Dog Emergencies - Healthy Dog Experts

Emergency care is just that - care applied to a potentially serious condition as soon as possible while you are trying to reach your veterinarian or a 24 hour emergency clinic. One of the cardinal rules in dealing with any emergency is for you to remain calm. If you panic, you won't be thinking clearly and you will panic your dog. Take a deep breath, quietly reassure your dog and then do what is necessary. Don't hesitate to ask for help and remember your dog is relying on you.

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Home Emergency Medical Kit
Container for equipment	Tweezers
Penlight	Scissors
Blanket	Grooming clippers
Nylon leash	Needle-nose pliers
Muzzle (nylon or leather)	K-Y lubricant or petroleum jelly
Rectal thermometer	Rubbing alcohol
Surgical gloves	Sterile saline eye wash
Cotton balls	Hydrogen Peroxide
Cotton swabs	Topical antibiotic ointment
Surgical adhesive tape (1 inch-25mm wide)	Betadine or similar antiseptic scrub
Gauze roll (3 inches-70mm wide)	List of Emergency Phone Numbers:
Ace bandage (3 inches-70mm wide)	Your veterinarian's office
Gauze pads (3 inches-70mm wide)	24 hour emergency clinic
Syringe (plastic) without a needle	Friend or neighbor
Compressed activated charcoal tablets (5 grams each)	ASPCA Animal Poison Control Center (888) 426-4435

Handling and Restraint

Any dog, no matter how docile he may be, has the potential to bite when he is severely injured, frightened, or in pain. It is important to recognize this and take proper precautions to keep from being bitten. An injured dog who growls, snarls or raises his hackles is sending a clear message. Do not approach or attempt to restrain this dog. Call your local animal shelter or animal care and control agency for help.

Muzzles

All dogs should be muzzled for any handling or treatment that may be frightening or painful. Cloth muzzles are easy to store and can be slipped on easily. Soft muzzles with velcro closures can be purchased at most pet supply stores. An open cage muzzle is preferred for an injured or sick dog. It allows the dog to breath easily and if the dog vomits he will not aspirate the vomitus. Keep the muzzle with your home emergency medical kit (see chart above). If you do not have a commercial muzzle, you can make an acceptable substitute using adhesive tape, a piece of cloth, a length of roll gauze or a leash. Wind the tape around the dog's muzzle. Or make a large loop with the other materials that you can slip over the dog's muzzle. Then tighten this down around the dog's muzzle, bring the two ends behind the dog's ears and tie the end behind his head. Make sure the muzzle is not so tight that the dog cannot open his mouth slightly to breathe. There are circumstances where a dog should not be muzzled. It can be dangerous to muzzle a dog who is vomiting, coughing, having difficulty breathing or aggressively resisting the muzzle. Never muzzle an unconscious dog.

Restraining for Examination and Treatment

For the cooperative dog, routine procedures such as grooming, bathing and even medicating seldom require restraint. Gentle handling and a soothing voice will coax most dogs to accept such handling. Approach the task with quiet confidence. Dogs are quick to sense anxiety in their owners and copy it. For examinations and treatments that may excite or hurt the dog, it is important to restrain the dog before attempting the treatment. Once a dog is restrained, he usually settles down and accepts the procedure with little complaint.

The headlock is an excellent restraint for a large dog. First muzzle the dog. Then hold the dog securely against your chest with one arm around his neck and the other arm around his waist. This is the most commonly used restraint for a quick procedure such as giving an injection. To restrain a small dog, support the abdomen with one arm and grasp the outside front leg. Immobilize the head with the other arm. Hold the dog close to your body.

An Elisabethan collar, named for the high neck ruff popular during the reign of Queen Elisabeth 1 of England is also an excellent way of restraining dogs who are prone to bite. The collar is also used to keep a dog from scratching at his ears, removing sutures and biting at wounds and skin sores. These collars can be purchased at most pet supply stores. The size of the collar must be tailored to the dog. For the dog to be able to eat and drink, the outer edge of the collar should not extend more than one to two inches beyond the dogs nose. Most dogs adjust well to an Elisabethan collar. If the dog refuses to eat or drink with the collar on, temporarily remove it.

A newer option is the bitenot collar.This high-necked collar prevents a dog from turning his head to bite. As with an Elisabethan collar, good fit is important. The collar must be just as long as the dog's neck.

Another way to restrain the dog is to restrain him on his side by grasping the inside front and back legs and then sliding the dog down your knees to the floor. Hold his legs out straight and keep pressure with your forearms on his chest and pelvis to prevent him from getting up.

Incorrectly picking up or carrying a dog can make injuries much worse. Never pick up a dog by his front legs, as this can result in a dislocated shoulder or elbow. Carry a small dog cuddled in your arms with the injured side away from your body. With a large dog, place one arm around his chest or between his front legs. Place the other arm around his rump - or between his back legs if you suspect a hind-limb injury. Hold the dog close to your chest so you can't drop him if he squirms.

A dog in shock should be lying down on a flat surface or in a hamhock stretcher to facilitate breathing and to prevent a sudden drop in blood pressure. Suspect a back or spinal cord injury in any dog who is unconscious or unable to stand after a fall from a height or after being struck by a car. These dogs require special handling.

Artificial respiration is the emergency procedure used to assist air exchange in an unconscious dog. Heart message (chest compressions) is used when no heartbeat can be felt or heard. When chest compressions combined with artificial respiration, it is called cardiopulmonary resuscitaion (CPR). Because cessation of breathing is soon followed by heart stoppage and vise-versa, CPR is required in most life-threatening situations. While CPR can be performed by one person, it is easier and more often successful when done by two. One person does the artificial respiration while the other does the chest compressions. To determine which basic life-support technique will be required in an unconsious dog see the chart below.

Artificial Respiration or CPR ?
Is the dog breathing ?	Observe the rise and fall of the chest. Feel for air against your cheek
If YES	Pull out the tongue and clear the airway, observe
If NO	Feel for a pulse
Does the dog have a pulse ?	Feel for the femoral artery located on the inside of the mid-thigh
If YES	Start artificial respiration
If NO	Start CPR

Lay the dog on a flat surface with his right side down. Open his mouth and pull his tongue forward as far as you can (without injuring the dog) Clear any secretions with a cloth or handkerchief. Check for a foreign body. If present remove it if possible. If it is impossible to dislodge, perform the Heimlich Maneuver.

CPR is a combination of artificial respiration and heart message. If a dog needs heart message, he also needs artificial respiration. On the other hand, if the dog resists your attempts to perform CPR, he probably does not need it!

Continue CPR until the dog breathes on its own and has a steady pulse. If vital signs do not return after 10 minutes of CPR, the likelyhood of success is remote. Consider stopping CPR.

Note: that CPR has the potential to cause complications, including broken ribs and pneumothorax. Also, never practice artificial respiration or heart message on a healthy dog; you can seriously injure the dog.

Shock is caused by insufficient blood flow and oxygen to meet the body's needs. Adequate blood flow requires effective heart pumping, open, intact blood vessels and sufficient blood volume to maintain flow and pressure. Adequate oxygenation requires an open respiratory tract and enough energy to breathe. Any condition that adversely affects the circulatory or respiratory systems can cause shock. The cardiovascular system of an animal in shock will try to compensate for inadequate oxygen and blood flow by increasing the heart and respiratory rates, constricting the skin's blood vessels and maintaining fluid in the circulation by reducing urinary output. This requires additional energy at a time when the vital organs aren't getting enough oxygen to carry out normal activities. After a time, shock becomes self-perpetuating. Untreated, it results in death. Common causes of shock are hemorrhage, heart failure, anaphylactic (allergic) reactions, dehydration ( heat stroke, vomiting, diarrhea), poisoning and toxic shock associated with sepsis and peritonitis. Signs of early shock include panting, rapid heart rate, bounding pulses and a bright red color to the mucous membranes of the lips, gums and tongue. Many of these signs will be missed or considered mild - perhaps regarded as signs of a dog who overexerted himself. The later signs are when most owners notice and respond to their dog's condition. Signs of late shock (the ones seen most often) are pale skin and mucous membranes, a drop in body temperature, cold feet and legs, a slow respiratory rate, apathy and depression, unconsciousness and a weak or absent pulse.

