What are head injuries?
As a Veterinarian whose practice predominantly covers emergency medicine and surgery, I frequently see head and neck trauma cases. Head injuries in our pets can occur from trauma to the skull, brain or associated structures from the simplest incidence such as hitting furniture from a height or while playing with other pets, falling out of an owners hands, to trauma in a hit by car incidence. Head injuries can also occur when pets bodies get hit causing the brain to wobble severely inside the skull. Regardless of the inciting cause, the brain tissue, its, nerves, its surrounding blood vasculature and cerebrospinal fluid containing structures are extremely delicate and are easily damaged. The brain is surrounded by layers of tissue (meninges) that contain cerebrospinal fluid which can help act as a buffer. At the same time the brain sits in a skull cavity that has a defined space which cannot expand beyond its limits. If the brain swelling is limited by the skull cavity space, the intracranial pressure increases causing further damage. Inflammation, bleeding and buildup of carbon dioxide inside the brain from any inciting cause will most likely lead to similar neurological problems. Other causes of brain injury may result from drowning, smoke inhalation, asphyxiation from tight collars, causing hypoxia, infections and benign or malignant masses either growing in the skull cavity or in and around the brain; or from metastasis.
What are the signs of head injury?
The initial signs of brain injury can extended from a pet having a wobbly gait, inattentive to stimulus, difficulty breathing, cortical blindness, unconsciousness, bleeding and seizures amongst others. The severity of the injury may have a correlation to the inciting cause which will then assist your veterinarian in a prognosis.
What kind of therapy would you expect from your veterinarian?
On presentation your veterinarian will most likely start oxygen therapy, keep the pets head elevated, place an intravenous catheter, do a physical exam to find problems that are either neurological, orthopedic, metabolic or other soft tissue injury related. If clinical signs of a head injury based on history, physical exam and clinical signs amongst other problems are noted, your veterinarian will then proceed to make a plan with you to help your pet with medical therapy that will most likely involve, further oxygen therapy, mannitol to reduce the intracranial pressure amongst other therapies such as hyperbaric oxygen therapy, hypertonic saline therapy, with medications such as gastric protectants, ant-acids, ant-emetics, anti-inflammatory dose of a steroid, and antibiotics as deemed fit.
What is the duration of therapy?
After completing initial diagnostics and correlating the results with those on a clinical examination, the prognosis and duration of therapy will depend on the progress of clinical signs of the pet for the better or worse. Every hour to 6 hours of monitoring clinical signs and trends gives a better understanding of the progress and prognosis. Head trauma cases are generally hospitalized for 4 -7 days based on clinical improvement. After that serial exams every day or every other day will continue depending on your pet’s progress.
What is hyperbaric oxygen therapy (HBOT)?
Hyperbaric oxygen therapy provides 100% oxygen under a comfortable pressure to damaged tissue of the body such as brain cells, kidney cells, cardiac muscle cells. The tissues are nourished with oxygen which in turn helps reduce edema, inflammation caused from trauma, hypoxia, ischemia, infarction, and pathways of apoptosis and necrosis. Hyperbaric oxygen therapy (HBOT) has helped many loving pets that have head injury, brain, spinal cord and muscle trauma, renal, and myelopthisic disease amongst other problems, recover to live a comfortable and functional life.
What’s is the prognosis?
Unfortunately, due to the nature of head trauma injuries, the prognosis varies widely and is based on initial findings and the trend of clinical signs over days. Above and all, what helps our dearest furry family members heal early is a soft touch and tender loving care.