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Abuse 9

and may develop periapical pathology (e.g., • Learn how to obtain dental radiographs SUGGESTED READINGS
uncomplicated crown fracture). to assist the veterinarian in patient Reiter AM, et al: Periodontal and endodontic disease.
VetBooks.ir endodontic therapy) of teeth that have pulpal Client Education disease in small animal surgery, ed 3, Jackson, WY, Diseases and Disorders
management.
• Perform prompt treatment (extraction or
In Bojrab MJ, Monnet E, editors: Mechanisms of
2010, Teton NewMedia, pp 125-128.
disease (e.g., complicated crown fracture).
Technician Tips • Explain the pathophysiology of pulpal and AUTHOR & EDITOR: Alexander M. Reiter, DVM, Dr.
periapical disease.
• Dental radiography is paramount for the • Train owners to examine the oral cavity and med. vet, DAVDC, DEVDC
evaluation of periapical disease. look for abnormal teeth.

Abuse

BASIC INFORMATION HISTORY, CHIEF COMPLAINT they are retained because of potential legal
Crucial to note that none of the following ramifications. Relying on memory can be
Definition features alone is diagnostic. A combination problematic because it may be some time
• Physical abuse: actions such as kicking, raises suspicion, and the combination varies. before the case goes to court.
punching, beating, burning, microwaving, • History supplied is inconsistent with the
drowning, asphyxiation, and administration injury. Usually, the injury is too severe to fit PHYSICAL EXAM FINDINGS
of drugs or poisons the history. Owner’s explanation to account Wide spectrum of possible injuries
• Sexual abuse: any use of an animal for sexual for the pet’s injuries merits attention by its • Superficial injuries are common: bruising of
gratification lack of plausibility (e.g., animal with severe head, thorax, abdomen, and limbs; scleral/
• Emotional abuse: threatening behavior burns “sat too close to the radiator” or “lay conjunctival hemorrhages. Shaving of the
• Neglect: failure to provide the basic physical too close to the fire”; animal with fractures hair can reveal bruising, even in animals with
and/or emotional necessities of life (e.g., “fell down the stairs,” “fell off the sofa,” “fell very dark coats. Bruising is likely to be
food, shelter, veterinary attention) from child’s arms,” or “fell off the bed”). present over bony structures such as ribs or
• Discrepant history (e.g., person presenting vertebrae but may be absent in the (soft)
Synonyms the animal may change his/her story, history abdominal wall. Necropsy examination of
Battered pet syndrome, non-accidental injury, may differ from person to person) suspected fatal cases must include thorough
physical abuse • Particular person implicated (e.g., partner, examination of all subcutaneous areas for
child, even self-admission) bruising.
Epidemiology • Repetitive injury (i.e., animal presented more • Fractures and locomotor injuries: The most
SPECIES, AGE, SEX than once with injuries and/or different ages common fractures involve the skull, ribs,
Young male dogs and young cats are particularly of injury are identified). All body systems and femurs, although other bones may be
at risk. may be involved, but fractures are important. involved.
• Previous injury or death of another animal • Physical signs of internal thoracoabdominal
GENETICS, BREED PREDISPOSITION in the same home, particularly when injuries: rupture of major organs (liver, kidney,
Crossbred dogs, Staffordshire bull terriers, and unexplained spleen, urinary bladder); intrapulmonary
domestic short-haired cats are at increased risk • Lack of history of a motor vehicle accident hemorrhage; rupture of bowel uncommon
in the United Kingdom, but this may represent or any possible accident to explain injury • Sexual abuse injuries involve the genitalia
favoring of particular breeds by owners of low • The behavior of the owner causes concern and/or the anal or rectal area. Both sexes
socioeconomic status. (e.g., implausible, aggressive, embarrassed, may be abused.
obviously discomfited, lack of concern for
RISK FACTORS the animal). Etiology and Pathophysiology
There is an association between animal abuse, • The behavior of the animal causes concern • Owner-associated risk factors for the animal
domestic violence, and child abuse. Links within (e.g., animal shows fear of owner, happier include domestic abuse, alcoholism, sub-
the community (e.g., social workers, police, when hospitalized away from owner). stance abuse, and mental illness.
child protection teams, animal welfare organiza- • Family violence known or suspected • Some authors suggest that animal abuse is
tions) are highly advantageous for addressing • When obtaining the history of a case where more common in areas of social deprivation,
the public health aspects of abuse. Interagency abuse is on the differential diagnosis, some but this is largely anecdotal, and abuse does
collaboration is effective and helps to reduce points are essential: occur in affluent groups.
stress on the veterinarian. ○ It is important to be objective and avoid
jumping to conclusions. DIAGNOSIS
Clinical Presentation ○ It is necessary to remain polite and calm
DISEASE FORMS/SUBTYPES and avoid being confrontational. Diagnostic Overview
A variant of abuse is fabricated or induced ○ If the decision is made to discuss concerns A diagnosis of physical abuse is suspected when
illness. with the client, it can be helpful to present an animal suffers a series of injuries for which
• Factitious illness by proxy those concerns nonconfrontationally along no satisfactory explanation is offered and/or
• Munchausen syndrome by proxy the lines of the following: “It’s difficult the history does not fit the injuries.
○ Uncommon for me to match Spot’s injuries with what
○ Involves invention or falsification of illness you are saying. Is there anything else you’d Differential Diagnosis
in animal by owner, motivation being like to tell me?” • Naturally occurring conditions such as skel-
attention seeking by owner ○ It is important to ensure that clinical notes etal disorders (e.g., metabolic bone disease)
○ May involve repetitive injury are comprehensive and thorough and that and blood dyscrasias causing bruises

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