The categories are perfusion, cardiac, respiratory, skeletal, neurological, and eye/muscle/integument (all in 1 category) with the higher the score, the more severe the injuries sustained. A MGCS ≤ 11 was 84% sensitive and 73% specific when it came to predicting non-survival.įor comparison, the ATT score was first described in 1994 and is calculated based on 6 categories, each assigned a score of 0-3. (VETgirl is very geeky and has a living will specifically stating that if my GCS is 15 predicted 100% survival. However, a score of 7 resulted in a 54% probability of non-survival.

Remember that the MGCS is calculated based on 3 categories, each assigned a score of 1-6 points the lower the score, the more severe the brain injury. Overall, 72 dogs were included in the study (with an average age of 2). 89% of the dogs sustained blunt head trauma, more than half of which were due to motor vehicle accidents. The overall mortality was 15%, with 91% of non-surviving dogs being euthanized. Of the 72 dogs, 89% had neurologic deficits suggesting traumatic brain injury, as indicated by a MGCS score less than 18, which is normal. Of the clinical and laboratory values recorded, lower SpO2, pH, bicarbonate, base excess, total protein, and albumin, as well as higher potassium, lactate, or BUN were predictors of non-survival.Īll 3 scoring systems were also predictive of non-survival, although ROC curve analysis revealed that the MGCS had the highest predictive value. Outcome was recorded as survival or non-survival to hospital discharge.

Signalment, history, treatments performed at the referring clinic, and several clinical and laboratory variables were recorded such as vital signs and blood gases. Findings from the neurologic assessment and physical exam were used to calculate the MGCS, mentation, and ATT scores. Other recorded information included the use of interventions such as mannitol or hypertonic saline, oxygen supplementation, or endotracheal intubation, as well as benzodiazepine, anti-seizure medication, or steroid administration. Information from the first 6 hours of admission was included and the closest values to admission chosen if multiple measurements were taken. This was a retrospective study that evaluated dogs sustaining head trauma within 5 days of admission to the Ontario Veterinary College between January 2001 and March 2011. Dogs were excluded if they had pre-existing neurologic disease, an inconclusive history of trauma, or missing medical record information. Therefore, the purpose of this study was to determine whether clinical and laboratory variables or scoring systems such as the modified Glasgow coma scale, mentation, or ATT scores recorded at hospital admission have prognostic value in dogs with head trauma. Alternatively, large studies investigating the utility of the Animal Trauma Triage (ATT) score have been published recently, but this score has not been specifically investigated in a population of head trauma patients. A study investigating the utility of a modified Glasgow coma scale score (MGCS) was published back in 2001 and showed an almost linear correlation between the score and mortality. Studies investigating veterinary patients with head trauma are relatively sparse. Some dogs or cats admitted with signs of traumatic brain injury make astounding turnarounds, whereas others do not seem to respond to therapy.

In today’s VETgirl online veterinary continuing education podcast, we review prognostic factors in dogs with head trauma based off a recent study by Sharma et al entitled “ Retrospective evaluation of prognostic indicators in dogs with head trauma.” Many of us in emergency practice see head trauma patients and would agree that the prognosis for these patients can be difficult to predict.

Signs of head trauma in dogs