K9 Emergency Aid 101: Bleeding Control
People get hurt, which is why we carry IFAKs. If you have a dog it should be no surprise to you that dogs also get hurt. If a dog is a member of your department, squad, or family, you should be carrying equipment for them as well.
Accidents happen. This article and series isn’t just for the police officer and his Belgian Malinois. It’s also for your duck hunting uncle and his Brittany, or even for you and the Miniature Schnauzer you share your apartment with.
We covered in our K9 IFAK Composition article what you should have and why. ISG is for those who want to be prepared for whatever comes at them. This includes medical skills. I’m expanding that scope to include more than just our species.
This article series will assume you already have a cursory knowledge of TCCC, or at the very least, the MARCH Algorithm. If you are not, there are ample resources available. I recommend the script available on Deployed Medicine for an in-depth look, or the Combat Medic Essentials video series form UF Pro.
Please know that the medical videos from them are the ONLY thing I am recommending. You won’t find a lot else that they publish that we’d endorse.
What We’re Preparing For
Much of the information available about K9 trauma seems to be focused towards working dogs. Part of the preparation I did for this series was to get my certification in Hostile Environment Injuries in K9s from the Tactical Veterinary Group. This information was obviously geared towards your average bomb-sniffer and fur-missile.
But that leaves a huge swathe of the dog loving community out. I grew up training dogs and currently have a pair of Labradors who are getting pretty good at water retrieval. They certainly may not be running headlong into fire from Kalashnikovs, but is the field hunting Pointer not also around men with shotguns? I know none of my hunting buddies ever carried first aid for their dogs. When I was a young boy I had a Jack Russell Terrier that would chase squirrels into trees for me to pick off with my bolt action twenty-two. I was 8 or so, how quickly could disaster have struck there?
Even if you’re a city dweller, bad dogs attack, cars hit dogs, and a host of other hypotheticals pose danger to your four legged friends. This isn’t meant to sew some sort of paranoia into you, but to start understanding the well being of the dog in your life in the same way you understand yours.
Your pup is going to have blood vessels of relatively the same location as you are used to. The brachial artery runs along the inside of the forelimbs, extending downward from the “armpit” of the dog. Likewise, the femoral artery runs from their underside along their groin and down the inside of their hind limbs. On either side of the neck will be the carotids. One additional vessel to worry about is the caudal artery, which supplies blood to the tail. If cut, the dog does have the potential to bleed out from this. It isn’t nearly as common as the other limbs, but be prepared to treat the tail as a 5th limb if the injury is close enough to the base and catastrophic.
An essential part of any K9 kit is a muzzle. You can’t treat a patient if you become one, and even the most friendly and familiar of dogs can bite if injured and stressed. A dog’s mouth is how it interacts with the world. If in extreme pain, disoriented, or highly anxious, any dog can revert to a fear response. Some procedures for bleeding control are also painful themselves. The pup may see the action of biting as self defense, since you’re the one incurring the extra pain.
It means that if you’re going to carry a K9 IFAK, you must begin muzzle training your dog.
This is not a hard behavior to train, and can be done while you read the rest of this article. For a recommendation, my favorite video on muzzle training is by a YouTube channel called Blue Cross.
Bleeding control for a dog is very much the same as you’re going to find with humans. Luckily, it will be much of the same equipment as well. However, due to the obvious differences in anatomy and physiology, there are concerns for tourniquets beyond “just buy for them what I buy for myself.”
Even with a large breed, a CAT or SOF-T will be much too wide. The upper rear leg of most dogs has a roughly triangular shape, and trying to apply wide tourniquets with large pressure plates like the CAT will often slip down as you try to tighten, especially when there is blood present to lubricate the limb in an unhelpful way.
Larger breeds, such as my oldest Labrador (pictured to the left)do have a “pocket” where their limb attaches, and this is a great landmark to understand where to put a hasty tourniquet for a life-threatening bleed. Likewise, if you pull the skin up on the front legs, you can see an angle towards the armpit. When placing a hasty tourniquet, place them here. There are purpose-built tourniquets for dogs.
You can buy the purpose-built K9 tourniquet if it makes you feel good, but it’s absolutely not a requirement. In conversations had via direct message with @specialforcesmedic and @den_motherk9, many professional handlers and dog-adjacent medics simply carry ACE wraps and pressure bandages. The pressure needed to occlude a dog’s artery is much less than that of a grown person. The windlass and clips can often just be unnecessary bulk.
Placement of a tourniquet is indicated by life threatening arterial bleeds. “Massive Hemorrhage” is the M in the MARCH algorithm. When your dog is bleeding profusely from a limb, or perhaps even missing a portion of a limb, this is where you use your TQ or a bandage as a tourniquet.
Combat Gauze and Junctional Wounds
Just as with us, sometimes life threatening bleeds will happen in a place that isn’t convenient or even possible to place a tourniquet. This is when we rely on hemostatic agents like Combat Gauze. Quik Clot is effective on K9’s just like it is on humans and the goats and pigs we practice with it on. It is not something to be used for minor bleeds that will heal up on their own, or a slow oozing bleed that may just need a stitch or two from the veterinarian. It is for life-threatening bleeds.
There are 3 main places we will be called on to use combat gauze on our dogs. First is the neck for the pair of carotid arteries that run on the underside of the neck, both on the left and right side of the trachea. If you place a finger on your dog’s trachea by the collar, and trace outwards, you should find their carotid pulse. If a bleed occurs from here, it’s a job for combat gauze.
The other two places are long where the brachial and femoral arteries meet the dog’s trunk. In layman’s terms, the dog’s armpit and groin. Be careful with this, as you do not want to introduce combat gauze to the dog’s abdominal cavity. You’ll want to keep packing specifically to the joint where the legs meet the trunk.
Likewise, we don’t pack wounds in the thoracic cavity. If your dog is bleeding from anywhere on his chest wall that isn’t directly where his forelimb joints are, do not pack with combat gauze. This will require an occlusive dressing to be covered in a later article.
Dogs get all sorts of knicks and scrapes, but that’s not what we’re talking about here. Even if a bleed isn’t immediately life threatening, it can be an emergency. Large cuts or avulsions can require urgent attention to due the pain involved or great potential for an infection that will be life threatening later.
For this we can use regular gauze to pack or cover the wound, followed up with ACE Wrap or an Israeli bandage to secure the gauze and add a bit of pressure to the wound to aid in clotting. Sometimes dogs do not tolerate bandages well, so you will have to reassess and pay attention to bleeds that the dog can get at with their feet or muzzle to ensure they don’t try to remove them, or fuss with them enough that the wound becomes exposed again.
Also remember to keep your priorities straight. Life threatening bleeds get treated first, but non-life threatening bleeds can wait until later. The C in the MARCH algorithm is for circulation, which is the section that you’ll attend to these sorts of wounds. If the pup has some ripped skin on his hide, that injury will have to wait until you’ve ensured the Massive Hemorrhage, Airway, and Respiratory concerns have all been addressed.
Next: Airway and Respirations
That’s it for bleeding control. In the next section we’ll cover basic airway and respiration concerns that you can tackle. If unfamiliar with opening the airway, occlusive dressings, or needle chest decompression, please review for humans before jumping into it for dogs.