Bullet, Bite, and Burn Wounds in Dogs and Cats

Case report: Radiofrequency-induced thermal burn injury in a dog after magnetic resonance imaging

A 10-year-old male Shar-Pei was referred for lethargy and proprioceptive deficits of the left thoracic limb. An magnetic resonance imaging (MRI) examination of the cervical spinal column and the brain was performed. The MRI examination of the brain was normal. A left-sided C3-C4 intervertebral disc extrusion with spinal cord compression was diagnosed. Medical treatment was elected. Within a week after the MRI examination, the dog presented with deep partial-thickness skin burn wounds in both axillae. Since the specific absorption rate had not exceeded the safety limits during any of the scans and no other procedures or circumstances were identified that could possibly have resulted in burn injuries, the thermal burn injuries were diagnosed as radiofrequency (RF) burns. The wounds healed by secondary intent over the next month. RF burns are the most reported complication in humans undergoing MRI but have not been reported in veterinary patients. Clinicians and technicians should consider the potential risk for RF burns in veterinary patients and take precautions regarding positioning of the patient and take notice of any signs of burn injury when performing follow-up examinations.

Cutaneous and Respiratory Lesions in Bushfire-Affected Koalas

In the wake of increasingly frequent bushfires emerging as a threat to wildlife worldwide, koalas have notably been the most rescued species in Australia. However, our understanding of burns and their severity in koalas is limited; hence, this study investigated the histopathological features and depth of burns in koala skin, as well as the presence of smoke-induced respiratory tract damage. In four bushfire-affected koalas that had been euthanised on welfare grounds, skin burns in various body regions were scored based on clinical appearance as superficial, partial thickness, or full thickness. Histological sections of affected regions of skin were assessed as Grades I-IV and showed that furred regions on the ear margins and dorsum were histologically more severe, at Grade III, compared with the clinical score. There was a similar finding for footpad burns, which were the most common body region affected. In the respiratory tract, pulmonary oedema and congestion were evident in all koalas. Overall, the results highlight that cutaneous burn lesions on furred and palmar/plantar surfaces can have higher severity based on the burn depth than is clinically apparent. Therefore, there is a need to consider this when developing treatment plans and establishing prognosis for burnt koalas at triage, as well as that a high likelihood of pulmonary oedema exists.

Ballistic trauma to the axial skeleton in 13 animals

OBJECTIVE

To describe the clinical presentation and outcome of small animals that sustained ballistic trauma to the axial skeleton.

DESIGN

Retrospective, multicenter observational study.

SETTING

Two university teaching hospitals.

ANIMALS

Twelve client-owned dogs and 1 client-owned cat sustaining ballistic trauma to the axial skeleton.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Thirteen animals sustaining ballistic trauma to the axial skeleton with complete medical records were included in this study. Twelve of 13 animals survived to discharge; 1 animal was euthanized shortly after presentation. Two animals had ophthalmic abnormalities, 9 animals had neurologic lesions, and 2 animals had no significant ophthalmic or neurologic deficits. Neurolocalization of injury included peripheral vestibular (n = 1), multifocal brain (n = 1), brainstem (n = 1), C1-C5 (n = 1), C6-T2 (n = 1), T3-L3 (n = 3), and L4-S3 (n = 1). Seven dogs underwent surgical intervention: 5 neurosurgical, 1 enucleation, and 1 laparotomy. Median hospitalization time was 6 days with a range from 1 to 31 days.

CONCLUSIONS

Overall prognosis and outcome are variable and dependent on specific injury location and degree of injury.

Histopathological Evaluation of the Healing Process of Standardized Skin Burns in Rabbits: Assessment of a Natural Product with Honey and Essential Oils

Skin burns are one of the most difficult medical problems. Recently, studies have been directed towards development of natural products in order to identify effective and safe remedies. In the present study, we evaluated the efficacy of a natural composite (formulated from honey and essential oils) compared with MEBO® (0.25% β-sitosterol) and DERMAZIN® creams (1% silver-sulfadiazine) in the treatment of thermally induced skin burns. For this purpose, four burn-wounds were created on the back of male New Zealand rabbits (n = 10) using a thermal stamp under the effect of general anesthesia. Each wound represents one of the following groups: non-treated, natural composite-cream, MEBO®-cream, and silver-sulfadiazine treated groups, respectively. Treatments were applied once a day topically until one of these wounds appeared to be healed grossly. The non-treated group received no treatment. Grossly, skin burns have been healed after 28 days of the treatment in all groups except of the non-treated group. The healing efficacy of the natural composite, MEBO® and silver-sulfadiazine creams was quite similar macroscopically. However, microscopically, the epidermal layer of the composite-cream treated group was more mature than those of both MEBO® and silver-sulfadiazine creams treated groups. In conclusion, the tested composite may be a promising effective and inexpensive treatment of skin burns.

