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Avoiding the Hit by Car (HBC) Trauma

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September 21, 2011 / (20) comments

In the ER, I see a lot of trauma cases: dogs attacked by dogs (typically what we call big-dog-little-dog, or "BDLD" attacks); cats attacked by predators (e.g., dogs, neighborhood kids, coyotes, mountain lions, etc.); and the most frequent, the hit-by-car, commonly known as the "HBC" in veterinary medicine.

 

While trauma cases can be really rewarding to treat as an emergency doctor, I’d rather not see them in the first place. Not only can they be life threatening and cause significant pain and injury to your dog or cat, but they are very expensive to treat for you.

The severity of trauma from being HBC ranges from mild scrapes and bumps to fatalities that never even make it to the ER (due to severe internal bleeding). In the past 14 years of my veterinary career, I’ve treated hundreds of HBC cases, mostly from the following:

  • Pet owners letting their dogs run off leash
  • Dogs or cats slipping out of the house inadvertently through an open door
  • Dogs jumping the fence (yes, your dog may actually be able to hop it)
  • Dogs out on long flexi-lead type leashes, only to be hit on the edge of the road (as the dogs' owners can’t pull them back on the leash in time)
  • Dogs chasing cars (please, teach your dog that this is bad!)

And lastly,

  • Pet owners accidentally running over their own dogs in their driveway (this type is actually one of the worst types of HBC, as it’s a "slow roll" and results in more internal damage)

First of all, if your dog can’t be trusted off leash, don’t tempt the fates and let him run around, as he’s likely to be hit by a car. My test? If you can’t call your dog off a squirrel (or deer) immediately, he doesn’t pass the test for being off leash. JP, my rescue pit bull, was so highly obedient trained that I could holler "Down!" while he was chasing vermin and he’d drop to all fours immediately. If your dog can do that, then you win rights to off-leash romping.

Secondly, if you have a cat, keep him inside. I got a lot of grief from cat owners when I released my book It’s a Cat’s Life …You Just Live In It. Why? Because I made two opinionated statements:

  • If you have more than six cats, you’re crossed over to crazy-cat lady (that’s a whole other blog!)
  • If you have cats, do us all a favor and keep them inside.

There are actually several medical reasons why keeping your cat indoors is important, but I’ll expand on that more in next week’s blog (Should I Keep My Cat Indoors?).

So, back to being HBC. Why should you care? Being hit by a car commonly results in the following:

  • Road rash (i.e., having your skin shredded off thanks to the drag against asphalt)
  • Pulmonary contusions (i.e., lung bruises, which result in difficulty breathing or coughing of blood)
  • Pneumothorax (i.e., a tear in the lung lining, resulting in abnormal leaking of air out of the lung into the chest cavity)
  • Fractures
  • Degloving wounds (i.e., having the skin ripped completely off the bone or body, resulting in expensive surgery and daily bandages)
  • Head trauma
  • Eye proptosis (i.e., having your pet’s eyeball "pop" out from severe facial fractures or trauma)
  • Internal bleeding (e.g., laceration of the spleen or liver)
  • Bladder rupture (i.e., tearing of the bladder or ureters — the tubes leading from the kidneys to the bladder, resulting in severe pain and expensive surgery to repair the rupture)
  • Bile peritonitis (i.e., rupture of the gall bladder, resulting in leaking of bile into the sterile abdomen)

While this list isn’t all inclusive, most of it will cause you to pay at least a few thou'. Being HBC requires intravenous fluids to stabilize the patient, pain medication, X-rays, minor or major surgery under general anesthesia, heart and blood pressure monitoring, and advanced diagnostics (like blood work, fluid analysis, abdominal ultrasound, etc.). When in doubt, save your pet some grief and pain, and you some bling, by simply keeping your dog on a leash and your cat in the house…

Have you had the unfortunate experience of having your pet HBC? Any tips to help others avoid it?

