Plus-Hex CLINICAL
Introduction
This case study examines the nursing care provided to a 2-year-old border terrier presenting with a distal humeral fracture caused by a road traffic accident.
Initial management of the patient is evaluated to determine the effectiveness of early care decisions. Ongoing monitoring is assessed to ensure that clinical signs and patient comfort were appropriately addressed throughout hospitalisation. In addition, pre- and postoperative interventions are reviewed in relation to their impact on recovery and the minimisation of the risk of complications.
Emphasis is placed on the multidisciplinary approach within the hospital environment, with a focus on evidence-based nursing protocols for the management of traumatic orthopaedic injuries.
Patient signalment
Species Breed Sex Age Weight
Dog Border terrier Male, neutered 2 years 7 months 11.5 kg Body condition score 5 / 9
Patient assessment
The patient was dysphoric on presentation at the out-of-hours( OOH) clinic, his primary care practice having administered the opioid methadone( methadone hydrochloride at a dose of 0.04 mg / kg [ 1 ]; 0.46 ml administered). He was given a full physical examination; parameters noted are shown in Table 1 [ 2 – 4 ]. His body temperature was 37.2 ° C, below the normal range for dogs, which could have indicated he was recovering from shock. He was 10 / 10 lame on his right forelimb but was otherwise able to walk and move around.
The patient was whining when he was presented to the practice; however, his owners stated that he was quite a vocal dog so, in light of this and the opioid administration, there were no concerns about his pain levels at that time.
In some cases, splenic contraction and relaxation may release red blood cells into the circulation, which may mask any anaemia associated with haemorrhage, so it is important to monitor the patient ' s blood pressure for signs of possible internal bleeding [ 5 ].
The patient was able to pass urine consciously, which, before any diagnostic imaging, indicated that his bladder was most likely intact and he was still able to maintain one of the bodily functions contributing to normal homeostasis.
Veterinary investigations
On admission to the clinic, the patient had an epoc critical care blood gas analysis [ 6 ] performed. This showed normal values, indicating that liver and kidney function were not of concern following the vehicular trauma.
If there had been any indications of diminished renal capacity, non-steroidal anti-inflammatory drugs( NSAIDs) would have been avoided. This is due to their potential to exacerbate renal dysfunction by impairing renal autoregulation, as well as their adverse effects on platelet activity and gastric mucosal protection [ 7 ]. Evidence suggests waiting until adequate fluid resuscitation has been carried out before administering NSAIDs [ 8 ].
A manual packed cell volume( PCV) measurement would have been a good addition to this patient ' s investigations, to monitor for signs of haemorrhage, in case shock was being masked by splenic contraction.
Table 1. Patient parameters.
Parameter Measurement Normal range Comment Temperature 37.2 ° C 38.3 – 39.2 ° C [ 2 ] Low, due to patient recovering from shock
Heart rate |
72 bpm |
70 – 120 bpm |
Within the normal range, on the lower side |
|
|
|
but not of concern. No obvious murmurs |
|
|
|
detected |
Blood pressure 125 / 90 mmHg 110 – 160 / 60 – 90 mmHg [ 3 ] Within normal range
Mean arterial pressure
Mucous membranes
108 mmHg 85 – 120 mmHg Normal
Pink, moist Salmon pink, moist Normal
Capillary refill time < 2 s 1 – 2 s Indicating good blood flow [ 4 ]
Volume 41( 1) • February 2026
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