Treatment: First, evaluate. Is the dog breathing? Is there a heartbeat? What is the extent of the injuries? Is the dog in shock?

Anaphylactic shock is an immediate, serious allergic reaction. It occurs when a dog is exposed to an allergen to which he has been sensitized. Sensitivity occurs through prior contact. The most common drug allergen that causes anaphylactic shock is penicillin. The venom in the stings of bees and wasps can also occasionally produce anaphylactic shock. Some dogs have been known to experience shock after a vaccination. Anaphylactic shock causes signs and symptoms different from those previously described for shock. Initially there may be local signs at the point of contact, including pain, itching, swelling and redness of the skin. With acute anaphylaxis, the allergic response becomes generalized, either immediately or over the course of several hours. Signs are agitation, diarrhea, vomiting, difficulty breathing, stridor (harsh breathing sounds) from a swollen voice box, weakness and circulatory collapse. In untreated cases, coma and death follow.

Treatment: Emergency treatment of anaphylactic shock involves administering intravenous or subcutaneous adrenaline, oxygen, antihistamines, IV fluids and hydrocortisone - drugs not available in the home. This is why it is best to have a trained professional (doggy doctor) give vaccinations (vaccinations can be very dangerous and damaging to a dogs immune system and vital organs), they have the drug and equipment to treat allergic reactions in time. A dog who has had an allergic reaction to a drug in their past should not be given that drug again.

An acute painful abdomen is an emergency that may lead to death of the dog unless treatment is started at once. The signs of an acute abdomen are the sudden onset of pain, along with whining and crying, retching and vomiting, extreme restlessness and an inability to find a comfortable position, grunting and labored breathing. The abdomen is extremely painful when pressed. Characteristically, the dog may assume a prayer position with his chest to the floor and his rump in the air. As the condition worsens, the dog's pulse becomes weak and thready, the mucous membranes become pale and the dog goes into shock. If you see any of these signs call an emergency animal hospital at once. Early surgical intervention is life-saving.

Most fractures are caused by automobile accidents and falls from a height. The bones most commonly broken are the femur, pelvis, skull, jaw and spine. Fractures are classified open or closed. In an open fracture (also called a compound fracture), a wound exposes the bone. Often the bone is seen sticking through the skin. These fractures are contaminated by dirt and bacteria and thus are accompanied by a high rate of bone infection. Signs of bone fractures include pain, swelling, an inability to bear weight and deformity with shortening of the affected leg.

Treatment: Injuries that cause fractures can also cause shock, blood loss and trauma to internal organs. Controling shock takes precedence over treating any fractures. A dog in pain is often uncooperative and may bite in self-defense. Take precautions to avoid being bitten. If necessary muzzle the dog. Open wounds over bones should be covered with a sterile dressing, using several gauze pads, if available. If you cannot get gauze pads, cover the wound with a clean cloth or towel and wrap loosely. If there is continued bleeding, carefully apply pressure to the site. Splinting fractures relieves pain and prevents shock and further tissue damage while the dog is being transported to the emergency animal hospital. The decision to splint is based on a number of factors, including the severity and location of the injury, the time it will take to get professional help, the presence of other injuries and the availability of materials. Note that improper splinting can cause more harm than good. Do not attempt to splint the leg if the dog resists. Always splint the limb in the position in which you find it. Do not attempt to straighten a crooked leg. An affective splint is one that crosses the joints above and below the fracture. When the fracture is below the knee or elbow, fold a magazine, a newspaper or a piece of thick cardboard around the leg. A cardboard roll, such as for paper towels or toilet paper may work if you slit it open. Extend the splint from the toes to a point well above the knee or elbow. Hold the splint in place by wrapping it with a roll of gauze, a necktie or tape. Do not wrap tightly. Fractures above the elbow and knee are difficult to splint. The best way to prevent further damage is to keep the dog as still as possible. Dogs in shock should be transported lying down, either on a flat surface or in a hammock stretcher, to facilitate breathing and prevent a drop in blood pressure. Head injuries and spinal cord injuries require special handling and transport. Fractures where the ends of bones are at angles or far apart must be reduced under general anesthesia by a trained professional, to bring the ends together and realign the bone. This is accomplished by pulling on the leg to overcome the muscular forces causing the displacement. Once reduced, the position of the bones must be maintained. In most dogs with fractures above the knee or elbow the position is held with pins and metal plates, while fractures below the knee or elbow are immobilized with splints and casts. Fractures involving joints usually require open surgery and repair with pins, screws and wire. Displaced jaw fractures cause malposition of the teeth. The jaw should be adjusted and the teeth wired together to maintain the correct position until healing is complete. Depressed skull fractures may require surgery to elevate the depressed fragments.

Burns are caused by heat, chemicals, electric shock or radiation. Hot liquids may scald a dog. Sunburn is an example of a radiation burn. It occurs on the noses of dogs with insufficient pigment and on the skin of white-coated dogs who are clipped short in the summer. The extent of skin damage depends upon the length of exposure.

A first-degree burn causes the skin to become red, slightly swollen and painful. It usually heals in about five days.

A second-degree burn is deeper and there is blistering. These burns are extremely painful. If there is no infection, healing is usually complete in 21 days.

A third-degree burn involves the full thickness of skin and extends into the subcutaneous fat. These burns appear charred, dry and leathery. The hair comes out easily when pulled. Deep burns, because they destroy nerve endings, usually are not as painful as second-degree burns. If more than 50 percent of the dog's body surface is involved with second-degree burns or if more than 30 percent is involved with third-degree burns, survival is unlikely.

Treatment: All but minor burns require professional attention. Protect the area from further injury by wrapping it with a loose-fitting damp gauze dressing and proceed at once to an emergency animal hospital. Extensive burns require extensive care to treat shock, adjust fluid and electrolyte losses and prevent secondary infection. If your dog appears to be suffering from electric shock, use a wooden implement to slide any cords away from him before you touch him. Alternatively, unplug all cords or turn off the circiut breakers so that you won't get a shock too. Small superficial burns that involve less than 5 percent of the body surface can be treated at home. Apply cool compresses (not ice packs) for 20 minutes to relieve pain and lessen the depth of the injury. Clip the coat over the burn and wash the skin gently with a surgical antiseptic such as dilute chlorhexidine solution. Apply a topical antibiotic ointment such as triple antibiotic and bandage the area. The bandage should be removed daily and the wound medicated and redressed. When acid, alkali, gasoline, kerosene or other chemicals have caused the burn or even come in contact with the skin, immediately flush the area with large amounts of water for 10 minutes. Wear rubber or plastic gloves and bathe the dog with mild soap and water. Blot dry, If there are any signs of burning (such as redness or blistering), call your local veterinarian for further instructions.