 

 

Dr. Justine Lee

 

 

Pic of the day: A Dog crossing the street by Nikola B

 

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COMMENTS (20)
1
Thumbs up and thumbs down
by bloomingpsycho on 09/21/2011 06:40am

I am in full agreement about being a careful pet owner and insuring that the animals do not get struck by cars. Many are killed this way. But I am not keen on your "crazy cat lady" stereotype comment. First of all, it isn't only women who end up with too many animals. Second, sometimes circumstances may end a person up with one or two "too many." They may inherit one from an elderly relative who passes away, for instance. I did at one point have seven cats when my ex husband moved to another state and I ended up with his cat. When he moved back, I returned his cat and allowed him to take another that I had gotten shortly before he left--not because I didn't love her, but because my calico cat was terrorizing her. At this point I am holding at five. I do struggle with hoarding items though I have always been careful to not hoard animals because I do care about them. Thus, for someone like me who does have a struggle of this nature, your cavalier comment is very hurtful. I realize that it must be wonderful to be among the beautiful people who do not have a struggle with mental illness, but not everyone is so lucky. I wish that "normals" would think before they apply hurtful stereotypes. I usually enjoy reading your blog but I am not thrilled when I see people using stigmatizing commentary of this nature.

by Dr Justine Lee on 09/21/2011 10:51am

I'll talk about it more next week, but statistically, the majority of hoarders are single, female, white, and older (>60 years of age), so the female comment does pertain.

The "beautiful people" however, doesn't - doesn't matter what people look like superficially, as anyone can suffer from mental health disease.

Yes, there is definitely mental health disorders associated with hoarding, but as a veterinarian, my goal is to be a pet's advocate, and having too many cats in a household results in severe medical, behavioral, and financial strain.

I'll delve into this in the future, but the majority of hoarders actually have dead pets (typically cats, rabbits, or small dogs) in their house that they were unaware of.

It is extremely rare for you to ever meet a veterinarian who has > 6 cats... and that's because we see the behavioral reasons associated with it (urinating out of the box, intercat aggression, as you discussed with your calico).

No more than 6 for me! In fact, in Minneapolis, the city ordinance is no more than 5 pets TOTAL per household, which I also support.

by 4_Fab_Felines on 09/23/2011 02:33am

I'm personally not a fan of blanket legislation regarding the number of pets one is permitted to keep. I've met plenty of people with more than five animals who were all well cared for, and plenty of others who had no business keeping one. I just don't see the benefit of imposing an arbitrary cutoff. Odds are, an irresponsible owner driven to obtain more animals than they can properly care for isn't going to be swayed by such legislation... and, in the event that someone isn't properly caring for the animals that they do have (regardless of number), we already have applicable laws on the books that don't simultaneously penalize responsible owners. Why not just enforce them?

Just my two cents. :)

by Dr Justine Lee on 09/23/2011 01:25pm

I normally agree that government shouldn't interfer, but unfortunately it's to prevent hoarding... of which there are often poor legislation for! Sad!

2
Containment
by TheOldBroad on 09/21/2011 06:55am

Fido may not be able to jump the fence, but s/he may be able to dig under the fence. Please don't put Fido in the back yard to "do his/her business" while you take your morning shower.

Please don't let Fido or Fluffy outside to run the neighborhood and enjoy nature on their own.

There are a myriad of dangers out there ranging from predators to humans, not to mention getting lost and not coming home again.

I have to ask how you arrived at the number of six cats being the tipping point of a hoarder. I respectfully and heartily disagree!

3
by JessiesGirl on 09/21/2011 09:50am

In addition to the issue of digging under a fence, I also wanted to point out another fence-escape hazard that people often fail to consider: snow! If you have 2-3 feet of snow in your yard, your 6 foot high fence has been effectively reduced to 3-4 feet, which gives many dogs a very solid opportunity of escaping over a fence which could otherwise be relied upon to contain him.

I don't trust anyone's fence when there is a significant amount of snow on the ground.

4
by Dr. Kenney on 09/21/2011 10:05am

Dr. Lee,

Wow! Looks like you're gonna catch it on the number of cats advice, but sounds like you expected it.

As a veterinarian, I am glad to see you write about HBC. The disheartening thing is that it is almost always preventable. The consequences of not following your advice are the heartache and grief of family members who see their beloved pet suffer needlessly and/or have their pet's life cut short and a leaner pocketbook after paying for treatment of injuries sustained in a HBC case.

I'm amazed at the number of clients who confide that they let their dog out in the front yard unattended or with them just watching from a distance. When I advise them that this isn't wise, I hear comments like, "He never goes outside my yard." I've seen this come back to haunt many pet owners.

By the look on client's faces when I tell them to not let their dogs into the front yard without being leashed, I can tell they just don't believe what I say.
The problem is that they don't see what you and I see in practice everyday. That's why I finally decided to write "The Wise Pet Owner" that details much of the information that I would like to tell clients if only I had enough time in the examination room to do so.

