Suddenly all chaos broke loose. For a second it sounded like an unknown dog had got inside the fence. I grabbed my staff and was out the door before anyone else could react.
I was briefly reassured to see the fence was holding an unknown pit bull out but my pit bull was in full war mode. They were in fact fighting, trying to fight through the fence. Given enough time they would get through it, over it or under it. The hose was called for.
Moving quickly but carefully I unwind some hose and return to see the Sheltie engaged at the fence and I saw the moment that a two way fight through the fence turned into a three -way fight as the pit bull had engaged...pretty much everything around him. Just a split second too late I turned on the hose, disengaged my dogs and chased off the unknown dog with water.
Even though I've done many emergency and security roles, I can't eliminate that pulse of terror that runs through my body when I actually see somebody get injured. It's bad enough to be called to scenes where people are injured but you have some prep time. You are usually briefed on the situation, you get to assemble your gear on route for the call and you have some time to mentally steel yourself. I can't tell you how many hours I've spent in training for emergencies but when they actually happen there's that moment. And for me words like terror, horror and revulsion kick in first. And for me this one was pretty personally horrifying.
Shelties are herders. They are designed to work with a group, to have actual situational awareness and maintain long distance communication (visual or aural). They are fast and agile and they are made basically of legs and lungs. They can run almost for ever on dainty, almost spindly legs. Legs that fit almost entirely in the mouth of a large pit bull. And pit bulls want to bite and hold, they want to bite down. A large dog can break any single bone in yours or my body with about 850 pounds of crushing force. Therefore the extra dose of horror as I realized this conflict was for real and had injured the little one. Oh no.
The little guy was hurt. He cried in pain. Bad news. Bad, bad news. But then “the elevator goes all the way to the top” and that adrenaline rush hits that us emergency types not only know how to manage, we thrive on it. Your senses suddenly turn up to 110%, mind goes into hyperdrive, all of your training descends upon you like a gown of silken armor and in a split second, bam. You are in action.
- Separate combatants, war dog out, Sheltie in.
- Lift and cradle Sheltie off injured leg, very gently place on bed. Shut and lock door to establish control of scene.
- Reassurance flowing to Sheltie, I am the human, I will take care of you.
- Begin calming dog through kind touch and breathing patterns. Eliminate fear.
- Begin primary survey: determine extent of injury, single bit to left foreleg, no other injuries, no blood in ears, eyes, clear, nose and mouth clear.
- Gently palpate entire effected leg starting with shoulder. Shoulder still inserted into rotator cuff (good). Doggie humerus intact (good). Doggie radius and ulna seem intact (good). No puncture wounds on paw or paw pads (very good).
- Gentle, limited range of motion tests on all joints reveal no crepitus (grinding feeling of broken bones) or screams from dog.
- Swelling (edema) has begun around 6 puncture wounds--the classic dog bite pattern.
Diagnosis: Deep tissue puncture with deep tissue bruising due to crushing force. Classic large dog bite injury.
First aid: same as humans mostly. Immobilize the patient in a position of comfort that maintains airway, breathing and circulation (particularly in points on the other side of the injury from the heart (distil circulation) because broken bones can block off blood flow. No massive bleeding detected. At this point some splinting and dressing is indicted for the human, probably while we transport them to a hospital or doctor. For the animal most folks would have us transport the animal to a vet.
But heck we're preppers and in my family, dogs are a luxury animal. As have been horses for several generations. There's no budget for this treatment. If this same injury happened to me (which similar has several times) there's no budget for my treatment either. Besides we're preppers so here's where we begin our own second stage care and all following stages.
Remedial care: Try to clean and evaluate. the areas. With humans this might mean shaving hair away a good inch or so around the areas and with dogs it definitely means you are shaving. Shaving also preps you for sutures so don't be afraid to open up some field to work in. A good inch all around should suffice but hey, we want a sterile field so 2 inches is better.
Fortunately this dog wasn't scared to death by the little shaver I have on this face shaver I got in the thrift store for $2.00. It has a sideburn attachment or maybe a beard hacker and it's pretty quiet and didn't totally freak him out the way Bernie The Barber's scaled down lawn mowers would. If that didn't work I have a pair of those old fashioned “balding clippers”.
Manual balding clippers are a little trick I keep in my first aid kit (which is more like a field surgery than first aid kit) that everybody should have along with disposable razors for this purpose. For depilation (hair removal) in the field when you can't plug in a buzzer. Balding clippers are these old fashioned scissor thingies you might have seen in your grandfathers water closet cabinet. Pick up a pair in good order, the blade can be sharpened up and they work pretty good when you get the hang of them. There's a trick to not snagging the patient's hair with them and making them squeak (the patient not the shears).
Balding the bitten areas on my little guy I could see he got the primary canines in the center of leg mass. There wasn't much to do but clean the skin surface with some peroxide and let him bleed for bit.
Puncture wounds like bite wounds don't bleed profusely. In a way we almost wish they did. A good puncture will go through all of your dermal layers, the fatty layer underneath, the gliding membranes that cover our muscles, the muscles themselves, tendons, nerves and right down to bone. Whatever contaminants or pathogens you got punctured with might get flushed out a bit more with blood flow. My patient was internally contaminated.
See whatever was in pit bull's mouth was now in my patient's blood stream. Dog mouths, contrary to popular wisdom are not sanitary, antibacterial environments. To science they are full of very virulent (nasty) bacteria. So the continuing steps of care remained consistent with human treatment. Having shaved a good part of the Sheltie's leg I began to try to flush out and “departiculate” the punctures. And there's really not much you can do. “Washing” a wound that goes right through the skin and into the body is basically potentially injecting more foreign agents directly into the patient. With most lacerations and abrasions you don't have a direct hole into the body cavity and we more aggressively departiculate (pull out gravel twigs, dirt, etc). In this case I opted for peroxide to try and lift any contaminants close to surface and let them ooze.
