Shock is lack of adequate blood flow to meet the body’s needs. Adequate blood flow requires effective heart pumping, open intact vessels and sufficient blood volume to maintain flow and pressure. Any condition adversely affecting the heart, vessels or blood volume can induce shock.
At first the body attempts to compensate for the inadequate circulation by speeding up the heart, constricting the skin vessels and maintaining fluid in the circulation by reducing output of urine. This becomes increasingly difficult to do when the vital organs aren’t getting enough oxygen to carry on these activities. After a time, shock becomes self-perpetuating. Prolonged shock causes death.
Common causes of shock are dehydration (prolonged vomiting and diarrhea), heat stroke, severe infections, poisoning and hemorrhage. Being hit by a car is the most common cause of traumatic shock in the dog.
Transporting a dog in shock. Muzzle only when absolutely necessary. (J. Clawson)
The signs of shock, which are caused by the effects of poor circulation and the adjustments made to compensate for this, are a drop in body temperature; shivering; listlessness and mental depression; weakness; cold feet and legs; pale skin and mucus membranes; a weak faint pulse.
Treatment: First evaluate the signs present. Is the dog breathing? Is there a heartbeat? What are the extent of the injuries? Is the dog in shock? If so, proceed as follows:
1. If not breathing, proceed with artificial respiration.
2. If no heartbeat or pulse, administer heart massage.
3. If unconscious, check to be sure the airway is open; clear secretions from the mouth with your fingers; pull out the tongue to keep the airway clear of secretions. Keep the dog’s head lower than the body.
4. Control bleeding (as described under Wounds section that follows).
5. To prevent further aggravation of shock:
a. Calm your dog and speak soothingly.
b. Let the dog assume the most comfortable position, and adopt the one with the least pain. Don’t force your dog to lie down-it may make breathing more difficult.
c. When possible, splint or support broken bones before moving the dog (see MUSCULOSKELETAL SYSTEM).
d. Cover your dog with a coat or blanket. Do not wrap tightly.
e. Transport large dogs on a flat surface or in a hammock stretcher. Carry small dogs with injured parts protected.
f. Muzzle only when absolutely necessary. It may impair breathing.
In the care of wounds, the two most important objectives are first to stop the bleeding, and then to prevent infection. Since wounds are painful to the dog, be prepared to restrain or muzzle before you treat the wound.
Control of Bleeding
Bleeding may he arterial (the spurting of bright red blood), or venous (oozing of dark red blood), or sometimes both. Do not wipe a wound that has stopped bleeding. This will dislodge the clot. Don’t pour hydrogen peroxide on a fresh wound. Bleeding then will he difficult to control.
The two methods used to control bleeding are the pressure dressing and the tourniquet:
The Pressure Dressing: Take several pieces of clean or sterile gauze, place them over the wound and bandage snugly. Watch for swelling of the limb below the pressure pack. This indicates impaired circulation. The bandage must be loosened or removed.
Apply pressure over the artery in the groin to control arterial bleeding in the leg. (J. Clawson)
An alternate method to control bleeding is to apply pressure over the artery in the groin or axilla. (See CIRCULATORY SYSTEM: Pulse). Often this will control bleeding long enough to permit an assistant to apply a pressure dressing.
If material is not available for bandaging, place a pad on the wound and press it firmly. Hold in place until help arrives.
The Tourniquet: A tourniquet may be needed to control a spurting artery. It can be applied to the tail or leg above the wound (between the wound and the heart). Take a piece of cloth or gauze roll and loop it around the limb. Then tighten it by hand, or with a stick inserted beneath the loop and twisted around until bleeding is controlled. If you see the end of the artery, you might attempt to pick it up with tweezers and tie it off with a piece of cotton thread. When possible, this should be left to a trained practitioner.
A tourniquet should be loosened every thirty minutes for two to three minutes to let blood flow into the limb.
Treating the Wound
All wounds are contaminated with dirt and bacteria. Proper care and handling will prevent some infections. Before handling a wound, make sure your hands and instruments are clean. Starting at the edges of a fresh wound, clip the hair back to enlarge the area. Cleanse the edges of the wound with a damp gauze or pad. Irrigate the wound with clean tap water. Apply antibiotic ointment. Bandage as described below.
Older wounds with a covering of pus and scab are cleansed with 3% hydrogen peroxide solution or a surgical soap. Blot dry. Apply antibiotic ointment and bandage as described below.
Dressings over infected wounds should be changed frequently to aid in the drainage of pus, and to allow you to apply fresh ointment.
Fresh lacerations over one-half inch long should be sutured to prevent infection, minimize scarring and speed healing. Wounds over twelve hours old are quite likely to be infected. Suturing is questionable.
Bites are heavily contaminated wounds. Often they are puncture wounds. They are quite likely to get infected. They should not be sutured. Antibiotics are indicated.
With all animal bites, the possibility of rabies should be kept in mind (see Infectious Diseases: Rabies).
The equipment you will need is listed in the Home Emergency and Medical Kit, in the photo at the beginning of this chapter.
Foot and Leg Bandages. To bandage the foot, place several sterile gauze pads over the wound. Insert cotton balls between the toes and hold in place with adhesive tape looped around the bottom of the foot and back across the top until the foot is snugly wrapped.
A method of applying a foot bandage for a lacerated pad. Tape loosely to allow good circulation. (J. Clawson)
A sock slipped over a gauze square is a good bandage for ease of dressing change.
For leg wounds, begin by wrapping the foot as described. Then cover the wound with several sterile gauze pads and hold in place with strips of adhesive tape. Wrap the tape around the leg but don’t overlap it so that the tape sticks to the hair. This keeps the dressing from sliding up and down, as often happens when a roll gauze bandage is used. Flex the knee and foot several times to be sure the bandage is not too tight and there is good circulation and movement at the joints.
When a dressing is to be left in place for some time, cheek on it every few hours to be sure the foot is not swelling. If there is any question about the sensation or circulation to the foot, loosen the dressing.
Many-Tailed Bandage. This bandage is used to protect the skin of the neck or abdomen from scratching and biting and to hold dressings in place. It is made by taking a rectangular piece of linen and cutting the sides to make tails. Tie the tails together over the back to hold it in place.
A many-tailed bandage may be used to keep puppies from nursing
Eye Bandage. At times your veterinarian may prescribe an eye bandage in the treatment of an eye ailment. Place a sterile gauze square over the affected eye and hold it in place by taping around the head with one inch adhesive. Be careful not to get the tape too tight. Apply the dressing so that the ears are free.
You may be required to change the dressing from time to time to apply medication to the eye.
The ear bandage is discussed in the chapter EARS.
Elizabethan Collar – An Elizabethan Collar, named for the high neck ruff popular in the reign of Queen Elizabeth. It is a useful device to keep a dog from scratching at the ears and biting at a wound or skin problem. They are recommended for certain disorders discussed in the SKIN chapter. They can be purchased from some veterinarians or pet stores, or can be made from plastic and cardboard. Plastic Flowerpots, wastebaskets and buckets work well.
Elizabethan Collar. (J. Clawson)
The size of the collar if tailored to the dog Cut just enough out of the bottom to let the dog’s head slip through, then fasten the device to a leather collar by strings passed through holes punched in the sides of the plastic. The neck of the collar should be short enough to let the dog eat and drink. Most dogs adjust to them quite well after a few minutes. Others won’t eat or drink with the collar in place. In that case, temporarily remove the collar.