Your dog has completely fractured both it left femur and right tibia and fibula.  These 
bones are broken in multiple places and there are bone fragments that are going to 
complicate the healing process.  Your dog is dehydrated due to the fact that it lost some 
blood from the trauma but we are going to correct that by giving it some fluids. We are 
going to keep an eye on your dog's liver enzymes while it is in the hospital because its 
liver enzyme levels are consistent with blunt liver trauma induced by the accident.  Over 
the next few days we expect liver enzyme levels to return to normal levels but we will 
keep a close eye on this to make sure that your dog is okay.  

In order to repair all of these fractures we are going to have to operate to remove the bone 
fragments that are no longer connected to the intact bone and to place the plates, screws 
and pins necessary to stabilize the broken bones.  The bone fragments have lost their 
blood supply during this traumatic incident and they are in the process of dying.  If we 
don't remove these fragments before we try to splint your dog's legs the bones will never 
heal properly.  We would like to splint the femur using internal fixation and splint the 
tibia and fibula using external fixation.  The difference between these two types of splints 
is simply the placement of the splinting device.  Internal fixation of the femur will 
stabilize the fracture significantly through the placement of a plate on the outside of the 
bone after we have reassembled the complex fracture.  Since this will all be internal your 
dog will be able to walk during the healing process.  Applying external fixation to the 
tibia and fibula through the use of an external splint pin/screw system will provide 
significant support while these bones heal.  This procedure will allow us to adjust the 
position of the splint as necessary to promote normal bone conformation without having 
to operate again.  However you are going to need to keep your pet in confinement since it 
will have an external splint system that can easily get tangled up in furniture, etc.  You 
are also going to need to keep a close eye on the external system to ensure that it is not 
causing an infection.  You should cleanse the pin tracts on a daily basis by spraying them 
off and drying to prevent infection.  

After surgery we are going to place your dog on oral antibiotics to reduce the risk of a 
bone infection.  You need to keep your dog cagebound for one week and then it should 
only be permitted to take controlled leash walks for a period of at least 5 weeks.  We will 
schedule appointments at your convenience to keep an eye on your dog, monitor healing 
and then decide when to remove the fixation devices.  Complete recovery may take as 
long a six months but it is highly likely to happen as long as bone infections do not occur.