TPR. It stands for temperature, pulse and respiratory rates. They are among the most foundational measurements a doctor takes of his patient, regardless of species. There are times you might need to take the parameters at home, so we are providing you with the easy steps to do so. Along with all of these procedures, supplying treats will help make a positive association, and make your next session easier.
TAKING THE TEMPERATURE
It is an easy process to take your pet’s temperature. Go to any drug or retail store and purchase an electronic thermometer and a box of thermometer probe covers. Any thermometer over about $7.00 will be fine. You don’t need a special “dog,” “cat” or “rectal” thermometer. Install the thermometer cover, put a little lubricant on the probe cover (K-Y jelly, Vaseline or cooking oil), lift your pet’s tail and gently insert the tip of the probe. 1/4″ to 3/8″ is plenty. If you have an assistant, have the helper hold your dog’s head and gently caress and speak to him. If you think he might try to bite, have the assistant wrap an arm around the neck of a dog or hold the scruff of a cat. If your helper cannot control the pet, it is not worth being injured, and you should abort and take your pet to see his doctor. Nor is it worth puncturing the colon, so if your pet is rowdy, stop. The electronic thermometer will beep when it is finished, and you can take the reading. Normal body temperature for dogs and cats is 101.0 degrees Fahrenheit to 102.5 (38.3 Celsius to 39.2 Celsius). Most dogs run toward the lower end of that scale. If your pet (especially dogs) is easily excited and/or shivering his body temperature may be elevated but he may not truly experiencing a fever. In fact, this is a common reason your veterinarian might have you take your pet’s temperature at home; it is not unusual for a nervous pet to have a falsely elevated body temperature in the examination room.
TAKING THE HEART AND/OR PULSE RATE
Heart rate is the number of times the heart beats in a minute. Pulse rate is the number of times a wave of blood is sent through a peripheral artery each minute. In the normal patient these numbers will be identical. However, if the heart beats, but fails to send a significant amount of blood through the aorta and into arteries around the body, a pulse deficit is created.
To obtain the heart rate, place your hand flat against the chest, about 1/3 of the way back from the front of the chest and down low, but not all the way to the bottom. In most dogs you will be able to feel the thump-thump-thump of the beating heart. In the smallest dogs, and most cats, you can cup the sternum (breastbone) in your hand, placing your thumb on one side of the chest and outstretched fingers on the other side to feel the heartbeat. Large dogs present the greatest challenge because their chests are so big and their hearts do not always reside close to the chest wall. If neither of the above techniques is working, try laying your pet on his side. Slide your hand between the floor and the pet. If you feel the heart beating, proceed to count. If not, try the method in the next paragraph.
Place an ear to the chest in the same spots described above for hand placement. Move your ear around until the heart sounds are the loudest.
Important safety note: Some pets may resent being lain on their sides or having your head close to them while in a position they consider vulnerable. Watch for signs of fear and/or aggression, such as growling, showing teeth or actually trying to bite. Your first consideration must be your own safety!
Now, let’s try to take the pulse. In the middle of the thigh, slide your fingers between the leg and body wall from the front of the leg toward the back, the inside of your hand against the inside of your pet’s leg. If you feel the femur (thigh bone), you have gone a little too far. The femoral artery lies just in front of the femur. It is a big artery with a strong flow of blood, however it is pretty deep, so it can be difficult to find in some pets. However, it is the best and easiest artery from which to obtain a pulse count. If you can palpate the femoral artery with one hand and feel the heartbeat with the other, you should experience a pulse of blood flow in one hand each time the other hand feels the heart beat. If not, report a pulse deficit to your pet’s doctor.
Heart rates vary widely, usually in proportion to the size of the pet. A giant-breed dog can have a resting heart rate as low as 40 beats per minute (bpm). Average for the largest dog may be expected to range between 40 and 100 bpm. Small-breed, excitable dogs may vary from 70 to 150 beats per minute and may go to 200 bpm for short durations and still be considered normal. Few cats will register rates below 100 bpm but may escalate to 260 bpm if aroused.
TAKING THE RESPIRATORY RATE
Respiratory rate is the easiest of the three parameters to measure and is reported in breaths per minute. It is simply how many times your pet breathes in one minute. Respiratory rate is usually measured in the resting patient, so don’t take it right after exercise or when he is excited about the postman ringing the doorbell. There is no “normal range” for respiratory rate, although smaller-breed dogs tend to breathe more rapidly than larger dogs and cats. It is usually easiest to watch the chest rise and fall to count breaths.
A COUNTING SHORTCUT
The longer the time period the heart and breathing rates are measured, the greater the accuracy of the measurement. That said, unless the clinician suspects a problem in these body systems, he will usually count the number of heartbeats in 15 seconds and multiply by 4. Ditto for the breathing rate. Alternatively, you can count for 30 seconds and multiply by 2, or count for a minute, or count for two minutes and divide by 2. The choice is yours.
See you next week, Dr. Randolph.