Your Pet's Best Friend

Hip Dislocations

So here we are with our hip joint back in place, taped up in a "sling", but still under anesthesia.  It usually takes a lot of force to dislocate that ball-and-socket joint, so it's unusual to have a big dog like this with her hip dislocated and no other major injuries.  If there's that much force, it usually breaks a few other things, too.  Calli here just has some road-rash and minor cuts to go with her injury.

We medical professionals call this a "coxo-femoral luxation".  "Dislocated hip" just doesn't sound scientific enough for us cool guys.  Most can be replaced without surgery (though some cannot).  Most of the time, the head of the femur (the "ball") is displaced in front and above the socket.  Then the muscles lock up in a spasm, so that even under anesthesia it is really hard to manipulate things back to their normal alignment.  You have to fatigue the muscles by pulling on them and manipulating the hip.   Bigger dogs have bigger muscles and are more difficult to manipulate. It took about 45 minutes for this one on Saturday night (which is unusually long).  I began to wonder whether my own muscles would turn into dishrags before Calli limbered up enough to pop back in place.   It reminded me of when I had my shoulder dislocated the first time -- a complete separation, they called it.  The next day my wrist hurt worse than my shoulder (I think they pulled on it pretty hard when they put things back in place).  It didn't hurt as badly as the shoulder did when it was displaced, though.

Sometimes it feels almost right, so you stop and take an X-ray.  It's still out, so back to the tug-of-war.  When you finally get it right, everything moves smoothly and the muscles relax.  You push hard while you manipulate the hip so that you mash the blood clots out of the socket and make room for the femoral head.  Then you tape things up.  Those muscles and ligaments are really stretched out, and they need time to tighten up and heal a little before the dog puts weight on the limb.

Most dogs return to normal activity in a couple of weeks.  That hip may get arthritis before the other one, but not for a few years (we hope).

Calli went home with her sling, instructions to rest (on a 10-months old Lab: good luck with that!) and pain meds, of course.  We'll be rechecking her soon.

Proptosed Eye = Eyeball out of socket

Warning: There is a gross "before" picture at the bottom of this post.

Some time ago, in my discussion of bug-eyed dogs, I touched on proptosis globus.  This means that the eyeball has been popped out of the socket.  Since the bug-eyed dog has a shallow socket and a big eyeball, it doesn't take much force to do the deed. A slap to the head, a rough grab of the neck scruff, a scary movie ... (I made up that last one.)   

This guy looks like he's more than half-way there, and it's just an average day for him (we fixed this guy later, by the way).  One good thing is that if you can catch it right away, these eyes can often be saved.

For an animal with a normal eyeball-socket relationship, it takes a much greater trauma, and is a rare injury.  If there's enough force to pop that eyeball out, the rest of the head will probably have a lot of other problems... like a skull fracture, and it's unlikely you could just pop it back in.  That's why I was really surprised to see this kitten with a proptosed eye with no other major injuries (the gross picture is at the bottom).  Apparently a big dog grabbed his head and squeezed. The eyeball was unsalvageable, so we just had to remove it so the little kid wouldn't be in pain (plus we gave pain medicine, of course).

So, here we are after surgery.  You have to remove the tear-producing glands, and the third eyelid (with its tear-producing gland) or the thing will open up later and ooze.  You trim off the edge of the eyelids and sew it all together, nice and neat.  Doesn't it look nice and neat?  It doesn't?  Well, it will when the hair grows back.  Fortunately, the socket doesn't sink in and need a glass eye.

Of course, you could always go pirate, but you really don't have to.

Here's what it looks like when the sutures come out.  The hair hasn't all grown back yet, but you can see that it looks pretty good already.   When it's soft and furry, she'll just look like she's giving you a sly wink.

Here are the gross pictures.  

Bruising on pets may be hard to see.

