Look Out For Beanballs and Other Hazards To Your Dog's Head.

One of my most memorable cases of head trauma in a dog happened when a dog was hit by a baseball right on the top of his skull. A round area of bone was shattered like a hard-boiled egg that was tapped on a plate. He was nearly comatose, and getting worse. In surgery, bone pieces were meticulously picked out of brain tissue, and bleeding staunched with skin sutures and a pressure bandage. Over the next several days, he made a virtually complete recovery.

There are other causes of head trauma that are a lot more common - getting hit by cars, falling out of pickup trucks or high windows, and abuse by humans, to name a few. Cases where emergency surgery is likely to help, much less make the difference between life and death are rare but immediate emergency treatment often makes the difference between death and recovery with a good quality of life.

Trauma causes swelling. If you sprain your ankle, you can take off your shoe. The brain, however, is completely encased in hard bone. If the initial injury doesn't do fatal damage, the patient may die from the swelling and inflammation that develops over the next hours or days. An important part of first aid is to minimize swelling. Keep the head slightly elevated and avoid pressure on the neck, as from a leash or collar.

It can be tricky to evaluate brain injury patients at first because many of the symptoms caused by shock due to any major injury are similar to those caused by brain injury. Even cases that initially appear hopeless sometimes make dramatic recoveries.

Treating for shock is also tricky. Lots of IV fluids, and other treatments so critical in shock can make brain injuries worse. It is important to monitor blood pressure, heart function, breathing, and the levels of oxygen and other blood tests. There are other clues to brain function. For example, the pupils of the eyes are normally "mid sized." They get larger in the dark, and smaller when a light is shined into them. In mild brain injury, these reflexes are slow or incomplete. Pupils that are constricted to little pinholes indicate moderate brain injury. It is a bad sign if the pupils are dilated wide open and don't respond at all to light. There are other things like this, many quite subtle, that a trained specialist in neurology can use to evaluate and monitor a patient with brain injury.

If your dog or cat has a head injury, call your veterinarian. An emergency examination may make the difference between life and death. If after the initial examination and perhaps lab tests or X-Rays, treatment is deemed necessary, your veterinarian will likely place an IV catheter and start with some medications to treat for shock and reduce inflammation and swelling. Then, referral to a specialist may be recommended. Continuous close monitoring and changes to treatment are best done in a facility that can provide around the clock intensive care. The initial day or two are critical but some patients continue to improve over weeks or even months after the injury.

It could happen to your dog, even if he's a couch potato. We treat dogs now and then who get squeezed in recliner chair mechanisms. My associate, Dr. Cumberland, told me about a dog who was injured when the tow handle slipped out of a water skiers hands, came flying forward into the boat, and hit the dog's head. And I once saw a tiny Chihuahua whose head was smashed in a closing door. This world is dangerous!