Unfortunately, trauma after being hit by a car is one of the most common causes of fractures and emergency veterinary visits that I see.  Many of the injuries when an animal is hit by a car are obvious - fractures, lacerations and abrasions. However some of the most serious injuries that can be sustained after trauma (such as being hit by a car) are internal, and are much more difficult to diagnose and treat. 



For example, a diaphragmatic hernia can occur after trauma in many cases, and involves the diaphragm - the sheet of muscle that separates the chest and lungs from the abdominal cavity.  When this muscle is torn, it is possible for the abdominal internal organs and intestines to herniate, or move through the tear in the diaphragm into the chest cavity.  When this occurs, it is called a diaphragmatic hernia.  Less commonly, diaphragmatic hernias can be a congenital defect (from birth), and can be asymptomatic for months or years.

Diaphragmatic hernias can be difficult to diagnose, and some patients will not show symptoms for several days.  When symptoms begin to appear, whether it is
immediately or later, veterinary care should be sought immediately.  The most common clinical signs are respiratory distress, vomiting, lethargy, and an irregular heartbeat.  Surgical repair of the hernia is necessary to repair the tear in the diaphragm, however it is imperative that the patient is stable prior to surgery.  For many traumatic hernias, breathing and heart rates need to be normalized before anesthesia should be attempted.  During surgery, the surgeon will evaluate the diaphragm, find the tear (which can be difficult in some cases), return any abdominal contents to the abdominal cavity, and suture the tear closed.  Any organ or intestinal damage can also be evaluated at that time, and repaired surgically if necessary. 

Congenital diaphragmatic hernias are often diagnosed incidentally (most commonly when the patient is anesthetized for the first time for a spay or neuter), and frequently the patients are asymptomatic.  Symptoms can onset gradually, however, and can include heart problems, muffled chest sounds during examination by a veterinarian, an abnormal abdomen (if some of the abdominal contents have moved into the chest), and breathing difficulty.  Certain breeds can be predisposed to congenital hernias, although the exact cause of the hernias is unknown.  Pets with congenital diaphragmatic hernias can sometimes be affected by other congenital malformations, and should be thoroughly evaluated by a veterinarian. 

Surgical correction is recommended as soon as medically possible for both traumatic and congenital diaphragmatic hernias.  Check with your family veterinarian or schedule a consult with a surgeon to learn more about this common problem!

Working at a specialty hospital, I am able to have access to and utilize the newest technologies and treatment options available for veterinarians treating injuries and illness.  In orthopedics, more often than not we deal with injury.  Many times surgical intervention is necessary to treat and repair the damage, however, a new technology is emerging that may help patients who are not surgical candidates, or improve the prognosis for patients who do receive surgical care.  This technology is called platelet rich plasma, or PRP.

Platelet rich plasma is technically not a new technology.  It has been used in human medicine beginning decades ago for use in heart surgery patients, but the
veterinary applications have only recently begun to stretch their legs, and become more affordable for the average pet owner.  Most people know that platelets are an integral part of blood clotting, but not everyone is aware that platelets are also responsible for the cleaning and clearing of damaged or dead cells after an injury, as well as releasing the different growth hormones that are critical for the restoration of cells and tissue.  PRP treatment attempts to harness this process to use directly on an injured area and stimulate as much of the body's own healing processes as possible.  PRP is obtained by drawing blood from the patient, then funneling that blood through a specialized centrifuge, where is it separated into two parts - red and white blood cells on one side, and platelets on the other.  This produces plasma that has a higher than normal concentration of platelets.  When the platelet rich plasma is then injected into the site of the injury, the platelets encourage healing, and attract even more new cells to the area to further stimulate the body's own natural healing processes.  Unlike injecting donor blood cells or artificial stimulants, there is no risk of rejection or reaction when using the patient's own blood to create the PRP. 

PRP is a new technology in veterinary medicine, and studies are still being performed to try and quantify the efficacy of the treatment when compared to traditional treatments.  However, it is an exciting new opportunity to treat injuries in a faster, more natural way, as well as assist the healing process after surgery.  We can also inject PRP with stem cells.  As we've discussed in prior blogs, stem cells are immature cells that have the capability to mature into cell to repair damaged tissues.  The combination of PRP and stem cells may give the best opportunity to repair or treat chronic injuries.  If you would like to learn more about PRP or stem cells, don't hesitate to use the "Ask Dr. Beale" link at the top left of the page!

It's been a while since we discussed heat-related problems in our pets, but since summer is officially here, it's important to remember heat safety for our pets! 

Unfortunately, dogs are the pets most affected by heat, as a general rule.  There are several medical conditions that can affect a dog's heat tolerance, and typically, dogs are outdoors and active more than cats.  This can expose them to the risk of over-heating, especially for happy, playful dogs who don't know when enough is enough when playing outdoors in the heat.  It is always important to make sure that dogs have plenty of fresh water for hydration when outdoors, but especially during the hot summer months.  Even if they don't want to, sometimes forcing your pet to take a break from playing outdoors is the best for their health.  Dogs main source of heat-relief is panting, unlike people, who are able to sweat all over their bodies to help release excess heat.  This makes them more likely to overheat quickly when compared to people.  If your pet has become over-heated, seek veterinary care immediately.  Heat stroke is very serious for dogs, and is can be fatal in many cases.  Always remember that the car is no place for a dog in the Houston heat, even with the windows cracked.  Cars' internal temperatures can rise very quickly - even 5 or 10 minutes can be too long for your dog. 

Older dogs and animals, certain breeds, or patients with other health problems can also be more susceptible to the heat of the summer.  If your pet is a brachycephalic breed (a breed with a snub-nose, like Pugs, English Bulldogs, and Pekinese), it can be harder for your pet to breathe when it is hot outside, which can lead to distress very quickly.  In addition, there are various conditions and diseases that can increase the risk of heat stroke.  Check with your family veterinarian for information for your pet's specific case, and always be diligent in observing your pet during the hot summer!