Can you see all the bruises on this cat?  What, you can't?  I guarantee you that they are there.  This cat was rescued from a situation where a big dog was chewing it and a person (I use the term loosely) was hitting it with a stick.  There are no broken bones, no obvious wounds, no apparent bleeding.  Circulation is good, so probably no internal bleeding.  Lungs sound okay with the stethoscope.  He must be un-injured, then, right?  Wrong.   He didn't want to eat, he didn't want to move.  That is, he wouldn't eat until we gave him some pain control medication.  I wouldn't call him perky at that point, but he did get up and eat.  After three days of rest (and pain medication) he was behaving pretty normally.

We are accustomed to seeing discoloration when we think of a bruise.  A visible bruise means that the tissue has been damaged enough by blunt trauma that blood vessels are leaking blood into the tissue.  This produces the lovely colors.  On a pet, the skin is usually concealed by the fur, so you just don't see that very often, even when it is there.  Sometimes the hairless belly of a dog will show a purple spot, but if the pet has a dense coat, you'd have to shave them to find the bruises.

As a teenager, one of my more foolish decisions resulted in a motorcycle crash that sent me rolling quite a ways across the pavement.  Fortunately, I did not collide with a vehicle, and I was wearing new Levis, leather jacket, boots, gloves and helmet.  I did not have any visible bruises or scrapes, but my whole body felt like one big "charley-horse".  I felt like someone had beaten me like a xylophone from one end to the other.  I was stiff and sore and hurt everytime I moved for several days, this despite having no visible injuries.

Last week I was presented with a little dog who had been bitten in the head by a big dog.  His owners couldn't understand why he was acting so sadly. He just had this small wound on top of his head.  Of course, that wound was produced by the big dog's fang punching through the scalp while the whole head was getting crunched between the jaws.  This dog did not have a lot of visible injuries, but he had received the equivalent of having your head smashed in a car door while somebody stabs your scalp with a screwdriver.  Even with pain medication, you are going to be pretty sore for a while.

Sometimes we have to use a little intuition, combined with our history, combined with my usual question, "If this were me, would I be hurting?"

Steel shot is for waterfowl, not dogs.

Not that any kind of buckshot is that good for a dog.  This has been a heavy week for trauma.  We had a guy who was horribly lacerated by large dogs.  After removal of dead tissue, partial closure of wounds, surgical drains, four days on I.V. antibiotics and fluids, hot compresses, hand-feeding and general heavy-duty nursing care, he's doing okay.  The dog whose foot got run over with one toe mashed off -- we're still having trouble with that one.  Crushing injuries are the worst.  I think we'll save the foot, but we're not out of the woods yet.

A little bird-shot is a bit of an occupational hazard for a working retriever.  Sometimes folks are not all shooting in the same direction at the same time, and the guy bringing in the ducks gets more than he bargained for. 

Fortunately, this was from some distance.  The pattern of shot is pretty spread out and the pellets only penetrated about 1cm from their entry wounds.   With lead pellets, the body will encapsulate them and they are pretty inert.  If you leave them alone, they rarely cause any problems (provided they are not impinging on some vital structure).   It doesn't cause lead poisoning when it sits there, though it would if you ate it.  And thereby hangs the tale.

Around 1990, folks decided that those bottom-feeding waterfowl were getting way too much lead poisoning by eating shot that fell into the water (after missing its target).  Thus, it came to pass that a law was passed mandating the use of steel shot for waterfowl hunting in any federally managed wildlife area.  When the birds eat steel shot they don't get poisoned.  On the other hand, steel shot is not inert in the body.  It corrodes, and this can produce inflammation.  In fact, in 1991 a study was done comparing lead pellets to steel after surgically implanting sterilized pellets.  The lead pellets caused no problems, and the steel pellets festered and got nasty.

So, does the same thing happen when dogs actually get shot?  I've had a hard time getting an authoritative answer, but if it were a very big problem, I think you'd hear more about it.   I've got a test case going now, though.  Here are six steel pellets that I removed today.  These six were easy to get to (relatively speaking, that is -- it's more complicated than the "hot knife and a bottle of whiskey" used in many a Western movie). 

Max has one more pellet left.  If you look carefully, you might be able to see its entry wound just back of and above the surgical site at bottom left. It went deep into his cheek tissues and would have taken a lot of exploring to find (meaning: a lot of pain and damage for questionable benefit).  So, we'll just wait and see how much trouble it causes.  None, I hope.

