FRACTURES
These are of not unfrequent occurrence in the dog; and I once had five
cases in my hospital at the same time.
In the human subject, fractures are more frequent in adults, and,
perhaps, in old men, than in infants; but this is not the case with the
smaller animals generally, and particularly with dogs. Five-sixths of
the fractures occur between the time of weaning and the animal being six
months old; not, perhaps, because of their chemical composition, that
the bones are more fragile at this age; but because young dogs are more
exposed to fall from the hands of the persons who carry them, and from
the places to which they climb; and the extremities of the bones, then
being in the state of epiphysis, are easily separated from the body of
the bone. When the fracture takes place in the body of the bone, it is
transverse or somewhat oblique, but there is scarcely any displacement.
A simple bandage will be sufficient for the reduction of these
fractures, which may be removed in ten or twelve days, when the
preparatory callus has acquired some consistence. One only out of twenty
dogs that were brought to me with fractures of the extremities, in the
year 1834, died. Two dogs had their jaws fractured by kicks from horses,
and lost several of their teeth. In one of them the anterior part of the
jaw was fractured perpendicularly; in the other, both branches were
fractured. Plenty of good soup was injected into their mouths. Ten or
twelve days afterwards, they were suffered to lap it; and in a little
while they were dismissed cured.
It will be desirable, perhaps, to describe our usual method of reducing
the greater part of the fractures which come under our notice.
I.--The 'humerus' was fractured just above the elbow and close to the
joint. The limb was enclosed in adhesive plaster, and supported by a
firm bandage. The bones were beginning to unite, when, by some means
concerning which I could never satisfy myself, the 'tibia' was broken a
little above the hock. Nothing could well be done with this second
fracture; but great care was taken with regard to the former. The lower
head of the humerus remained somewhat enlarged; but the lameness became
very slight, and in three weeks had nearly or quite disappeared. Nothing
was done to the second fracture; in fact, nothing more than a slight,
annular enlargement, surrounding the part, remained--a proof of the
renovating power of nature.
II.--A spaniel was run over by a light carriage. It was unable to put
the left hind leg to the ground, and at the upper tuberosity of the
ileum some crepitus could be distinguished. I subtracted six ounces of
blood, administered a physic-ball, and ordered the patient to be well
fomented with warm water several times during the night. On the
following day no wound could be discovered, but there was great
tenderness. I continued the fomentation. Two or three days afterwards
she was evidently easier. I then had the hair cut close, and covered the
loins and back with a pitch-plaster. At the expiration of six days the
plaster was getting somewhat loose, and was replaced by another with
which a very small quantity of powdered cantharides was mingled. At the
expiration of the fifth week she was quite well.
III.--The 'thigh-bone' had been broken a fortnight. It was a compound
fracture: the divided edges of the bone protruded through the
integuments, and there was no disposition to unite. It is not in one
case in a hundred that an animal thus situated can be saved. We failed
in our efforts, and the dog was ultimately destroyed.
IV.--The 'femur' was broken near the hip. I saw it on the third day,
when much heat and swelling had taken place. I ordered the parts to be
frequently bathed with warm water. The heat and tenderness to a
considerable degree subsided, and the pitch-plaster was carefully
applied. At the expiration of a week the plaster began to be loosened. A
second one was applied, and when a fortnight longer had passed, a slight
degree of tenderness alone remained.
V.--The following account is characteristic of the bull terrier. The
'radius' had been broken, and was set, and the bones were decidedly
united, when the dog, in a moment of frantic rage, seized his own leg
and crushed some of the bones. They were once more united, but his wrist
bent under him in the form of a concave semicircle, as if some of the
ligaments of the joint had been ruptured in the moment of rage. It was
evident on the following day that it was impossible to control him, and
he was destroyed.
VI.--A spaniel, three months old, became fractured half-way between the
wrist and the 'elbow'. A surgeon bound it up, and it became swollen to
an enormous size, from the adhesive plaster that had been applied and
the manner of placing the splints. I removed the splints. On the
following morning I had the arm frequently fomented: a very indistinct
crepitus could be perceived at the point of the humerus: I applied
another plaster higher up, and including the elbow. The hair not having
been cut sufficiently close, the plaster was removed, applied much more
neatly and closely, and the original fracture was firmly bound together.
No crepitus was now to be perceived.
