CANINE MEDICAL EMERGENCIES
AND
FIRST AID

ESTELLE C. L. WARD, DVM
SEPTEMBER 7,1995

I. Recognition and Initial Response to an Emergency Situation

Common situations requiring emergency veterinary attention:

1. trauma
2. suspected fracture
3. severe bleeding
4. eye injury
5. difficulty breathing
6. collapse/seizure
7. gastric dilatation/volvulus
8. unable to urinate
9. suspected toxin/poison ingestion
10. choking
11. whelping interval > 2 hours
12. heat prostration
13. vomiting/diarrhea for >24 hours
14. other non-specific signs:
     pale, bluish gums
     depression/fever
     trembling/shaking/obvious discomfort
     "distressed look"

Recognizing signs of shock

1. What is "shock" 

 There are several different types of shock, and each type may be associated with many different emergency situations. 

Examples:

1.  trauma/severe blood loss
2.  intestinal obstruction
3.  severe infection

2. Shock, generally defined as collapse of the cardiovascular system, is not a disease, but is a syndrome (i.e. a group of signs) secondary to some primary disease process

3. Characteristic signs:

1.  rapid heartbeat
2.  confusion/severe depression
3.  collapse
4.  shivering
5.  weak pulse
6.  pallor

4. Severe shock will usually lead to irreversible damage unless treated promptly!
Treatment consists of IV fluids, steroids, and warming the patient, as well as controlling the underlying primary problem.
There are many "emergency" situations which do not require immediate veterinary care, but do require veterinary consultation. If there is any doubt, CALL YOUR VETERINARIAN!
Initial response -- You should know how to: 

1. Weigh your dog (you should know your dogs normal weight for comparison.)
2. Take your dogs temperature
3. Measure pulse/heart rate
4. Measure respiratory rate/note character
5. Muzzle your dog
6. Check ocular response
7. Check mucous membranes and capillary refill time
8. Perform CPR if necessary (the "ABC's")
9. Transport a sick or injured animal

II. A Short List of Emergency Situations 
(Absolute Emergencies, and those requiring Veterinary Consultation)

Trauma/Wounds Falls; fractures; HBC; severe lacerations; gunshot wounds

1. Things to consider: (AFTER your dog is confined and under control -- that is, MUZZLED.)

1.  assess injury for joint/body cavity/deep tissue involvement
2.  assess condition of tissues (contamination, foreign bodies/debris, insect larvae -- old wound?)
3.  fracture assessment - open (compound) or closed, combination
4.  assess wound size, shape, orientation, and specific location on your dog's body (will greatly aid your veterinarian's assessment over the phone)

2. Bleeding 

1.  assess character (oozing vs. spurting) and amount
2.  direct pressure (NOT TOURNIQUETS) -- clean bandage/cloth preferable, but use anything available if bleeding is severe, even your fingers.
3.  know how to properly apply a good bandage, with moderate pressure, for transport.

3. Fractures/Dislocations

to splint or not to splint, that is the question

4. Care prior to transport (if time permits)

1.  rinse, rinse, rinse, rinse,....
2.  topical medications  
        should be non-irritating (e.g. Neosporin)
        avoid concentrated antiseptics (e.g. Betadine and Nolvasan) and all disinfectants

5. Never pull out a penetrating object! (Having the object in place will help your veterinarian determine where and how deep it has gone, and it may actually help control the bleeding.)

6. DO NOT give your dog anything for pain (e.g. aspirin, Banamine, Advil, etc.) 

These drugs can be dangerous, and should not be given for any condition without veterinary approval.

Bleeding (other than traumatic)/Pale gums

1. Nasal bleeding
2. Rectal bleeding
3. Blood in urine
4. Blood in vomitus
5. Blood in stool
6. Spontaneous bruising/hematomas

Save sample of any bloody fluids for your veterinarian.

Eye Injuries

Eye out of socket; corneal ulcer; severely red eye; foreign body; lacerations very close to eye (e.g. eyelid)

1. Eyes are very intolerant of trauma; need RAPID veterinary attention
2. Use only commercially available, sterile,0phthalmic saline solutions for cleaning (you should keep a bottle of the saline solution used by contact lens wearers on hand -- it is also excellent for cleaning lacerations and wounds)
3. DO NOT put ANY medication in your dogs eye without consulting your veterinarian!

Difficulty Breathing

Heart failure; pneumonia; foreign body in airway; fluid or air in the chest; tumors

1. Use great care in moving the dog -- avoid stress
2. Keep the dog as calm as possible - continuously reassure the dog and let them assume the most comfortable position for them.

Collapse/Seizures

Epilepsy; metabolic diseases (e.g. diabetes, Addison's disease); tumors; coonhound paralysis; toxin/poison exposure

1. May be intermittent or subtle; localized or generalized.
2. Provide adequate control/restraint/protection (for you and your dog) during transportation.
3. Prolonged seizures may result in critical elevations in body temperature, but most seizures are self-limiting.
4. Certain diseases leading to collapse -- such as diabetic ketoacidosis and Addison's disease -- are among the most critical of emergencies for your dog. RAPID veterinary attention (within legal limits) is required.

