Trauma in Dogs

Bite wounds

Q: I went hiking with my dog, and when we returned home I noticed that she had a nasty looking scrape on her front leg. I treated it with some anti-bacterial soap and a topical analgesic. I am concerned that the scrape may be an animal scratch. Should I take the dog to the vet or "wait and see"? How can I tell if the scratch is infected? P.S. My dog is current with all her shots.

A: P- The best thing to do for wounds that might be animal bites is to flush them copiously with clean water. Keeping a wound under running water for several minutes greatly reduces the risk of rabies and other infections from bite wounds. Using an antiseptic such as betadine solution will also help and the antibiotic ointments such as Neosporin (Tm) may help as well. Deep wounds should be examined by your vet. If there is any question in your mind about whether a wound is deep it is best to be sure. It is also a good idea to review your dog's vaccination status and make sure that his or her rabies vaccination is current whenever a bite or suspected bite of unknown origin is present.

Mike Richards, DVM  

Pneumothorax after HBC

Q: Dear Dr Mike, My dog, a two year old Dalmation was hit by a car a week ago. She is still in the veterinary hospital- but I would like to have some further clarification on some medical terms related to her condition. * She has what is called a pneumo thorax- what is this exactly and what are the long term effects of this? * If she has a hair line fracture in her pelvis what will this mean for her mobility- how long may this take to heal? * She had a 15cm (7") irregular gash on her side and so far it hasn't been stitched- why would this be? * She is nearly due to come home and will be spoilt on her return. How can I ensure that the balance is kept between caring for her and giving her lots of care and attention and her thinking that she can do anything she wants in the 'name' of her injury? Thanks- this is my first visit to your site- it won't be the last! Annette

A: Annette- Pneumothorax refers to air accumulation in the chest cavity. As odd as this sounds, the chest cavity must have a vacuum (no air) to work properly. There should be no air pressure outside the lungs. This enables them to inflate when the muscle of the chest are relaxed and it expands. The air is then forced out of the chest by contraction of the muscle of the chest. When the lung is damaged and leaks air, it collapses the lung. The same thing happens when there is a hole in the chest allowing air in. Either situation can be the cause of pneumothorax after a traumatic even like being hit by a car. If there is only a small amount of air accumulated it can be reabsorbed. This is commonly the case with blunt trauma in which the lung ruptures, then heals itself quickly. If there is a lot of air or continuous leakage of air, it is usually necessary to place a drain in the chest to remove the air and maintain a vacuum. There are several ways of doing this to ensure continuous evacuation of air. We use a Heimlich valve (same guy as the Heimlich maneuver, I'm sure) attached to a silicon tube in the chest.

Pelvic fractures which do not involve the acetabulum (the socket of the hip joint) or are not severe enough to cause rotation of one wing of the pelvis into the pelvic inlet usually will heal with little problem. It sounds like this is the case for your dog but this is a good question to ask your vet. Pelvic injuries tend to be pretty painful, even when they are minor, so don't neglect pain relief.

I try not to suture road wounds. They are very difficult to get completely clean and suturing them can lead to infections that are difficult to treat. It is often better to leave them open so that they can be cleaned as they heal and can be monitored for infection. Not all vets agree with this way of dealing with wounds but so far we are doing well with it. It does mean they have to be cared for longer and there is always the chance that they'll get infected anyway but it really seems to happen less often when the wound is left open to heal by "second intention" --- without being sutured.

Mike Richards, DVM


Radial nerve paralysis

Q: One year ago (May 11, 1996) our Malamute-Shepherd mix jumped from the back of a truck going 50 mph even though he was tied in. He has paralysis in one of his front legs (I cannot remember the medical term). He can move the leg forward and back, such as to hit the door when he wants out, but he has not put weight on it for a year. We've taken him to two vets, who say the leg will probably have to be amputated, though they really could not tell if the nerves were merely traumatized or permanently damaged. I don't think there has been advancement of feeling (he has feeling to the elbow joint) but it has not been pinch tested lately. We are about ready to give up and have the amputation. So question one is, have you ever seen the feeling come back in similar situations? Is it worthwhile to see a specialist and have more definitive tests after all this time? Also, he doesn't chew the limb and it usually doesn't seem to bother him, but he licks it until there is no hair and he is raw. He's gotten to the point of infection a couple of times. We keep an Elizabethan collar on him but when the wound is bad he bends and chews the collar and makes the wound worse. Is this a sign he feels tingling? Is this a good or bad sign? Any info or resources you can give us on this topic would be helpful in making this decision. We just want Fargo to be healthy and happy, which he has been the times when we haven't had wounds on the leg. He gets around quite well on 3 legs, can run, etc. He is 7 1/2 years old and weighs 115 lbs. Thank you very much, E.