Local wound management: A review of modern techniques and products

Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.

Enhanced Healing Activity of Manuka Honey and Nitrofurazone Composite in Full-Thickness Burn Wounds in the Rabbit Model

Burns cause many significant changes in metabolism and inflammatory reactions, leading to poor regeneration in animals and humans. A list of medicines to treat burns is available in the market. But due to the high cost of these medicines, these are unaffordable, especially for farmers of middle-class families of Africa and Asia. Therefore, a low-cost complementary treatment has always been a topic of many researchers, and there is a dire need of time for the welfare of animals to save them. The current study was planned to scrutinize the therapeutic effects of Manuka honey and Nitrofurazone ointments on full-thickness burn wounds in the rabbit model. The healing efficacy was performed through wound contraction rate, hematological analysis, the thickness of dermis and epidermis, and collagen content percentage. Histopathology was performed after taking biopsy samples at the end of the research. Based on statistical analysis using wound healing time (days, D), the combination (MO + NT) resulted in a shorter period (27 D ± 1) than the average healing time of controlled (36 ± 2), Manuka ointment (31.33 D ± 1.52), and Nitrofurazone ointment (32 ± 1). A significant decrease in the count of red blood cell (RBC), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in all treatments was noticed mainly in MO + NT. Furthermore, burns induced a significant difference (p < 0.05) in the white blood cells (WBCs) count levels in the MO-treated group. While the level of platelets (PLTs) was not significantly different from the healthy control group. Histopathological assessment (epithelialization, fibrosis, and angiogenesis) of skin showed burn healing to be better in MO and MO + NT groups. In conclusion, the composite of Manuka honey with Nitrofurazone led to the faster recovery than other treatments.

Survey of current trends in the management of traumatic subcutaneous emphysema in dogs

BACKGROUND

Subcutaneous emphysema (SCE) is a common occurrence in emergency veterinary practice, but published information regarding treatment and management strategies is lacking. This study examined trends in diagnostic and treatment recommendations.

STUDY DESIGN

An internet-based survey with cross-sectional analysis. There were 129 respondents: board-certified and nonboard-certified veterinarians in private practice and university settings.

KEY FINDINGS

Significant differences in the choice of diagnostics and treatment were found based on the etiology and severity of SCE and between respondent groups. Computed tomography (CT) was selected more frequently for SCE resulting from blunt or penetrating traumas by the board-certified veterinarians practicing in a teaching hospital (VTH group; P < 0.001). All veterinarians were more likely to select tracheobronchoscopy as part of their workup for SCE as a result of endotracheal intubation trauma (P = 0.0093 [penetrating traumas]; P = 0.0002 [blunt force traumas]). Intermittent SC drainage and ventral cervical exploratory surgery were more likely to be chosen as treatments when SCE was classified as severe generalized (P < 0.0001).

SIGNIFICANCE

There is significant variation in the treatment of SCE in veterinary medicine as well as associated diagnostics to determine severity and treatment options. Further studies are indicated to determine the optimal approach and provide guidance to clinicians.

Outcomes and Complications Associated with Acute Gunshot Fractures in Cats and Dogs

OBJECTIVE

 The aim of this study was to summarize outcomes and complications of gunshot fracture management in small animals.

STUDY DESIGN

 Review of cats and dogs with radiographically confirmed acute gunshot fractures, presenting data on signalment, fracture location, fracture management (surgical vs. non-surgical, type of surgical repair), fracture comminution, extent of soft tissue trauma, postoperative complication and overall outcome. A poor outcome was defined as patient death, major postoperative complication or limb amputation (both as primary treatment or secondary to postoperative complications).

