Dog Bite Lacerations -Graphic Content
Updated: Mar 14, 2018
Before Reading this article please note: not all of Veterinary medicine is pretty. If you are easily disturbed over blood, wounds, or injured animals, please select a different blog post to read. Viewer discretion is advised.
Depending on where I am doing my ER shifts (I do ER all over CA and FL), I will see anywhere from three to six lacerations a night from dog attacks. In areas where people do not keep their animals on leashes or in yards, it is much worse. I also see cats with lacerations, but the wounds are usually from a dog. When cats have wounds from fighting with other cats, they usually present with an abscess, or a wound that is filled with purulent (pus) fluid. When there is an abscess, this is a bite wound or laceration that has gone on for awhile and become infected. I will discuss cat abscesses in a later blog.
I have included some pictures of bite wounds. The concerns with bite wounds and lacerations are multifold.
Active bleeding is a major concern. As an owner, you would want to place pressure on any active bleeding area and seek Veterinary care immediately. When you bring your dog or cat to a Veterinary hospital, this is part of our triage assessment. The Vet Techs and Vets will obtain vital signs including temperature, pulse quality and rate, respiratory rate, breathing effort, and quantify the level of pain your animal is in.
An IV catheter will be placed and staff will assess if there is any obvious blood loss or internal blood loss from damage to organs. A picture of a bite wound to the abdomen can be seen here.
In these types of cases, we are very concerned about penetration and damage to internal organs.
In this blog, we will discuss the steps taken if a patient is stable and does not appear to have active bleeding. We will place an IV catheter, start IV Fluids, and either induce deep sedation or general anesthesia. For patients that will require more extensive surgery, I opt for general anesthesia where the patient is intubated and receives gas anesthesia and oxygen with ventilation. If the patient has minor lacerations that are not that extensive, I will opt for deep sedation with local anesthesia (lidocaine/ numbing agent injected to help alleviate pain).
Any bite wound, we consider contaminated and refer to as “dirty surgery.” It is not literally dirty surgery as we clip and surgically prep the laceration area, but basically the wound is dirty because it is a bite wound. This is in comparison to what we refer to as “sterile surgery” where we do a surgery that has not been previously contaminated. A spay or neuter are examples of sterile surgery. With sterile surgery, we perform them in the Operating Room and wear cap, mask, and surgical gowns (see the attached picture). With dirty surgery, we perform this in the treatment area (outside the operating room) unless we feel the wounds have penetrated the chest or abdomen and we need to open a part of the body that should be sterile.
When I have lacerations such as the ones in these pictures, I open the wound up a bit to see how deep it is and do something called lavage. Lavage is flushing the contaminated wound with sterile water that has a small amount of antiseptic such as betadine or chlorhexidine. The key to preventing infection is to lavage, lavage, lavage and flush out the contaminants. Sometimes there is hair or dirt in the wound. Any tissue that does not look viable (alive) we will clip off. We call clipping dead tissue debriding. We will then suture the layers of tissue together.
Drains can be seen in these pictures of surgeries I have performed so that fluid comes out of the wound rather than building up and causing potential infection.
The drains are usually removed within a few days. The skin sutures are left in for 14 days. Antibiotics, anti-inflammatory medications, and pain medications are dispensed.
The number one thing to remember is to leave the Elizabethan Collar on at all times until your Veterinarian tells you otherwise.
I cannot tell you how many animals we see come back after surgery with their entire wound torn open because the E-Collar came off too early. Animals can be gross!