and fluid resuscitation with isotonic crystalloids
- Supplemental oxygen via face mask or intubation
- Blood transfusion if severe blood loss is causing shock
- Vasopressors and inotrope drugs to improve cardiac output
- Analgesics for pain control
- Sedatives to reduce anxiety and oxygen demand
- Treatment for the underlying cause, e.g. surgery for trauma
- Antibiotics if infection is present
The vet will closely monitor blood pressure and perfusion parameters like mucous membrane color, pulse quality, capillary refill time, and urine output to assess if resuscitation therapy is working. Vital signs and laboratory tests will also guide ongoing shock treatment and supplemental oxygen use.
Prognosis and Recovery from Shock
The prognosis for a cat recovering from shock depends heavily on the severity of shock at presentation and the underlying cause. In general, cats that receive prompt first aid followed by aggressive veterinary treatment have the best prognosis if reversible underlying causes are addressed.
However, cats presenting with severe shock that leads to multi-organ failure may have a guarded to poor prognosis even with the best care. Causes that can permanently damage organs, like toxin exposure or prolonged oxygen deprivation, also carry a poorer long-term outlook.
During recovery, close monitoring and follow-up care is needed to watch for secondary complications like organ dysfunction, electrolyte abnormalities, coagulation disorders, and more. Nutritional support and physical rehabilitation may be needed during the recovery process.
With prompt, appropriate treatment of shock and any underlying conditions, many cats can make a full recovery back to normal function and life quality. Careful post-discharge monitoring by owners at home is recommended and any concerns should be quickly addressed by contacting the veterinary team.
Preventing Shock in Cats
While it’s not always possible to prevent a cat from going into shock given potential trauma and medical causes, certain steps may help reduce risk:
- Keep cats indoor-only to prevent trauma from cars, fights with other animals, falls from heights, etc.
- Have regular veterinary wellness visits to monitor health and catch issues early
- Vaccinate cats appropriately for common infectious diseases like panleukopenia and rabies
- Follow vet recommendations for parasite prevention like heartworm and flea/tick medications
- Manage chronic illnesses carefully like kidney disease, heart disease, hyperthyroidism
- Provide safe containment if a female cat is in heat to prevent trauma from roaming or mating aggression
- Use well-fitting safety collars and harnesses instead of collars alone to lower choking risk
- Keep toxins and hazardous chemicals out of reach from curious cats
While not every case can be avoided, proactive wellness care, safety precautions, and prompt illness treatment may help reduce the likelihood of a cat going into life-threatening shock. As a cat owner or caretaker, knowing the key signs of shock, like tachycardia, pale mucous membranes, weak pulse, lethargy, and poor capillary refill, allows for faster emergency response and care-seeking when needed. Stay alert to subtle signs of illness in cats that could progress to shock if left untreated. With awareness, preparation and prompt action, the outcome for cats in shock can be greatly improved.
Shock is a complex, life-threatening syndrome requiring emergency medical treatment to stabilize cats and restore adequate circulatory perfusion. The three most consistent clinical signs of shock in cats include tachycardia, pale grey mucous membranes, and prolonged capillary refill time. However, various other symptoms may also be present like weakness, hypothermia, rapid breathing, and dilated pupils.
Causes of shock are diverse, ranging from trauma and blood loss to sepsis, organ dysfunction, heart failure, and more. Immediate first aid steps like maintaining warmth, giving oxygen, stopping bleeding, and starting IV fluids can help stabilize cats in shock until veterinary treatment is accessed. Aggressive hospital therapy like fluid resuscitation, blood transfusions, vasopressor drugs, oxygen support, and treating the underlying condition are necessary to properly manage shock and give cats the best chances of recovery from this life-threatening syndrome.