I saw no more of our patient for four days, when I found that he had
fallen, and that the elbow on the other side was fractured within the
capsular ligament. A very distinct crepitus could be felt, and the dog
cried sadly when the joint was moved. I would have destroyed him, but he
was a favourite with his master, and we tried what a few days more would
produce. I enclosed the whole of the limb in a plaster of pitch, and
bound it up without splints. Both the bandages remained on nearly a
fortnight, when the fractures were found to be perfectly united, and the
lameness in both legs gradually disappeared.
VII.--July 22, 1843. A spaniel was frightened with something on the bed,
and fell from it, and cried very much. The instep, or wrist, of the
right leg, before was evidently bowed, and there was considerable heat
and tenderness. It was well fomented on the two following days, and then
set, and adhesive plaster was tightly applied, and a splint bound over
that.
24th. The foot began to swell, and was evidently painful. The outer
bandage was loosened a little, but the inner bandage was not touched.
Aug. 4. The bandage, that had not been meddled with for eleven days, now
appeared to give him some pain. For the last two days he has been gently
licking and gnawing it. The splints were removed; but the adhesive
plaster appearing even and firm, was suffered to remain.
26th. Everything appeared to be going on well, when he again leaped from
his bed. The wrist was much more bowed, and was tender and hot. Simple
lint and a firm calico bandage were had recourse to.
27th. He is unable to put his foot to the ground, and the joint is
certainly enlarging. An adhesive plaster, made by a Frenchman, was
applied at the owners request, over which was placed a splint. The dog
soon began to gnaw the plaster, which formed a sticky but not very
adhesive mass. Before night the pain appeared to be very great, and the
dog cried excessively. I was sent for. We well fomented the leg, and
then returned to our former treatment. There was evidently a great deal
of pain, but it gradually passed over, and a slight degree of lameness
alone remained.
I have great pleasure in adding the following accounts of the successful
treatment of fractures in dogs by Mr. Percivall:
"Hopeless as cases of fracture in horses generally are, from the
difficulty experienced in managing the patient, they are by no means
to be so regarded in dogs. I have in several instances seen dogs
recover, and with very good use of the parts, if not perfect
restoration of them, when the accidents have been considered, at the
time they took place, of a nature so irremediable as to render it
advisable to destroy the animals.
"May 4, 1839. A valuable Irish spaniel fell from a high wall, and
fractured his 'off shoulder'. On examination, I found the 'os humeri'
fractured about an inch above its radial extremity, causing the limb
to drop pendulously from the side, and depriving the animal of all use
of it. The arm, by which I mean the fore arm, was movable in any
direction upon the shoulder, and there was distinct crepitus: in a
word, the nature of the accident was too plain to admit of doubt; nor
was there any splinter or loose piece of bone discoverable. I directed
that the animal might be laid flat upon his sound side in a hamper, or
covered basket or box, of sufficient dimensions, but not large enough
to admit of his moving about; to have his hind legs fettered, his
mouth muzzled, and his injured parts covered with a linen cloth wetted
with a spirit lotion.
'May' 5. The parts are tumefied, but not more, nor even so much as one
night have expected. Continue the lotion.
'6th'. At my request, Mr. Youatt was called in to give his opinion as
to the probability of effecting a cure. He thought from the
inconvenient situation of the fracture, that the chances of success
were doubtful; and recommended that a plaster, composed of thick
sheep-skin and pitch, cut to the shape of the parts, should be
applied, extending from the upper part of the shoulder down upon the
arm, and reaching to the knee; and that the whole should be enveloped
in well-applied bandages, one of them being carried over the shoulders
and brought round between the fore legs, to support the limb, and aid
in retaining the fractured ends in apposition. Prior to the
application of the pitch plaster the hair was closely shorn off. Thus
bound up, the dog was replaced in his hamper, and had some aperient
medicine given to him.
'8th'. The medicine has operated; and he appears going on well, his
appetite continuing unimpaired.
'10th'. He growls when I open the basket to look at him. On examining
him (while his keeper had hold of him), I found the plaster loosening
from its adhesion; I took it off altogether, and applied a fresh one,
composed of the stopping composition I use for horses' feet.
June 7. Up to this time everything appears to have been going on
properly. The fracture feels as if it were completely united, and, as
the plaster continues to adhere firmly, I thought the bandages
enveloping it, as they were often getting loose, might now he
dispensed with, and that the dog might with benefit be chained to a
kennel, instead of being so closely confined as he has been. In
moving, he does not attempt to use the fractured limb, but hops along
upon the three other legs.
July. He has acquired pretty good use of the limb. Being now at
liberty, he runs about a good deal; halting, from there being some
shortness of the limb, but not so much as to prevent him being
serviceable, as a 'slow' hunter, in the sporting-field.