It's much better to "prevent the preventable." It not only keeps pet's happier and healthier, but saves our clients money at the same time.

by TheOldBroad on 09/21/2011 06:30pm

"I hear comments like, 'He never goes outside my yard.' I've seen this come back to haunt many pet owners."

Oh how I agree with that statement! I can't tell you how many cat owners I hear say things like that or "He never leaves the deck" or "He's only outside if I'm with him."

A cat can run away faster than you can imagine if startled or decides to participate in a squirrel chase. Do these people really think they could catch Fluffy?

I've also heard heart-wrenching stories that include, "I just don't know what Fluffy was doing three blocks away in that busy intersection. Fluffy only goes across the street to play in the empty field."

Well, duh. Fluffy is crossing a street which is an invitation to some drivers to create a Flat Cat. (Yes, sadly some people really do try to run down animals with their car.) And do these people really think that Fluffy never leaves that empty field?

I am truly disturbed when I see "LOST - NEEDS MEDICATION" or "LOST - NEEDS SPECIAL DIET" signs for critters that I know for a fact are let outdoors unattended. Does Fluffy or Fido know they must be home in time for meds? Do they know they shouldn't eat garbage or something offered by a tender-hearted Crazy Cat Lady?

*sigh*

5
Loose dogs
by 3dognight on 09/23/2011 01:13pm

My pet peeve is that people do not put identification on their pets. Our three dogs are all chipped and when we move,the first thing we do is change chip info and their ID tags.I hate finding a lost dog and not being able to call their owner immediately.

by Dr. Kenney on 09/23/2011 09:06pm

I read a study that was done of dogs and cats that entered a shelter where they routinely scan for microchips. Microchipped cats were 20 times and dogs 2.5 times more likely to be reunited with their owners than those who weren't microchipped.

And you hit on the number one reason that microchipped pets aren't eventually reunited with their owners - because when they moved, they didn't update their information with the registering agency.

6
I agree!
by ReflectAwear on 09/26/2011 12:58pm

I agree! Keep them on a leash, if they're not mature enough to be without one, especially at night! This is why we came up with our "Illuminated Pet Safety System!"

7
Underground fences ROCK!
by RSTP5200 on 09/30/2011 09:15pm

Dr. Lee, thanks for a well-written blog. I have three (unexpected) rescue dogs, mama and her two daughters, now 50 lb. two-year-olds. I guess you'd say when I found them as puppies huddled up on my driveway, they and mama won the lottery. Mama dog (now Mollie) was feral, and aggressive enough that I felt unsafe caring for her pups to the point of carrying a gun for my own protection. I would, of course, only used it if physically attacked, but she was SCARY! Long story made short, I spent hours with the pups, and talking calmly to mama dog. Over days, I gained her trust, and now she's not happy unless she's draped over my lap.

But...I digress. (I just like telling my little story about Mollie, Ginger and Julie.) My wife and I live on a busy main highway on my family home place in a small southern town. We fortunately have 10 acres, but there's that highway frontage. Having lost my first childhood pet terrier mix to HBC injuries (he survived the first, but not the second) the issue of containment played a huge role in our decision-making when we considered keeping our three dogs. Mama dog was "street smart," but not the puppies.

Having recently gone in debt up to our eyeballs renovating our house, putting up a fence was cost-prohibitive. I researched the "underground fences" that use receiver collars that deliver a static shock to establish a boundary. I made a decision on a brand, and installed it myself, giving them roughly 2 acres in which to roam, while keeping them well away from the highway. I was astounded by how quickly all three responded to the training, and I highly endorse the underground fence containment system. It is wonderful! Instead of putting up a barrier to keep the dogs IN, the underground fence changes their behavior so that they no longer want to go OUT, and they're perfectly happy with the freedom to run within their area.

I have found that each dog is different, of course, and one of ours (Ginger--my "favorite" of the bunch) qualifies as a STUBBORN dog. She learned that if you run fast, it only stings a second. Thus, she earned herself a receiver for stubborn dogs that delivers a stronger shock correction, and I widened the active boundary by adjusting the transmitter. I've had no problem since.

Sorry if I was long-winded, but I know there are pet owners (or potential pet owners) out there that face the same dilemma. I hate to see dogs penned or tied up all day, but I hate much worse seeing someone's lovely pet lying in the road. Maybe my story will help save a pet, and present owners with an option that might not have been previously considered.