RESULTS

 Ninety-seven animals with 137 acute gunshot-induced fractures were identified. There were 21 (15.3%) maxillofacial, 16 (11.7%) vertebral column, 8 (5.8%) rib, 56 (40.9%) distal long bone (below stifle/cubital joint) and 36 (26.3%) proximal long bone (at or above stifle/cubital joint) fractures. Overall, 20/37 cases with sufficient follow-up details incurred a poor fracture outcome. Extensive soft tissue trauma at the fracture site was associated with an increased likelihood of poor outcome. The most common poor outcomes were primary limb amputations (7 cases) and postoperative complications (3 osteomyelitis/surgical site infections, 4 delayed/non-unions).

CONCLUSIONS

 Gunshot fractures overall have high likelihood of poor outcome. Severe soft tissue injury is associated with complications. Mitigating poor outcome likely requires early aggressive wound management.

Patient Triage, First Aid Care, and Management of Oral and Maxillofacial Trauma

Maxillofacial trauma is a common presentation in veterinary medical practice. Accurate assessment, diagnostics, pain management, and finally repair are tenants to treatment. In addition to typical tenants for fracture repair, the restoration of occlusion and return to function (eating, drinking, grooming) are unique to trauma management in these patients. Options for repair include conservative management (tape muzzles), noninvasive repair techniques (interdental wiring and composite splinting), and invasive repair techniques (interfragmentary wiring and plate and screw fixation).

An Analysis of Demographic and Triage Assessment Findings in Bushfire-Affected Koalas (Phascolarctos cinereus) on Kangaroo Island, South Australia, 2019-2020

Simple Summary

In the 2019–2020 Australian bushfires, Kangaroo Island, South Australia, experienced catastrophic bushfires that burnt approximately half the island, with an estimated 80% of the koala population lost. During and after the fires, koalas presented to a designated triage facility over a span of 10 weeks, with 50.2% during the first 14 days of the bushfire response (304 records available). Burns were observed in 67.4% of koalas, with the majority (60.9%) classified as superficial burns, primarily affecting the limbs and face. Poor body condition was recorded in 74.6% of burnt koalas and dehydration in 77.1%. Negative final outcomes (death or euthanasia, either at triage or at a later date) occurred in 45.6% of koalas and were significantly associated with higher mean burn score, maximum burn severity, number of body regions burnt, poor body condition score, and dehydration severity. The findings of this retrospective study may assist clinicians in the field with decision making when triaging koalas in future fire rescue efforts.

Abstract

In the 2019–2020 Australian bushfires, Kangaroo Island, South Australia, experienced catastrophic bushfires that burnt approximately half the island, with an estimated 80% of the koala population lost. During and after the event, rescued koalas were triaged at a designated facility and a range of initial data were recorded including rescue location and date, sex, estimation of age, body condition and hydration, and assessment of burn severity (n = 304 records available). Koalas were presented to the triage facility over a span of 10 weeks, with 50.2% during the first 14 days of the bushfire response, the majority of which were rescued from regions of lower fire severity. Burns were observed in 67.4% of koalas, with the majority (60.9%) classified as superficial burns, primarily affecting the limbs and face. Poor body condition was recorded in 74.6% of burnt koalas and dehydration in 77.1%. Negative final outcomes (death or euthanasia, at triage or at a later date) occurred in 45.6% of koalas and were significantly associated with higher mean burn score, maximum burn severity, number of body regions burnt, poor body condition score, and dehydration severity. The findings of this retrospective study may assist clinicians in the field with decision making when triaging koalas in future fire rescue efforts.

Treatment of moderate grade dog bite wounds using amoxicillin-clavulanic acid with and without enrofloxacin: a randomised non-inferiority trial

BACKGROUND

Dog-to-dog bite wounds are a common veterinary emergency presentation: despite this, there is insufficient information to guide veterinarians on appropriate empirical antimicrobial management.

OBJECTIVES

Investigate the effectiveness of amoxicillin-clavulanic acid with and without enrofloxacin in the treatment of moderate grade dog bite wounds (DBW). To describe common pathogens and their antimicrobial susceptibility patterns.

MATERIALS AND METHODS

In a single-centre parallel group pragmatic trial, 50 dogs presenting with moderate grade DBW were prospectively randomised to receive amoxicillin-clavulanic acid (group A) or amoxicillin-clavulanic acid and enrofloxacin (group B). Swabs were taken for culture and susceptibility testing at admission. Stabilisation, wound care and surgical debridement were performed at the discretion of admitting clinicians. The primary outcome was complication due to infection at 10 days, with Bayesian inference used to estimate the difference in proportions between treatment groups.

