Cat With Blue Gums: Breathing Rate and the 5-Minute Line

Blue, grey or purple gums mean hemoglobin is not carrying enough oxygen, and the useful unit is minutes. Count breaths for 30 seconds with the cat asleep and double it: 40 per minute or more, or any open-mouth breathing at rest, means leave now. If gum colour has not moved toward pink 5 minutes after you removed the obvious cause, or the cat is gasping, you have 5 minutes to be in the car. Do not wait for a call-back, do not finish the meal, do not drive to the clinic that opens at 9.

Normal resting rate for an adult cat is 16 to 30 breaths per minute, and a sleeping cat sits at 16 to 22. A rate of 40 to 60 with pink gums is distress. A rate above 60 with blue gums is failure in progress, and survival at that point depends on oxygen starting within 15 to 30 minutes.

Count the rate in 4 steps, 1 minute

Watch the flank in good light while the cat sleeps, not while it plays or 30 minutes after a meal. Count chest rises for 30 seconds and multiply by 2. Do it 3 times over 10 minutes and keep the highest number, then write it down with the time. Film 20 seconds on a phone if the cat will not settle, because a vet reads rate and effort from video faster than from a description.

Gum colour against breathing rate: 6 rows

Gum colour	Rate (breaths/min)	Effort	Act within
Salmon pink	16-30	None	24 h
Pale pink	30-40	Slight abdominal lift	4 h
Grey	40-60	Open mouth, neck extended	30 min
Blue	50-70	Gasping, elbows out	5 min
Purple	60-80	Paradoxical breathing	0 min
White	40-70	Weak, collapsing	0 min

Colour and rate disagree often enough that you record both. A cat with blue gums and a rate of 24 is compensating badly and can crash in 10 minutes; a cat with grey gums and a rate of 55 may have been like that for 6 hours and be steadier than it looks. The worse of the 2 readings sets the clock.

What the 5-minute line is for

The 5 minutes is not treatment time. It is the window to remove the obvious cause, look once, and move. Cats that go blue after a collar was tightened, a window was shut, or a diffuser was plugged in often gain 1 to 2 shades within 3 to 5 minutes of fresh air. If the shade has not changed at 5 minutes, the cause is inside the chest, and no amount of fresh air fixes a pleural effusion or a failing heart.

What not to do on the way

• Do not open the mouth to hunt for a foreign body. A panicking cat bites, and a hand injury costs 10 minutes and a course of antibiotics.
• Do not put a collar or harness back on. Both press on the neck and cut the last 10 to 15 percent of airway you still have.
• Do not lie the carrier flat with the door facing up. Keep it level, vents clear, and skip the blanket over the front.
• Do not use ice packs, cold water or a fan. Shivering raises oxygen demand by 10 to 20 percent.
• Do not give a human inhaler or any pill. Feline doses differ by 10 to 100 times, and aspiration is a real risk in a gasping cat.
• Do not induce vomiting, and do not wait 2 hours to see whether it passes.

4 systems that turn gums blue

Airway: a foreign body, laryngeal paralysis, or a 3 to 4 mm grass blade caught behind the soft palate. Lung and pleura: fluid, air or a mass in the chest, where 100 to 200 mL of effusion in a 4 kg cat can collapse both lungs. Heart: hypertrophic cardiomyopathy or a failing valve, seen from 4 years in Maine Coons and Ragdolls. Blood: a hematocrit under 15 percent, or hemoglobin that cannot bind oxygen after zinc, onion or human painkiller exposure. That last group is the one a toxin history catches, and the zinc and coin page covers the 30-minute window after ingestion; the toxin list flags the household items that cause it.

First 15 minutes at the hospital

Flow-by oxygen at 40 to 60 percent, with no mask strapped on. A 2 to 4 minute bedside ultrasound to see whether the chest is full of fluid. Thoracocentesis removing 60 to 120 mL per side if it is. A PCV and total protein from 1 mL of blood. Chest films only after the cat is stable, because 2 views cost 6 to 10 minutes of handling. If the rate is still above 60 after 15 minutes of oxygen, the next move is a 40 percent oxygen cage and a sedative, not more tests.

The 48-hour watch after discharge

Count the resting rate every 6 hours for 48 hours and keep the numbers on paper. Over 40 at rest, a rise of 10 or more from the discharge figure, or hiding with the head down means go back. Most relapses after a pleural tap happen at 24 to 72 hours, which is why the recheck is booked at 48 hours rather than 1 week. Keep the carrier out and open for those 2 days, so the next trip does not start with a 10-minute chase.

5 steps right now

• Look at the gums in daylight, then count 3 sets of breaths over 30 seconds each.
• Photograph the gums beside the white chest fur, so colour has a reference.
• Take off the collar, unplug the diffuser, open a window, and recheck in 5 minutes.
• Call the nearest 24-hour hospital while you are already moving; do not ring 3 clinics from the sofa.
• Carry the toxin history, any pill bottle, and a 20-second video of the breathing.

Terms mentioned in this article

MMPCV

Frequently asked

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