I'd love to hear your opinion of these fences, and I'd be happy to share any "how to" information with your readers who comment or reply to my post. (And, no...I don't work for or endorse any fence company, I work in a law firm!)

Oh...six cats? Do they eat less than three dogs???

by TheOldBroad on 09/30/2011 10:24pm

@RSTP5200

"Oh...six cats? Do they eat less than three dogs???"

I contend that one four healthy kitties are about equal to the trouble of one dog. Dogs require socialization, walking (in minus 60 degree wind chill!) and training. Cats are.... well .... cats. Unless you are planning on Fluffy becoming the next Fancy Feast Cat, there's not much, if any, training involved. Mine don't go outside. They don't want play dates.

I suspect that feeding an adult cat would be about as expensive as feeding one small dog. However, if you're talking about a larger breed, the dog would win hands down over the cost of feeding several cats.

I don't think I could handle three dogs, but I know I could easily handle six kitties - even if three of them had serious health problems simultaneously. (Been there. Done that.)

by RSTP5200 on 09/30/2011 11:22pm

You're estimate is probably pretty close!

Sounds to me like you and I are on opposite ends of the spectrum. You (like my Mom) are undoubtedly a cat person. I've always liked cats, too, don't get me wrong. I just like other peoples' cats. Gimme a DOG or three so that when I come driving in my driveway they're all three jumping up and down, tails wagging, just can't wait 'til I'm out of my truck. Mama dog jumps and licks until I tell her to sit, and then she gets petting. She always sits, but her expression is priceless impatience. Ginger rubs against my legs for attention, and Julie (the "coolest" of the three) just sort of hangs around, tail wagging, and waits her turn. When things calm down, there's nothing more therapeutic than having a dog in your lap and one on either side. Kind of like those kitties curled up by you, huh?

by TheOldBroad on 10/03/2011 06:29am

@RSTP5200

You description of homecoming is pretty close to the same thing at my house. It's just that all the activity is inside the house.

The thundering herd greets me at the back door. (Ever heard a whole bunch of cats fly down hardwood stairs?) The rest of the activity is the same.

8
Pitfalls of e-fences
by JessiesGirl on 10/01/2011 03:50pm

I'm not a fan of electronic fences. As one poster already discovered, a number of dogs will be motivated enough to cross the barrier in chase, but then will not be motivated enough to sustain the shock in returning to the yard. So once they're off you're property, they won't return.

People seem to forget that fences are also meant to keep others OFF your property! Your dog can still be stolen from your yard, taunted, poisoned, etc. as humans can enter the porperty pain-free. Other animals can also enter your property at any time, as can small children, as neither are wearing the shock collars. It's a MASSIVE mistake to think your dog is completely protected behind an e-fence.

Not only that, but the dog can come to associate the shock he receives approaching the border with whatever he is moving towards. That could be children, it could be dogs, cats, strangers, cars, etc. You can rather easily start an aggression issue in a dog who previously had none if he gets a shock whenever he sees these things just beyond your property line.

I used to walk a dog who was terrifed to leave her yard after the owners installed an e-fence which they had long-since stopped using. I literally had to carry this 60 poiund dog off and back on to the property to walk her. Poor, poor dog!

by RSTP5200 on 10/02/2011 12:53pm

JessiesGirl,

While I respect that you're "not a fan" of electronic fences, I'd also respectfully suggest your opinions are clearly not based on experience, so you're missing the point. Underground fences are most certainly not the solution for every pet owner, but if they are properly used, and the pet(s) are properly TRAINED, they can indeed be the best solution in many instances.

In response to your first objection, yes, some dogs will be motivated enough to cross the barrier. I wrote that my Ginger was hard-headed enough to do just that. The only time she crossed the line was in an attempt to follow me! The change to a "stubborn dog" collar with a stronger correction shock, plus the increase in boundary width accomplished at the control box, PLUS additional training, has ended that behavior. Certainly there are some dogs that may not be suited for an electronic fence, but I would guess they are a small percentage. By the way, on the few occasions that Ginger crossed the boundary line, she was indeed reluctant to cross it again to re-enter the fenced area. However, she was sitting just outside the boundary, and with a sheepish look on her face, she allowed me to remove her collar and return her to the inside of the fence line, via a particular route I'll discuss later.