RESULTS

Of the 24 dogs in treatment group A, 1 required the addition of enrofloxacin at re-examination. None of the 26 dogs in group B required alteration of antimicrobial coverage. The difference in complication rate due to infection between treatment groups was 4.2%. Twenty-one different organisms were identified: Staphylococcus pseudintermedius, Neisseria spp., Pasteurella multocida and P. canis were the most common. Over 90% of gram-negative and gram-positive isolates were susceptible to amoxicillin-clavulanic acid. Ninety-six percent of gram-negative and 86% of gram-positive isolates were susceptible to enrofloxacin.

CONCLUSION AND CLINICAL SIGNIFICANCE

Amoxicillin-clavulanic acid is an appropriate empirical antimicrobial choice for moderate DBW in South East Queensland. Reduced empirical enrofloxacin use will promote antimicrobial stewardship and potentially antimicrobial resistance.

Filling the vacuum: Role of negative pressure wound therapy in open wound management in cats

Practical relevance:

Open wounds and their treatment present a common challenge in veterinary practice. Approaching 15 years ago negative pressure wound therapy (NPWT) started to be incorporated into clinical veterinary medicine, and its availability is becoming more widespread in Europe and the USA. Use of this therapy has the potential to significantly increase the healing rate of open wounds as well as free skin grafts in small animals, and it has been occasionally described for the management of feline wounds.

Aim:

This review describes the mechanisms of action of, and indications for, NPWT, and offers recommendations for NPWT specific to feline patients.

Evidence base:

The information presented is based on the current evidence and the author’s clinical experience of the technique gained over the past 12 years. Comparative studies of different treatment options are lacking and, since wound healing in cats and dogs differs, cat-specific studies are especially needed. Well-designed wound healing studies comparing different advanced techniques will improve open wound healing in cats in the future, and potentially allow better understanding of the role of NPWT in this setting.

Therapeutic effect of mesenchymal stem cells on histopathological, immunohistochemical, and molecular analysis in second-grade burn model

Background and aim

Deleterious cutaneous tissue damages could result from exposure to thermal trauma, which could be ameliorated structurally and functionally through therapy via the most multipotent progenitor bone marrow mesenchymal stem cells (BM-MSCs). This study aimed to induce burns and examine the effect of BM-MSCs during a short and long period of therapy.

Material and methods

Ninety albino rats were divided into three groups: group I (control); group II (burn model), the animals were exposed to the preheated aluminum bar at 100°C for 15 s; and group III (the burned animals subcutaneously injected with BM-MSCs (2×10⁶ cells/ ml)); they were clinically observed and sacrificed at different short and long time intervals, and skin samples were collected for histopathological and immunohistochemical examination and analysis of different wound healing mediators via quantitative polymerase chain reaction (qPCR).

Results

Subcutaneous injection of BM-MSCs resulted in the decrease of the wound contraction rate; the wound having a pinpoint appearance and regular arrangement of the epidermal layer with thin stratum corneum; decrease in the area percentages of ADAMs10 expression; significant downregulation of transforming growth factor-β (TGF-β), interleukin-6 (IL-6), tumor necrotic factor-α (TNF-α), metalloproteinase-9 (MMP-9), and microRNA-21; and marked upregulation of heat shock protein-90α (HSP-90α) especially in late stages.

Conclusion

BM-MSCs exhibited a powerful healing property through regulating the mediators of wound healing and restoring the normal skin structures, reducing the scar formation and the wound size.

Clinical management and outcomes for goats, sheep, and pigs hospitalized for treatment of burn injuries sustained in wildfires: 28 cases (2006, 2015, and 2018)

OBJECTIVE

To characterize injuries and describe medical management and clinical outcomes of goats, sheep, and pigs treated at a veterinary medical teaching hospital for burn injuries sustained during wildfires.

ANIMALS

Goats (n = 9), sheep (12), and pigs (7) that sustained burn injuries from wildfires.

PROCEDURES

Medical records were searched to identify goats, sheep, and pigs that had burn injuries associated with California wildfires in 2006, 2015, and 2018. Data regarding signalment, physical examination findings, treatments, clinical outcomes, time to discharge from the hospital, and reasons for death or euthanasia were recorded.