Prolonged exposure to cold will result in a drop in body temperature. Toy breeds, breeds with short coats, puppies and very old dogs are most susceptible to hypothermia. Because a wet coat loses its insulating properties, hypothermia is a potential complication for all dogs who have been submerged in cold water. Hypothermia also occurs along with shock, after a long course of anesthesia and in newborn puppies that get chilled because of inadequately heated whelping quarters. Prolonged cold exposure burns up stored energy and results in low blood sugar. Signs of hypothermia are violent shivering followed by listlessness, a rectal temperature below 95 degrees fahrenheit (35 degrees celsius), weak pulse, lethargy and coma. Note that hypothermic dogs can withstand prolonged periods of cardiac arrest, because the low body temperature also lowers the metabolic rate. CPR may be successful in such individuals.

Treatment: Wrap the dog in a blanket or coat and carry him into a warm building. If the dog is wet (he fell into icy water), dry him vigorously with towels. Wrap the dog in a warm blanket and take his rectal temperature. If the temperature is above 95 degrees fahrenheit, continue the warm blankets and encourage the dog to swallow a sugar solution such as honey or 4 teaspoons (32 grams) of sugar dissolved in a pint of water. If the dog's rectal temperature is below 95 degrees fahrenheit, notify a nearby emergency animal hospital or your veterinarian. While awaiting instructions, begin rapid warming by applying warm water bottles wrapped in towels to the dog's armpits and chest, then wrap the dog in a blanket. The temperature of the packs should be that of a baby bottle (warm to the wrist). Take the rectal temperature every 10 minutes. Change the warming packs until the rectal temperature reaches 100 degrees fahrenheit (37.8 degrees celsius). Do not apply heat directly to the dog, as this may cause burns, for the same reason, do not use a hair dryer to warm the dog.

Frost occurs when a part of the body freezes. It often accompanies hypothermia. Frostbite tends to involve the tail, ear tips, pads of the feet and scrotum. These parts are the most exposed and least protect by fur. Frostbitten skin is pale white or blue. As circulation returns, it becomes red and swollen and may begin to peel. Eventually it looks black with a line of demarcation between live and dead tissue. Dead skin and tissue separates from the body in one to three weeks.

Treatment:Apply warm (not hot) water soaks to the frostbitten part for 20 minutes or until the tissue becomes flushed. Never use snow or ice; tissue damage is made much more severe if thawing is followed by refreezing. Do not rub or message the affected parts. Handle them carefully. Take your dog to an emergency hospital for further evaluation or treatment. Note as sensation returns, frostbitten parts can be painful. Prevent the dog from biting at the skin and inflicting further injury using the restraint techniques described in handling and restraint (see above). The total extent of the damage may not be apparent for a week or more.

Dehydration occurs when a dog loses body fuids faster than he can replace them. Dehydration usually involves the loss of both water and electrolytes. In dogs, the most common causes of dehydration are severe vomiting and dirrhea. Dehydration can also be cause by inadequate fluid intake, often associated with fever and severe illness. A rapid loss of fluids also occurs with heat stroke. A prominent sign of dehydration is loss of skin elasticity. When the skin along the back is pulled up, it should spring back into place. In a dehydrated animal, the skin stays up in a ridge. Another sign of dehydration is dryness of the mouth. The gums, which should be wet and glistening, become dry and tacky. The saliva is thick and tenacious. In an advanced case, the eyes are sunken and the dog exhibits signs of shock, including collapse.

Treatment: A dog who is visibly dehydrated should recieve immediate hospital care, including intervenous fluids, you replace fluids and prevent further loss. For mild dehydration, if the dog is not vomiting you can give him an electrolyte solution by bottle or syringe into the cheek pouch. Balanced electrolyte solutions for treating dehydration in children, such as Ringer's lactate with 5 percent dextrose in water or pedialyte solution, are available at drug stores and are also suitable for dogs. Gatorade is another short-term substitute to help replace fluids. Administer the solution at a rate of 2 to 4 ml per pound (1 to 2 ml per kilo) of body weight per hour, depending on the severity of the dehydration.

Any condition that prevents oxygen from getting to the tissues causes suffocation. The most common emergencies in this catagory are drowning, smothering in an airtight space, being overcome by toxic fumes (smoke, gasoline, propane, refrigerants, solvents and others), choking from a foreign body in the throat, being poisoned by carbon monoxide and suffering a penatrating wound of the chest. Signs of oxygen deprivation (called hypoxia) are extreme anxiety, straining to breathe and gasping for air (often with the head and neck extended), followed by loss of consciousness as the dog succumbs. The tongue and mucous membranes turn blue, a condition called cyanosis. One exception to the blue color of hypoxia is carbon monoxide poisoning. Carbon monoxide turns the blood and mucous membranes bright red. Carbon monoxide poisoning is seen in dogs who are trapped in burning buildings, transported in the trunk of a car or left in an unventilated enclosure such as a garage with the car engine turned on. Although most dogs are good swimmers, drowning can occur if a dog swims to far out and becomes fatigued, falls through the ice, is caught in a flood or is unable to climb out of a swimming pool. The sudden onset of gasping and struggling to breathe in a healthy dog suggests a foreign object lodged in the throat.

Treatment:The immediate need to reestablish breathing with fresh air. If breathing is shallow or absent, begin artificial respiration (as seen above). As soon as possible, transport your dog to the nearest animal hospital for ventilation support. Carbon monoxide poisoning is frequently associated with smoke inhalation and burns of the mouth and throat. Carbon monoxide binds with hemoglobin and blocks the delivery of oxygen to the tissues. Even though the dog is breathing deeply, oxygen transport will be compromised for several hours. Breathing a high concentration of oxygen helps to overcome these effects. A trained professional will be able to provide this therapy using an oxygen mask, a nasal tube or an oxygen cage. If the dog has an opened wound in the chest (pneumothorax) with air sucking in and out, pinch the skin together over the wound to seal the chest. Maintain the seal with a bandage wrapped around the chest and transport the dog to the nearest emergency animal hospital. The first step in treating drowning is to remove the water from the dog's lungs. Hold the unconscious dog upside down by his middle (hold a small dog by his back legs) and allow as much water as possible to run out his nose and mouth. Then quickly position the dog on his right side with his head lower than his chest (accomplish this by placing a blanket or coat beneath his hindquarters) and begin artificial respiration. Check for a pulse. If there is none, begin CPR. Continue until the dog breathes on his own or until no pulse is felt for 10 minutes. Dogs who drown in cold water are often hypothermic and can sometimes be resuscitated even though they have been under water for a considerable amount of time. Following resuscitation, the dog should be seen and treated by a trained professional. Inhalation pneumonia is a frequent complication.

Electric shock (electrocution) can occur when dogs bite electric cords or come into contact with downed wires. A lightning strike is a rare cause of electrocution, but a dog does not have to be struck to be seriously injured or killed. A tall tree with deep roots and spreading branches can act as a conduit for a bolt of lightning, conducting electricity through the ground to any animal in the immediate vicinity. Most lightning strikes are fatal. The singed hair and skin give evidence of the cause of death. A dog who gets an electric shock may be burned. The electric shock may cause an irregular heartbeat with circulatory collapse, followed by cardiac arrest. Electric current also damages the capillaries of the lungs and leads to the accumulation of fluid in the air sacs, a condition called pulmonary adema. A characteristic sign of electric shock injury is finding the unconscious dog on the floor near an electrical outlet. Electric shocks cause involuntary muscle contractions of the dog's jaw that may prevent him from releasing his hold on a live wire. Dogs who survive electric shock may cough, have difficulty breathing, drool, have an offensive mouth odor and have burns in the mouth.

Treatment: If your dog is found in contact with an electric cord or appliance, do not touch the dog. First shut off the main power and pull the plug. If that's not possible, use a piece of wood to move the source of the electricity off the dog, or to move the dog away from the electricity. If the dog is unconscious and is not breathing, administer artificial respiration (as described above) or CPR if needed (also described above). Dogs who revive from electric shock should be seen by a veterinarian at once.

