A Case Report on the Management of a Canine Knife Wound

A canine knife wound represents a significant veterinary emergency demanding prompt and thorough management. This report details the diagnosis, treatment, and postoperative care of a canine patient presenting with a penetrating knife wound.

I. Case Presentation:

A 7-year-old, male, mixed-breed dog was presented to the veterinary clinic after being found with a penetrating knife wound to the abdomen. The owner reported finding the dog with the knife still embedded, providing no history regarding the incident. The dog was alert but exhibiting signs of pain and distress, including tachypnea (rapid breathing) and tachycardia (rapid heart rate). Initial palpation revealed a significant abdominal wound with the knife protruding. There was no obvious external hemorrhage.

II. Diagnostic Procedures:

1. History and Physical Examination: A thorough history was attempted, although limited information was available from the owner. The physical examination revealed a body temperature of 103°F (39.4°C), a rapid heart rate of 160 bpm, and respiratory rate of 40 breaths per minute. The mucous membranes appeared slightly pale. Auscultation of the heart revealed a regular rhythm, but lung sounds were slightly diminished in the caudal lung fields due to discomfort from the abdominal wound. Palpation of the abdomen elicited significant pain. Careful palpation of the superficial lymph nodes revealed no significant enlargement.

2. Laboratory Investigations: Pre-operative bloodwork was performed, including a complete blood count (CBC), serum biochemistry profile, and blood gas analysis. The CBC revealed a mild leukocytosis (elevated white blood cell count), indicative of an inflammatory response, but no significant anemia. The biochemistry profile was within normal limits, excluding any pre-existing hepatic or renal compromise. Blood gas analysis showed mild respiratory alkalosis consistent with pain and distress.

3. Imaging: Radiographic examination (lateral and ventrodorsal views) revealed the presence of a foreign body (knife) penetrating the abdomen. The radiographs indicated the knife’s depth and trajectory, suggesting penetration of the stomach and possibly other abdominal organs.

III. Surgical Intervention:

Given the severity of the injury and the radiographic findings, the decision was made to proceed with exploratory laparotomy. After induction of general anesthesia and aseptic preparation of the surgical site, a midline celiotomy was performed. The knife was carefully removed, revealing lacerations to the stomach and spleen. The gastric laceration was relatively small and was closed in two layers using absorbable suture material (PDS II). Exploration of the spleen revealed a more extensive laceration with significant parenchymal damage. Due to the severity of the splenic injury and the risk of continued hemorrhage, a splenectomy (surgical removal of the spleen) was performed. Hemostasis was meticulously achieved throughout the procedure. The abdominal wall was closed in layers using absorbable sutures, and the skin was closed with non-absorbable suture material (nylon).

IV. Postoperative Management:

Postoperatively, the patient was closely monitored for signs of hemorrhage, infection, and pain. Intravenous fluids were administered to maintain hydration and electrolyte balance. Analgesics (buprenorphine) were provided for pain management. The patient was maintained on intravenous antibiotics (ampicillin/sulbactam) for seven days to prevent infection. Serial hematocrits were performed to monitor for post-operative anemia. The patient’s progress was closely monitored over the next 72 hours. The incision site was cleaned and the sutures were removed after 10 days.

V. Discussion:

Penetrating abdominal trauma in dogs often involves significant visceral injury. Rapid assessment and prompt surgical intervention are crucial to minimize morbidity and mortality. The present case highlights the importance of a systematic approach to diagnosis, including a thorough physical examination, laboratory testing, and radiographic imaging. While splenectomy carries risks (increased susceptibility to infection), it was a necessary measure in this case to control hemorrhage and prevent further complications.

Post-operative management plays a critical role in successful outcome. Close monitoring for complications such as hemorrhage, infection, and pain is essential. Adequate pain management and antibiotic prophylaxis significantly reduce the risk of adverse events.

The specific surgical techniques employed, such as the layered closure of the gastric laceration and the meticulous hemostasis during the splenectomy, reflect best practices in canine abdominal surgery. Long-term follow-up is recommended to monitor for any potential long-term effects of splenectomy, including increased susceptibility to infections.

VI. Conclusion:

This case report illustrates the successful management of a canine knife wound involving significant splenic and gastric injury. The prompt diagnosis, surgical intervention, and diligent post-operative care resulted in a favorable outcome for the patient. This case underscores the importance of prompt veterinary attention for penetrating abdominal wounds in dogs to achieve optimal results. The incident also highlights the need for responsible pet ownership and preventative measures to avoid similar occurrences.