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Dog Health & Care

What Is the External Extraction Technique (XXT) & Why It Could Save Your Dog's Life

Chantelle Fowler
By Chantelle FowlerUpdated on June 17, 2026
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Veterinarian Petting a Noble Golden Retriever Dog

If you've ever witnessed your dog choking, you know how terrifying and traumatizing it can be. Learning the proper techniques to help your pup in a choking event can be the difference between life and death.

The external extraction technique (XXT) is a safe, effective, and non-invasive treatment for choking dogs, but we’re willing to bet you’ve never heard of it. If you’re serious about learning everything you can to save your pup’s life in a choking event, keep reading. We’re going to answer all your questions, including “What is the XXT maneuver?” and “When is XXT recommended?”

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How Does It Work?

Let's take a closer look at the steps you need to follow to perform XXT successfully. We also recommend checking out the videos on YouTube of veterinarians performing this procedure, especially if you're a visual learner.

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The Steps on Performing XXT: Procedure One

1. Assume the Proper Starting Position

Place the choking dog on their back to perform the external extraction technique. Their neck and airway should be straight and parallel to the floor. Depending on the dog's breed and size, you may have to straddle their ribcage but don't put too much pressure on them. A second person can be helpful if someone is nearby, as they can help hold the pup's back limbs.


2. Identify Body Landmarks

From this overhead position, you should be able to identify the location of the trachea and the object that's lodged inside of it. You may even feel the ball in your dog's throat.


3. Position Fingers

Form an open diamond shape with your hands and place them on both sides of your dog's trachea below the lodged object. There should be a slight gap between your thumbs. Your middle fingers should push into the "V" notch of your dog's mouth to help open their jaw.


4. Dislodge the Object

Using your thumbs, lock out your arms and push the ball down and up toward the mouth in a J-stroke motion. This pressure, if applied to the right spot, should then eject the obstruction from the mouth.


5. Rescue Breaths

If your dog doesn't start breathing when the object is dislodged, provide two mouth-to-snout rescue breaths. It's essential to keep your dog's neck straight so there's a clear pathway from their nose to their lungs. Close their mouth and blow twice into their nose.

Image Credit: Przemek Iciak, Shutterstock

6. Begin CPR

If your dog is still not responding after the rescue breaths, begin CPR immediately. Check our blog for step-by-step instructions here.


7. Seek Veterinary Care

Even if you manage to save your dog from choking, you should still take them to your veterinarian for examination. This is especially true if you've performed CPR, as they need to be checked for chest trauma.

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What Are the Different Types of the External Extraction Techniques?

There is a second XXT procedure called the PullGrip alternative. What sets the two techniques apart is your body and finger placement. You'll still need to use a fair amount of pressure and perform a J-stroke to dislodge the ball, just from a different perspective.

The Steps on Performing XXT: The PullGrip Alternative

1. Assume the Proper Starting Position

Lay the dog on their back and position their head in an in-line position. Their airway should be parallel to the floor with the spine, nose, and ears, all forming a straight line.

You will want to position yourself in front of your pup, so you're facing their snout.


2. Identify Body Landmarks

Feel for the lodged object by examining the outside of the trachea.


3. Position Fingers

Use your thumbs to grip the cheeks or lips and open the lower jaw vertically. Your fingers should be on both sides of the trachea below the lodged object.


4. Pull

Pull your fingers against the object while you press down and out through your pup's open mouth. Like the other technique, this step involves a "J" stroke.

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Where Is It Used?

The external extraction technique is particularly useful in three instances:

  • When there's a complete airway obstruction
  • When it is a ball or similar round object that is lodged
  • When the dog is unconscious

Advantages of the External Extraction Technique

There are two main advantages to using XXT over other techniques when faced with a choking dog.

First, it's safe for the owner to perform the procedure as the method is done externally. Pet owners have suffered injuries, including finger amputations, while trying to retrieve an object lodged in the back of their dogs' throats.

Second, trying to dislodge an object from the throat with your fingers can push it further back.

Disadvantages of the External Extraction Technique

The external extraction technique works when performed properly in the right circumstances. As we mentioned above, XXT is most useful if your dog is experiencing a total airway obstruction, choking on a ball or round object, or unconscious. The technique may be less useful in other applications.

XXT requires some level of confidence and calmness to perform it as designed. Unfortunately, choking emergencies aren't known for their tranquility, which can make performing XXT properly tricky. However, any technique an owner tries to save their dog from choking can be less effective if performed in a high-stress situation.

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Frequently Asked Questions (FAQ)

Who created XXT?

The first person to describe this technique was James Herriot, a British veterinary surgeon and author who wrote about XXT in his memoir, which was published in the 1970s. However, Dr. Tim Crowe, a veterinarian and founding American College of Veterinary Emergency and Critical Care member, brought this technique to the forefront of modern veterinary care.

What else can I do to help my dog in an emergency?

We highly recommend finding a pet-centric first aid course if one is available in your area. Knowing what to do in an emergency will not only provide peace of mind but could also be the difference between life and death for your dog. The American Red Cross offers online cat and dog first aid training. Meanwhile, St. John's Ambulance provides an in-person equivalent for Canadians.

How can I prevent my dog from choking in the future?

The most important thing you can do to ensure your dog doesn't choke on balls or other objects in the future is to supervise them to ensure they're engaging in safe play. You can also choose toys that are aligned with their breed size and capabilities and make it a point to thoroughly inspect all toys regularly for damage or cracks.

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Conclusion

Seeing your dog choking on an object is a terrifying experience for both you and your pup. Fortunately, complete airway obstructions are rare, but if you do believe your dog is suffering from one, you now know what needs to be done to save them.

If you're not already familiar with pet first aid techniques, we highly recommend educating yourself. You never know if you might need to use the external extraction technique to save your dog's life.

Sources

Featured Image Credit: Gorodenkoff, Shutterstock

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Chantelle Fowler
Authored by

Chantelle Fowler

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