Prevention: Electric cord shocks can be prevented by placing cords in inaccessible locations, covering cords with plastic sleeves, unplugging cords when not in use and providing appropriate chewing toys for puppies and dogs.

Heat stroke is an emergency and requires immediate treatment. Because dogs do not sweat (except to a minor degree through their foot pads), they do not tolerate high environmental temperatures as well as humans do. Dogs depend upon panting to exchange warm air for cool air. But when air temperature is close to body temperature, cooling by panting is not an efficient process.

Heat stroke begins with heavy panting and difficulty breathing. The tongue and mucous membranes appear bright red. The saliva is thick and tenacious and the dog often vomits. The rectal temperature rises to 104 degrees to 110 degrees fahrenheit (40 degrees to 43.3 degrees celsius). The dog becomes progressively unsteady and passes bloody diarrhea. As shock sets in, the lips and mucous membranes turn gray. Collapse, seizure, coma and death rapidly insue.

Treatment: Emergency measures to cool the dog must begin at once. Move the dog out of the source of heat, preferably into an air-conditioned building. Take his rectal temperature every 10 minutes. Mild cases may be resolved by moving the dog into a cool enviornment. If the rectal temperature is above 104 degrees fahrenheit, begin rapid cooling by spraying the dog with a garden hose or immersing him into a tub of cool water (not ice water) for up to two minutes. Alternatively, place the wet dog in front of an electric fan. Cool packs applied to the groin area may be helpful, as well as wiping his paws off with cool water. Monitor his rectal temperature and continue the cooling process until the rectal temperature falls below 103 degrees fahrenheit (39 degrees celsius). At this point, stop the cooling process and dry the dog. Further cooling may induce hypothermia and shock. Following an episode of heat stroke, take your dog to an animal hospital as soon as possible. Heat stroke can be associated with laryngeal edema. This seriously worsens the breathing problem and may require an emergency tracheostomy. Other consequences of hyperthermia include kidney failure, spontaneous bleeding, irregular heartbeat and seizures. These complications can occur hours or days later.

A poison is any substance harmful to the body. Dogs, being curious by nature, tend to explore out-of-the-way places such as wood piles, weed thickets and storage areas. These environments put them into contact with insects, dead animals, toxic plants and poison baits. Itr also means the exact cause of poisoning will not be known in many cases. Intensional, malicious poisoning is a factor to consider whenever a dog is found dead without apparent cause. However, several studies have shown most cases of sudden death are caused by accidents and natural events. Malicious poisoning does occur, but it is far less common than accidental poisoning. General recommendations for the treatment of poisoning are discussed in the next section. In the sections that follow, specific poisons are discussed in the order in which they are most frequently seen by a trained professional (doggy doctor).

If your dog ingests an unknown substance, it is important to determine whether that the substance is a poison. Most products have labels that list their ingredients, but if the label does not tell you the composition and toxicity of the product, call the ASPCA Animal Poison Control Center at (888) 426-4435 for specific information. The Poison Control Center has a staff of licensed veterinarians and board-certified toxicologists on call 24 hours a day, every day of the year. You will be charged a consultation fee of $50 dollars per case, which can be charged to most major credit cards. There is no charge for follow-up calls in critical cases. At your request, they will also contact your veterinarian. In some cases, you can call the emergency room at your local hospital , which may be able to give you information on how you can treat the poison. Specific antidotes are available for some poisons, but they cannot be administered unless the poison is known, or at least suspected by the circumstances. Some product labels have phone numbers you can call for safety information about their products. When signs of poisoning develop, the most important consideration is to get your dog to the nearest emergency animal hospital as soon as you can. If possible, find the poison and bring the container with you. This provides the emergency personnel with an immediate diagnosis and expedites treatment. If the dog has ingested the substance recently, residual poison is often present in his stomach. An initial and most important step is to rid the dog's stomach of any remaining poison. The most affective way to empty the stomach is to pass a stomach tube, remove as much of the stomach contents as possible and then wash the stomach out with large volumes of water. This must be done by a trained professional.

In many cases it is preferable to induce vomiting at the scene rather than proceed directly to the animal hospital. For example: if you see the dog swallow the poisonous substance, it is obviously best to make the dog vomit it right back up. Similarly, if the poison was ingested within two hours but it will take 30 minutes or longer to get to a animal hospital, it is frequently advisable to induce vomiting at home.

4If the dog is in a stupor, breathing with difficulty, or shows any sign of neurologic involvement

4If the dog has swallowed an acid, alkali, cleaning solution, household chemical or petroleum product

4If the dog has swallowed a sharp object that could lodge in the esophagus or perforate the stomach

Induce vomiting by giving the dog hydrogen peroxide. A 3 percent solution is most effective. Give one teaspoon (5 ml) per 10 pounds (4.5 kg) body weight of the dog. Repeat every 15 to 20 minutes, up to three times, until the dog vomits. Walking the dog after giving each dose may help to stimulate vomiting.

Once the poison has been cleared from the dog's stomach, give him activated charcoal to bind any remaining poison and prevent further absorption. The most effective and easily administered home oral charcoal product is compressed activated charcoal, which comes in 5 gram tablets. The dose is one tablet per 10 pounds (4.5 kg) of body weight.

If activated charcoal is not available , coat the intestines with milk and egg whites using 1/4 cup (60 ml) egg whites and 1/4 cup per 10 pounds (4.5 kg) of body weight. Administer into the dogs cheek pouch using a plastic syringe.

Intensive care in a animal hospital improves the survival rate for dogs who have been poisoned. Intravenous fluids support circulation, treat shock, and protect the kidneys. A large urine output assists in eliminating the poison.

Seizures caused by poisons are associated with prolonged periods of hypoxia and the potential for brain damage. Continuous or recurrent seizures are controlled with intravenous diazepam (Valium) or barbiturates, which must be administered by a trained professional. Note that seizures caused by strychnine and other central nervous system poisons may be mistaken for epilepsy. This could be a problem, because immediate veterinary attention is needed in cases of poisoning, but not for most epileptic seizures. Seizures caused by poisoning usually are continuous or recur within minutes. Between seizures the dog may exhibit tremors, lack of coordination, weakness, abdominal pain and diarrhea. In contrast, most epileptic seizures are brief, seldom lasting more than two minutes, and are followed by a quiet period in which the dog appears dazed but otherwise normal.

If your dog's coat or skin comes in contact with a poisonous substance or toxic chemical, flush the site with large amounts of water for 30 minutes. Wear rubber or plastic gloves and give the dog a complete bath in lukewarm water. Even if the substance is not irritating to the skin, it must be removed. Otherwise the dog may lick it off and swallow it.

Unintentional overdose with veterinary medications and ingestion of both human and veterinary pills are the most common causes of poisoning in pets. Veterinary products, in particular, are often flavored to encourage a dog to take them and will be eagerly consumed if they are discovered. Many people give over-the-counter medications to their dogs without veterinary approval, to treat a variety of symptoms; they believe that what works for people works for dogs. Unfortunately, this is not correct. Drugs given to dogs in human dosages are often toxic - and some human drugs cannot be given to dogs in any amount. Common pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) are a particular problem. Dogs and cats do not have the necessary enzymes to detoxify and eliminate these drugs. This can lead to the accumulation of dangerous substances in the animal that are left behind when the drugs are metalbolized. As few as two Tylenol tablets can produce severe organ damage in a medium-size dog. Symptoms develop quickly and include abdominal pain, salivation, vomiting and weakness. Other human drugs that produce a variety of toxic effects and are commonly involved in accidental poisonings include antihistmines, sleeping pills, diet pills, heart pill, blood pressure pills and vitamins.

