2001-Tue Sep 25 19:07:33 EDT 2018
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Humpty Dumpty has nothing on some of the dogs we veterinarians see. Dogs who have been hit by cars or who have undergone some other trauma can suffer multiple fractures — what we call polytrauma. Putting them back together again takes extensive surgical repair and sometimes calls for some difficult decisions. Here’s how cases like this may be treated.
We start by stabilizing the dog, which may require the use of intravenous fluids, pain medications and antibiotics to ward off infections. He may need to be transferred to a specialty veterinary hospital with high-tech surgical facilities and emergency and critical care or surgical specialists who are experienced in treating these complicated cases.
Before taking a dog into surgery, it’s important to assess vital signs. Animals hit by cars often develop internal bleeding from a tear in the spleen or liver or from sharp bone fragments that pierce organs or tissues. The dog may need a blood transfusion.
We take radiographs of the chest to check the heart and lungs. The trauma of being hit by a car can cause a collapsed lung, or a pneumothorax, which is abnormal air between the lungs and the chest wall. We’ll also take radiographs of areas such as the pelvis and the front and back legs, to assess for fractures.
Usually these dogs are in no condition to walk, so we place a urinary catheter. That prevents them from urinating on themselves or being stressed about being unable to stand up and urinate. Relieving stress is an important part of care.
Lacerations are bandaged until they can be treated more thoroughly. Once the blood transfusion, fluids and pain meds have done their work of stabilizing the dog, we can address the fractures. Deciding how to repair them is where the difficult decisions come in.
In most cases, a broken bone is surgically repaired with pins, plates and screws. That can cost several thousand dollars, and even more if there are multiple fractures. If the dog also has severe lacerations, he’s at higher risk of infection.
Financially and medically, amputation is sometimes a better choice than repair if a leg has multiple fractures because it is less likely to heal well. If more than one leg is fractured, removing the most severely damaged leg and repairing the others can be the best way to go.
Most dogs get around very well on three legs, but many people struggle with the idea of amputation. Dogs have an advantage, though, because they start out with four legs. Adjusting to three legs is usually not difficult for them. With amputation, the dog usually recovers fairly quickly, and owners usually don’t have to worry as much about the cost of the procedure or ongoing medical care. It also allows the veterinarian to focus on the dog’s other surgical needs.
Before surgery, your dog may need another unit of blood. After he’s anesthetized, the leg or legs being repaired may be x-rayed to check for ligament damage. The x-rays are usually performed under anesthesia because it’s necessary to stress the joint to see if the ligaments are damaged. Once the extent of the damage is known, the amputation — if that is the approach taken — is performed, any remaining fractures are repaired, and lacerations are cleaned and sutured. It can take several hours to complete the surgery.
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