A multicenter retrospective comparison of trauma in toy breeds versus giant breeds: A Veterinary Committee on Trauma registry study

Abstract

Objective To retrospectively evaluate and stratify the differences in signalment, mechanisms, and severity of injury between toy and giant breed dogs. Design Retrospective, observational cohort study. Setting Multicenter, university veterinary teaching hospital, and private referral hospitals contributing to Veterinary Committee on Trauma (VetCOT) patient registry. Animals Two thousand seven hundred and five (2589 toy and 116 giant breed) dogs presented for trauma with complete data entries recruited into the Veterinary Committee on Trauma registry from September 1, 2013 through December 31, 2017. Interventions None. Measurements and Main Results Injury etiology in toy breeds was predominantly blunt trauma (1532/2587 [59.2%]), commonly falling from a height or motor vehicle accident, whereas in giant breeds penetrating trauma was more common (71/116 [61.2%]). Eighty‐seven percent (2231/2558) of toy breeds and 94.7% (108/114) giant breeds survived to discharge. When stratified by severity of injury (animal trauma triage [ATT] ≥ 5), mortality increased. Severely injured toy breeds had a 45.6% (200/438) survival rate, and severely injured giant breeds had a 62.5% (5/8) survival rate. Patient size did not impact survival in a logistic regression model; however, ATT score (odd ratio, 0.55; 95% CI, 0.52–0.58; P < 0.001), modified Glasgow Coma Scale (mGCS; odds ratio, 1.2; 95% CI, 1.11–1.32; P < 0.001), and base excess (odds ratio, 1.15; 95% CI, 1.09–1.22; P < 0.001) were predictive of nonsurvival. Surgical intervention was required in 743 of 2587 (29%) toy breeds and 65 of 116 (56%) giant breeds. Surgery was associated with an increased survival rate (odds ratio, 4.43; 95% CI, 2.45–8.83; P < 0.0001). Conclusions Evaluation of a large, multicenter dataset showed that ATT score along with base excess, plasma lactate, and mGCS were predictors of mortality independent of patient size. Severely injured dogs, as defined by an ATT score ≥ 5, were less likely to survive, and toy breed dogs had a higher mortality rate than giant breeds in the subcategory.

ACVECC‐Veterinary Committee on Trauma registry report 2017–2019

“…Multiple projects utilizing the Vet-COT trauma registry have been published to date. [10][11][12][13][14][15][16][17][18] Additionally, the trauma registry provides trauma centers with information that can…”

“…One objective for this report is to provide a summary of registry data to inform additional research questions that may ultimately lead to improved trauma patient outcomes. Multiple projects utilizing the VetCOT trauma registry have been published to date 10–18 . Additionally, the trauma registry provides trauma centers with information that can lead to data‐driven planning and implementing Performance Improvement Patient Safety plans.…”

“…At the time of writing, 17 projects have been approved to utilize registry data, over 20 abstracts presented at local, national, and international conferences, and many manuscripts have been published (n = 8) or accepted for publication (n = 4). [10][11][12][13][14][15][16][17][18] Based on feedback from VTC leads, data entry personnel (DEP), Vet-COT conference attendees, and clinical researchers utilizing trauma registry data, an updated version (2.0) of the trauma registry's data dictionary was implemented on April 1, 2017. These modifications were targeted to improve data quality, streamline data entry processes, reduce "other" categories, and expand patient data being collected for subsequent analysis.…”

“…Since 2013, an increasing number of VTCs have joined the veterinary trauma network contributing to the registry, ultimately forming a database that contains over 55,000 trauma cases through December 2021. At the time of writing, 17 projects have been approved to utilize registry data, over 20 abstracts presented at local, national, and international conferences, and many manuscripts have been published ( n = 8) or accepted for publication ( n = 4) 10–18 …”

Prospective evaluation of platelet function and fibrinolysis in 20 dogs with trauma

“…63 Low median ATT scores of 1 (1) and 2 (2) have also been reported for a cohort of 2583 toy breed dogs and 116 giant breed dogs, respectively. 64 This suggests that severe injury is uncommon in dogs or underreported, or that those with a high ATT score succumb to their injuries before receiving veterinary care. 13,19,35 It is possible that dogs that do survive trauma and present to a veterinarian may not have sustained injuries severe enough to incite coagulation derangement.…”