Plan of Action

Diagnostic tests will include radiographs, orthopedic exam with 
sedation, blood chemistry and CBC to assess health status (anemia, 
muscle damage).

Orthopedic Exam

This exam would be conducted under sedation.  Careful palpation 
would be conducted for abnormalities, pain, swelling, heat, 
crepitus, and additional malformations.  Palpate for range of motion 
and pain on flexion and extension.  Specific tests  - Cranial drawer 
test on both the left and the right stifle, and the Ortolani sign on 
the left hip should be assessed.  Neurologic exam should be 
conducted to evaluate the peripheral nerve function and the spinal 
cord.  Hopefully the abnormalities can be precisely located, and 
then we can proceed to radiographs.


Radiographs

Survey radiographs of the thorax and the abdomen should be taken to 
evaluate any trauma sustained to these areas.  This dog was hit by a 
car, and the possibility of damage to other organs is high. 
Radiographic evaluation of the hind limbs will include at least two 
radiographs of each affected area (proximal left femur and hip 
joint,  right tibia) at 90 degree angles to each 
other.   Joints above and below the suspected areas will be included 
to rule out possible luxations.  Radiographic signs of fracture will 
include disruption in bone continuity, one or more radiolucent 
fracture lines, possible sclerotic lines or zones due to overlapping 
of bone fragments, and alterations in bone size, shape, and 
position. The degree of soft tissue damage should also be assessed.   
Radiographic signs of abnormalities in muscle and soft tissue 
structures (joints, ligaments) might include increased radioopacity 
around the suspected area, indicative of swelling.  Neurologic 
abnormalities would not be evident Ð the lesions in this case are 
only 3 days old and not enough time to induce muscle atrophy.



CBC and Blood Chemistry
Specific concerns would include anemia, organ damage, and muscle 
degradation.  It is standard to perform blood tests on trauma cases.

Urinary function
Damage to the urinary system is common in hit by car situations.  
Assess urine output and perform a urinalysis by cystocentesis. If 
dog is not producing urine, cystography may be performed to check 
bladder, urinary system integrity.