Being hit by a car, running and jumping and coming up lame, accidentally being banged by a door — all of these are examples of trauma that may afflict your dog. Trauma may lead to obvious wounds or injuries such as a broken leg or deep cut, but it can also cause internal damage that is harder to see. If you know your dog's normal state, you will be better at picking up any changes.
Fractures are broken bones — in dogs, this most often means a leg. Fractures are usually associated with being hit by a car. A leg that dangles, that your dog will not put any weight on, that is obviously wounded, or where the bone is showing are all examples of broken bones. If your dog has been hit by a car, you must take her to a veterinarian even if no bones appear to be broken. Along with obvious leg fractures, she could have broken ribs. The chances of having internal damage are high — most dogs can't tangle with a motor vehicle and win. You need to stabilize the fracture if possible. If your dog will lie down, gently put a paper towel tube next to the leg. Use masking tape to hold it by the leg, and then tape a towel over the whole thing. Another option is gently sliding your dog onto a board or blanket and having two people pick it up. A small dog may be carefully scooped up into a blanket or large towel. Remember your first aid basics (described in Chapter 16), and be sure you don't get bitten! A broken leg will require a splint, cast, or surgery, using metal pins and plates to repair the damage. Do not allow a broken bone to dangle as this will cause more tissue damage.
While broken bones are dramatic and catch our attention right away, internal damage may be more life-threatening to your dog. If she is having trouble breathing, is breathing very shallowly, or is coughing up blood, you know there is damage to the lungs and the chest. Open wounds directly into the chest are very serious. Again, these are emergencies, and you must take her directly to your veterinarian. Try to keep airways clear — wipe off the nose, clean anything in the mouth if you safely can. If the chest is flailing (ribs moving strangely in and out), put a wrap around the chest. Pneumothorax, the entrance of free air into the chest, can be deadly.
While broken bones and damage to the chest and lungs are usually apparent right away, trauma injuries to the abdomen may be subtler in appearance. If your dog is bleeding internally, she may look fine at first glance. A check of her gums or feeling her pulse may indicate otherwise.
To check for internal bleeding, first look at your dog's gums. If she has pink areas, touch them. The color should go away, then quickly come back. If the pink areas are already whitish or the color only returns slowly, she has problems. You can feel for a pulse in the groin area on the inside of a hind leg. Use your fingers (not your thumb) and you should feel a strong, steady beat.
Any distension, or expansion, of the abdomen could indicate free blood or urine pooling in the tissues. This is cause for alarm, as is blood in the urine or stool. If your dog is suddenly very touchy about having her abdomen touched or “splints” her abdomen (holding it very taut) you know she has pain there.
When a dog with obvious trauma arrives at the veterinary hospital or emergency clinic, the first actions are to guard against shock. Your dog's breathing, heart rate, and temperature will quickly be checked. Direct pressure is put on any bleeding areas. An intravenous line will be placed so that fluids can be quickly injected into her system to combat shock, along with any necessary medications. Many of these tasks are performed by skilled veterinary technicians. In the meantime, your veterinarian will do an overall evaluation of your dog. Most trauma cases will require a chest X ray. Even a small air leak can build up over time and cause death. If there is free air in your dog's chest, a special tube will be placed that allows air to escape but no air to go in. The chest itself may be wrapped.
If the heart and lungs are okay the next step is checking the abdomen. Your veterinarian may take X rays of the abdomen as well as palpate (feel) it gently for any abnormalities. Sometimes a needle will be put into the abdomen to see if there is free fluid (urine, blood, or gastrointestinal leakage) present. If there is evidence of major problems in the abdomen, your dog will be stabilized and then go to surgery for repairs. If no major damage shows up, your dog will still probably at least stay overnight for careful observation.