Sometimes, there's nothing I can do...

A couple of weekends ago, our front door burst open, and a young girl came barreling through, sobbing hysterically. She was clutching a small breed dog in her arms. Blood oozed from the obvious wounds, and the dog struggled to breathe.

My technician took the dog and brought her straight to the back while the receptionist received approval for Class I triage.

The patient was obviously in shock. She was on her side, unable to stand. Her front limbs were rigidly extended, while her back legs were flaccid. This position is called Schiff-Sherrington posture. When you see this position in an animal, it means that severe trauma has occurred to the thoracolumbar ("middle") of the spinal column. It often means the back is broken, although I have seen cases where the spine was intact but the spinal cord suffered a great shock (hit-by-car cases, etc).

As we placed face mask oxygen, placed an IV catheter, obtained vitals, and started fluids, I examined my patient carefully. She had a huge wound on one side of her chest wall. Out of the hole was hanging fatty tissue but no lung, thankfully. On the other side, she had penetrating wounds into her abdomen. We quickly shaved the wounds and wrapped her chest and abdomen in bandages, then tapped her chest to remove any free air.

Her back legs had no sensation, her tail was flaccid, and she had no anal tone. She seemed to feel nothing from about mid-abdomen down. I knew it was bad, but I couldn't risk moving my patient to xray yet to confirm what I suspected - not until she was more stable.

After 45 minutes of aggressive fluids, pain medications, and oxygen, her blood pressure was stable, her gum color had improved, and she was more alert. Carefully, we moved her to xray. Unfortunately, my suspicion proved correct. Her spine was broken in half. The cranial portion was overriding the caudal portion. It was a severe spinal fracture, likely representing spinal cord transection. The prognosis is unbelievably grim for that type of injury.

Add to that - thoracic trauma and abdominal trauma - one and/or both requiring exploratory surgery.

The owners were dumbfounded. They had adopted a large breed dog a mere 1 day before, doing a good deed for a dog that needed a home. Unfortunately, the dog proved aggressive, bit their small terrier across the back (the dog only weighed 12 pounds), and shook it.

The damage was too grave, and I was left to do nothing but deliver the sad news. The hardest part was the 15 year old girl. She had owned the little terrier for 11 years, since she was 4 years old. Sobbing, she held the little dog and begged me to do something. I gently explained that there was nothing I could do for her companion, that she had suffered too much trauma. Her mother struggled to make a decision, asking over and over, "isn't there something you can do?" I said that we could stabilize the dog and refer it to the university for neurology consultation, but I explained that her chances for survival, at 12 years old, and quality of life, were very slim.

In the end, the owners made the decision to let her go. My heart went out to that little 15 year old girl, losing her lifelong companion. It was likely her first experience with death, and it made me very sad. Trying to do a good deed, her parents had invited into their home a dog who took away her companion. I can only hope that - for the big dog's sake - they didn't go home and shoot it, as they said they would.

My technician rescues that particular breed of dog, and she offered to help them place it safely...but they were very angry. I shudder to think of what might have happened when they got home.

It's an important reminder to think very carefully before introducing new, unknown pets into the household, especially when they are significantly larger or smaller than your other pets.