Treatment: if you suspect your pet has swallowed any drug, immediately induce vomiting. Call your trained professional for further instructions. A specific antidote may be available for the drug in question.

Prevention: Accidental poisoning can be prevented by always consulting your trained professional before administering any medication. Follow instructions exactly for frequency and dosage. Store all drugs in a secure place to prevent inadvertent consumption by pets and children. Never assume that a human drug is safe for pets!

Common rat and mouse poisons include anticoagulants and hypercalcemic agents. Both can be deadly if your dog ingests them.

Anticoagulant rat and mouse poisons are the most commonly used household poisons. These products account for a large number of accidental poisonings in dogs and cats. Anticoagulants block the synthesis of vitamin K, essential for normal blood clotting. Vitamin K deficiency results in spontaneous bleeding. Observable signs of poisoning do not occur until several days after exposure. The dog may become weak and pale from blood loss, have nose bleeds, vomit blood, have rectal bleeding, develop hematomas and bruises beneath the skin or have hemorrhges beneath the gums. The dog may be found dead from bleeding into the chest or abdomen. There are two generations of anticoagulants, both in current use. The first generation are cumulative poisons that require multiple feedings over several days to kill the rodent. These poisons contain the anticoagulants warfarin and hydroxycoumadin. Second-generation anticoagulants contain bromadiolone and brodifacoum, poisons that are 50 to 200 times more toxic than warfarin and hydroxycoumadin. These products are more dangerous to pets and are capable of killing rodents after a single feeding. It is even possible for a small dog to be poisoned by eating a dead rodent with residual poison in its stomach. Closely related to the second-generation anticoagulants are the long-acting anticoagulants of the indanedione class (pindone, diphacinone, diphenadione and chlorphacinone). These products are extremely toxic.

Treatment: Seek immediate trained professional help. If at all possible, bring in the product container so the trained professional can identify the poison. This is important because treatment depends on whether the poison was a first-or-second generation anticoagulant. With observed or suspected recent ingestion, induce vomiting. Treatment of spontaneous bleeding caused by all anticoagulants involves administering fresh whole blood or frozen plasma in amounts determined by the rate and volume of blood loss. Vitamin K 1 is a specific antidote. It is given by subcutaneous injection and repeated subcutaneously or orally as necessary until clotting time returns to normal. With first-generation anticoagulants, this often occurs within a week. With long-acting anticoagulants, treatment takes up to a month because of the length of time the poison remains in the dog's system.

Hypercalcemic agents are poisons that contain vitamin D (cholecalciferol) as their effective agent. Cholecalciferol poisons work by the calcium content in blood serum to toxic levels, eventually producing cardiac arrhythmias and death. They are becoming increasingly popular because rodents do not develop resistance to them and, with the rare exception of a puppy or small dog, dogs who eat poisoned rodents will not develop toxicity. In virtually all cases, the dog must eat the poison itself to become ill. In dogs, signs of hypercalcemia appear 18 to 36 hours after ingesting the poison. They include thirst and frequent urination, vomiting, generalized weakness, muscle twitching, seizures and finally death. Among survivors, the effects of an elevated serum calcium may persist for weeks.

Treatment: If you suspect your dog has ingested one of these poisons within the past four hours, induce vomiting and notify your trained professional. Trained professionals treatment involves correcting the fluid and electrolyte imbalances and lowering calcium levels using diuretics, prednisone, oral phosphorus binders and a low-calcium prescription diet. Calcitonin is a specific antidote, but it is difficult to obtain and has only short-term effects.

Poisoning by antifreeze that contains ethylene glycol is one of the most common small animal toxicities. Antifreeze has a sweet taste that appeals to dogs. Exposure typically occurs when antifreeze drips from the car radiator and is lapped up by the pet. Dogs may also drink from the toilet bowl in vacation homes that have been winterized by pouring antifreeze into the bowl. Less than 3 ounces (88 ml) is enough to poison a medium-size dog. The poison primarily affects the brain and the kidneys. Signs of toxicity are dose-related, and occur within 30 minutes to 12 hours after ingestion. They include depression, vomiting, an uncoordinated "drunken" gait and seizures. Coma and death can occur in a matter of hours. Dogs who recover from acute intoxication frequently develop kidney failure one to three days later. Death is common.

Treatment: If you see or suspect that your pet has ingested even a small amount of antifreeze, immediately induce vomiting and take your dog to the trained professional. If treatment will be delayed, administer activated charcoal to prevent further absorption of ethylene glycol. A specific antidote (4-methylpyrazole) is available to treat poisoning. It is most effective when given shortly after ingestion and early in the course of treatment. Intensive care in an animal hospital may prevent kidney failure.

Prevention: This common cause of pet and child poisoning can be prevented by keeping all antifreeze containers tightly closed and properly stored, preventing spills and properly disposing of used antifreeze. A new generation of antifreeze products contain propylene glycol rather than ethylene glycol. The U.S.Food and Drug Administration has labeled propylene glycol as "generally recognized as safe," which means it can be added to foods. However, that is in small amounts. Ingesting propylene glycol antifreeze can cause lack of coordination and possibly, seizures, but is unlikely to be fatal.

Animal baits containing strychnine, sodium fluoroacetate, phosphorus, zinc phosphide and metaldehyde are used in rural areas to control gophers, coyotes and other predators. They are also used in stables and barns to eliminate rodents. These baits are highly palatable and therefore may be accidentally ingested by a dog. Many are extremely toxic and kill in a matter of minutes. Fortunately, they are being used less frequently because of livestock losses, concerns about persistence in the environment, and the potential to poison pets and children.

Strychnine is used as a rat, gopher, mole and coyote poison. In concentrations greater than 0.5 percent its use is restricted to certified exterminators. It is available to the public in concentrations of 0.3 percent or less. With better regulation and the use of lower concentrations, strychnine is becoming a less common cause of accidental poisoning. Signs of strychnine poisoning appear within two hours of ingestion. They include agitation, excitability and apprehension followed rather quickly by intensely painful convulsions with rigid extension of all four limbs. Seizures last about 60 seconds, during which time the dog throws his head back, stops breathing and turns blue. The slightest stimulation, even touching the dog or clapping the hands, can trigger a seizure. This type of seizure response is typical only of strychnine. Other signs of poisoning include tremors, champing, drooling, uncoordinated muscle spasms, collapse and paddling of the legs.

Treatment: Induce vomiting immediately after ingestion. But do not induce vomiting if the dog is unresponsive, convulsing or having difficulty breathing. Cover the dog with a coat or blanket and proceed as quickly as possible to the nearest trained professional clinic. Further treatment involves administering intravenous diazepam (Valium) or barbiturates to control seizures. The dog is placed in a dark, quiet room and disturbed as little as possible.

Sodium fluoroactate (compound 1080/1081), a very potent rat and gopher poison, is restricted to licensed pest control operators and is used infrequently in the United States. Dogs and cats have been poisoned by eating a dead rodent that has ingested the poison. The onset is sudden and begins with vomiting, followed by agitation, staggering, convulsions and collapse.

This poison, often combined with arsenic, is found in rat, snail and slug baits. It is also used as a solid fuel for camp stoves. The dry form looks and tastes like dog food. Signs of toxicity include excitation, drooling and slobbering, uncoordinated gait, muscle tremors, inability to stand and continuous seizures that eventually lead to death from respiratory paralysis. Signs may appear immediately or up to three hours after ingestion. Dogs who survive the acute poisoning may die from secondary liver failure.

This extremely toxic chemical is used in rat and roach poisons and is also found in fireworks, matches and matchboxes. A poisoned dog may have a garlic odor to his breath. The first signs of intoxication are vomiting and diarrhea. this is followed by an interval of normal behavior, then by further vomiting, cramps, pain in the abdomen, convulsions and coma.

