Treatment by handlers and combat medics may have been performed, with varying degrees of success.1,2 Expect dogs to arrive with pressure dressings, hemostatic gauze packed into wounds, and improvised tourniquets. Expect untreated or inadequately treated extremity hemorrhage, and suspect “hidden” intracavitary hemorrhage in the chest and abdomen.

- Assess for unrecognized hemorrhage and control all sources of external bleeding. Use direct pressure initially, or rapidly clamp and ligate major vessels if traumatized. Dogs have excellent collateral circulation, and paired major vessels can be ligated without concern for tissue ischemia or edema, to include the femoral arteries and veins, external jugular veins, external carotid arteries, and brachial arteries and veins.3,4
- Tourniquets are unreliable on the limbs of dogs due to the anatomic shape of the leg. Conventional human tourniquets do not remain in place or effectively control hemorrhage. Some success is reported in use of improvised tourniquets, such as surgical rubber tubing or constrictive gauze bandage. If delay in definitive care of major extremity trauma is expected, use hemostatic agents, direct pressure, and compressive bandaging to assist with hemorrhage control.
- Use thoracic FAST (TFAST) and abdominal FAST (AFAST) to rapidly scan for intracavitary fluid (See CPG 4 and CPG 7).5,6 Assume intracavitary fluid is due to bleeding until proven otherwise.