Punctures tend to kinda ooze blood and they can continue to for a long time. Days in fact. Not only do you have severed blood vessels but with bites you have all this swelling and fluid building up because of crushed tissue. We actually want this to drain. Dogs have more of a tendency to abscess, which is develop pockets of infection below your skin and this is because a dog's skin kinda glides over their muscles. It's not as bound to their subderma the same way ours is and infection tends to develop right between those layers. Not that humans don't run the same risk but we also have hands and great flexibility to treat ourselves. For dogs, immediate sutures, steri-strips, skin glue in this case is not indicated. We don't want the skin to close with this type of puncture if we're not trying to control major bleeding. I applied triple-antibiotic to the areas and dressed them per normal to move on in treatment.
See the clock was running and each treatment phase has a window. The effected limb was now swelling and this would complicate treatment, increase risk and increase recovery time. So to reduce this, in addition to immobilization we have elevation, compression and ice.
Now with animals, immobilization, elevation, compression and ice aren't always practical, especially without tranqs but you use the options that you can. In our case, immobilization and ice worked better than anything else as we moved into phase 2 of care. We managed to calm the Sheltie enough to keep him on his side, effected limb in the air, immobilized and then we tried to get cold ice compresses on him and keep them there as long as we could. By now I had enlisted help. The “we” part was making a big positive difference as Shelties are very curious and he kept wanting to pick his head up to see what was going on. Having help to keep him reassured was very helpful. And just like a human patient he was very curious about all of the instruments and dressings and he wanted to find out what everything was by sniffing at it.
Again we come to a juncture where if you have received the same treatments at the hospital Emergency Room (ER), you would be given a course of follow up treatment and discharged on an outpatient basis. But we are the ER and we are the follow up treatment and we are the outpatient basis. And I had a problem with supply. I was out of antibiotics. And a ride to get some was not immediately at my disposal. I canvassed the neighbors and found no antibiotics. “You are who we come to for that stuff, L.J.", they said. It was true. And I had not restocked fast enough.
Garlic is a bactriostatic agent. It sometimes doesn't totally wipe out bacteria but it will keep it's growth in check. The little guy didn't like being made to swallow raw garlic but...he was a very good patient. Very tolerant. This held him to day 2 at which he was showing signs of sepsis. In dogs you will see the eyes go unclear, reddish, kinda fuzzy, nose will warm up and dry out and lethargy set in. A friend relented to my begging, and got to the pet store for fish antibiotics.
Perhaps the golden jewel in the prepper pharmacopial cabinet, pet stores have long been our exclusive source of affordable antibiotics. In this case we chose erythromycin. Intended for use in fish tanks, this comes in powdered form. A bit of research on human child dosages and a bit of guesstimation led me to about 1mg administered twice orally after an initial dose of 2 milligrams.
Lethargy diminished in 12 hours. His full energetic character resurfaced more fully in 24 hours. A save! See left untreated this dog would have suffered sepsis and died of organ failure probably within 48 hours. His immune system had already tried and failed to beat the bacteria in his blood. It was filling his body up with deadly toxins. That bite in the wild would have been fatal. I kept him on an 8 day course of treatment.
Now for a human the story would have likely been the end of it. Send them home with some gauze and some tape and let them dab vitamin E oil on their scabs. Human instinct tells them to complain. Dog instinct tells them to lick. A dog will lick right through their skin. Licking injuries are ugly and they can lead to all kinds of problems.
To make things worse, you really don't want to wrap gauze, tape or Ace bandages around animals like dogs. There's the chance they can get snagged on something or if you are wrapping their legs, the animal might nibble, tear and then find enough to actually pull on. They might tighten the bandage and cut off their own circulation and become seriously injured if you don't detect and correct the problem immediately. But I was running low on supplies. I left the little guy with a neighbor and dashed off to Prepperfest. Luckily not only did I know the guy behind one of the best stocked prepper medic tables but he heard the situation and picked up what I needed. Gauze bandage impregnated with no-lick, a chemical that doesn't harm dogs permanently, they just hate the taste. A quick loop of that stuck in place with no threat to circulation. Now little guy's wounds have closed nicely. He's out of the woods. A dog's life was saved. Take a deep bow folks. Our methods work.
Note that dosage here is important. The troublesome acute results of over-medicating with antibiotics can be anaphylaxis which is where your body becomes allergic to an element or compound which in time will produce symptoms like the sepsis we were originally treating for. Both will manifest in “shock” in acute stages (rapid, thready pulse, shallow respirations, lack of perfusion, low to no level of consciousness and eventually death).
Now as I've indicated, this is pretty much the same course of treatment I'd apply to myself or another human without access to medical care and as usual I take the legalistic precaution of saying “don't you try this at home.” But it's a common scenario and a very real application of preps. I'm fortunate to have had the training to be able to cope with a little help from friends.
The little Sheltie is back to springing like an arrow loosed from a compound bow (they accelerate through release), blazing through open fields and it's looks like we have many more years of fun together. It certainly makes me grateful to be a prepper and to have learned from so many people.
About The Author: L. Joseph Mountain recently published Hidden Harvest: Long Term Food Storage Techniques For Rich And Poor. He keeps a web site at www.LongTermStorageFood.com where "articles are sometimes archived, info is irregularly updated and questions are occasionally answered."