Bleeding Control: Pressure, Bandage, Tourniquet

Bleeding from a cat is controlled with 3 things in this order: pressure, layers, and a clock. Direct pressure for 5 to 10 minutes without lifting the gauze stops most cuts on a paw, an ear or a torn nail. A tourniquet is only for a spurting artery in a limb, and only below the elbow or the hock. A 4 kg cat holds about 260 mL of blood, so losing 26 mL — 4 teaspoons — is a 10 percent loss, and 52 mL is shock.

First 10 minutes: pressure and nothing else

Fold a 10 x 10 cm gauze into a 5 x 5 cm pad and press with 2 fingers or the flat of your hand. Set a timer for 5 minutes and do not lift the pad at 1 minute, because a clot needs 3 to 4 minutes to firm up and peeking restarts it at zero. If blood soaks through, put 2 fresh gauze on top and keep pressing; never remove the bottom layer. A limb goes 15 to 20 cm above heart level on a stack of towels, and a cat that is biting gets wrapped in a bath towel with the head covered.

Pressure alone works on 8 of 10 small paw, ear and nail cuts. It does not work on a spurting wound, a bite puncture, or a cut over a joint, which is what the next 2 sections are for.

Four layers, then check one toe

Layer 1 is the gauze you were already pressing with, left in place. Layer 2 is 2 folded gauze pads, 5 x 5 cm each, directly over the wound. Layer 3 is a conforming bandage 5 cm wide, wrapped from the toes upward with 50 percent overlap. Layer 4 is self-adherent tape 5 cm wide over the lot. Leave the middle 2 toes out so you can see them.

Check the toes at 15 minutes, then every 15 minutes for 2 hours. A toe that is cool, pale, or puffy by 1 cm means the wrap is too tight: cut the outer 2 layers, wait 2 minutes, rewrap 20 percent looser. Two fingers should slide under the top edge and no more. Never use an elastic bandage on its own, because it narrows another 30 percent as the limb swells, which is how a 30-minute bandage becomes a dead toe by morning.

Tourniquet: 4 rules, 20-minute clock

Use one only when blood spurts 10 to 30 cm with each heartbeat and 10 minutes of firm pressure has failed. Place it 5 to 7 cm above the wound, on the side of the wound toward the heart. Width 1.5 to 2 cm: a shoelace at 0.3 cm cuts skin and crushes the nerve running beside the artery. Tighten until the spurting stops, then a half turn more, and write the time on the tape with a marker.

Release at 20 minutes for 30 to 60 seconds, then retighten if bleeding restarts. Two hours is the practical ceiling before nerve and muscle damage; a cat that has worn one for 60 minutes needs a vet, not a longer wait. Never on a tail, a neck, or around the abdomen, and never over a limb that may be fractured.

Styptic powder: 1/4 teaspoon, 30 seconds

For a torn nail bleeding from the quick, pour 1/4 teaspoon — about 0.5 g — into a small cup, dip the nail into it, and press for 30 seconds. Repeat once after 2 minutes if it still oozes. Cornstarch at 1/2 teaspoon held for 5 minutes is the kitchen backup. Powder suits a 1 to 2 mm surface, not a 1 cm laceration, and never goes into a puncture 1 cm deep where it seals bacteria under the skin.

If the quick is exposed by more than 2 mm, or the nail is split to the base, the cat needs the nail trimmed back and bandaged at the clinic, usually with 3 to 5 days of pain relief.

What not to do

• No ice directly on skin for more than 10 minutes: it narrows the vessel you are trying to clot and can freeze a 2 cm patch.
• No hydrogen peroxide. At 3 percent it damages tissue and dissolves the clot you just built.
• No aspirin or human painkiller for a bleeding cat: 1 tablet of 325 mg is 81 mg/kg for a 4 kg cat, far past the toxic line (check the toxic plant and drug list).
• No lifting the soaked gauze, no probing with a cotton bud, no powder packed into a deep puncture.
• No tourniquet on a tail, a neck, or a limb that is bent the wrong way.

How much blood is too much

Weight	Blood volume	10 % loss	20 % loss	30 % loss
2.5 kg	150-175 mL	15-18 mL	30-35 mL	45-53 mL
3 kg	180-210 mL	18-21 mL	36-42 mL	54-63 mL
4 kg	240-280 mL	24-28 mL	48-56 mL	72-84 mL
5 kg	300-350 mL	30-35 mL	60-70 mL	90-105 mL
6 kg	360-420 mL	36-42 mL	72-84 mL	108-126 mL

At 10 percent the cat is quiet with a heart rate 10 to 20 percent above its own baseline. At 15 percent the gums go pale and refill takes 2 to 3 seconds. At 20 percent systolic pressure falls under 90 mmHg and the cat stops grooming. At 25 to 30 percent only blood restores oxygen carrying capacity, because saline and colloids add volume without carrying any oxygen; 10 to 15 mL/kg is the usual dose.

When to drive in now

Now, not in the morning, for any of these: spurting that continues after 10 minutes of firm pressure; blood soaking through 3 layers inside 5 minutes; gums white or grey; breathing over 40 per minute; heart rate over 240; collapse; a wound longer than 2 cm; any wound on the chest, abdomen or neck; a bite puncture, which closes in 12 to 24 hours and abscesses in 2 to 5 days (cat bite abscess); or a limb that is swollen and deformed (broken bone after a fall). A 1 cm paw cut that stopped in 5 minutes is a morning appointment.

After the bleeding stops

Keep the bandage on 12 to 24 hours and look at the toes every 2 hours while you are awake. At 24 hours, open the wrap in good light; a wound that is 1 cm redder than yesterday, warm, or leaking fluid needs a vet visit, and so does a cat that stops eating. A stopped bleed is not a closed case: a cat that has lost 20 percent of its volume will look bright for 6 to 12 hours before it crashes, so keep it quiet, indoors, and warm at 20 to 22 C for the rest of the day.

Do this now

• Press with gauze for 5 minutes on a small cut, 10 minutes on a spurting one, and time it.
• Add layers instead of removing soaked gauze, then wrap 4 layers and leave 2 toes visible.
• Check the toes at 15 minutes, then every 15 minutes for 2 hours; rewrap 20 percent looser if they are puffy.
• Only for a spurting limb artery: tourniquet 5 to 7 cm above, time written on the tape, released at 20 minutes.
• Use 1/4 teaspoon of styptic powder for a nail, and drive in for a 2 cm wound, pale gums, or breathing over 40.

Terms mentioned in this article

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