Treating Head Injuries in Dogs
Treating shock takes precedence over managing the head injury. If the dog is
unconscious, establish an open airway by extending the head and pulling the
tongue forward as far as you can beyond the level of the canine teeth.
Signs of death are no pulse, no effort to breathe, dilated pupils, and soft
eyes. Usually it is impossible to tell at the time of an accident whether such
signs are reversible. Accordingly, begin administering CPR immediately if you
suspect the dog is dead.
At the scene of the head injury, before transporting the dog to the nearest
veterinary hospital, be sure to:
• Handle the dog with extreme care and gentleness. Pain and fright deepen
the level of shock. Cover the dog with a warm blanket.
• Control bleeding.
• Place the dog on a flat stretcher.
• Stabilize all fractures, if possible.
• Record a baseline neurological exam (level of consciousness, limb
movements, pupil size).
• Transport the dog with her head higher than her hindquarters; this helps
lower intracranial pressure.
Signs of cerebral edema can appear at any time during the first 24 hours
after a blow to the head. The most important thing to observe is the dog’s
level of consciousness. An alert dog is easily aroused (no apparent brain
swelling). A semi-comatose dog is sleepy but arousable (mild to moderate brain
swelling). A comatose dog cannot be aroused (severe brain swelling).
Cerebral edema is treated with intravenous corticosteroids, oxygen, and
diuretics such as mannitol or furosemide. Seizures are controlled with an intravenous or oral
anticonvulsant such as diazepam (Valium).
Open skull fractures require surgical cleansing and removal of devitalized
bone. Depressed bone fragments may need to be elevated to
relieve pressure on the brain. Antibiotics are often necessary with open fractures to
Only dogs who are fully alert, are not having seizures, and exhibit no
neurological signs should be permitted to return home. Awaken the dog every two
hours for the first 24 hours at home to check her level of responsiveness. Any
change from an alert status is an indication to return at once for veterinary
evaluation. In addition, be sure to check the dog’s pupils. They should be of
equal size. An enlarged pupil that does not constrict when light is shined in
the eyes indicates pressure on the brain. Also notify your veterinarian if the
dog’s breathing becomes rapid or irregular, if she exhibits any form of muscle
weakness, or if she has a seizure.
The prognosis for recovery depends upon the severity of the brain injury.
When the dog remains in a coma for more than 48 hours, the outlook is poor.
However, if the dog steadily improves throughout the first week, the outlook is
Dogs who recover may exhibit a posttraumatic syndrome that can include
seizures, behavior changes, head tilt, and blindness.