The veterinarian's role in recognizing animal cruelty, part 2 (Proceedings)

It is always important to document and handle all materials related to a case as evidence.  Often, however, situations arise when veterinarians only later realize that they were witness to an abuse case.  For this and many other reasons, it is always a good idea to take clear notes on any patient and maintain good records. 

What is evidence?

Evidence is something that furnishes proof or the data upon which a judgment or conclusion is based. Basically anything related to a case can be considered evidence.  Examples include:

·         The body of the animal

·         Photos

·         Leashes, collars, anything on the fur

·         Medical records, lab samples, x-rays

The physical exam

A thorough physical exam should be recorded with both abnormalities and normal signs listed clearly.  In addition to any obvious signs of trauma, note signs of neglect:

·         Filthy, matted hair

·         Avulsed nails

·         Untreated wounds

·         Unusual odors

·         Broken teeth           

·         Body Condition Score

Laboratory tests

Obtain additional samples as necessary to document cases.

Radiographs

·         Whole body radiographs to document rib fractures and fractures at varying stages of healing

·         Use radiologists when possible to strengthen the case

Laboratory samples

·         Standard CBC, Chemistry panels

·         Urinalysis

·         Fecal

·         Toxicology?

Necropsy

In addition to any obvious lesions, note the following and submit to a lab when appropriate:

·         Gastric contents, vomit, food

·         Liver, kidney, body fat

·         Parasites

·         Fractures

Soft tissue wounds or blunt force trauma

Remember that bruises do not form as easily in animals as they do in humans because an animal has reduced blood supply to the skin. For this reason, it often takes extreme force to cause a bruise in an animal.  It is important to use the correct terms when describing wounds.  Use a ruler to measure wounds and give dimensions.

·         Abrasions – Caused when the superficial (epithelial) layer of skin is scraped away

·         Contusions – Defined as an area of bleeding into the skin or soft tissue as a result of blood vessel rupture

·         Laceration – a tear in tissue, such that the tissue is stretched, sheared or avulsed

eck wounds

For neck wounds caused by embedded collars or chains, measure the circumference of the neck and compare to collar.  Take clear photos of both. 

You can estimate the length of time the collar has been on based on the following:

·         3 to 5 days for a granulation bed to form

·         Granulation tissue grows at a rate of 1 mm per day initially and then slows as lesion ages to 1 cm per month 

Dog fighting

Dog-fighting victims have numerous lesions in various stages of healing on the head and legs. 

·         Describe number, location, and severity of bites

·         Ears are often cropped very close to the head

·         “Ring lesions” on legs

Burns

Classify burns according to the degree or depth of the burn, location, and percentage of total body surface area (TBSA). 

·         First degree – superficial burns only affecting epidermis

o    Heal within 5 days usually without scarring

·         Second degree – include superficial and deep partial-thickness burns affecting the epidermis and one-half the dermis

o    Heal within 2-3 weeks with mild scarring

·         Third degree – full thickness burns involving all layers of skin

·         Fourth degree – includes damage to underlying muscle and bone

The percentage of TBSA can be calculated by measuring the burn in centimeters compared to the body surface area in meters. 

Neglect

Cases of neglect are perhaps the most difficult for veterinarians to assess but they are also the most common form of abuse you will encounter in practice.  Neglect can involve a wide range of issues from failure to provide the basic necessities such as food, water, and shelter, to failure to provide medical care.  Neglect is usually assessed over a period of time when a particular action is omitted on a regular basis or when a certain action is taken that causes suffering over time.  It is important to assess the following when considering neglect:

·         What is the environment the animal is living in?

o    If this is a case that is presented to you, make sure to ask for photos of the housing, food bowls, water bowls, and general environment. 

o    Check to see that dogs have access to clean water and appropriate food as well as a dry shelter. 

o    Describe the smell of the location or ask officers who were at the scene to provide you with these details.  This will help you better assess the animal's condition.

o    Look for evidence of infectious disease in the environment such as bloody diarrhea or vomit. 

o    In hoarding situations, you will often smell ammonia on the animals or owners when they come to the shelter or clinic.  Hoarding households are often severely cluttered, with feces and urine present on many surfaces.  There are varying degrees of hoarding however and some situations may not have the marked levels of urine and feces present that we often associate with hoarding.  In these cases, the animals may instead be covered with fleas or have infectious diseases that are not being appropriately treated (ex. ringworm, giardia).

·         Attempt to establish a time course for the condition.

o    If you are able to view the housing situation, look for signs that the neglect has been occurring for a long time such as moldy food, algae in water bowls, and no grass growing on the site. 

o    Look through medical records to see if previous visits had similar clinical signs present such as specific odors, matted coats, untreated medical conditions.

Specific cases of neglect include the following which will be discussed during the lecture:

·         Embedded collars

·         Starvation

·         Animal Hoarding

·         Untreated injuries

·         Demodicosis