Friday is always busy, especially in the afternoon, what with the mad rush of OMG-I-just-noticed-Fluffy`s-been-vomiting-all-week-and-I-don`t-want-

to-end-up-at-the-emergency-clinic-over-the-weekend emergencies.

Yesterday was no different. We had two critical cases come in simultaneously (different clients): one geriatric cat and one small dog. Both had been attacked by dogs—two days before.

The cat, Muffy, had been set upon by a German Shepherd on Wednesday. The dog, Ruffles, by a dog of indeterminate breed—on Thursday morning. Both were suffering from their wounds—yet, seeing no obvious wounds, their owners had not felt it necessary to bring them in immediately.

The kitty was my responsibility, the small dog my colleagues,` so I’ll restrict my comments to Muffy and her injuries.

Muffy had, indeed, been bleeding, contrary to her owners` discerning observations. Her coat was matted with saliva, dirt and dried blood. She was untouchably painful. I had to administer a whopping dose of an opiate drug before I could assess the damage.

X-rays revealed surprisingly little damage—just a lot of soft tissue swelling consistent with a muscle-crushing injury. Shaving her entire hind end revealed two huge punctures on either side of her lower back. Thankfully, they appeared not to penetrate into her abdomen.

Her tail sported multiple small gashes and she could barely rise to walk (before the opiates). After the opiates she could walk but dragged the right hind limb—damage to the nearby spinal cord or excruciating pain—or both? I couldn’t tell which. Her reflexes seemed depressed but it was hard to tell.

Whenever I have cases like Muffy`s I have a difficult time differentiating real nerve damage from the heightened sensitivity to pain. I’m always worried I’ll inflict more pain than necessary to get the answers I need. So I always err on the side of caution.

In this case I determined that it was not essential to assess her neurological status exhaustively, as I wasn’t going to be able to do anything about it right now, anyway. Best to treat the pain and deep tissue damage—everything else would be dealt with later.

Dog jaws are extremely powerful, as some of you might know firsthand. When in predatory mode, dogs exert maximum, super-canid force in dispatching their prey. The key is to grab (with the sharp, canine teeth) and then shake the prey to enhance their crushing ability through the momentum of a brisk snap of the neck and shoulder muscles. The result is a devastating amount of tissue injury due to compression distributed over a wide area of tissue. If the prey is not killed outright, it will likely be immobilized by the tissue damage or overwhelming stress of the encounter.

Some animal behaviorists feel that a so-called prey response is common to small mammals and relevant to how we treat them. In this theory, prey will often respond to an overwhelming attack with a stress hormone-mediated, quick-death mechanism intended to limit the time of suffering. Complete circulatory shutdown (circulatory shock) often rapidly ensues. If presented for medical treatment rapidly, medically inducing a state of reduced consciousness is therefore helpful—in spite of its potential side effects. The release of an animal’s death-hastening, biological molecules might then be limited by its diminished realization of the severity of its injuries.

Muffy had no such luck. Her family thought she was going to be OK. Just a little shake (from her owners` POV) and she was running off to the safety of her screened-in enclosure.  If she can run, they reasoned, she must be fine. They brought her in two days later only because she could no longer walk.

This brings up the next issue (no, not Muffy`s owners` ignorance—that’s too obvious to discuss). Crushing injuries, if they do not lead immediately to prey-response death or involve key structures like vessels or the spine, are slow to reveal themselves.

It takes a bit of time for the bacteria from the predator’s teeth and saliva to proliferate in the crushed tissues—usually two to three days. At this point infection begins to take hold, festering, and eventually leading to sepsis (a whole-body infection) and septic shock (a condition whereby the body shuts down in response to an overwhelming attack by bacterial invaders).

With Muffy, this is what I have to work hard to prevent. Pain relievers, fluids, blood components (like plasma—the clear, liquidy part of blood), antibiotics, and basic wound care are my only tools. Careful, gentle nursing care is the mainstay of treatment.

Muffy is receiving fluids, antibiotics, and pain relievers (including a pain-relieving opiate patch, non-steroidal anti-inflammatory drugs, and additional opiates, as needed before wound treatments). At this point we are also cleaning her wounds with hot packs of saline solution to reduce inflammation and limit additional superficial bacteria. She seems to like this if she has enough pain control before the treatments. We are careful to force-feed her so she receives nutrition along with some sugar in her fluids to keep her body going as strong as possible.

Our efforts constitute serious intensive care, best handled by a specialty hospital. But Muffy`s owners are not exactly eager to spend the cash necessary for intensive care at a specialty facility. They will, however, receive a sizable bill from me—no doubt about it. The care is constant and requires expensive drugs.

Based on how Muffy looks today, I think I can fix her. Hopefully she won’t need surgery and her hind limb function will recover well enough. Ruffle’s injuries are deeper. It looks bad. But who knows? A small mammal’s body is as tricky a piece of work as a dog’s killing ability is effective. I’ll have to keep you posted.