Treatment: Induce vomiting when you suspect the dog has ingested a product or poison that contains phosphorus. Do not coat the bowel with milk or egg whites, as this can actually promote absorption. Take your dog to the nearest trained professional facility. There is no specific antidote.

This substance is found in rat poisons and is used by pest control professionals as a grain fumigant. Zinc phosphide in the stomach releases gas that has the odor of garlic or rotten fish. Intoxication causes depression, rapid labored breathing, vomiting (often of blood), weakness, convulsions and death.

Treatment: Treatment is similar to that described for strychnine poisoning. The lavage must be done at a trained professionals clinic. There is no specific antidote. The stomach should be lavaged with 5 percent sodium bicarbonate, which raises the gastric pH and delays the formation of gas.

There are dozens of products sold at hardware, home repair, and agricultural stores to kill ants, termites, wasps, garden pests and other insects. most of them contain organophosphates and carbamates as thier active ingredients. With the development of pyrethrin insecticides that are equally effective but much less toxic, organophosphates and carbamates are being used less frequently.

The organophosphates include chlorpyrifos, diazinon, phosmet, fenthion, cythioate and tetrachlorvinphos. The common carbamates are carbyl and propexur. Most cases of organophosphate or carbamate poisoning occur because the dog ingested a poison bait. Exposure to high concentrations of chemicals in sprays and dusts also occurs. Signs of toxicity are hyperexcitability, excessive salivation and drooling, frequent urination, diarrhea, muscle twitching, weakness, staggering, collapse and coma. Death is by respiratory failure.

Treatment: If you suspect that your dog has ingested an insecticide poison, immediately induce vomiting and notify your trained professional. With any sign of toxicity, the first priority is to get your dog to the trained professional as quickly as possible. The specific antidote for organophosphate poisoning (not carbamate poisoning) is 2-PAM (protopam chloride). Atropine is given for both organophosphate and carbamate poisoning to control excessive salivation, vomiting, frequent urination and defecation and to reverse a slow heart rate. Seizures are controlled with diazepam (Valium) or barbiturates. In the event of skin exposure, give the dog a bath with soapy water and rinse thoroughly to remove residual insecticide.

These compounds, of which the prototype is DDT, are added to sprays and dusts to control plant pests. Their use has been curtailed because of persistent toxicity in the environment. Only lindane and methoxychlor are approved for use around livestock. Chlorinated hydrocarbons are readily inhaled and easily absorbed through the skin. Toxicity can occur from repeated or excessive exposure. Signs of toxicity appear rapidly. They include hyperexcitability with twitching of the face, followed by muscle tremors that begin at the head and progress back to involve the neck, shoulder, trunk and the rear legs. Seizures and convulsions are followed by respiratory paralysis and death.

Treatment: There is no specific antidote. Treatment includes supporting life functions, removing ingested poison from the stomach and controlling seizures.

These compounds are incorporated into many insecticidal shampoos, sprays, dusts, dips, foggers and sprays. Pyrethrins and the synthetic pyrethroids are much safer to use on and around dogs (and humans) than are other insecticides, and they are being used more widely. Many over-the-counter topical flea-control products have concentrated pyrethrins as their active ingredients. Some dogs may be adversely affected by that level of pyrethrins. Common chemicals in this class include permethrin, allethrin, fenvalerate, resmethrin and sumethrin. Signs of toxicity include drooling, depression, muscle tremors, staggering, vomiting and rapid labored breathing. Toxicity occurs primarily in small dogs. Death is rare. Simultaneous exposure to organophosphates increases the toxicity of pyrethroids.

Treatment: Induce vomiting within two hours of ingestion. Call your local animal hospital for further instructions. Do not induce vomiting if the product contains a petroleum distillate. With signs of toxicity, proceed immediately to the trained professionals clinic. For topical exposure, remove residual insecticide by bathing the dog in lukewarm water and Dawn dishwashing soap or canine shampoo to strip out the chemicals. (Do not use flea shampoo). Rinse very thoroughly. Bathing in hot or cold water may actually incease the rate of absorption or cause hypothermia, which increases toxicity. After bathing, keep the dog warm.

Prevention: Most cases of poisoning occur because of improper application of flea-control products. That may be because the product is being used more often than the instructions call for, or is being combined with another flea-control product. Follow all instructions carefully.

This heavy metal is used in herbicides, insecticides and wood preservatives. Sodium and potassium arsenate are used in ant poisons. Arsenic has a very rapid action and therefore poses a major risk for accidental poisoning. Death can occur quickly, even before symptoms are observed. Fortunately, the use of arsenic has been greatly curtailed. Signs of poisoning include thirst, drooling, vomiting, staggering, intense abdominal pain, cramps, diarrhea, paralysis and death. The breath of the dog has a strong garlic odor.

Treatment: Proceed at once to the nearest emergency Trained Professionals facility. BAL (British Anti Lewisite) is a specific antidote and should be given as soon as the diagnosis is suspected.

Corrosive and caustic chemicals (acids and alkalis) are found in household cleaners, toilet bowl cleaners, dishwasher detergents, anti-rust compounds, alkaline batteries, drain decloggers and commercial solvents. When ingested, they cause burns of the mouth, esophagus and stomach. Severe cases cause perforations of the stomach and strictures of the esophagus, which may develop over time due to the tissue damage.

Treatment: Do not induce vomiting. Vomiting can result in rupture of the stomach and burns of the esphagus. Rinse the dog's mouth immediately after contact and take him as quickly as possible to the nearest Trained Professionals clinic. If you can't get to the clinic very quickly, give the dog water or milk (30 ml per 6 pounds or 2.7 kg of body weight) by plastic syringe to dilute the acid or alkali in the stomach. The practice of giving an acid to neutralize an alkali and vice versa is no longer recommended, because it causes heat injury to the tissues. With topical exposure, flush the area with water for 30 minutes.

Gasoline, kerosene and turpentine can cause pneumonia if aspirated or inhaled. (Ingesting them usually causes gastrointestinal upset, but is not as serious). Signs of toxicity include vomiting, rapid labored breathing, tremors, convulsions and coma. Death is by respiratory failure.

Treatment: Do not induce vomiting. Treat as described in the previous section on for corrosive household products. Flush the mouth with water to remove petroleum residue. Petroleum products are extremely irritating to the skin and must be removed as quickly as possible. Bathe the skin using warm soapy water.

Lead is found in fishing weights and is a base for some artists' paints. Other sources of lead include linoleum, drywall (sheetrock), batteries, plumbing materials, putty, lead foil, solder, golf balls, old paint chips and tar paper. The use of commercial lead-free paints has significantly reduced the frequency of lead intoxication. Poisoning occurs primarily in puppies and dogs who chew and swallow objects that contain lead. Toxicity usually requires repeated exposure. Acute lead intoxication is characterized by vomiting and a very painful abdomen. With chronic exposure, a variety of central nervous system signs can develop. They include seizures, uncoordinated gait, excitation, continuous barking, attacks of hysteria, weakness, stupor and blindness. Chewing and champing fits may be mistaken for the encephalitis of distemper.

Treatment: If you suspect your dog has ingested lead, induce vomiting. Seek trained professional attention. Blood tests will be done to check for lead levels. Specific antidotes to bind and remove lead from the dog's system are available from your trained professional.

Pennies made after 1982 have a zinc core. This heavy metal can be toxic to dogs, leading to hemolytic anemia, blood in the urine, and possible kidney failure. If you see your dog ingest pennies, induce vomiting. Many times clinical signs do not show up for days, as the stomach acid dissolves the metal. Surgery to remove any pennies may be required and your dog may need hospitalization for fluids and to attempt therapy to chelate (remove from the body) the zinc.