A: This injury is probably radial nerve paralysis or avulsion of the nerves in the brachial plexus, or possibly a nerve root problem at the spinal cord level considering the possible severity of the forces involved in the injury. Usually most of the progress is made towards recovery in the first 6 weeks or so following injury so it seems unlikely to me that you have much hope of increased nerve function at this point. Another complicating factor in these cases is muscle fibrosis. When a muscle does not get signals from the nerves it doesn't flex. After awhile, it can't flex anymore and just gets fibrosed in one position. Once this happens the leg is not functional even if the nerve function does return. While amputation is always a difficult choice and is even more difficult to consider in a dog this size, it usually works out better than owners anticipate it will.

Since amputation is a final decision, you may be more comfortable if you do have a veterinary neurologist evaluate the situation prior to making that decision. I'm sure your vets can arrange this if you prefer.

Mike Richards, DVM


Radial nerve paralysis

Q: Dr. Mike,

My family is just going through the heart break of a loved doggy getting hit by a car.  The good news is that he is going to make it. Unfortunately, he apparently has lost the use of his front, right leg. He cannot feel it.  We are not sure if he will get the use of it back or if it will need to come off.  I'm sure that I am looking for a miracle cure, but is there something I can do?  He is a very fun and active dog to say the least.  I have to believe that his quality of life is going to drop immensely.  It happened yesterday.  He is a two year old cairn terrier.  Have you heard of methylsulfonylmethane?  Could it help?  Our vet said that Bogey's problem is more than likely a nerve problem and that we just don't know that much about it.  So, I'm looking for something that may help.  Massage, medications, whatever.  Thank you for your time.  Sincerely, Shelly  

A: Dear Shelly  

It sounds like your dog probably has radial nerve paralysis. This nerve crosses bone just above the elbow and it is very vulnerable to injury when a dog is hit by a car. There is no treatment that I am aware of that helps the nerve regenerate if it is severely damaged. However, the nerve will often recover from the injury on its own. It is very important to do physical therapy to ensure that the muscles have not contracted too much for the leg to work when the nerve does regenerate. When the nerve is completely damaged the foot tends to turn inward and become contracted in that position. Splinting the foot may prevent this inward turning and allow some use even if the nerve won't heal. It may not be too late to consider this option if recovery has not occurred. In other cases, nothing seems to help much and amputation is necessary because the dog tends to try to walk on its wrist area since that is where the bend inwards occurs. This leads to chronic skin ulcers and infections and amputation stops these problems.

I hope this turned out OK for you.

Mike Richards, DVM      

Hit by Car -- How long should recovery take

Q: Aloha; Our dog was hit by a car five days ago. We called the vet and she sutured his leg which was lacerated. It was a deep wound and there was some tendon damage. He is on antibiotics. He suffered minor injury to his head, there was a small amount of nosebleed after he was hit, and the sclera of one eye was red (but has now cleared). He has never complained about his leg, and we change the dressing every day. It's looking very good. The problem is he doesn't get up. Two days ago he walked a little, but hasn't moved since. He appears alert, is not ataxic, has no fever, and yet when we go to bring him up he yelps in pain. Light palpaton elecits no response, however, deep palpation in his ribs has him yelping. Should we be very concerned that he is not walking? If he broke ribs, how long does that take a dog to heal? He is eating and drinking, but we have to get him to swallow a bit to stimulate his appetite. We're not sure how much he has eliminated, as he hid when he walked off two days ago. Please advise.

A: I really think it would be best to have your vet examine your dog again. It really sounds like something more serious is going on than was initially suspected. I can't remember any dog with a laceration of one leg not walking on the other three, even with really severe injury to the affected leg. Perhaps there is blindness that wasn't apparent, a worse head injury than appeared to be present or back, rib or pelvic injuries that just didn't get picked up due to the other more obvious trauma. I suppose it is possible that your dog just has a lower pain threshold than most, but I wouldn't bank on that. Please let your vet look at him again. Rib injuries usually aren't fixed (most will heal OK) but pain relief may go a long way towards helping your dog get around, if they are the cause of the unwillingness to move.

Mike Richards, DVM


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...