Head trauma is a blunt or penetrating injury occurring to the head. In dogs it may occur due to a variety of causes, the most common of which is a motor vehicle accident. Other causes include blunt trauma such as being hit by bats or swings or being stepped on, falls, gunshot wounds or animal fights.
Brain dysfunction may be the result of concussion, swelling, bruising, laceration, fractures, compression or bleeding.What to Watch For
If you suspect that your dog has suffered head trauma observe him for the following: Abnormal level of consciousness
Differences in pupil size
Unusual eye movement
Bleeding from the nostril
Bleeding from the ear canal
Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Diagnostic tests are needed to recognize head trauma and determine its severity. A complete medical history and physical examination are important parts of the initial diagnosis of head trauma. Tests and procedures that your veterinarian may wish to perform include:
Initial neurologic examination. Your veterinarian will need to rapidly assess your dog's status, which may include evaluation of brain function and determination of the site of the damage. During the initial evaluation, your dog's level of consciousness will be assessed. The size of the pupils and their response of light will also be tested to help determine the severity of the injury. A more complete neurologic examination may need to wait until your dog is alert; however, eventually it will be important to determine if there are other significant injuries, such as to the spinal cord.
Physical examination. Your veterinarian will perform a more complete physical examination as soon as your dog is stable. Other injuries, particularly those that are not life-threatening, may have been overlooked during the initial examination when your dog's condition was critical. Once your veterinarian has the opportunity to examine your pet thoroughly, trauma to the abdomen, chest or even fractures of the limbs may be noted.
Radiographs (X-rays) or CT Scan. If indicated, your veterinarian may recommend radiographs in order to look for skull or spinal fractures and CT scan to look for fractures as well as brain injury.
The treatment of head trauma will depend upon the cause and magnitude of the injury.
Repeat neurologic examinations. If your dog has evidence of head trauma, your veterinarian will perform repeat neurological examinations because the status of the injured brain can change quickly. Even if your dog initially seems normal, it is wise to have your veterinarian observe him for 24 hours to allow repeat neurologic examinations to be done. Abnormalities may become apparent as the brain swells or bleeding occurs into or around the tissues.
Supportive care. An intravenous catheter will be placed to allow fluids to be given to prevent dehydration. Your veterinarian may provide pain-killers as needed.
Control of seizures. Seizures may occur in animals that have suffered brain trauma. Diazepam (Valium®) or phenobarbitol may be given to control these seizures.
Treatment for brain swelling. Drugs may be administered to prevent or treat swelling of the brain tissue. Solutions that draw fluids from the tissues (hyperosmotic solutions) and/or decrease the production of spinal fluid, such as mannitol, may be given. Oxygen therapy may also be recommended. Care should be taken to avoid cough/sneeze reflexes as much as possible because these raise intracranial pressure, which is pressures within the skull or cranium. Any increase in brain swelling or intracranial pressure may contribute to neurologic deterioration such as dullness, stupor or coma.
Skull fractures. Conservative non-surgical treatment may be recommended for fractures that are not displaced, that is the bone is broken but the fragments have not shifted position. However, fractures that place pressure on the brain – that are displaced inwards – may need to be removed or repaired surgically.
Treatment of shock. If your dog has evidence of shock or other injuries associated with trauma, specific treatment should be provided for these conditions.
Home Care and Prevention
Head trauma is a life-threatening emergency. If you suspect that your dog has suffered head trauma, take him to your veterinarian for evaluation as soon as possible.
While you are waiting for your dog to be examined, keep him warm, hold his head elevated or level with the rest of the body and minimize pressure on his neck, head or back.
Be careful when handling your dog to avoid being bitten. Your dog may not be aware of what he is doing and could inadvertently injure you.
Keep your dog on a leash to avoid the potential for an accident that might result in head trauma. Take special care with frightened animals; they may run into the street or highway. Do not let dogs outside unleashed and unattended.
Puppies are particularly prone to injury by being stepped on, rolled on with a rocking chair or caught in a recliner. Do not allow young children to handle puppies unsupervised.