Dogs running loose

I took Old Red out for a spin this afternoon and there were an exceptional number of dogs running loose.  It was a beautiful fall day with a little nip in the air, the kind of day that makes the horses "feel their oats".  These dogs were loping happily along the roadside, in and out of yards.  I managed to miss them all, which is pretty important for a motorcyclist.  Road hazards can be generally classified as squishable versus non-squishable.  Dogs are not too squishable, so you really can't run over them successfully ("successfully" meaning here that you keep rolling forward with the shiny side up and the rubber side down).

For a dog, getting successfully run over could be defined as having injuries that are fixable.  I've posted on HBC (hit by car) before, but this has been a bit of a bad week for it... dogs being unsuccessfully run over, I mean.  A swell Labrador's rear end was fractured to the point that multiple expensive orthopedic surgeries would be required, and that with no guarantee of normal function.  Last night a beautiful Great Dane puppy's head was smacked hard enough to scramble his brain.

Maybe loping along free and unfettered is the dog equivalent of riding a motorcycle.  Maybe the E.R. physicians have the same opinion of motorcyclists that I do of letting your dog run loose.  On the other hand, I always wear my body armor and I spend a lot of time watching out for cars... and dogs running loose.

Falling dog rises again

Does he look a little brighter here?  He sure acts that way.  After being totally hand-fed, hand-watered with a syringe, and receiving lots of oxygen, this guy is back on track today.  He's eating well and running and playing.

I had a terrible time getting a picture of him because he'd keep running up to me and I couldn't get the camera to focus fast enough. I set him down, ran back thirty feet and started shooting.  He's still a little out of focus here, but I'm okay with that.  The picture may be out of focus, but his life and lungs are nice and clear at the moment.  I love a happy ending.

Falling Dogs

"The bigger they are, the harder they fall."  You know, I think that's generally true. Of course, I also believe that the older they are (or the older I am, anyway), the harder they fall.  When I was a little kid and made accidental dismounts from the horse, it seemed like a longer distance to the ground than it does now.  Despite the reduced distance vs. my height, the impacts are a great deal more solid now.  I don't check the weather report, I check the gravity report. "Things gonna be heavy today?"

Newton's second law says that force equals mass times acceleration.  That's why when I was a tyke and supposed to be napping, I didn't get hurt when I played "magic carpet".  I'd hop off the top bunk with a pillow under me and be amazed when I didn't die -- of course, I only weighed about 20 pounds.  Now (in addition to being a fragile old geezer), I weigh more, so more mass.  Add more acceleration, like the time I leaped off the loading dock chasing a dog, and the force of landing was enough to break my heel.  A word of advice: if you're going to make some sort of gravity-defying leap, get a stunt-double.

This mass times acceleration thing is also important when little puppies fall off tables, or get dropped, or fall down stairs, or out of cars.  Little puppies don't weigh much, and this low mass often results in avoidance of injury even when the puppy has taken a rather appalling fall.  Unfortunately, if you're going fast enough (like in a moving automobile), you can still get enough force to be fatal. 

Even when you're going slowly, you have to consider your point of impact.  It's possible to land just right and dissipate your energy by rolling, and I've seen dogs that bailed out of pickup trucks at forty miles per hour get away without a scrape.  I've also seen them climb out of the window of a parked car and break a leg on impact.   

Most of the time when a kid is wagging the dog around, the distance to the ground is so short and the dog weighs so little that drops are pretty minor traumas.  Sometimes, you hit "just wrong".  Back in 1978, I saw a puppy that only fell 3 feet, but he hit his head on the edge of concrete step.  He was in a coma before they picked him up again, and he didn't last an hour.

Today we're treating a one-pound puppy who got dropped and whacked his chest hard enough that it bruised his lungs inside.  He was unresponsive and not moving much air when he arrived.  Fortunately, with some anti-inflammatories and several hours under oxygen, he's starting to come around a little.  He's still having some breathing problems, but you can hear the air moving in his chest now.  Plus,  he's walking around his little oxygen chamber instead of just lying there like a lump.

