Certain species of toads, namely the marine toad Bufo marinus and the Colorado River toad, Bufo alvarius, produce a strong toxin that can easily and quickly be absorbed if the dog comes in contact, often by mouthing, one of these creatures. Dogs will most commonly be affected during warm, humid summer nights when the toads are most active. Most dogs cannot resist using the toad as a play-toy when they catch the eye of the ever-curious canine.

Clinical signs will usually include heavy salivation and a very bright or dark redness to the lips and gums. The dog will be very excited and difficult to handle or restrain. Most dogs will have moderately elevated body temperatures, cry and paw at the mouth, stagger or have some difficulty walking, collapse, seizure, have difficulty breathing and death can occur. Diagnosis is based on either the history of toad exposure or by these clinical signs and a high degree of suspicion for the problem. Most tests are of no value although an EKG analysis can be very useful as the poison can affect the heart beat. 

Firstly, rinsing the mouth with large amounts of water to eliminate any remaining toxin is important. If the dog has a body temperature over about 105F, then cooling the patient in a cool water bath is also essential. IV fluids, strong sedatives, atropine to reduce salivary secretions and medications to control cardiac arrhythmias and seizures are all important. If treated properly, most dogs will recover in 24-36 hours.

Pit vipers include the snakes known as rattlesnakes, Crotalus spp., pigmy rattlesnakes and massassauga snakes, Sistrurus spp. and cottonmouth water moccasins and copperheads, Agkistrodon spp. All inject a potent hemotoxin that destroys blood cells and tissues, but a few species can also inject an even more deadly neurotoxin. In general, rattlesnakes are considered the most toxic of the group.

The damage caused by snakebites may not be evident for hours after the actual bite. If one sees his dog bitten or is even highly suspicious of a bite, treatment should be begun immediately. Clinical signs include puncture wounds with local swelling, heavy bruising of the area, pain, small hemorrhages on lips, gums and other skin areas, rapid heart rate, shock, salivation and destruction of tissues around the bite. Most dogs are bitten on the head, neck or front legs. ((Snake Bite))

Diagnosis is usually based on the history and clinical signs alone, but blood counts, serum chemistries, urinalysis and EKG testing may all help to confirm the diagnosis and the severity. Clotting tests are performed on some occasions to access the bleeding tendencies of the patient and the need for treatment thereof.

First aid should concentrate on getting the pet to a veterinary facility as soon as possible. IV fluids, antivenin given slowly in the IV, antihistamines, antibiotics and general supportive care should be given. Wounds should be well-cleaned and dead tissues removed. Most dogs will survive with prompt attention.

Coral snakes are most common from Texas through the Southeastern United States and must be distinguished from harmless kingsnakes. As a rule, poisonous coral snakes will have yellow and red bands that touch, while king snakes do not. Coral snakes belong to the Micrurus spp. and tend to be reclusive, only biting if confronted unexpectedly.

These snakes inject a strong neurotoxin that may not elicit symptoms until a day or more after the bite. Clinical signs include acute paralysis of all four legs, trouble swallowing, salivation, respiratory failure and death. Diagnosis is based on a history of a bite, clinical signs and blood counts. Other tests are usually of no value.

All dogs should be hospitalized for at least 2 days, given IV fluids, antivenin and antibiotic therapy. First aid should be avoided, as spread of the neurotoxin is a serious concern. Sometimes multiple doses of antivenin will be needed.

Not all insect bites are poisonous but some bites may produce serious reactions in some dogs. Bites of the Black Widow and Brown Recluse spiders are most toxic; bees, wasps and ants will tend to cause localized discomfort or hypersensitivity reactions.

Reactions to bites are usually acute, meaning they appear suddenly and without notice. Black Widow bites usually cause signs including muscle tremors, severe pain, restlessness, cramps, increased salivation, rapid heart rate and breathing, local swelling and pain near the site of the bite. The face may swell and lymph nodes in the area can become swollen and tender. Diagnosis is usually based on these clinical signs.

Brown Recluse bites usually produce signs of pain and soreness in the area of the bite, which may last for several hours, itching and soreness of the skin, a round "target" lesion that looks like a bulls-eye where the bite occurred and later ulcerating with the skin being lost in the area. Rarely a hemolytic anemia can develop, or there may be signs of a fever, rash, chills and weakness. Diagnosis is based on these clinical signs, a history of a bite and blood counts.

