Retrospective evaluation of concurrent intra‐abdominal injuries in dogs with traumatic pelvic fractures: 83 cases (2008–2013)

Abstract

Objective -To report the occurrence of intra-abdominal injury (IA) in dogs with pelvic fractures due to blunt trauma, to evaluate for association between characterization of pelvic fractures and the presence of IA, and to evaluate for association between IA and other specific clinical conditions. Design -Retrospective case series (2008)(2009)(2010)(2011)(2012)(2013)). Setting -University teaching hospital. Animals -Eighty-three client-owned dogs with pelvic fractures due to blunt trauma. Interventions -None. Measurements and Main Results -Pelvic injuries included pubic fractures (90.4%), ischial fractures (80.7%), sacroiliac luxations (57.8%), iliac fractures (43.4%), acetabular fractures (30.1%), and sacral fractures (13.3%). Thirty-one dogs (37%) had IA, which included hemoabdomen (27 dogs), uroabdomen (3), and septic abdomen (3); 2 dogs had 2 types of IA. Dogs with sacral fractures were significantly more likely to have IA than dogs without sacral fractures (P = 0.0162). Characterization of pelvic fractures included the direction of compression, presence of a weight-bearing bone fracture, and degree of pelvic narrowing, none of which had an association with IA (P > 0.05). Dogs were more likely to have IA if they had cardiac dysrhythmia (P = 0.0002) or hematuria (P = 0.0001), and were more likely to have a hemoabdomen if they had cardiac dysrhythmia (P = 0.0005). Dogs with hematochezia were more likely to have a septic abdomen (P = 0.0123). Dogs were more likely to receive a transfusion if they had AI (P = 0.033) or hemoabdomen specifically (P = 0.0033). Overall survival to discharge was 89%, which was significantly greater than survival in dogs with pelvic injury that also had septic abdomen (33%; P = 0.0299). Conclusions -IA is common in dogs with pelvic fractures, especially those with sacral fractures. Pelvic fracture characterization had no bearing on the presence of IA. (J Vet Emerg Crit Care 2016; 26(2): 288-294)

Retrospective evaluation of factors influencing transfusion requirements and outcome in cats with pelvic injury (2009–2014): 122 cases

“…The finding that the ATT score was associated with transfusion requirement and also survival to discharge is similar to the relationship between ISS and transfusion requirement and mortality in people with pelvic fractures. A previous study also demonstrated this relationship in dogs . This same study also suggested that hemoperitoneum, as detected by abdominal focused assessment with sonography for trauma (A‐FAST) scans, is a common finding in canine pelvic fracture patients with high ATT scores .…”

“…A previous study also demonstrated this relationship in dogs. 26 This same study also suggested that hemoperitoneum, as detected by abdominal focused assessment with sonography for trauma (A-FAST) scans, is a common finding in canine pelvic fracture patients with high ATT scores. 26 Although the cats in this study were not routinely screened for hemoabdomen, given the data available in dogs, inclusion of serial A-FAST evaluation may have further helped identify cats at risk of requiring a transfusion.…”

Abdominal trauma in dogs 1. emergency investigation

“…The pulse should be palpated at the same time to allow detection of pulse deficits (Fig 1). Dysrhythmias were shown to be associated with an increased likelihood of haemoabdomen in one canine trauma study (Hoffberg and others 2016). Pulse quality should be assessed at the level of both the femoral and the dorsal metatarsal pulses.…”

“…The presence of bruising around the umbilicus (Cullen's sign) can be suggestive of abdominal/retroperitoneal haemorrhage. Rectal examination can reveal the presence of pelvic fractures and also allow detection of haematochezia, which was found to be more frequent in dogs with septic peritonitis than in those without septic peritonitis in one retrospective study (Hoffberg and others 2016). The authors of this study also found that dogs with haematuria were more likely to have intra‐abdominal injury.…”

“…Although it is always important to consider the possibility of abdominal pathology in the trauma patient, if hindlimb or pelvic fractures are present it should be strongly considered and further investigation contemplated. One recent study found that 37 per cent of dogs presenting with pelvic fractures also had intra‐abdominal injuries (ie, haemoabdomen, uroabdomen or septic peritonitis) (Hoffberg and others 2016).…”