╨╧рб▒с>■  +-■   *                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴ ┐?jbjbjкjк "╚╚?      ]ввввввв····· ·█ ъ........Ш Ъ Ъ Ъ Ъ Ъ Ъ ,┼ Ї╣ Р╞ в.....╞ жвв...жжж.rв.в.Ш ╢"╪"вввв.Ш жЄжШ ввШ " ~ц╢··аШ Group 11 Ц Facts Document Dog was hit by a car 3 days ago: Indicates cause of current presentation, consider common injuries seen with HBC, and gives time line for progression of injuries/healing of those injuries. 17 month old, intact male, black & tan Doberman Pinscher: Young animal important in terms of bone healing and physeal closure; intact status could have contributed to dog leaving home and being hit by car; large breed dog helps to clarify what parts of the dog would most likely have been hit by the car. In addition, this breed is predisposed to osteosarcoma at this age, but since this is primarily a forelimb neoplasia and we have history of trauma we can rule this out. Past history reveals healthy dog with no know problems: No other obvious historical problems to consider while looking at current case Inside/outside dog: Possible route of escape to be HBC. Consideration for management plan Ц dogТs activity will probably need to be restricted during recovery. Treated with 2 L LRS IV over 48 hrs: corrected probable hypovolemia caused by trauma and subsequent shock. 500 mg prednisolone-sodium succinate IV in two doses over 12 hrs: could have reduced swelling/inflammation. Consider possible immune suppression caused by steroid administration. Consider possible side effects. Duragesic 25 mg/hr for 1st 24 h after accident: could possibly mask pain, watch for side effects Butorphanol 5mg IM: could mask pain, watch for side effects Cefazolin 700mg SC BID on 1st day, then 1000 mg PO BID since: prevent bacterial infections particularly important with bony trauma, watch for side effects. Fed 4 cups Big Red dry dog food daily free choice: consider putting on higher quality diet during recovery Lives with 3 other dogs, 3 horses, 2 ferrets, & 4 rabbits: activity level during recover, need to isolate from other dogs to avoid playing Respiration = 18 breaths/min : Low Ц normal variation Ц could be affected by current medications. Rule out pneumothorax, hemothorax, or other thoracic injuries that would cause increased respiration rate Temperature = 99.3 : Low temperature, possibly caused by hypovolemia, consider other causes Pulse = 60 bpm : Low - normal pulse, could be slightly decreased due to medications BW = 67 lbs : check BCS Ц consider nutritional plane for recovery. Animal is probably not obese, which will make fracture recovery go more smoothly Non-wt bearing on hind legs: Consider all causes: trauma to bone, joints, soft tissues, neurologic, neoplasia. Superficial/deep pain sensation in both hind legs: Has functional sensory nerves to these areas, still potential for motor nerve dysfunction. Reflex responses in hind legs inconsistent and nonrepetitive: Consider neurological dysfunction, other causes for nonrepetitive responses? Motor function present in both hind legs & tail: motor function present, coordination of movements may not be intact. Dewormed 2 weeks ago with pet store dewormer: on parasite control program Distemper/Parvo booster due now: Probably not virus related Rabies due next month: current on rabies vac Upper L hind leg swollen: soft tissue injury, bone injury resulting in swelling, hematoma, neoplastic all possible causes. Bone continuity of L femur suspect/abnormal movement & crepidation: suspect fracture of femur, disruption of coxofemoral joint, or pelvic fracture near joint. L hind leg is swollen all the way to toes: Again, soft tissue injury, bone injuries, hematoma, suggests involvement of proximal and caudal limb, possible edema Diffuse subcutaneous fluid accumulation in L hind leg: same as previous Bone/joint of remainder of L leg seems to be normal: focus further exams on femur/os coxae area they are most likely involved primarily Source of abnormalities could not be precisely located to L femur, hip joint, or pelvis: could be any or combination of all, examine with further diagnostics Joints of R hind leg appear to be normal: This rule out joint deformities from trauma, look elsewhere Palpable instability of bone of R tibia: probable fracture Ц use advanced diagnostics to evaluate further R leg swollen distal to stifle: focus on area distal to stifle Ц see L leg for possible causes Superficial skin abrasions on lateral side of R hind leg: indicates how animal was hit Ц either hit by car on lateral side of R hind leg or this is subsequent road rash from being hit on left side. 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