The backyard is thought to be a safe haven for pets and children but where there is a will, there is a way, and some poor pooches have found the defenses can easily be bypassed. In the past few weeks, we have seen two patients who were attacked on their own properties. One of the victims was attacked twice by the same dog from a neighbouring property – a scary prospect for the owners who have another dog at home and are worried about a third attack for their elderly friend.
This post is about another patient of mine, Abby, a beautiful King Charles Cavalier Spaniel, who was on the receiving end of an argument with the neighbour’s dog. She was brought to us one night by her owners after seeing her local veterinarian briefly, who treated her shock and pain and sent her to us as soon as she was stable. On arrival, Abby was still quite shocky and weak, unwilling to stand up. She was not using her right hindleg much and while we were concerned about potential nerve damage to the limb, it was probably the least important issue in the scheme of things. A non-functional leg would not be likely to kill her, while deep bite injuries definitely could!
When we examined Abby, we noticed injuries on the right side of her abdomen, one being a puncture wound with bruising in the groin area, the other just a bruise over her mid-abdomen. There was also a puncture over her tail base and I could feel a lot of air under the skin forward of that puncture. Big dog-little dog interactions such as this are common, and in many cases, the damage is greater than it appears. What can look like a couple of small bite marks on the outside can actually lead to quite life threatening trauma on the inside. It isn’t the teeth or the risk of infection that is the issue so much as the potential for tissue to be crushed by large muscular jaws that can lead to smaller animals dying a few days after the incident.
The skin is a supple organ and is quite loosely attached to the underlying muscle, so when grabbed by a large dog mouth, it will be pulled and torn as well as crushed. This is why there was a large amount of air under the skin over her back, associated with one small puncture at the tail base. One of my concerns about the wound in her groin region was whether the tooth had gone deeper at that point, or whether, by dragging the skin, it had perforated through further up the abdomen. A puncture through the abdominal wall can be associated with crushing of the internal organs as well as potentially leading to widespread intra-abdominal infection (peritonitis).
We then became concerned because we detected that her haematocrit (PCV or red blood cell percentage) had fallen significantly since she had seen her vet earlier along with her blood protein levels, a clear indication of ongoing bleeding. The bruise in her groin region appeared to be getting larger and an ultrasound scan revealed a small volume of fluid in her abdomen, which we presumed was blood. It could have been urine, but there was no evidence of significant fluid around the bladder, especially after expressing the bladder (while she was anaesthetised) which I would have expected if the bladder was torn.
At that point, we made a decision to take Abby to surgery to clean and explore her wounds as well as to investigate for potential damage inside the abdomen. I was concerned Abby’s liver, spleen or intestine may have been crushed, or other blood vessels in the abdomen torn, to lead to haemorrhage in her abdomen. We prepared her owners that she may need a blood transfusion if the bleeding continued, and once we felt she was relatively stable, we took her to theatre.
An exploratory laparotomy (essentially exploring the abdomen) was performed and the findings were interesting. Fortunately, all of her major organs were intact and there did not appear to be evidence of bruising or crushing to the liver, spleen or intestine. There was a moderate volume of blood sitting in the folds of her intestine and a large blood clot in the ligament on the right side of her bladder – pretty much opposite where the largest bite mark was located. Exploring deeper in the area, we found a hole welling up slowly with blood down near the groin (the inguinal region). Going even deeper, we managed to locate a large bleeding vein in the deepest recesses amongst torn and traumatised muscle.
Luckily for Abby, the vessel was a vein and not an artery. Abby would not have reached us had an artery been torn. And given it was a larger vein, we were able to place a couple of tiny sutures in the edge of the vessel to help stop the flow. At this point though, we rechecked her haematocrit value which had dropped to a critically low level and a blood transfusion was now definitely required and commenced immediately. Once we were happy with the abdomen, the deep flank wound was explored and a perforation through the muscle was found and closed. She came out of surgery with multiple drains in her wounds and a slightly pinker gum colour! Abby recovered amazingly well from her surgery and within a few hours her haematocrit was back to normal.
We were pleased to see Abby improving over the next couple of days in hospital. She began to use her injured right hindleg and went home three days later. When I saw Abby return for her suture removal she looked happy and comfortable, the bruising and swelling having resolved.
The main point to Abby’s story is that big dog-little dog interactions can lead to much more significant injuries than are evident on the outside. I have seen two small punctures on the skin (in other cases) hiding extensive muscle tears underneath. The power of a large dog’s jaw can be amazing, and in the wild, is used to kill for survival. Dog attacks are an ongoing issue, sometimes it is due to lack of training, sometimes due to temperament. I know this can be a sore point, however it can not be denied that in some breeds this temperament has been specifically bred for through generations, to obtain the perfect attack dog. We as owners need to be responsible for our pets and do our best to train bad behaviours out of our charges, or just make sure there is no way they can threaten the life of other creatures.
Abby was fortunate to not have any major organ injuries and to have received such prompt care from her owners. She will be getting a new fence to her yard soon and hopefully border disputes can remain just that – words instead of action!