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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 prevent infection.

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 good.

Dogs who recover may exhibit a posttraumatic syndrome that can include seizures, behavior changes, head tilt, and blindness.

WebMD Veterinary Reference from "Dog Owner's Home Veterinary Handbook"

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