RESULTS

The eyes, ears, nose, mouth, hooves, perineum, and ventral aspect of the abdomen were most commonly affected in both goats and sheep. In pigs, the ventral aspect of the abdomen, distal limb extremities, ears, and tail were most commonly affected. The median (range) time to discharge from the hospital for goats and pigs was 11 (3 to 90) and 85.5 (54 to 117) days, respectively. One of 9 goats, 12 of 12 sheep, and 5 of 7 pigs died or were euthanized. Laminitis and devitalization of distal limb extremities were common complications (13/28 animals) and a common reason for considering euthanasia in sheep and pigs.

CONCLUSIONS AND CLINICAL RELEVANCE

Burn injuries in small ruminants and pigs required prolonged treatment in some cases. Results suggested prognosis for survival may be more guarded for sheep and pigs with burn injuries than for goats; however, further research is needed to confirm these findings.

Cats with thermal burn injuries from California wildfires show echocardiographic evidence of myocardial thickening and intracardiac thrombi

Recent increases in the prevalence and severity of wildfires in some regions have resulted in an increased frequency of veterinary burn patients. Few studies exist regarding diagnostics and management of burn wounds in veterinary patients and current knowledge is extrapolated from human literature and research models. Post-burn cardiac injury is a common finding and predictor of mortality in human patients and echocardiography is an important tool in monitoring response to therapy and predicting outcome. We describe the notable findings from cats naturally exposed to California wildfires in 2017 and 2018. Domestic cats (n = 51) sustaining burn injuries from the Tubbs (2017) and Camp (2018) wildfires were prospectively enrolled and serial echocardiograms and cardiac troponin I evaluations were performed. Echocardiograms of affected cats revealed a high prevalence of myocardial thickening (18/51) and spontaneous echocardiographic contrast and thrombi formation (16/51). Forty-two cats survived to discharge and 6 died or were euthanized due to a possible cardiac cause. For the first time, we describe cardiovascular and coagulation effects of thermal burn and smoke inhalation in cats. Further studies in veterinary burn victims are warranted and serve as a translational research opportunity for uncovering novel disease mechanisms and therapies.

Cats with thermal burn injuries from California wildfires show echocardiographic evidence of myocardial thickening and intracardiac thrombi

Recent increases in the prevalence and severity of wildfires in some regions have resulted in an increased frequency of veterinary burn patients. Few studies exist regarding diagnostics and management of burn wounds in veterinary patients and current knowledge is extrapolated from human literature and research models. Post-burn cardiac injury is a common finding and predictor of mortality in human patients and echocardiography is an important tool in monitoring response to therapy and predicting outcome. We describe the notable findings from cats naturally exposed to California wildfires in 2017 and 2018. Domestic cats (n = 51) sustaining burn injuries from the Tubbs (2017) and Camp (2018) wildfires were prospectively enrolled and serial echocardiograms and cardiac troponin I evaluations were performed. Echocardiograms of affected cats revealed a high prevalence of myocardial thickening (18/51) and spontaneous echocardiographic contrast and thrombi formation (16/51). Forty-two cats survived to discharge and 6 died or were euthanized due to a possible cardiac cause. For the first time, we describe cardiovascular and coagulation effects of thermal burn and smoke inhalation in cats. Further studies in veterinary burn victims are warranted and serve as a translational research opportunity for uncovering novel disease mechanisms and therapies.

Clinicopathologic abnormalities associated with increased animal triage trauma score in cats with bite wound injuries: 43 cases (1998-2009)

OBJECTIVE

To document the clinical and clinicopathologic changes in cats presenting with trauma from bite wounds, identify common abnormalities associated with bite wounds, and to determine whether the calculated animal trauma triage (ATT) score is related to any clinicopathologic abnormalities.

DESIGN

Retrospective descriptive study.

SETTING

University veterinary teaching hospital.

ANIMALS

Forty-three client-owned cats that presented for bite wounds to a large, urban, veterinary hospital between 1998 and 2009.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Pertinent history, physical examination findings, results of biochemical testing, and outcome were extracted from medical records. Animal triage trauma score was calculated based on the physical examination at presentation in cats with adequate available information. Patients were classified as having either a low (<5) ATT (n = 20) or a high (≥5) ATT (n = 23) score. Male cats were overrepresented (65.1%), and a majority of cats had outdoor access (53.4%). Low venous blood pH (P = 0.047), high plasma lactate concentration (P = 0.018), and low ionized calcium concentration (P = 0.004) were associated with higher ATT scores.

