What are the current RECOVER guidelines for CPR in dogs and cats including drug dosing and compression ratios?

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The 2024 RECOVER guidelines recommend initiating CPR with immediate chest compressions at 100–120 compressions per minute, a compression-to-ventilation ratio of 30:2, and cycles of 2 minutes of uninterrupted CPR before pausing to assess rhythm or administer drugs.13 Basic Life Support: compressions are the priority. Compressions should be delivered at 100–120/min with the patient in lateral recumbency; conformation-specific technique modifications are recommended for wide-chested dogs.3 When intubation is not possible, bag-mask ventilation using a tight-fitting facemask with oxygen supplementation is recommended over mouth-to-nose ventilation.13 Chest compression pauses should be minimized, and high-quality, uninterrupted compressions remain the single most important intervention.3 Vasopressors are the cornerstone of Advanced Life Support (ALS) pharmacotherapy. Epinephrine at 0.01 mg/kg IV is recommended for nonshockable rhythms (asystole, pulseless electrical activity); high-dose epinephrine (0.1 mg/kg) is no longer recommended under any circumstance, including prolonged CPR.15 Vasopressin is the preferred vasopressor in shockable rhythms refractory to initial defibrillation, with epinephrine as the alternative if vasopressin is unavailable.5 Atropine, when indicated, is administered once only — repeat dosing is no longer recommended.15 Defibrillation is the definitive treatment for ventricular fibrillation and pulseless ventricular tachycardia. If initial defibrillation is unsuccessful, the defibrillator dose should be doubled once.5 In animals with refractory shockable rhythms, esmolol and antiarrhythmics are added: lidocaine is recommended in dogs, and amiodarone is recommended in cats.5 Lidocaine and amiodarone are not interchangeable between species per these guidelines. End-tidal CO₂ (ETco₂) monitoring is the recommended method for assessing CPR quality and detecting return of spontaneous circulation (ROSC). The 2024 guidelines raise the target ETco₂ to 18 mm