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10 signs your cat may be going into shock

Analysis by Dr. Karen Shaw Becker

shock in cats

Story at-a-glance -

  • Shock in cats is a life-threatening condition in which the body isn’t getting adequate blood flow, which means the cells and organs aren’t getting sufficient oxygen and nutrients to function properly
  • Many organs can be damaged as a result of shock and death, so immediate veterinary intervention is required
  • Common causes of shock in cats include blood loss from trauma, dehydration, heatstroke, an overwhelming infection and poisoning
  • Classic signs of shock in kitties are a too-slow heart rate (bradycardia), too-low blood pressure (hypotension) and too-low body temperature (hypothermia)
  • Diagnosis of shock is usually made through a physical examination and confirmed with additional tests after the cat is stabilized; the goal of treatment for shock is to restore oxygen delivery to tissues as quickly as possible

Even if you've (thankfully) never had a personal experience with a human or an animal suffering from shock, most people have watched enough TV to know that "going into shock" is very dangerous and something first responders and medical personnel try to prevent at all costs. In case you're wondering about the specifics of the condition, here's a detailed description of shock from MedicineNet:

"In medicine, [shock is] a critical condition that is brought on by a sudden drop in blood flow through the body. The circulatory system fails to maintain adequate blood flow, sharply curtailing the delivery of oxygen and nutrients to vital organs. It also compromises the kidneys and so restricts the removal of wastes from the body. Shock can be due to a number of different mechanisms, including not enough blood volume and not enough output of blood by the heart.

The signs and symptoms of shock include low blood pressure (hypotension); overbreathing (hyperventilation); a weak, rapid pulse; cold, clammy, grayish-bluish (cyanotic) skin; decreased urine flow (oliguria); and a sense of great anxiety and foreboding, confusion, and sometimes combativeness. Shock, which is a major medical emergency, is common after serious injury.

Emergency care for shock involves keeping the patient warm, giving fluids by mouth or, if necessary, intravenously, and frequently the administration of drugs that act to improve cardiac and circulatory function."1

MedlinePlus describes the dangers more succinctly:

"Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do not get enough oxygen and nutrients to function properly. Many organs can be damaged as a result. Shock requires immediate treatment and can get worse very rapidly. As many 1 in 5 people who suffer shock will die from it."2

Common causes of shock in cats

Common causes of shock in kitties include:

Blood loss (often from the trauma of being hit by a car or burned)

Overwhelming infection leading to septic or toxic shock

Dehydration (from prolonged vomiting and/or diarrhea)



Heart disease

The three types or classifications of shock most often seen in cats are:

  • Hypovolemic shock — This is the most common reason for shock in kitties and results from a decrease in blood volume. Potential causes include blood loss from trauma (such as being hit by a car), gastrointestinal (GI) bleeding, sodium loss caused by vomiting or diarrhea and plasma loss (for example, when there's fluid discharge from burns). Cats with common diseases such as pancreatitis or hepatic lipidosis can also develop hypovolemia.
  • Cardiogenic shock — Cardiogenic shock is caused by decreased blood circulation due to damage to the heart and is a special risk in cats with hypertrophic cardiomyopathy.
  • Distributive shock — This condition is characterized by abnormal distribution of blood volume due to vasodilation and hypotension. Causes of distributive shock include sepsis (the body's extreme response to infection), pancreatitis, trauma, anaphylaxis (a life-threatening allergic reaction) and bacterial translocation (passage of bacteria from the GI tract to other organs and the bloodstream).
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Signs to watch for

Weak and rapid pulse (normal pulse rate is 160 to 240 beats per minute)

May be unaware of surroundings


Gums turn dark pink or red, then grey

Shallow, rapid breathing (greater than 40 beats per minute)

Pale skin and mucous membranes

Difficulty standing

Hypothermia (decreased body temperature)

Listlessness or depression

Slow capillary refill time

Needless to say, if your cat displays one or more of these symptoms of shock, take the following steps and get her to your veterinarian's office or the closest emergency animal hospital immediately.

Stay calm yourself and keep your cat as calm as possible. If she's unconscious, check that her airway is open and clear secretions from her mouth with your fingers. If she isn't breathing, give her artificial breaths; if you can't detect a heartbeat or pulse, perform CPR. Control bleeding by applying direct pressure to the wound.

Place a towel or blanket on your cat to keep her warm, and don't give her anything to drink or eat. Keep her head lower than her heart to maintain blood flow to the brain.

Diagnostic steps

Your veterinarian will perform a physical exam on your cat as the first and most important step in making a diagnosis. The three classic signs of shock in kitties are heart rate abnormalities, too-low blood pressure (hypotension) and too-low body temperature (hypothermia).

Since cats in veterinary clinics typically have heart rates of at least 180 beats per minute, a heart rate under 160 means the patient is in serious trouble until proven otherwise. There are other disorders that can cause the heart rate to slow down, so those must be ruled in or out, as well as other causes of pale mucous membranes (e.g., anemia).

It's also important to note that some cats in shock have the opposite of bradycardia — they have tachycardia, or a too-fast heart rate, especially if there has been blood loss. Veterinarian Dr. Adesola Odunayo, a board-certified emergency and critical care specialist, recommends that veterinarians perform a physical examination, measure blood pressure and obtain a blood lactate level (if possible) on feline patients suspicious for shock.3

In addition, electrocardiography and focused assessment with sonography in trauma (FAST) can sometimes be performed quickly as well. Odunayo advises that patients be stabilized before undergoing additional diagnostic tests, such as complete blood count, blood chemistry analysis, urinalysis, thoracic and abdominal x-rays and ultrasound examinations other than FAST.

Treatment for shock in cats

The goal of treatment for a kitty in shock is to restore oxygen delivery to tissues as quickly as possible. The quicker this happens, the better your cat's chances for a full recovery. Cats in shock, except cardiogenic shock, require fluid resuscitation via intravenous (IV) or intraosseous (directly into the bone marrow) catheterization. According to Odunayo, neither subcutaneous (SubQ) nor oral fluids are sufficient to treat shock patients.

Kitties with shock should be actively rewarmed, in particular because they don't respond as well to fluid therapy while hypothermic. Odunayo recommends quickly warming a cat suffering from shock while delivering the first round of fluid therapy and waiting until the body temperature has reached 98 degrees F before giving additional fluids.

Cats in shock resulting from hemorrhage may require whole blood or packed red blood cell transfusions. Odunayo recommends that veterinarians make transfusion decisions based on each patient's clinical signs rather than on a specific hematocrit number or packed cell volume. Blood typing should be done before transfusion.

Cats with distributive shock that doesn't respond to fluid resuscitation may require treatment with a vasopressor. Kitties with heart disease, arrhythmias or respiratory distress may develop cardiogenic shock and should receive supplemental oxygen, diuretics and assisted ventilation as necessary.

Additional treatments depend on the cause of shock, for example, cats with septic shock will require antibiotics. "Steroids do not appear to change outcomes for patients in shock," says Odunayo. Shock in cats can be prevented or at least minimized by seeking immediate veterinary care after a trauma. Also, any illness or injury to your cat that results in blood or fluid loss should be taken very seriously.

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