There are two species of poisonous toads in the United States: the Colorado River toad, found in the Southwest and Hawaii; and the marine toad, found in Florida. There is one species of poisonous salamander: the California newt, found in California. All toads, even the ones that aren't poisonous, have a bad taste. Dogs who mouth them slobber, spit and drool. This does not necessarily mean the dog has been poisoned. Toxicity depends upon the virulence of the toad or salamander venom, the size of the dog and the amount of poison absorbed. The marine toad, for example, is highly poisonous, causing death in as few as 15 minutes. Symptoms can vary from slobbering to convulsions, blindness and death. Puppies and small dogs are more likely to develop toxicity.

Treatment: Repeatedly flush the dog's mouth using a garden hose if necessary and induce vomiting. Be prepared to administer CPR. Dogs with salamander poisoning generally recover quickly.

The stings of bees, wasps and yellow jackets and the bites of ants all cause painful swelling and redness at the site of the sting, usually on a hairless area such as the nose of feet. The swelling may include the face and neck, even if the dog was not stung on the face. If the dog is stung many times, he could go into shock as a result of absorbed toxins. Occasionally, anaphylactic shock develops in a dog who has been stung in the past. The bites of black widow and brown recluse spiders are toxic to animals. The first sign is sharp pain at the site of the bite. Later the dog develops intense excitability, fever, weakness and muscle and joint pains. Seizures, shock and death can occur, especially with the bite of the black widow spider. An antivenom is available to treat these bites. The stings of centipedes and scorpions cause a local reaction and at times severe illness. These bites heal slowly.

If the dog exhibits signs of hypersensitivity to the venom (agitation, face, scratching, drooling, vomiting, diarrhea, difficulty breathing, collapse or seizures), take him at once to the nearest animal hospital for treatment of anaphylactic shock.

Poisonous and nonpoisonous snakes are widely distributed throughout North America. Ninety percent of snakebites in dogs involve the head and legs. In the United States there are four types of poisonous snakes: cottonmouths (also called water moccasins), rattlesnakes, copperheads and coral snakes. The diagnosis of poisonous snakebite is made by the appearance of the bite, the behavior of the animal and your identification of the species of snake. In general, bites of nonpoisonous snakes do not cause swelling or pain. They show teeth marks in the shape of a horseshoe, but no fang marks.

You can identify these species by their large size (4 to 8 feet, 1.2 to 2.4 m, long), triangular heads, pits below and between the eyes, elliptical pupils, rough scales and the presence of retractable fangs in the upper jaw.

The bite: You may see one or two bleeding puncture wounds in the skin; these are fang marks. These marks may not be visible because of the dog's coat. The pain is immediate and severe. The tissues are swollen and discolored due to bleeding at the site of the bite. Note that 25 percent of poisonous snakebites lack venom and thus do not produce a local reaction. While absence of local swelling and pain is a good sign, it does not guarantee the dog won't become sick. Severe venom poisoning has been known to occur without a local reaction.

The dog's behavior: Signs of envenomation may take several hours to appear because of variables such as time of the year, species of the snake, toxicity of the venom, amount injected, location of the bite, and size and health of the dog. The amount of venom injected bears no relationship to the size of the snake. Signs of venom poisoning include extreme restlessness, panting, drooling, vomiting, diarrhea, uncoordinated gait, respiratory depression, shock and sometimes death.

Compare the characteristics of pit vipers and
nonpoisonous snakes. Note the elliptical pupil,
pit below the eye, large fangs, characteristic
bite and single row of subcaudal plates on the
belly of the pit viper.

Identify this snake by its rather small size (less than 3 feet, .9 m, long), small head with black nose, and brightly colored alternating bands (red, yellow and black) fully encircling the body. The fangs in the upper jaw are not retractable.

The bite: The puncture wounds from a bite are small and the pain is mild. There is little local reaction.

The dog's behavior: Coral snake venom is neurotoxic, meaning it affects the nerves and causes weakness and paralysis. Signs may be delayed for several hours. They include muscle twitching, pinpoint pupils, weakness, difficulty swallowing, shock and collapse. Death is by respiratory paralysis.

First identify the snake and look at the bite. If the snake is not poisonous, clean and dress the wound as described in the section on Wounds (below). If it appears the dog has been bitten by a poisonous snake, proceed at once to the trained professional's hospital. (If the snake has been killed, take it with you for identification. If not, try to describe it as completely as you can.) some specific precautions:

4Keep the dog quiet. Venom spreads rapidly. Excitement, exercise and struggling increase the rate of absorption. If possible, carry the dog.

4Do not make cuts over the wound and/or attempt to suck out the venom. This is never successful and you could absorb venom.

4Be aware that the snake's fangs may be venomous for up to two hours after it dies, even if you have cut off the head.

Professional treatment involves respiratory and circulatory support, antihistamines, intravenous fluids and species-specific antivenin. The earlier the antivenin is given , the better the results. Because signs of envenomation are often delayed, all dogs who have been bitten by a poisonous snake-even those who don't show signs-should be hospitalized and observed for 24 hours. If you live in an area where your dog is likely to come in contact with poisonous snakes, you may choose to take him through sensitization training. A skilled professional will use an electric collar to train your dog to fear and avoid snakes.

The two most important goals in treating wounds are to stop the bleeding and to prevent infection. Wounds are painful, so be prepared to restrain and muzzle the dog before treating the wound.

Bleeding may be arterial (bright red blood will spurt out) or venous (dark red blood will ooze out), or sometimes both. Do not wipe a wound that has stopped bleeding, as this will dislodge the clot. Similarly, don't pour hydrogen peroxide on a fresh wound. Peroxide dissolves clots and starts a fresh round of bleeding. It may also damage the tissues and delay healing. The two methods used to control bleeding in an emergency situation are a pressure dressing and a tourniquet.

The most effective and safest method for controlling bleeding is to apply pressure directly to the wound. Take several sterile gauze squares (or, in an emergency, use any clean cloth such as a thickly folded pad of clothing) and place over the wound. Apply direct pressure for 5 to 10 minutes. Leave the dressing in place and bandage snugly. If material for bandaging is not available, hold the pack in place until help arrives. Watch for signs of swelling of the limb below the pressure pack. This indicates impaired circulation. If you see these signs, the bandage must be loosened or removed. Consider adding more bulk to the pack and apply a second bandage over the first. Transport the dog to a trained professional's hospital.

Tourniquets can be used on the extremities and tail to control arterial bleeding that can't be controlled with a pressure pack. Tourniquets should never be used if bleeding can be controlled by direct pressure. Always place the tourniquet above the wound (between the wound and the heart). A suitable tourniquet can be made from a piece of cloth, belt, tire or length of gauze. Loop the tourniquet around the limb as shown in the photo below. Then tighten it by hand or with a stick inserted beneath the loop. Twist the loop until the bleeding stops. A tourniquet should be loosened every 10 minutes to prevent tissue hypoxia and to check for persistent bleeding. If bleeding has stopped, apply a pressure bandage as described in the previous section. If bleeding continues, let the blood flow for 30 seconds and then retighten the tourniquet for another 10 minutes.

Nearly all animal wounds are contaminated with dirt and bacteria. Proper care and handling will reduce the risk of tetanus and prevent many infections. Before handling a wound, make sure your hands and instruments are clean.

