Management Plan:
Although previous medications proved ineffective, due to the severity of the injury more 
potent analgesics are indicated for palliation.  Intensive and expensive internal fixation of 
the femur and tibial fractures could be attempted via pins, rods, and wire.  However, our 
clientele is in the lowest income bracket, so realistically surgery probably wonÕt be 
considered.  Therefore, euthanasia would probably be the final decision.   External 
fixation would not be sufficient due to the severity of this injury.  If surgery was chosen 
fluids and a transfusion of whole blood or packed red blood cells would be necessary due 
to the anemia detected in the clin path results.