Musings of a Law Enforcement Paramedic – Part 4, by LEO Medic

Yesterday, we read about TCCC and the “MARCH” priorities of field care. We’ll continue with this five-part article by focusing, today, on emergency treatment for dogs because many of us will be depending ours after the SHTF.

CANINE ALS/TCCC

A very interesting aspect of TCCC that we have found is that it has extremely high carry over to the canine world.

Two of my squad mates have working law enforcement canines assigned to them. In addition, we utilize many search and rescue dogs, from bloodhounds to labs for various missions and searches. I imagine most of you reading plan on having at least one as a part of your security post SHTF. With this many dogs in the environment we currently work in, many of them run into some nasty injuries that can, for the most part, be easily treated. If your dog is part of your security plan, there is an increased likelihood that it may be shot, stabbed, or otherwise injured as well.

I am not a vet. Keep in mind that I am a cop/medic treating a dog. What this means is that the average reader with a desire to learn and some basic gear can provide any of this care, too. Again, this is presented as what I have learned and trained on, and hopefully it will be of some use to the readers. There will come a day when, in addition to playing doctor, you will have to play vet, too. Dogs are very similar to people in emergency care.

First, muzzle any dog you are working on. A proper muzzle does not hurt and is not inhumane. If you own a dog, you should own an appropriate muzzle. An expedient one can be made by going over the dogs nose with cloth or strapping, crossing under the chin, and tying behind the head. In today’s world, using a muzzle may save you a few stitches and a trip to the doctor. In TEOTWAWKI, a dog bite and infection may be a matter of life and death. Play it safe. Make sure you have an Elizabethan collar that fits your dogs as well, to keep them from gnawing on something they shouldn’t.

Like humans, dogs have a normal range for vital signs. For dogs, TPR (temperature, pulse, respiratory rate) is an easy way to think about it. Check your dog’s vital signs on a regular basis in varying conditions, so you have some idea of what ”normal” is.

A dog’s heart rate is between 70-140, with 100 being the average number. You can measure pulse on the femoral equivalent by grabbing the meat of the rear thigh and sliding your hand towards the groin until the pulse is felt. A dog’s temperature runs from 100 degrees to 102.5 degrees. Respiratory rate is 10-30 times a minute.

As a general rule, the dose you would give a small human female will work for a canine, in regards to human medication.

Here is a drug calculator for dogs and some human medications that will work on dogs as well.

Tourniquets work on dogs the same way as people and with the same indication– uncontrolled extremity bleeding. The CATs tourniquets work, but this is one instance that I like the SWAT-T. With the angle of a dog’s leg, it is sometimes easier to get it to stay with the SWAT-T. If you have to wrap it around the body to secure it, make sure you do not tighten the wrap on the part that is around the body. For junctional wounds and gun shots, QuikClot can be used. Do not confuse QuikClot with canine KwikStop (the styptic powder). KwikStop is for surface bleeding only. It is not approved to go inside of any animal. Like people, the wound must be packed, and pressure must be maintained. When bandaging a leg, apply a stirrup first and then padding. Follow with gauze, then coban-style wrap. Wrap all the way down to the toes to help blood return. You can apply pressure dressings to leg bleeds as well, but remember to overwrap all the way to the toe. For pad injuries, clean and apply superglue to the torn pad. Keep clean and wrapped. For suturing, have a pair of battery-operated shears to clear the area around the laceration. Skin staplers are available quite cheaply and do an excellent job of closing wounds. They are fast and fairly painless with no learning curve.

Canines can also get a tension pneumothorax from penetrating trauma and require occlusive dressings. SWAT-Ts work well as a wrap, as does saran wrap, to stay in place on a chest with fur. You can needle decompress a dog.

For a canine airway, make sure the neck is roughly straight. Place gauze on the tongue to get a better grip; then, you can pull the airway open and the tongue free. Dogs can be intubated really easily, sometimes without a blade even, and they do not have laryngospasms.

For allergic reactions, maintain an airway, and remove the allergen if it is still in contact. Canines can receive intramuscular (IM) Benadryl/diphenhydramine, Dexamethasone, or Epinephrine (1:1000) for a more serious reaction. For IM injections, you are aiming for the loin muscle, behind the ribs and in front of the hip, in the meaty strip along the back.

If you suspect poisoning, give the dog an apomorphine tablet in the conjuctival sac, with the tablet placed in the lower eye lid. This will make the dog vomit. A little while after vomiting has stopped, give a bottle of toxiban, which is kind of like activated charcoal for dogs.

For a broken jaw, a medical muzzle can be used to support the jaw. For broken legs, start with a base layer of tape placed vertically on the leg, extending about 6-8” past the bottom of the foot, then stirrup it like a “J”. Wrap the entire leg including the foot, so that blood is able to return and does not get trapped. Rolled up newspaper around the leg can work too, but again wrap all the way down to the foot.

If the dog’s temperature gets above 105 degrees, it can go into heat stroke. Cool rapidly with water and fans. Start cool IV fluids and remove from heat.

For dehydration there are two places to give fluids to dogs. The first is the traditional IV method. Two common places for IV insertion on a canine are on the lower legs. Dog skin is very tough compared to human skin. If you try to use any smaller than an 18 or 20 gauge needle, it is very possible that you will kink or accordion the catheter. You can make a small nick in the vein at the entry site if desired as well for easier insertion.

The second (and much easier) way to give fluids to a dog is in the scruff of the neck. When you scruff a dog, imagine you are making a tent with the skin. You can insert an IV catheter into the skin (from the tail towards the head), and give fluids into the subcutaneous space. It will look funny, as this large mass starts to form under the skin. It’s completely safe. The fluid will work its way down and hang under the chest eventually. The fluid is absorbed over time. I have heard of people doing this by drawing IV fluids up with a 20 ml syringe and giving multiple injections if an IV set up is not available, but I have never tried it this way. We have pre-loaded dogs with fluids if it is a particularly hot day for a ground search before heading afield.

The shock dose for IV fluids for a dog is a 250ml bolus. Do not exceed 500 ml. It is very easy to overload a dog with fluids if given IV, so be careful. Start slow. If it is simple dehydration and not shock, go with the subcutaneous route.

A dog’s blood pressure can be measured, too. Use a pediatric cuff. If it is below 90, treat for shock.

Dogs need to be kept warm after an injury to help prevent shock, and casualty blankets work. Dogs can be given CPR and rescue breathing (mouth to snout). The dog’s heart is where the elbow rests on the chest if you bring the front arm back to the chest. With CPR, while the dog lies on its side, compress 1/3 to ½ the side of the chest at 100 beats per minute. Pulse oximeters work on a hairless part of the dog (lips, ear, or vulva). Dogs can be given the Heimlich maneuver and back blows (5 and 5, like an infant) with an airway obstruction. Do not blindly reach in and start pulling on things though. A dog has bones at the base of the tongue that can be mistaken for an obstruction and will break if pulled on.

I am a firm believer that a dog is a dog and expendable. However, that dog may be a $10,000 trained canine that keeps your family safe or a hunting dog that helps you keep the kids fed. Even the loyal family mutt from the pound may get mauled by a mountain lion protecting the kids or shot alerting you to robbers. Sometimes it may be nothing more than a morale boost to save the dog. Plan ahead, and purchase first-aid supplies for your dog. Have enough so you won’t have to make a choice between treating them or letting them die in order to save the supplies for someone else. With that being said, accept that fact that death happens. It’s a fact of life. Sometimes the most humane act is putting the animal out of its misery. The point of this section is that in addition to expanding your training, I want you to have the option, along with the skills and supplies, to go either way.

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