Gastric Dilatation and Volvulus (GDV)

1. Signs:

1.  belching
2.  non-productive vomiting
3.  abdominal distention
4.  hypersalivation
5.  increased pulse/heart rate
6.  restlessness

2. This is an ACUTE EMERGENCY!

Inability to Urinate

Bladder/urethral stones or other obstruction; trauma; spinal cord injury 

1. Leads to retention of metabolic wastes and electrolyte imbalances.
2. Painful and life-threatening

Poison Ingestion

Rodent/insect poisons; animal or human drugs; toxic plants; antifreeze; garbage

1. DO NOT do anything without consulting your veterinarian and a poison control center.
2. Try to identify the poison,. and bring a sample if possible (the container, with the list of active ingredients, is most helpful)
3. Hydrogen peroxide is as excellent emetic (contact your veterinarian first -- you do not want to induce vomiting in certain cases.)

Choking

1. Signs:

1.  excessive rubbing of the face
2.  hypersalivation
3.  retching/difficulty breathing

2. The Heimlich maneuver may be attempted if the airway is obstructed.
3. Prompt veterinary attention required
4. May be confused with acute pharyngitis

Pyometra

1. Shortly after a heat cycle
2. Vaginal discharge may or may not be observed
3. Signs:

1.  depression/decreased appetite
2.  increased thirst/urination
3.  fever
4.  ± vomiting/diarrhea

4. This is a very critical infection that requires prompt veterinary treatment. It can be avoided by spaying all non- breeding bitches (e.g. retired bitches).

Whelping Problems/Eclampsia

1. Contact veterinarian if > 2 hours pass after the onset of obvious parturition before the first puppy, or > 2 hours between puppies.

2. Eclampsia/hypocalcemia -- weakness, depression, lethargy, possible seizures -- usually occurs AFTER parturition.

Heat Prostration/Stroke

1. Usually due to a combination of high heat and humidity.

2. Contributing factors include lack of available water , confinement (in an enclosed space,0r exposed to full sunlight),0besity, inability to normally regulate body temperature (e.g. an upper airway problem preventing normal panting), and over-exertion.

3. Signs:

1.  confusion
2.  weakness/collapse
3.  "brick-red" gums
4.  extreme panting

4. Body temperatures > 105 F can cause severe problems if not addressed promptly.

Vomiting and/or Diarrhea > 24 hours duration

1. 95% of all cases are self-limiting; if > 24 hours, or accompanied by other signs (e.g. pain, abdominal distention , blood), a veterinarian should be contacted immediately.

2. Food should be withheld for 12-24 hours in all cases.

3. NEVER WITHHOLD WATER. If your dog drinks excessively and immediately vomits, offer small amounts frequently.

4. If no further signs in 12-24 hours, offer gradual oral alimentation using cooked rice or cottage cheese (low fat)

Non-Specific Signs Possibly Requiring Veterinary Attention

1. Fever

1.  Due to infection or inflammation
2.  Represents a normal physiologic response
3.  If severe, can rapidly lead to depression and dehydration

2. Trembling/Shaking/Pain

Disc rupture; metabolic disease; acute abdominal disease; fever

1.  Use care when moving the dog
2.  Time may be of the essence, especially with disc disease.
3.  Pain relief may be required, but not until a veterinarian has been consulted.

III. First Aid and Common Sense in Some Common Emergency Situations

HBC

1. Can the dog stand? Any apparent fractures?
2. Check color of gums. Any ongoing bleeding?
3. If dog is conscious, seriously consider muzzling.
4. Call veterinarian and transport ASAP.

Animal Bite Wounds

1. Rinse with copious amounts of water (faucet or hose).
2. The damage beneath the skin surface (what you can't see) is often the worst.
3. Can you identify the offending animal? Call veterinarian immediately.
4. Dog should receive rabies booster within 5 days, even if currently vaccinated.

Cut Foot Pads

1. Rinse, rinse, rinse,...
2. Neosporin/light bandage
3. Call veterinarian
4. Avoid irritating surfaces (e.g. gravel or hot pavement)

Seizures

1. How long was episode? How frequent? What did the dog do during the seizure? Past history? BE OBSERVANT!

2. Keep the dog on the ground/in a protected environment (hazard free, quiet, dim lights,etc.), and call your veterinarian.

3. Stay away from the dog's mouth.

4. Seizure terminology -- an understanding may help in working with your veterinarian:

1.  aura
2.  ictus
3.  post-ictal

Heat Stroke

(In the following order!)

1. If suspected, hose down immediately-- especially non- haired areas (ventral abdomen, perineum, feet)

2. Take temperature and look at color of gums; aim a fan at your hosed-down dog (if it is readily available - don't waste time looking for one).

3. Contact veterinarian (keep hosing until contacted), and transport.

Bee Stings/Insect Bites

1. Keep dog. calm. Severe problems are not common -- most occur with multiple stings,- or stings around the head/neck that cause swelling and affect breathing.

2. Try to remove stinger (careful not to squeeze the venom sac if still attached.)
3. Apply cold compress/cold water, and call veterinarian.
4. Reactions variable -- immediate (anaphylaxis) or delayed

IV. K9 Emergency First Aid Kit

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