He's still not out of the woods, but he's thinking about looking for the path now.

Walk carefully with a new puppy.

There are several reasons for that, but the main thing is that your new puppy wants to be right with you.  It's pretty easy to step on him.   When we picked Anna (our first family dog together), her breeders said, "Remember to do the Puppy Shuffle".   Is that some kind of dance?  No, it means to shuffle along, not actually lifting your feet from the floor.  As long as you're just sliding along, you can't step on the puppy.

Well do I remember racing across the yard with 4-months old (and forty pounds) Anna, when we collided and down I went.  I don't know whether I stepped on her foot and tripped, or she knocked me down and I landed on her.  In any event, when we got up, her foot was broken: two of the four metacarpals (those long bones in your hand, that go from the wrist to the knuckles).  She's six months old in this picture, and none the worse for the wear.

Young puppies heal fast while they are still in their rapid growth phase.  Two weeks in a splint like this was enough to put her right.  These splints look like a big plastic spoon with some padding inside, and a recess for the carpal pad on the back of the dog's wrist joint.  Sometimes they are called metasplints, spoon splints, or carpal splints.  You just add some padding and apply them with stretchy tape.  They are pretty good for foot fractures.

Even the "toy-size" splint pictured above was way too big for Missy, here.  She only weighs about 2&1/2 pounds.  Since she was unsupervised with a couple of pre-schoolers, we don't know exactly what occurred.  Mom had given the kids such a dressing-down before they got here that they weren't talking much.  Since seven out of eight metacarpals were broken, I'm guessing she got stepped on.  Probably everybody was having a great time right before that happened.  Could have been worse -- I've seen little dogs who had their heads stepped on.  Hard to un-mush them.

With some padding and some tongue depressors (and some pain meds, and a couple of weeks), I think this kid will soon be getting underfoot again.  Maybe everyone will have learned the Puppy Shuffle by then.  Maybe Missy will learn to walk on her hind legs... and dodge.

Frankenbutt

I've previously offered my thoughts on pets being hit by cars.  "Oh, I can't stand to see them penned up."  Well, as Charlie Alnutt (Humphrey Bogart) says in "The African Queen",  "You pays your money and you takes your choice." [Our high school English and Drama teacher, Mr. Joe Newman was fond of that saying, too.]  By which I mean, yeah, you can give them the freedom to run loose, but you have to know that someday they are going to get hit, shot, chewed up in a fight, poisoned by someone's garbage, and so forth.   

That sure came home to roost for Buddy last night.  Look at the road-rash on that face.  He has little cuts and scrapes all over his body, and big bruises under them, too (though you couldn't see them yet, I'm sure he was/is feeling them).

Buddy wasn't critically injured, but he had some wounds that needed attention.  After some pain meds and sedation to examine him, we proceeded to start I.V. fluids and get him anesthetized and on some oxygen.  After cleaning up the wounds, we first sutured this gash on his right front leg.

You've heard of "ripping somebody a new a________", and this is what it looks like.  There were several new holes besides the one he started with.  I really can't picture exactly how this happened in the sequence of getting hit and rolled, but obviously it did.

Here's "Frankenbutt" after being re-assembled.  Still doesn't look great, but we're down to just the one hole that belongs there.  I don't think he's even going to be incontinent.  He'll be on stool softeners for a while, though.  Pain meds, too, natch.

Buddy made it.

Buddy went home under his own power today.  He's still got a headache, and a little congestion in his left lung, but it looks like he's going to be okay.

As often happens, when we make a mistake, we look for somebody else to blame. [I spilled my hot coffee, so I'll sue McDonald's.]  Buddy's mama was pretty upset by how fast the driver was going when Buddy ran in front of them.  While she was out of the room, her husband said, "If you were going to stick your head in front of a car, I wonder what speed you could stand?"  I hope his wife isn't reading this -- we might find out how much frying pan your head could stand.

It's natural to want somebody else to be at fault, but really: cars are big, dogs are small.  If the driver had been going ten miles an hour, Buddy's head would have still taken quite the whack.  Use a leash.