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One busy Sunday afternoon, we received an urgent phone call from the Vancouver police department. One of their police dogs, Bear, had been electrocuted on the street as he was working a drug house. The officer on the phone told us that Bear had fallen to the ground in convulsions and had stopped breathing.
by Teresa Hall D.V.M.
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One busy Sunday afternoon, we received an urgent phone call from the Vancouver police department. A valued member of the Dog Squad, Bear, had been electrocuted on the street as he was working a drug house. The officer on the phone told us that Bear had fallen to the ground in convulsions and had stopped breathing. They believed that he was in cardiac arrest (that his heart had stopped) and they were doing CPCR (cardiopulmonary cerebral resuscitation). At the time of the phone call, Bear had not been breathing for several minutes. They were continuing CPCR as they placed Bear in a squad car for emergency transport to the hospital.
 Electrocution is a life-threatening emergency that can cause immediate problems such as cardiac arrest, seizures and fluid buildup in the lungs (noncardiogenic pulmonary edema). The lack of oxygen to the brain and body from cardiac arrest can have severe consequences even if the heart can be restarted and the patient begins to breathe again on their own. CPCR, although lifesaving, can have its own consequences such as bruising to the lungs that may need to be dealt with after resuscitation. In the days following electrocution, problems can include lung damage, heart arrhythmias, kidney failure and permanent brain damage from lack of oxygen.
The VAEC team had all these consequences in mind as we set into action to save this canine police officer. We prepared for CPCR by assigning team members roles that they would take in the CPCR. As team leader, Dr. Hall would intubate Bear while Galina (a veterinary technician) would be responsible for cardiac compressions. After his endotracheal tube was secured, Dr. Hall would take over cardiac compressions and direct team actions. Galina, a veterinary technician, would then ventilate Bears lungs with oxygen while Tanya, another technician, administered emergency medications, set up the ECG, placed an intravenous catheter, and remained ready to take over cardiac compressions. Sarah, the VOA, was to be a “floater” and perform tasks such as drawing up drugs and assisting in any way that she could.
The resuscitation area was readied by selecting endotracheal tubes of various sizes, preparing for oxygen delivery, drawing up emergency drugs such as epinephrine and atropine, readying ECG and blood pressure monitoring, setting up intravenous fluids and blood gas analysis.Within minutes we heard police sirens growing closer as the police escort rushed Bear to the hospital.
Bear was carried into the treatment area by his handler and several other police officers that had been on the scene. To our relief, Bear was sitting up and able to breathe on his own. CPCR would not be required but now we had to deal with the potentially life threatening consequences of cardiac arrest, CPCR, and electrocution damage in the body. Bear’s body had been without oxygen for up to 4 minutes.
 Although Bear was able to sit up on his own, he was breathing extremely heavily and his gums were a purplish-blue colour indicating lack of oxygen to his tissues. Bear was given oxygen by a facemask and we inserted an intravenous catheter while we assessed his vital signs. His handler, Constable Wong, was obviously upset but remained strong, constantly reassuring Bear and holding the oxygen mask on Bear’s nose.
Bear’s heart was racing and his blood pressure was slightly high. Rapid intravenous fluid therapy was started and an arterial blood gas was measured to assess how well Bear’s lungs were functioning. The blood gas showed that Bear’s body pH was too far on the acid side but that so far his lungs seemed to be functioning well. We gave Bear an injection of butorphanol (a combination of pain relief and a mild sedative effect), that helped him feel a bit less anxious.
Constable Wong helped us place a catheter right into Bear’s nose as a more efficient long-term method of oxygen administration. Bear was then taken into radiology for radiographs (Xrays) of his lungs. Surprisingly, there were minimal changes to Bear’s lungs at this point. There was some mild bruising but for the degree of trauma and shock sustained we were pleased with how the radiographs looked. A venous blood gas taken after Xrays showed complete normalization of his acid base status. By this time, Bear was able to stand up and walk around well on his own. He was receiving nasal oxygen, and had already urinated (which made us optimistic that his kidneys had not suffered damage as a result of shock).
One hour after presentation Bear appeared relatively stable. Although he had improved greatly since his partner first carried him into the clinic, it was far too early to predict if his condition would worsen or continue to improve. The next 12-24 hours would be most critical; Bear’s lungs might stiffen, bruising could continue to develop, and oxygen delivery to his body could be seriously reduced. In some cases, these results of lung trauma can be fatal.
 We were also concerned that the massive shock and lack of oxygen to body tissues might lead to serious inflammation in all his organs (Systemic Inflammatory Response Syndrome or SIRS) and collapse of his blood clotting system (DIC or disseminated intravascular coagulation). Platelets are small blood clotting components that become reduced in early DIC; a platelet count showed normal platelet numbers at this time. The plan for Bear was intensive. Treatments included oxygen supplementation, intravenous fluid therapy, and an acid blocker to reduce stomach acid. We were to monitor him his vital signs closely and frequently, and perform tests including arterial blood gases and pulse oximetry to assess his lung function, repeat chest radiographs to see if his lungs were worsening, platelet number counts, and blood tests to the Central Laboratory for Veterinarians to look at his white blood cell, total body profile and coagulation status. At this point we could only watch and wait to see which way Bear’s lungs and body would go but at this point we were cautiously optimistic that Bear would continue to improve.
Throughout the afternoon and evening, Constable Wong stayed close by his partner, Bear, offering him comfort and reassurance. His devotion and emotional bond to his partner was touching. A steady stream of concerned men and women in blue uniforms with guns and crackling radios at their hips wandered in an out of the hospital at all hours to check on their co-worker, Bear.
As feared, Bear’s blood gas values worsened in the middle of the night, indicating lung damage. By giving nasal oxygen we were able to keep the amount of oxygen in his blood normal, but without the extra oxygen he would become hypoxemic (low oxygen in his bloodstream). Repeat radiographs of his chest showed mild changes only. Although this turn for the worse was not unexpected it was still concerning and we remained vigilant for other signs of deterioration in his condition.
 Despite the worsening in his lung function, Bear himself was feeling much better at this point and we were having difficulty keeping his nasal oxygen line in place. Treatment can become a catch 22; the patients feel good so they resist the treatment that makes them feel good!
Bear improved throughout the morning and the next day. His nasal oxygen was gradually decreased and an arterial blood gas taken just short of 24 hours after presentation showed completely normal lung function. Amazingly, Bear was ready to go home 24 hours after his electrocution.
There was concern that Bear might have suffered enough brain damage from lack of oxygen that he would lose some of his training and would not be fit to resume work. Happily, this has not been the case and Bear returned to work as fit and able as ever.
Thanks to the heroic and quick actions of his fellow police officers, and his treatment at the VAEC, Bear has made a remarkable recovery. (The bare patches on Bear’s nose still bear testament to his brush with death!)
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