Rocco presented with history of severe trauma after a road traffic accident , the referring veterinary team had concerns over possible spinal , pelvic , hip and  rib fractures upon plain radiography, polymonary contusions,  anaemia and severe shock.

Rocco was referred to the Emergency and Critical Care Service for initial stabilisation and involved the large team of specialists and referral clincians in a multi-displinary approach to ensure a excellent / great outcome for him. On arrival he was in severe shock , with dyspnoea  and cardiac dysthymia , he was monitored with intensive care nursing , oxygen therapy ECG and blood pressure monitoring . Emergency abdominal ultrasound detected a haemoabdomen and he did not stabilise with crystalloids alone, therefore a blood transfusion was administered under the supervision of our Emergency and Critical Care specialist Adam Mugford.

To evaluate polytrauma cases such as Rocco CT is proving increasingly useful and is of great benefit of teams at Lumbry park to have direct access to this.  Rocco was sedated once his stability improved and monitored by our Specialist anaesthesia team and imaging confirmedthe presense of markedly displaced  rib fractures , small volume pleural effusion , pulmonary contusions , within the abdomen a splenic and hepatic haematoman was noted as a source of the abdominal haemorrhage ( in the majority of cases as in Rocco’s case traumatic haemoabdomen is a non surgical condition ) There was no evidence of spinal fracture or injury following review by our Neurology specialist

Upon the CT  the previously suspected Hip and pelvic fractures were not evident however there was evidence of a hip luxation (dislocated hip ), he received further critical care overnight and contionus ECG and oxygen therapy this was reduced ( closed reduction ) by our orthopaedic referral team and Rocco continued intensive care , unfortunately his markedly displaced rib fractures resulted in open rib fractures and therefore he had further surgery with the soft tissue team to remove the fracture fragments of the rib , at surgery it became apparent that there was also disrupture of the chest wall and this required a chest wall reconstruction . A feeding tube was placed and he was again recovered with on going crtical care and supervision with our ECC specialist.

Unfortunately his closed hip reduction failed as can be expected in a number of cases and therefore he had a second surgery to perform a open hip reduction , this was successful and after a number of days further critical care and hospitasation.

Rocco improved and was successfully discharged to the owners care. He has now made a full recovery from his injuries and is a great example of the team approach required and available at Lumbry park for successful treatment in such complex cases.