When to Take a Dog to the Emergency Vet: An ER Vet’s Advice

Figuring out when to take a dog to the emergency vet can sometimes be stressful. That’s why integrative veterinarian Dr. Julie Buzby asked Dr. Kathryn Williams to create this useful reference guide. In it, Dr. Williams, an emergency vet, shares when to take your dog to the emergency vet and when your dog’s situation can probably wait until regular office hours.

As a devoted pet owner, it is normal to worry about your dog or cat and want the best care for him or her. Sometimes you may find yourself in a situation where you know your dog is sick, but you aren’t sure if your dog needs immediate attention.

If you are having trouble deciding if your dog’s situation is an emergency or can wait until an appointment with your primary vet, I hope to offer some guidance from my years of experience as an emergency vet.

However, keep in mind that this is by no means an exhaustive list and the line between an emergency and not an emergency can be blurry sometimes. So if you are still worried about your dog, please call your vet or nearest emergency veterinary clinic so they can help guide you further. 

If there is any doubt, it is best to err on the side of caution and seek medical attention for your dog sooner rather than later.

How urgently should I take my dog to the vet?

When thinking about conditions that require veterinary attention, I tend to like to break the situations into three categories—those that require immediate attention, those that require attention within a few days, and those where you should schedule an non-urgent appointment with your primary care vet.

10 life-threatening situations where you need to take your dog to the emergency vet ASAP

The following are life-threatening conditions in dogs, and mean you should seek medical attention immediately:

1. Difficulty breathing is an emergency

Your dog breathing fast or struggling to breathe may be a sign of:

• Pneumonia in dogs
• Heart failure in dogs from heart disease in dogs
• Fluid in the chest cavity (i.e. pleural effusion)
• Respiratory crisis from laryngeal paralysis in dogs or collapsed trachea in dogs
• Other respiratory or heart conditions

Signs that your dog is having difficulty breathing and needs to go to the ER include:

• Increased resting respiratory rate (>50 breaths/minute when not panting)
• Blue or purple tint to the gums
• Extending the neck to breathe
• Using extra abdominal effort to breathe
• Abnormally loud or high-pitched breathing

2. Bloated abdomen can be an emergency

A pot-bellied dog appearance (i.e. enlarged or bloated abdomen) can be a sign of life-threatening conditions like:

• Internal bleeding due to a tumor (e.g. a ruptured splenic mass in dogs)
• Heart failure
• Gastric dilation and volvulus (i.e. bloat in dogs)

However, there are also some conditions such as Cushing’s disease in dogs which can cause gradual abdominal enlargement but are not immediately life-threatening.

3. Weakness, significant limping, trouble walking, or paralysis is an emergency

A dog who is wobbly and off balance, a dog’s back legs collapsing, any incoordination, altered mental state, trouble standing, severe limping, and/or continued seizures in dogs all call for a trip to the emergency vet clinic.

While far from an exhaustive list, these symptoms could indicate:

• Spinal stroke in dogs (i.e. fibrocartilaginous embolism or FCE)
• IVDD in dogs
• Brain tumor
• Shock (due to blood loss, trauma, allergic reactions, etc.)

4. Frequent or non-productive vomiting is an emergency

Throwing up multiple times in one day or trying to vomit without producing any bile or vomitus are highly concerning for potentially life-threatening conditions such as:

• Bloat
• Intestinal blockage
• Severe pancreatitis in dogs

Therefore, it is best to take your dog to the pet emergency room if you notice continued or non-productive vomiting.

5. Trauma is an emergency

Any sort of significant trauma, including bite wounds, cuts and wounds that continue to bleed, a dog being hit by car, snake bite on a dog, etc. warrant an emergency room visit.

6. Ingesting or being exposed to a toxin is an emergency

If your dog gets into a toxin or something that you think might be toxic, please call ASPCA Animal Poison Control Center or Pet Poison Helpline first. (Be advised these toxicology services do charge a fee, but it is well worth it.) 

The toxicology specialists will advise you if your dog needs to be seen by the emergency vet. Plus, the information the toxicologists provide will help the emergency team determine the best way to proceed. With toxicology cases, the vet may need to induce vomiting to try to remove as much of the toxin as possible and/or provide continued care. 

Common toxicity situations in dogs include:

• Grape or raisin toxicity in dogs
• Xylitol toxicity in dogs
• Chocolate toxicity in dogs
• Ingesting medications intended for other pets or humans in the house
• Getting into rat bait
• Antifreeze toxicity in pets

7. Hives (i.e. allergic reactions) is an emergency

If you see signs of an allergic reaction in a dog such as sudden hives, facial swelling, vomiting, and collapse, head to an emergency animal hospital. Just as anaphylactic shock can be dangerous in people, it can be life threatening in dogs as well.

8. Heat stroke is an emergency

Heat stroke in dogs constitutes a life-threatening emergency and can develop quickly. Some of the symptoms include:

• Sudden collapse
• Excessive panting
• Stumbling
• Disorientation
• Red, pale, or bluish gums
• Severely elevated body temperature

(For more information, check out my blog post on heat stroke vs heat exhaustion in dogs.)