Scorpion stings can vary from causing only mild, local swelling, to causing a life-threatening bite reaction. Clinical signs can include local pain and swelling, nervousness, trouble swallowing, trouble breathing, muscle spasms, increased salivation, visual deficits, uncontrollable urination and defecation, respiratory and cardiac failure and death. 

These and other bites can all produce local swelling, redness, pain, general muscle pain, salivation, vomiting, diarrhea, fever and swelling of the face. Most times, these reactions are allergic in nature and not life threatening if treated promptly. ((Insect Bite))

Most bites causing allergic or local reactions can be treated with cortisone drugs orally, topically or by injection. Anti-vomiting medications are sometimes needed. Swollen or painful areas can be soothed with ice packs applied for 5-10 minutes as first aid. More serious reactions are treated with IV fluids, IV cortisone and antihistamines, antibiotics in some cases and if needed, antivenin. Epinephrine and IV calcium has also been used for acute, life-threatening reactions. Almost all dogs treated promptly will survive.

LIZARD TOXICOSIS

...see TOAD POISONING

Clinical signs of a burn will wary with the type and severity of the burn. There are three basic causes of burns: heat or flame, electricity and chemicals. No matter the cause, all types of burns are classified according to their severity. Superficial burns affect only the very surface of the skin causing redness and slight pain. Partial thickness burns extend through the surface of the skin to the dermis and will be moderately painful. Full thickness burns, formerly known as third degree burns, are the most severe, with loss of skin through to underlying fat or muscle layers. Severe swelling and secondary infection often develops and the skin will turn black and fall off. These burns will generally not be painful, as nerves will have been destroyed. ((Thermal Burn))

As the skin is truly a protective barrier for the body, the loss of skin integrity can lead to severe infections, loss of fluid and electrolytes, even to the extent of causing shock and secondary damage to lungs, liver, heart and kidneys can all occur. Diagnosis is based on history and clinical signs, although blood counts, serum chemistry and urinalysis all may be needed to access secondary problems; cultures may be needed to treat skin infections.

First aid should be administered as quickly as possible and the dog should be transported to the nearest veterinary facility. Minor burns are treated by cleansing the skin and dressing the wound with aloe vera, silver sulfadine cream, furazone or some other antibiotic ointment. Regular changes of the dressing and oral antibiotics should be sufficient to heal the injury.

Full thickness wounds are much more serious. Most dogs will need to be hospitalized, put on IV fluids and large doses of antibiotics, electrolytes, oxygen and external treatment for the areas burned will all be necessary. For extensive burns, skin grafting and other restorative treatment may be needed. Daily bandaging and topical medications will be needed for up to a month or more after the initial burn. Excellent nutritional support will also be required for these patients.

Quickly washing or otherwise cleaning the chemicals from the skin should treat chemical burns. Clipping hair may be needed if tar or other thick chemicals are present. Consult the poison cross reference to find the treatment needed for specific chemicals and be careful to help the dog to otherwise avoid more serious internal exposure to the chemical(s) present. Otherwise, treat the burn itself as noted above.

Inhalation of smoke, most commonly associated with house fires, leads to thermal damage of the lungs, inhalation of toxic chemicals and carbon monoxide poisoning. Sometimes, the full extent of the damage from smoke inhalation will not manifest until days after the insult when the damaged lungs try to heal and/or fill with fluid (pulmonary edema). Clinical signs include coughing, red, bright gums and lips, rapid breathing and difficulty breathing, blue gums and lips, weakness, shock and death. Burns may also be present and the smell of smoke on/from the animal should be obvious. Diagnosis is based on the history and clinical signs. X-rays are needed to access lung damage and fluid accumulation.

Although it would seem common sense, dogs should be escorted to fresh air as quickly as possible. Oxygen therapy, treatment for carbon monoxide poisoning, respiratory support, IV fluids, electrolytes and bicarbonate, furosemide to clear fluids from the lungs, cortisone, bronchodilators, pain relievers and daily nebulization therapy are all recommended. Some dogs with burns of the lungs may develop chronic bronchitis or other respiratory ailments. Careful monitoring and attentive care, however, will save most dogs.

Heat stroke, by definition, occurs when the dog's body temperature increases above 106F and the capacity of the dog to cool itself is exceeded. While most people probably equate this to happening only to dogs left in the sun on a very hot day, dogs can easily stroke by simply becoming too excited on a warm humid day or being left for a few minutes in a closed car. Overall, the chances for a dog suffering heat stroke vary with the breed of dog, the temperature, humidity, air circulation, length of exposure, availability of cool water, existing diseases and the level of stress or anxiety of the dog.