CONCLUSIONS

There is a significant association between low venous blood pH, high plasma lactate concentration, and low ionized calcium concentration and higher ATT scores at presentation in cats suffering from bite wounds. Early recognition of these abnormalities may help to identify more severely injured patients.

Deep tissue culture and hemoculture in dogs with wounds and sepsis

ABSTRACT: Contaminated and infected wounds occur very frequently in veterinary medicine and can cause systemic inflammatory response syndrome, sepsis, and death. This study aimed to test the feasibility of collecting wound material by deep-tissue or punch biopsy for microbial culture, determine the frequency of bacteria in the wound(s) and blood cultures and the susceptibility of these microbes to antimicrobials, and evaluate clinical parameters that could be related to prognosis. Thirty dogs with wounds and signs of SIRS/sepsis were included in this study. Bacteria were isolated from all wounds and 41 bacterial isolates could be identified based on culture of the materials collected by punch biopsy; 53.66% of the isolates were gram-negative, mainly involving Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp., and 46.34% were gram-positive bacteria such as Streptococcus spp., Enterococcus spp., and Staphylococcus spp. The survival rate was 66.67%. Based on blood culture analysis, we identified bacteremia in seven patients, predominantly of gram-negative bacteria, which negatively affected patient survival, as six dogs died. Hypoglycemia (≤60mg/dL) and severe hyperglycemia (≥180mg/dL) also negatively affected survival as 23.33% of the hypo/hyperglycemic dogs died. Factors such as blood lactate level at admission and hematocrit levels, and mean arterial pressure were not significantly correlated with death or survival of the dogs.

Perforating Cervical, Thoracic, and Abdominal Wounds

Most body wall injuries in small animals are caused by bite wounds or vehicular trauma. Penetrating gunshot wounds are less common. Bite wounds are characterized by massive trauma to the body wall with associated defects, but fewer internal injuries, whereas gunshot wounds are associated with a high number of internal injuries. Vehicular accident injuries are caused by blunt force trauma and can lead to both body wall defects and internal organ damage. Impalement injuries are rare and are typically associated with internal damage. Exploratory surgery, herniorrhaphy, and aggressive wound management are recommended in the treatment of these injuries.

Review of 166 Gunshot Injury Cases in Dogs

The study is aimed to establish predilection signalment and history data, and to investigate clinical findings and risk factors associated with a poor outcome in dogs with projectile injuries. A retrospective study was undertaken of 166 canine cases in which a projectile was found on radiograph in a university׳s diagnostic imaging center more than a 4-year period. The study included dogs with both apparent (obvious recent traumatic event) and incidental (traumatic event unknown to the owner) projectile injury. Radiographs were reviewed and data regarding projectile position according to body region, number and type of projectile(s), bone fracture(s), and wound(s) related to projectile were recorded. The dogs were divided into groups according to owner address, hunting accident vs. shooting unrelated to hunting, and projectile type found on radiographs. Overall, 160 dogs met the inclusion criteria, making 0.76% the incidence of gunshot injuries. Further, 91 dogs were received with incidental projectile injury, and 75 dogs had apparent projectile injury. Male dogs were overrepresented (74.1%). Hunting accidents were the cause of projectile injury in 12.7% of cases. Fractures were observed in 20.5% of dogs. Most of the dogs (62%) were from an urban area, and the most common projectile type was airgun projectile (62%). The risk of fatal outcome was 14.4 times higher in dogs with thoracic injuries. Projectile injuries are still a real cause of trauma, especially in urban areas and in male dogs. Most gunshot injuries do not cause fatalities, although the thoracic projectile injury was associated with a greater fatality risk.

Metal projectile injuries in cats: review of 65 cases (2012-2014)

OBJECTIVES

The objective of this study was to compare the prevalence of different types of injuries caused by various types of projectiles among urban, suburban and rural cats of different ages in order to predict the type of injury sustained.

