Vet treating dog with broken bone

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.

Assessing the Situation

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.

Fracture Repair

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.

Surgery and Aftercare

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.

After surgery, the dog may need a stay in the intensive care unit. That’s expensive, no doubt about it, but there’s good reason for it. The ICU staff monitors dogs 24/7, checking incisions for oozing or signs of infection and changing bandages as needed. A wound-soaker catheter may be placed on the amputation site to help control pain in that area. Dogs are often reluctant to express pain, so a continuous infusion of pain medication helps keep them comfortable, which is a big part of a successful and speedy recovery.

After amputation, most dogs can start walking for short periods within a few days and no longer need as much pain medication. They can start to get up without help, although they may still need the urinary catheter. If the incisions look as if they are healing well, the dog can start taking pain medication orally and begin physical rehabilitation. Losing a leg does limit them. Depending on the severity of the injury and the number and type of fractures, dogs may go home as soon as the next day or be hospitalized for as long as 10 to 14 days. After a healing time of 8 to 12 weeks of restricted activity, they can get back to running up and down the stairs, playing and going for walks.

Today, the cost of this type of repair and hospitalization, which usually includes radiographs, anesthesia, pain medication, the surgery itself and follow-up visits, can be up to $10,000 depending on the number of fractures and whether the dog needs a stay in the ICU. That makes a good case for having pet health insurance. Not everyone can afford that level of veterinary care, and it’s heartbreaking when people must make a decision of economic euthanasia. Some people are able to use credit cards or Care Credit, borrow from family and friends, or set up fund-raisers to help cover the costs. I know that folks who are able to give their dogs this second chance are awfully grateful to still have them in their lives.