Tim and Megan Kelly's two mixed Boxers, Jack and Cassie, have a habit of gnawing everything in their Arbutus home.
Two-year-old Jack, in particular, has been a walking choking hazard, they said. They've had to reach down his throat to pull out what was choking him.
Earlier this month, the Kellys learned a few more ways to handle a pet emergency at a CPR class at Violetville United Methodist Church.
"I feel a lot more confident just being in the house with our dogs chewing on things that if something were to happen I'd be able to handle it and help them to recover," said Tim Kelly, a 30-year-old project manager at T. Rowe Price, a financial investment company.
The three-hour course was taught by Kat Novak, 64, who has run a dog training and pet-sitting business for 11 years.
Novak, of Catonsville, started offering CPR for pets classes in 2016 at a time when industry groups were grappling with establishing regulations and training standards for consumers.
While learning CPR is common practice for veterinary school students, a set of standard guidelines hasn't existed until recently, said Dr. Daniel J. Fletcher, associate professor of emergency and critical care at Cornell University College of Veterinary Medicine.
"This is where we're definitely very far behind human medicine," he said.
Fletcher is the co-chairman of the RECOVER Initiative. Launched in 2011, the all-volunteer group is trying to standardize pet CPR protocols.
In 2012, RECOVER — the Reassessment Campaign on Veterinary Resuscitation — worked with the American College of Veterinary Emergency and Critical Care to publish its first evidence-based guidelines for CPR care for dogs and cats.
Fletcher said 1,200 veterinarians and veterinary technicians have completed basic or advanced life support classes through RECOVER. Ultimately, he'd like anyone to be able to get a CPR trainer certification, but for now, he believes pet CPR should be taught by someone with veterinary medical training.
"We're talking about a life-or-death medical procedure," he said.
He added it could be frustrating for a layperson who wants to teach pet CPR because training isn't available. He'd like to have a network in place through RECOVER to screen potential trainers.
The American Red Cross this month launched a half-hour online animal first-aid course that includes CPR in its instruction and includes a first-aid certification. The Red Cross stopped offering first-aid classes in 2015, due to low enrollment and the preference of pet owners to get information digitally, said Lenore Koors, a spokeswoman.
The CPR guidelines in the Red Cross course are based on the RECOVER initiative, Koors said.
Fletcher said there are no statistics on how often pet CPR is needed.
He said pet CPR is useful for sudden problems that can be quickly reversed, such as an arrhythmia or if a dog is choking.
Breeds most notable for developing sudden arrhythmia — an abnormal heartbeat — include Boxer, Great Dane, Doberman pinscher and English bulldog, he said.
Novak had been certified for pet first aid by the Red Cross in 2012 and completed a course by Littleton, Colo.-based Pet Emergency Education in 2016, however she is no longer affiliated with them. She said she has no formal veterinary medical education.
She said she has consulted RECOVER guidelines to make modifications to her class.
Amy D'Andrea, director of operations at Pet Emergency Education, said the number of certified instructors has increased from 35 last year to 62. She said the goal is to have 100 instructors nationwide by the end of the year.
Novak's class provides instruction on how to perform CPR and other emergency response techniques, such as dealing with choking, hypothermia or hyperthermia.
Participants practice CPR on a dog mannequin and restraint techniques on a stuffed animal.
Novak has offered classes at her Catonsville home and the Baltimore Animal Rescue and Care Shelter in Baltimore. Earlier this year, she started offering the $45 class on the first Saturday of the month at the church. She has taught 25 people since March, she said.
"There are a lot of dog walkers and pet sitters who advertise on Craigslist and they don't have a clue what to do in an emergency," she said. "I wanted them to be better prepared just because I'm an animal advocate and I want to see the animals safe."
Fletcher said he could not speak about the classes — including Novak's or Pet Emergency Education's — because he was not familiar with what was being taught.
Since speaking with a reporter, Novak has consulted with Andrew Walther, an emergency veterinarian who works at Waldorf Emergency Care and has agreed to advise her and review her curriculum.
"It looks pretty thorough to me," Walther said. "She did a great job. She has put a lot of time and effort into it and done a lot of research."
Novak said she is no longer calling herself a "certified instructor" and has taken "pet emergency" from the certificates she gives to participants. She said she is now presenting herself as a trainer of pet CPR and first aid.
"I want this to be legitimate," she said. "I'm having trouble getting direction on how to go with that."
She believes there should be national guidelines for pet CPR trainers.
"I'm trying to make it as official as I can with what I have to work with," she said about her business.