METHODS

For the period 1 January 2012 to 30 April 2014, the medical records of cats with metal projectile injuries (PIs) were searched from the archive of the university's small animal diagnostic imaging centre. Age, sex, owner address, admission during a weekend or on a working day, month of admission, projectile position (head and neck; thoracic region; abdominal region, including lumbosacral spine; forelimbs; and hindlimbs, including tail), number of projectiles, presence of a wound and fracture related to the projectile, and the type of projectile were recorded for each cat.

RESULTS

Sixty-five cats with PIs were admitted during the defined period. In 38.5% of cats the projectiles found upon radiography were incidental findings. The frequency of PIs peaked in March. Airgun projectiles were found in 80.0% of the cats. PIs in two or more body regions were found in 29.2% of the cats. Among the cats that had only been shot in one body region, the projectile was most frequently found in the abdominal region, including the lumbosacral spine (41.3%).

CONCLUSIONS AND RELEVANCE

These results might prompt clinicians to evaluate closely and screen for feline PIs in emergency situations.

Thermal Injuries in Veterinary Forensic Pathology

Localized thermal injuries in animals may be caused by exposure to fire and radiant heat, contact with hot items including hot liquids or steam, inhalation of hot air, and exposure to cold temperatures. In addition, animal fire victims may have intoxications caused by smoke gas. This article reviews the causes, pathogenetic aspects, morphological findings, additional investigations, differential diagnoses, and causes of death in various forms of thermal injuries. Since these cases do not occur frequently in diagnostic pathology, they represent a challenging task in general but also with respect to forensic or criminal aspects, such as whether a lesion represents an accidental or nonaccidental effect. Besides detailed information about the circumstances at the location, thermal injuries in animals require a thorough morphological evaluation, including additional investigations in conjunction with a profound knowledge about the possible lesion spectrum and suitable additional investigations.

Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound

A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

Comparative wound healing--are the small animal veterinarian's clinical patients an improved translational model for human wound healing research?

Despite intensive research efforts into understanding the pathophysiology of both chronic wounds and scar formation, and the development of wound care strategies to target both healing extremes, problematic wounds in human health care remain a formidable challenge. Although valuable fundamental information regarding the pathophysiology of problematic wounds can be gained from in vitro investigations and in vivo studies performed in laboratory animal models, the lack of concordance with human pathophysiology has been cited as a major impediment to translational research in human wound care. Therefore, the identification of superior clinical models for both chronic wounds and scarring disorders should be a high priority for scientists who work in the field of human wound healing research. To be successful, translational wound healing research should function as an intellectual ecosystem in which information flows from basic science researchers using in vitro and in vivo models to clinicians and back again from the clinical investigators to the basic scientists. Integral to the efficiency of this process is the incorporation of models which can accurately predict clinical success. The aim of this review is to describe the potential advantages and limitations of using clinical companion animals (primarily dogs and cats) as translational models for cutaneous wound healing research by describing comparative aspects of wound healing in these species, common acute and chronic cutaneous wounds in clinical canine and feline patients, and the infrastructure that currently exists in veterinary medicine which may facilitate translational studies and simultaneously benefit both veterinary and human wound care patients.

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 1: burn classification and pathophysiology

OBJECTIVE

To review the literature related to severe burn injury (SBI), burn shock, and smoke inhalation injury in domestic animals. Current animal- and human-based research and literature were evaluated to provide an overview of thermal burn classification and the pathophysiology of burn shock and smoke inhalation injury.

ETIOLOGY

Severe burn injury, burn shock, and smoke inhalation injury may be encountered as a result of thermal injury, radiation injury, chemical injury, or electrical injury.

DIAGNOSIS

Burns can be subdivided based on the amount of total body surface area (TBSA) involved and the depth of the burn. Local burn injuries involve <20% of the TBSA whereas SBI involves >20-30% of the TBSA. The modern burn classification system classifies burns by increasing depth: superficial, superficial partial-thickness, deep partial-thickness, and full-thickness.

SUMMARY

Local burn injury rarely leads to systemic illness whereas SBI leads to significant metabolic derangements that require immediate and intensive management. SBI results in a unique derangement of cardiovascular dysfunction known as "burn shock." The physiologic changes that occur with SBI can be divided into 2 distinct phases; the resuscitation phase and the hyperdynamic hypermetabolic phase. The resuscitation phase occurs immediately following SBI and lasts for approximately 24-72 hours. This period of hemodynamic instability is characterized by the release of inflammatory mediators, increased vascular permeability, reduced cardiac output, and edema formation. The hyperdynamic hypermetabolic phase begins approximately 3-5 days after injury. This phase is characterized by hyperdynamic circulation and an increased metabolic rate that can persist up to 24 months post burn injury in people.