Remove the original pressure dressing and cleanse the area around the wound with a surgical scrub solution. The most commonly used solutions are Betadine (povidone-iodine) and Nolvasan (chlorhexidine diacetate). Both products are extremely irritating to exposed tissue in the concentrations provided in the stock solutions (Betadine 10 percent, chlorhexidine 2 percent), so be very careful that the solution does not get in the wound while scrubbing the skin around it. Dilute the solution to weak tea color for Betadine or pale blue color for Nolvasan. Three-percent hydrogen peroxide, often recommended as a wound cleanser, has little value as an antiseptic and is extremely toxic to tissues. After the scrub, start at the edges of the wound and clip the dog's coat back far enough to prevent any long hairs from getting into the wound.

The purpose of irrigation is to remove dirt and bacteria. The gentlest and most effective method of wound cleansing is by lavage, which involves irrigating the wound with large amounts of fluid until the tissues are clean and glistening. Do not vigorously cleanse the wound using a brush or gauze pad because this causes bleeding and traumatizes the exposed tissue. Tap water is an acceptable and convenient irrigating solution. Tap water has a negligible bacterial count and is known to cause less tissue reaction than sterile or distilled water. If possible, add chlorhexidine solution or Betadine solution to the tap water for antibacterial activity. Chlorhexidine has the greater residual antiseptic effect, but either antiseptic solution (not soap solutions) is satisfactory when correctly diluted. To dilute chlorhexidine, add 25 ml of the 2 percent stock solution to 2 quarts of water (2 liters), making a 0.05 percent irrigating solution. To dilute betadine, add 10 ml of the 10 percent stock solution to 2 quarts of water to make a 0.2 percent irrigating solution. The effectiveness of the irrigation is related to the volume and pressure of the fluid used. A bulb syringe is a low-pressure system. It is least effective and requires more fluid to achieve satisfactory irrigation. A large plastic syringe removes a moderate amount of dirt and bacteria. A home Water Pik unit (used by people to clean their teeth) or a commercial lavage unit that provides a high-pressure stream of fluid is the most effective. A garden hose with a pressure nozzle for the initial lavage, or a kitchen sink spray unit, followed by one of the methods just described to deliver the antiseptic, is a good alternative. You want to flush and clean the wound, not force dirt deeper into the tissues. Angle your flow of liquid to accomplish that and let the fluid pool to bring debris to the surface.

Debridement means removing dying tissue and any remaining foreign matter using tissue forceps (tweezers) and scissors or a scalpel. Debridement requires experience to determine the difference between normal and devitalized tissue, and instruments to control hemorrhage and close the wound. Accordingly, wounds that require debridement and closure should be treated by a trained professional.

Fresh lacerations on the lips, face, eyelids and ears are best sutured or stapled to prevent infection, minimize scarring and speed recovery. Lacerations longer than a half an inch (1.25 cm) on the body and extremities probably should be closed, but small lacerations may not need to be. Small V-shaped lacerations heal best if they are closed. Wounds contaminated by dirt and debris are quite likely to become infected if closed at the time of the injury. These wounds should be left open or sutured around a drain that can be used for through-and-through irrigation. Similarly, wounds older than 12 hours should not be closed for drainage. Suturing or stapling should be avoided if the appears to be infected (is red, swollen or has a surface discharge). Your veterinarian may decide to close a wound that has been left open for several days and has developed a bed of clean tissue. Wounds that are clean after several days are resistant to infection and usually can be closed with impunity. Suturing such a wound is called delayed primary closure. The length of time sutures or staples should remain in place depends on the wound's location and other characteristics. Most sutures and staples can be removed after 10 to 14 days.

Puncture wounds are caused by bites and pointed objects. Animal bites in particular, are heavily contaminated with bacteria. Bleeding may occur. There may also be bruising, particularly if the dog was picked up in the teeth of a bigger dog and shaken. Puncture wounds are often concealed by the dog's coat and may be easily overlooked until an abscess develops a few days later. Treatment of a puncture wound requires a trained professional (doggy doctor). It involves surgically enlarging the skin opening to provide drainage, after which the area is irrigated with a dilute antiseptic surgical solution. These wounds should not be closed. If there is a large, open wound area, parts of the wound may be sutured with a drain left in place to allow air to get in and discharge for drainage. With all animal bites, keep in mind the possibility of rabies. If it is a bite wound from an unknown animal, a rabies booster may be needed.

Small open wounds can be treated at home without sutures or staples. Medicate twice a day with a topical antibiotic ointment such as triple antibiotic. The wound can be left open or covered with a dressing. Make sure the dog is not constantly licking it. You can cover the area with a sock or T-shirt to keep the dog away from the wound. Infected wounds that are draining pus require the application of moist sterile compresses. A number of topical antiseptics are effective in treating superficial wounds infections. They include chlorhexidine and betadine (dilute as described in Wound Irrigation see above), Furacin (both the topical cream and 0.2 percent solution), 1 percent Silvadene cream and topical antibiotics containing bacitracin, neomycin and polymyxin B (triple antibiotic). Apply the topical antibiotic directly to the wound or place it first on a gauze pad. Change the dressing once or twice a day to facilitate pus drainage.

Wounds may be left open or bandaged, depending on their location and other factors. Wounds on the head and neck are often left open to facilitate treatment. Many wounds of the upper body are difficult to bandage and do not benefit greatly from being covered. Bandaging has the advantage of protecting the wound from dirt and contaminants. It also restricts movement, compresses skin flaps, eliminates pockets of serum, keeps the edges of the wound from pulling apart and prevents the dog from biting and licking at the wound. Bandaging is most effective for wounds to the extremeties. In fact, nearly all foot and leg wounds can benefit from a bandage. Dressings over draining or infected wounds must be changed once or twice a day. The bandage should be bulky enough to absorb the drainage without soaking through.

To bandage the foot, place several gauze pads over the wound and secure with surgical adhesive tape. Be careful not to make the tape too tight. To secure a foot dressing, you will need to continue the bandage up the leg. For leg wounds, cover the wound with sterile gauze pads. On top, pad the entire leg with plenty of cotton so the dressing won't become too tight and interfere with the circulation. Wrap first with roll gauze, then wrap the leg with elastic tape or bandage as shown in the photographs below.

Veterinary wraps such as VET Wrap works well, but you need practice to have the right amount of tension so you do not cut off circulation. Flex the foot and knee several times to be sure the bandage is not too tight and that there is good movement at the joints. Over the next few hours, check the toes for coolness and observe the feet for swelling. Swelling of the leg below the bandage will be seen in the toes. When the toes are swollen, the nails are spread apart instead of being side by side. If this swelling is not treated by removing the bandage, the foot becomes cold and loses feeling. If there is any question about circulation, remove the bandage. Put a plastic bag over a leg bandage when the dog goes outside so it will stay clean and dry. Use a sock or T-shirt to protect the bandage or to cover wounds that are difficult to bandage. Bandages over clean, healing wounds can be changed every two days, but should be inspected three to four times a day for signs of constriction, limb swelling, slippage, drainage or soiling. With prolonged bandaging, watch for moisture between the toes. If there are any signs of these problems, replace the bandage. Wounds on the foot or leg may be covered with a splint as well as a bandage. The splint minimizes movement of the area and speeds up healing. Watch for sores from a splint rubbing on the skin.

Many-Tailed Bandage

This type of bandage is used to hold dressing in place and to protect the covered skin from the dog's scratching and biting. It is made by taking a rectangular piece of clean cloth and cutting the sides to make tails. Tie the tails together over the dog's back to hold the bandage in place.

Place a sterile gauze square over the affected eye and hold it in place by taping it around the head with one inch wide surgical adhesive . Be careful not to wrap the tape too tight. Apply the dressing so the dog's ears are free. You may have to change the dressing from time to time to apply medication to the eye. Many dogs will need to wear an Elisabethan collar or a bitenot collar to keep them from rubbing or pawing at the bandage.