Dog w/ Concussion

[letie]

My husband dropped a grill onto my 3 y/o, 5lb Maltese's head.  He bled from the ears/nose & suffered many seizures.  Since then, he's improved greatly and it's been 4 days since the accident.  He does sleep a lot and is being controlled with medication for his seizures and an antibiotic.  My concern revolves around nutrition and hydration.  He doesn't want to eat (today is day #2 of very little-no food) and he takes sips of chicken broth (chicken boiled in water-no salt or anything), but that's it.  I guess my question is: how much water/liquid should he approximately consume so he doesn't dehydrate?  Any ideas on what else I can possibly feed him other than mushed up chicken/rice/turkey/peanut butter??  I was going to give cottage cheese/yogurt a shot, but then realized the last time that happened...he had the runs.  I don't really want to go there.  We've been watching him closely day/night.  He is able to kind of walk (although wobbly) and have been told we won't know the extent of the brain damage till months down the road.  I would really like input on nutrition/hydration though.  I think we have the other stuff covered.  Thanks

[Jim Humphries, B.S., D.V.M.]

I assume you got immediate care for the emergency.  Brain hemmorage and swelling can occur and must be addressed urgently or there will be irreparable and non-reversable damage.  

That said to address the nutrition.  

I think you are on the right track with an easily digestible protein and a complex carb.  with brain pressure from the swelling and subsequent headache it is very common to loose all appetite.  So what every liquids you can get in him, plus the protein/carb gruel is right on.  

if he is going to improve, then the appetite will also improve slowly.  As for amount my answer is what ever you can get down him.  That may not be scientific, but he will self regulate but at first be on the very low side consequently you will have to force feed as much as he will take.  

There is also a product you can buy at the doctors office called Nutri-Cal that will help get nutrients in him with a very concentrated paste.  I've kept many very sick animals alive on that until they can begin eating on their own.  

Yes, stay away from the dairy as it will cause diarrhea in small animals.  

Please let us know his progress.  I also invite our other doctor's opinions on this.  

[letie]

Miko is doing very well since the accident 11 days ago.  He's almost back to normal except one thing...he poops/pees in his crate at night.  This was never an issue prior to the accident, but as of now I've had to wash him every morning.  I've downsized his crate (since he is pooping/peeing on one side/sleeping on the other), walk him at night before going to bed around 11pm (and yes...he does relieve himself), restrict his water intake at night around 9pm, feed him at regular hours twice/day (with his Pb).  How do I break this habit?  I'm really getting tired of having to wash my dog each morning before going to work and after work.  Is it the Pb that makes him poop in his crate as well?

Thanks

[Kimberly Coyner, D.V.M., DACVD]

A general guide for minimum daily fluid requirement in dogs is about 30ml/lb/day, or about 150ml/day for a 5 pound dog (1 cup is 236ml). This assumes that no pre-exisiting dehydration is present and that fluid losses are not excessive (ie. if diarrhea was occurring his fluid need would be more, since he would be losing fluids in the stool). This includes both water he drinks and fluids he gains from liquified food, so it is a good idea to add water to the food you offer to increase his water intake. Nutrical is a good source of calories, and you can also ask your veterinarian about some of the prescription dog foods designed for ill animals, such as Hill's A/D, which is soft enough that it can be syringe fed to him, and is a good source of protein and moisture; your veterinarian can tell you how much A/D to feed him in a 24 hr period.
Good luck,
Kimberly Coyner, DVM

[letie]

Thanks for the much needed advice.  I just got home from work and to my suprise, Miko just chowed down a 1/2 a boiled breast of chicken and 1/4 cup of chicken broth.  I'm guessing he just doesn't like water b/c it doesn't taste good?  It looks like he's doing better since I last saw him this morning.  He was actually putting up a struggle this time when we had to give him his phenobarb and clavamox.  I guess that's a sign that he's regaining his strength.  I just hope his improvement continues till we see our Vet again in a couple of weeks.  Thanks again!