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Dear Peter and Mary Anne, I am not sure that I know exactly what information you are looking for in the note below so please feel free to send a clarifying note, if necessary. I am willing to talk to other veterinarians or correspond via email but it is important that everyone understand that I am not a specialist in any discipline.
I am simply a general practitioner with twenty years of experience in private practice who is reasonably adept at finding information for people. There are two good options for veterinarians seeking help with cases from veterinarians more expert than I am.
The first is the Veterinary Information Network, which is an online service. For information on this service call The AVMA has a web page at www. There is a link from our linkpage to the AVMA site.
While the exact details often vary it is not unusual at all for little dogs to have extensive and life-threatening damage that is inapparent until days after the initial attack. It is also not highly unusual for a trauma to occur in a dog that is harboring an inapparent illness and for the illness to surface during the treatment and rehabilitation of the little dog.
Attacks by a big dog on a small dog have the potential for injuries to the kidneys to occur in a number of ways. Big dogs often shake little dogs during an attack.
This may fracture a kidney or disrupt its blood supply, although this is unusual. The tooth may penetrate into the kidney or into the tissues surrounding the kidney and cause damage. Retroperitoneal abscesses occasionally occur after dog attacks and may surface weeks after the initial attack as the infection slowly builds in intensity.
Big dogs have tremendous crushing power in their bite and they may crush tissue such as muscle or skin and cause it to die. When large amounts of tissue die in the body it is hard on the kidneys and the other organs as they try to aid in the cleanup of the dead tissue.
Organ failure during this process can occur. Shock or blood loss from an attack can lead to hypotension low blood pressure. When blood pressure is low enough, the kidneys are damaged. In a pet with marginal kidney function prior to the attack shock can be enough to set off full blown renal failure.
Infection of the kidneys from bacteria introduced into the bloodstream or other tissues at the time of the bite and then spread to the bloodstream can lead to kidney failure days after the initial bite. A dog with hypoadrenocorticism Addison's disease prior to the initial attack that has not been diagnosed previously may die or suffer aggravated secondary effects such as kidney failure due to the pre-existing disease.
Addison's disease can have very subtle signs in many dogs and it is not unusual for it to go undiagnosed until a crisis occurs.
Blood clots formed due to trauma may break loose and damage any organ. The kidney is pretty susceptible to damage by blood clots due to its rich blood supply and the way the blood flow is directed through the kidneys.
Bleeding disorders associated with major trauma or shock may lead to kidney damage as well. Due to the potential for severe internal damage even in bites that do not seem to be especially serious based on the initial signs or skin injuries there are veterinarians who advocate surgical exploration of every puncture wound found after a dog attack.
This is expensive and it subjects the dog to anesthetic risks which may also be higher due to trauma so there are also a number of veterinarians who feel that it is better to try to stabilize the patient and assess the damage more as signs develop.
We have had success and failures using both approaches and I honestly do not know which is best in the majority of cases. When bite wounds start to develop secondary complications it is not unusual for a case to go from bad to worse to really awful rapidly.
Attacks by big dogs on little dogs are true nightmares from a diagnostic and treatment standpoint. This attack should be reported to the animal wardens or appropriate authorities, as you indicate.
In some localities it takes two or more confirmed reports of attacks before any legal consequences are possible.Pulsed electric field treatment is now widely used in diverse biological and medical applications: gene delivery, electrochemotherapy, and cancer therapy.
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