Rescuing an Injured Pet
off the Road.... a typical letter
Dear Dr. Ross,
Your web site has so much information, I just found it and look forward to spending lots of time reading through the site.
I am sure you're quite busy and I'm not sure if you entertain questions but I was wondering about your professional opinion on this situation. I would greatly appreciate it if you could read through this:
I rescued a stray who was hit by a car and left in the middle of the street. Me and two others took her to the vet (it may be important to note that although she was a stray, I told the vets I would pay at least initial costs, x-rays, meds, fluids, exams, etc..)
They examined her immediately and told me they would take x-rays and they had some concerns
about nerves on the side of the body that may have been destroyed.
The cat had a little blood that came out of her rectum that I noticed on the street and the vets were aware of. I called later in the day and she had fractured her pelvic bone in at least 2 places, maybe 3. The vet told me her breathing was still labored (this is about 4-5 hours after the accident) and said they would have to keep an eye on that. The vet said it may be due to shock or bruised lungs.
Later, her breathing seemed to get back to normal
and she was resting more comfortably. That night she urinated and defecated and ate all her dinner.
The next day by the early afternoon, her condition worsened to a critical state. Her red blood count (I don't remember the exact terminology) had dropped to 8 and I was told she had to get a blood transfusion soon or we would have to make a decision to put her down.
I was attempting to get in touch w/ organizations that would help in the cost of her surgery and to have her place for adoption or placed at a sanctuary. The vet also told me there was no guarantee that the blood transfusion would save her.
I found someone who would help pay for expenses (I wasn't concerned about the cost of the blood transfusion but more about surgery later on) and called the vet to tell her to go ahead w/ the transfusion. Sadly, the cat passed away on her own within 45 minutes after I saw her.
All these "what-ifs" are circling in my mind. What if we knew early about the internal bleeding being a serious threat (the x rays didn't detect that)... In your experience, does an animal go from a somewhat stable condition, eat, have bowel movements, etc. to a critical condition by the next morning?
Is it standard procedure after such an accident to check blood levels? Can internal bleeding worsen or not be detected early on after an accident? Can a blood count drop quickly?
What are the chances she would have recovered if I had made a decision right away about the blood transfusion instead of waiting 45 minutes, would it have still been too late? I can't help but have these questions...So much changed in her from the first day to the next.
I know there is nothing I can do now and I'm at least glad I was there to make sure she didn't die in the street or alone. If heaven forbid I'm ever in a similar situation, I want to make sure I have all the information about these types of injuries that I can.
Thank you so very much for the time you took to read this Dr. Ross.
Neither You nor your vet should be feeling quilty:
You, of course, deserve high praise for taking the trouble and financial responsibility of attempting the rescue.
If your patient had severe internal hemmorrhage on initial exam, your vet would not miss the many clues; severe paleness of the gums, slow gum color refill time, extremely low body temp, etc. Whether or not to run tests is a judgement call we base on the condition of the patient. Yes, some vets routinely check the hematocrit (also known as a PCV) (measures percent of red blood cells) after major trauma as a further clue about possible internal bleeding and for comparison during recovery, but you could run up huge bills doing every test "that might be helpful"...usually we choose appropriate tests based on how the patient is doing, and most of us try to keep the costs to a minimum...especially in stray situations.
As for explaining a sudden cause of blood loss: just as in human medicine, after stablizing the patient and addressing obvious wounds...we cross our fingers, pray, and monitor for all the potential disasters that we know from experience sometimes occur during the first 24-36 hours after major trauma: these include rupture of bruised lungs, tears of partially damaged arteries, and most common with histories like yours; spleen injuries.
Bowel ruptures, endotoxic shock, bacteremia, and vascular clotting are additional examples of deadly things that can go acutely wrong in the day or two after we thought we had a trauma patient stablized.
That's why we like to keep major trauma patients "for observation" for a day or two after addressing the obvious wounds.
Despite an arsenal of modern medications and skilled veterinary care, we are frequently reminded of how fragile life can be...especially after an encounter with a car.
I hope this eases your mind somewhat, and again, my respect for your valiant attempt.
As for your vet, I bet she or he did a great job. Whenever a patient dies we question ourselves to death with what if I did this or that differently...and that's healthy...and that's also why most of us are successful at saving a huge majority of trauma cases that make it to the hospital in time...but there's a million little things that can go wrong in a badly damaged body and sometimes we loose a patient that we don't expect too. Both life and love are fragile.
Give your vet a hug and if you're well off, donate $20 to be used to help cover expenses for the next stray pet brought in...I bet he or she gives uncompensated first aid at least several times a week to injured animals found near the road.
God Bless, Roger Ross DVM