True, fences are MEANT to keep other people or animals off your property. However, fences, like locks, are for honest people. Unless your pet is kept inside 24/7, there is no way you can keep it "completely protected." If some malicious individual wants to poison, shoot, steal or otherwise harm your dog, there's a good chance it will happen. Yes, other animals can indeed enter the property. In our case, there are no threats (bad dogs roaming free) in the neighborhood. The wild animals we have in our woods (deer, possums, 'coons, squirrels, etc.) have learned that 3 dogs live here, and they, for the most part, avoid the dogs' area. We have no issues with children nearby.

As for starting an aggression issue in a dog by association of the shock (negative stimulus) with a person or animal outside the border, your statement that such aggression can "rather easily" be initiated is simply wrong. Again, WITH PROPER TRAINING, the dogs know that the correction shock is related to the BOUNDARY, not someone or something outside it.

Your statement about having to carry the 60 pound dog off and on the property goes back to TRAINING as well. Dogs can be trained that there is indeed a way to cross over the boundary safely. That way is when the OWNER takes them across after (1) removing the shock collar and replacing it with a standard collar AND leash, and (2) taking the dog across the fence at the same location each time. In our case, it's the paved driveway. Without me leading them, the fence is "UP." When I'm leading them, the fence is "DOWN." Maybe my dogs are just smart. :)

True, there is no such thing as a 100% effective fence, but don't discount electronic fences as being so unreliable and hazardous. Let's re-visit your post of 9/21 that points out snow as another fence-escape hazard. Funny, but if that had been an electronic fence, the snow would not have provided a means of escape!

Life itself is not without risk. Do you take your pet to ride in a car? I don't know the numbers, but the risk of an auto accident and injury to you and your pet is certainly high. Do you not drive?

Even with the minimal risk that exists using an electronic fence and TRAINING the dog to stay within its boundaries, I would much rather have my dogs safely contained inside our fence than to keep them "penned" all day. It's a joy to watch them relish in their 2 acre play area (even though they've destroyed my drip irrigation!), chasing squirrels to no avail, and lying in the sun in their favorite spot under the pine tree.

JessiesGirl, this reply is not meant to be a condemnation of your opinions, to which you are entitled. It is simply a response to correct some misconceptions, likely brought about by a lack of experience with the product. While they are obviously not suitable for every application, underground fences are indeed a viable and safe containment method when carefully thought out, and the dogs are properly trained.

9
@RSTP5200
by JessiesGirl on 10/05/2011 10:33pm

I think it's fine to disagree and I am not offended at all.

I personally would not use an e-fence for the reasons outlined already, but I know they are quite popular and less expensive than standard fencing.

And you make a good point (with which I agree) that even dogs behind standard fences should be supervised.

10
Homecoming parade
by MiamiAngel on 10/07/2011 11:17pm

I have one dog, 5 cats and two foster cats.

First I do not take offense to Dr. Lee's comments about 6 cats is her definition of crazy cat lady. I understand it could be a sign of future hoarder. I have 5 which is plenty and 7 is too much for me. But the last two are fosters but very hard to find homes for two adult black cats, two strikes against them. But it just means I have to spend more time bestowing affection and attention. They are all treated equally! Except for the dog who travels with me. Frankly my definition of "crazy cat lady" is different from "hoarder". I'm crazy about cats like people are crazy about dogs. Three dogs is a big responsiblity and moreso than having 5 cats.

To get to my subject line: all my pets scramble to greet me at the door. I have to drop all bags, purse, kick off shoes and sit in middle of living room carpet and greet the dog first and all the other cats who want their head scratches. Even better, (Warning a little TMI forthcoming), when I get up first thing in the morning and sit on toilet--it's another "Good morning parade of pets" literally, one by one they walk by me for head and back scratches. All 8 of them! Mornings are quite the celebration in my household!

So I take no offense to any comments. I know my pets are loved and I have balanced life with work, pets and fun. (Of course working 10 minutes from home and coming home everyday for lunch helps.)

Regarding HBC--I NEVER LET MY DOG OFF the leash outside! And all cats remain inside!!! I have friends with both indoor and outdoor cats. Yes the HBC is likely to be their cause of death but some cats just prefer outdoors and pet owners are aware of the risk. I've warned many dog owners at my condo about accidents but they don't listen. I've done all that I can. Some people learn the hard way. May Bast watch over them all.

11
by Dr Justine Lee on 10/08/2011 06:29pm

Love it! :)

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