Brachycephalic dogs (i.e. short nosed dogs) or dogs with underlying respiratory issues are most at risk. I have seen heat stroke in a Bulldog when it was only 70° F outside. Therefore, it is important to know how to keep a dog cool in summer and how to cool down a dog, especially if you have a dog who is at high risk of becoming an overheated dog.

9. Sudden changes in eye appearance or sudden blindness is an emergency

Eye issues that require immediate veterinary attention include:

• Sudden blindness
• Trauma to the eye (e.g. protrusion of the eye, scratch or puncture from a cat nail or thorn, etc.)
• Squinting the eye or holding it closed (which often indicates eye pain)
• Cloudy eyes in dogs

Eyes can go bad fast, so it is important to get your dog to the vet quickly for an accurate diagnosis if you notice eye issues.

10. Dystocia (i.e. trouble giving birth) is an emergency

Thankfully, delivering puppies does not always constitute an emergency. However, if you see any of the following signs, seek veterinary attention immediately. The life of the puppies could be in danger, and medical intervention is necessary.

• 30 to 60 minutes of strong contractions without a puppy
• Over four hours between puppies when you know there are more inside
• When over 24 hours passes after the mother’s temperature drops and she does not go into labor
• Extreme signs of pain
• Over 70 days of gestation (i.e. pregnancy)

Certain breeds are more prone to having difficult births (especially Bulldogs). So a preplanned C-section with your regular vet may be the safest option for those dogs.

Situations where your dog needs to see a vet within a couple of days

Sometimes, there are situations that aren’t truly an emergency. But they do mean your dog needs to see a vet within a few days. Some examples include:

1. Vomiting (once or twice) and/or the dog having diarrhea but acting fine (if not resolving with supportive care)
2. Coughing (if still behaving normally, normal respiratory effort)—dogs with kennel cough for example
3. Dog limping—this can be a tricky one. If there is a broken bone, exposed bone, your dog cannot bear weight on the leg, or he or she is dragging one or more legs, this constitutes an emergency. However, if your dog is able to bear weight on his or her leg, but is a little more tentative than normal, this can likely wait for an appointment with your veterinarian.
4. Decreased appetite that lasts more than 24 hours
5. Changes in urination or more frequent accidents in the house (e.g. signs of a UTI in dogs)
6. Worms in feces
7. Dog ripped a nail off (if not painful or continuing to bleed)

Situations where it is best to make an appointment with your primary care vet (not to go to the emergency vet)

There may also be situations where your dog is stable enough to wait for an appointment, and seeing your regular vet (or a specialist) can better serve your dog’s needs. Some situations where this may be the case include:

1. Fleas and ticks

Many emergency clinics do not carry preventatives to manage flea or tick infestations. However, your primary veterinarian is well equipped to advise you on appropriate prevention for your dog.

2. Skin infections or ear infections

Chronic allergies are often the underlying cause for skin infections (e.g. pyoderma in dogs or dog paw yeast infections) and ear infections (i.e. otitis in dogs). While the local emergency clinic may have some skin and ear medications on hand, your primary veterinarian likely has a wider range of medications, shampoos, and preventatives to not only manage the infection, but also the underlying condition.

3. Chronic conditions

Unless your dog has taken a sudden turn for the worse, routine management of chronic conditions, such as glucose curves for diabetes in dogs and monitoring blood work for chronic kidney failure in dogs, are best performed by your primary veterinarian. Your vet knows your dog’s medical history well, which makes him or her best equipped to make changes to medication, diet, etc. 

However, if your dog suddenly gets sick and has a chronic condition such as diabetes, liver disease in dogs, or kidney disease, that does constitute an emergency. And your dog should be seen as quickly as possible.

4. Tumors or masses

Unless a tumor or mass has suddenly ruptured and the bleeding is uncontrollable, these typically are chronic conditions. Thus, they are best served with diagnostics and surgery with your primary veterinarian or a surgeon.

5. Cases that need a second opinion

Naturally, a diagnosis of a chronic or life-threatening condition is alarming. And it is important to do your due diligence if you feel the diagnosis is incorrect or want more information about what is going on with your dog. 

However, if your dog is stable, it would be best to seek a second opinion with a veterinary specialist near you (e.g. internist, oncologist, cardiologist, etc.) rather than heading to the emergency room. A specialist has the ability and tools to work up a case more thoroughly than is possible in the ER setting.

A bit of preparation goes a long way

Emergencies can happen when we least expect them, but there are some actions you can take to be as prepared as possible:

• Know how to take your dog’s vital signs and what constitutes normal
• Perform a weekly 5-minute dog wellness scan to make it easier to identify normal vs. abnormal and to help you tell when your dog is sick
• Make or buy a dog first aid kit and know how to use each item in it
• Review what to expect during an emergency vet visit

When in doubt, head to or call the emergency vet

Remember, if you are concerned about your dog’s health, it is always better to err on the side of caution. There’s a mantra in emergency medicine, “If you’re concerned, we’re concerned.” As emergency vets, we are happy to help you and your dog feel better as quickly as possible. And we are only a phone call or a visit away.

Disclaimer: The advice provided in this post is intended for informational purposes only. It does not constitute medical advice regarding pets. If you are concerned about your pet’s condition, please call your vet and note the advice they give you, or head to the nearest emergency clinic.

Why have you needed to take your dog to the emergency vet?

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