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 2: diagnosis, therapy, complications, and prognosis

OBJECTIVE

To review the evaluation and treatment of patients suffering from severe burn injury (SBI), burn shock, and smoke inhalation injury. Potential complications and prognosis associated with SBI are also discussed.

DIAGNOSIS

Diagnosis of burn injury and burn shock is based on patient history and clinical presentation. Superficial burn wounds may not be readily apparent for the first 48 h whereas more severe wounds will be evident at presentation. Patients are diagnosed with local or SBI by estimating total body surface area involved using the 'Rule of Nines' or the Lund-Browder chart adapted from the human literature.

THERAPY

Patients suffering from SBI require immediate and aggressive fluid therapy. Burn wounds require prompt cooling to prevent progressive tissue damage. Due to significant pain associated with burn wounds and therapeutic procedures, multimodal analgesia is recommended. Daily wound management including hydrotherapy, topical medications, and early wound excision and grafting is necessary with SBI.

COMPLICATIONS

There are numerous complications associated with SBI. The most common complications include infections, hypothermia, intra-abdominal hypertension, and abdominal compartment syndrome.

PROGNOSIS

The prognosis of SBI in domestic animals is unknown. Based on information derived from human literature, patients with SBI and concomitant smoke inhalation likely have a worse prognosis than those with SBI or smoke inhalation alone.

Use of a nanocrystalline silver dressing and vacuum-assisted closure in a severely burned dog

OBJECTIVE

To describe the first veterinary use of a nanocrystalline silver dressing (NSD) and use of vacuum-assisted closure (VAC) to treat a severely burned dog.

CASE OR SERIES SUMMARY

A 1-year-old female intact American Staffordshire Terrier with 50% total body surface area burned was referred for definitive care approximately 18-24 hours post injury. The dog was treated with crystalloid fluids, hydroxyethyl starch, and antimicrobials based on culture and sensitivity results of wound cultures, fresh frozen plasma, human serum albumin, and packed red cells. Wound care initially consisted of daily debridement under anesthesia with silver sulfadiazine application and bandaging. Because of the extent and the location of the wounds and morbid state of the patient, early wound grafting was not an option. Because of its reported improvement in granulation tissue formation and decreased tissue edema, VAC was used once the majority of burned tissue was manually debrided. Because of the pain caused by VAC and traditional bandaging techniques with this extent of injury, an NSD was utilized. This strategy was chosen due to the antimicrobial properties of NSD and the reduced necessity for daily bandage changes, which was reduced to only every 3 days. This protocol reduced the need for daily sedation or anesthesia.

NEW OR UNIQUE INFORMATION PROVIDED

VAC and NSD were used successfully for the treatment of a severe burn injury in a dog. The use of NSD decreased the cost of therapy by reducing the need for daily bandage changes, thereby reducing the anesthetic and analgesic costs and allowing the patient to be managed on an outpatient basis.

Treatment of a nonunion, secondary to gunshot fracture, of the distal radius with circular external fixation and rhBMP-2 in a cat

OBJECTIVE

To report the successful use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the treatment of an antebrachial non-union, secondary to gunshot fracture, stabilized with circular external fixation in a cat.

PROCEDURE

Following a diagnosis of a highly comminuted gunshot fracture of the distal right radius and ulna, the fracture was stabilized with a circular external fixation. A two-ring frame was placed in closed fashion.

RESULTS

The skin wound healed uneventfully by second intention in 21 days. Twenty-eight weeks after external fixation, bone healing was absent. 0.8mL of 0.2mg/mL of rhBMP-2 in two collagen sponges was placed in the bone defect. Eight weeks after rhBMP-2 implantation, an early bone healing response was noted on radiographic evaluation. Sixteen weeks after rhBMP-2 implantation, fracture union was achieved.

DISCUSSION

To the authors' knowledge, 160 μg is the lowest reported dose of rhBMP-2 that leads to bony union in a cat. However as an individual case study, this report can not be used as evidence that rhBMP-2 at this lower dose is appropriate for use in all cats. Further studies are needed to establish the minimum efficient dose of rhBMP-2 in cats.