"About a twelvemonth ago," continues Mr. Percivall, "I was consulted
concerning a blood-hound of great size and beauty, and of the cost of
£50, that had been a cripple in one of his hind limbs for some
considerable time past, owing, it was said or thought, to having
received some injury. After a very careful handling, and examination
of the parts about the hips, the places where he expressed pain, I
came to the conclusion that there had been, and still existed, some
fracture of 'the ischial portion of the pelvis', but precisely where,
or of what nature, I could not determine; and all the treatment I
could recommend was, that the animal should be shut up within a basket
or box of some, sort, of dimensions only sufficient to enable him to
lie at ease, and that he be kept there for at least six months,
without being taken out, save for the purpose of having his bed
cleansed or renewed. His owner had previously made up his mind to have
him destroyed; understanding, however, from me, that there still
remained a chance of his recovery, he ordered his groom to procure a
proper basket, and see that the dog's confinement was such as I had
prescribed. The man asked me to allow him to have his kennel, which,
being no larger than was requisite for him, I did not object to; and
to this he had an iron lattice-door made, converting it into a sort of
wild beast cage. After two months' confinement, I had him let out for
a short run, and perceived evident amendment. I believe altogether
that he was imprisoned five months, and then was found so much
improved that I had him chained to his kennel for the remaining month,
and this, I believe, was continued for another month. The issue was
the complete recovery of the animal, very much to the gratification
and joy of his master, by whom he is regarded as a kind of unique or
unobtainable production.
"The fractures of dogs and other animals must, of course, be treated
in accordance with all the circumstances of their cases; but I have
always considered it a most essential part of their treatment that
such portable patients as dogs and cats, &c., should be placed and
kept in a state of confinement, where they either could not, or were
not likely to, use or move the fractured parts; and, moreover, I have
thought that failure, where it has resulted after such treatment, has
arisen from its not having been sufficiently long persisted in."
In the opinion of Professor Simonds, when there is fracture of the bones
of the extremities, a starch bandage is the best that can be employed.
If applied wet, it adapts itself to the irregularities of the limbs; and
if allowed to remain on twelve hours undisturbed, it forms a complete
case for the part, and affords more equal support than anything else
that can possibly be used.
The following case was one of considerable interest. It came under the
care of Professor Simonds. Two gentlemen were playing at quoits, and the
dog of one of them was struck on the head by a quoit, and supposed to be
killed. His owner took him up, and found that he was not dead, although
dreadfully injured. It being near the Thames, his owner took him to the
edge of the river, and dashed some water over him, and he rallied a
little. Professor Simonds detected a fracture of the skull, with
pressure on the brain, arising from a portion of depressed bone. The dog
was perfectly unconscious, frequently moaning, quite incapable of
standing, and continually turning round upon his belly, his straw, or
his bed. It was a case of coma; he took no food, and the pulsation at
the heart was very indistinct.
"I told the proprietor that there was no chance of recovery except by
an operation; and, even then, I thought it exceedingly doubtful. I was
desired to operate, and I took him home.
"The head was now almost twice as large as when the accident occurred,
proceeding from a quantity of coagulated blood that had been effused
under the skin covering the skull. I gave him a dose of aperient
medicine, and on the following morning commenced my operation.
"The hair was clipped from the head, and an incision carried
immediately from between the eye-brows to the back part of the skull,
in the direction of the sagittal suture. Another incision was made
from this towards the root of the ear. This triangular flap was then
turned back, in order to remove the coagulated blood and make a
thorough exposure of the skull. I was provided with a trephine,
thinking that only a portion of the bone had been depressed on the
brain, and it would be necessary, with that instrument, to separate it
from its attachment, and then with an elevator remove it; but I found
that the greater part of the parietal bone was depressed, and that the
fracture extended along the sagittal suture from the coronal and
lamdoidal sutures. At three-fourths of the width of the bone, the
fracture ran parallel with the sagittal suture, and this large portion
was depressed upon the tunics of the brain, the dura mater being
considerably lacerated. The depressed bone was raised with an
elevator, and I found, from its lacerated edges and the extent of the
mischief done, that it was far wiser to remove it entirely, than to
allow it to remain and take the chance of its uniting.
"In a few days, the dog began to experience relief from the operation,
and to be somewhat conscious of what was taking place around him. He
still requires care and attention, and proper medicinal agents to be
administered from time to time; but with the exception of occasionally
turning round when on the floor, he takes his food well, and obeys his
master's call."[1]
[Footnote 1: Trans. Vet. Med. Assoc., i. 51.]
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