Section: Veterinary Care In-depth
Veterinary care should include diagnostic tests and subsequent treatment recommendations.
Diagnosis
A complete medical history and physical examination will be performed to evaluate for broken bones and/or internal chest or abdominal injuries. Most traumatic injuries are self-evident; however, the diagnosis of trauma may be difficult if the owner does not witness the traumatic event and the dog does not have external injuries.
Your veterinarian will likely ask whether you witnessed the accident to determine where your dog was struck.
Tests other than the physical examination often are necessary to rule out the presence of internal injuries. These may include:
A complete blood count (CBC) is often performed to look for evidence of blood loss (anemia) and a low or high white blood cell count, which can indicate infection or inflammation. The white blood cell count is particularly important if the injury is suspected to be older than 24 hours or if the dog has a fever.
A serum chemistry profile allows evaluation of the internal organs such as the liver, pancreas and kidneys. The liver enzymes are usually elevated in a traumatized patient due to direct trauma. Increases in pancreatic enzymes could indicate a traumatic pancreatitis (inflammation of the pancreas). Elevations in kidney blood values could indicate direct injury to the kidneys, rupture of the ureters (ureters carry urine from the kidneys to the bladder), rupture of the bladder or rupture of the urethra (connection between the bladder and the outside). A disruption of the urinary tract is life threatening and requires surgical intervention.
Chest radiographs (X-rays) are essential in a traumatized animal regardless of the animal's appearance. Chest X-rays identify pulmonary contusions (bleeding into or bruising of the lungs), pneumothorax (air in the chest cavity) and diaphragmatic hernia (abdominal organs in the chest cavity). These conditions may be missed with auscultation (listening to the chest with a stethoscope).
Abdominal radiographs are indicated if the dog has abdominal pain, bruising or distension. Abdominal X-rays are used to identify fluid or gas in the abdomen, which could indicate the accumulation of blood or urine or a rupture in the intestinal tract. These X-rays are also used to identify whether the bladder is visible and intact.
An electrocardiogram (EKG) may be run to identify the presence of an abnormal heart rhythm.
Additional diagnostic tests may be required on an individual pet basis, including:
Plain X-rays of the abdomen are not always sufficient to identify a leak in the urinary tract. If your veterinarian suspects a rupture to the bladder or urethra that cannot be identified on plain X-rays, a contrast cysto-urethrogram may be recommended. A contrast cysto-urethrogram is an X-ray taken of the bladder and urethra after a dye has been injected into the bladder. The injected dye outlines the contour of the bladder and urethra and is used to identify urine leakage from the bladder or urethra due to a tear or rupture. This procedure requires general anesthesia.
An IVP (intravenous pyelogram) is a radiographic study to identify the kidneys and the ureters. This study is done when your veterinarian suspects the kidney or ureter has been damaged. This study requires general anesthesia.
Radiographs of the skull are necessary if your dog has suffered severe head or facial injuries. These x-rays help identify fractures that may require surgical repair.
Surgery is considered a diagnostic and therapeutic tool when a wound appears to penetrate the chest or abdominal cavity. These wounds must be explored and repaired to prevent an infection in either cavity.
Thoracocentesis (inserting a needle in the chest to withdraw fluid or air) may be performed to diagnose a pneumothorax or hemothorax if your animal is in respiratory distress.
Abdominocentesis (inserting a needle into the abdominal cavity to withdraw fluid) is often used to diagnose the presence of internal bleeding or urine in the abdomen.
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