As the dog becomes overheated and more unable to cool itself, a chain reaction occurs leading to heart damage, electrolyte alterations, muscle damage, kidney damage, brain damage and death. Clinical symptoms include heavy panting, bright red gums and lips, rapid heart rate, high body temperature, respiratory distress, altered consciousness, small hemorrhages on the gums and skin, coma and death. Diagnosis is based on these symptoms. ((Petichia))

First aid should always be administered including cooling the dog with cool or even iced water. Rapid transport to a veterinary facility is essential. Oxygen, artificial respiration, cooling the patient further, IV fluids, electrolytes, cortisone, bicarbonate and general supportive care are all essential. Many patients survive but suffer such severe brain damage as to never be normal again. This is a true and urgent emergency.

Hypothermia is a dangerous decrease in body temperature. Frostbite occurs when body tissues become frozen. While most dogs can withstand some degree of cold, without protection from the elements even arctic breeds can suffer this type of injury. As body temperature falls, metabolism, cardiac output and local circulation falls, neurologic function diminishes and ultimately death can occur. When localized frostbite occurs, frozen tissues die and begin to decay.

Clinical signs include cold extremities, low body temperature, slow heart rate, weak respiration, shivering, lack of sensation to frozen areas and altered conciseness. Diagnosis is based on the history of exposure, clinical signs and notation of a body temperature under 95F. Toes, tails and ear tips are most susceptible to frostbite.

After initial first aid, dogs should be warmed to normal temperature in a slow and methodical fashion. Too rapid an increase will often cause shock. IV fluids, oxygen therapy, massage and manipulation of cold areas and other supportive treatments are necessary. For frostbite, protection of damaged areas with wraps and bandages, keeping the dog from biting the area and the use of antibiotics and even surgery to repair damaged skin may be required.

While dogs can be electrocuted in many fashions, most commonly young puppies are injured chewing on electrical cords. Electric current causes two types of injury: local tissue burn and fluid accumulation in the lungs. Clinical signs include burns often on the mouth or lips which many times will not bleed nor be very painful, troubled breathing even to the extent of severe distress, blue gums, muscle stiffness or tremors, vomiting, diarrhea, weakness, shock and death. Diagnosis is based on history of the electrocution, physical examination, clinical signs and X-rays.

Before handling any animal that has been shocked, make sure it is away from the electric line, or unplug the cord, or turn off the breaker. Administer CPR if the animal has stopped breathing and general first aid otherwise. Most patients need oxygen; IV fluids, furosemide to help remove fluids from the lungs, medications to dilate the air passages (bronchodilators), nebulization therapy and cortisone are all used. Treatment may be needed for up to 5 days if fluid has built-up in the lungs.

Trauma defines most any type of external insult upon the body. This would include all types of wounds, blunt injury, physical assaults, being struck by a vehicle, falls, collisions, dog fights, bites and so forth. What is difficult is that to generalize the symptoms and treatments of trauma in specific terms requires exacting knowledge of how the damage occurred, what has been damaged, how severe or extensive is the damage and how the dog in general is being affected.

Clinical signs of trauma can vary so greatly as to avoid definition. Trauma can cause cuts, abrasions or bruising to the skin and underlying tissues. Various fractures, subluxations or luxations can occur. Bleeding which leads to shock may be present. Lungs may collapse or fluid can collect in the lungs and inhibit respiration. Internal organs may be damaged. There simply is not one easy definition for traumatic injuries which creates a problems for most veterinarians; what needs to be done and what might be discovered later that hasn't been discovered yet.  

TREATMENT OF TRAUMA

The general principals of treatment for an injured dog can best be understood in step-by-step or outline form as given below:

1. Is the dog's heart beating and is it breathing? If not, administer CPR.
2. Has respiration been compromised? If it has, assist respiration and give oxygen.
3. Is there bleeding? Is it internal, external or both? If so, control bleeding.
4. How good is the dog's circulation? Give fluids and electrolytes to support circulation.
5. Is there neurological impairment? If so stabilize head and spine and treat accordingly. Control pain if warranted or give sedation to calm the dog.
6. Take X-rays if needed to access fractures, internal injury and status of the chest cavity.
7. Continue stabilization, continue to access the degree of internal damage; treat life-threatening problems.
8. Treat wounds or superficial injuries as warranted.
9. Treat fractures and other non-critical problems.

These basic steps are employed by most veterinarians but are, of course, altered or modified to meet the specific needs of an individual patient.

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©2007 James W. Day D.V.M., P.C.