Working dogs or canines (K9s), either in the Department of Defense (DoD), civilian law enforcement, or with search and rescue teams, are all involved in high-threat or demanding environments. These K9s are often require first aid, or trauma care. Even though the Tactical Combat Casualty Care (TCCC) trauma guidelines were developed in the late 1990s for all military personnel, there was no equivalent for military K9s until much later with some initial guidance by military veterinarians: 1) canine trauma physical examination and assessment; 2) massive hemorrhage control and physiological stabilization; and 3) thoracic and abdominal trauma.
In 2015, the American College of Veterinary Emergency and Critical Care, and Veterinary Committee on Trauma formed a prehospital subcommittee to develop out-of-hospital, veterinary care guidelines. Their vision was to develop trauma guidelines focused on general K9 (defined hereafter for any dog) care. However, these K9 trauma guidelines were not developed for the specific stages of care required in a civilian tactical environment. To fill this gap, the Committee for Tactical Emergency Casualty Care (C-TECC) proposed to form a civilian K9 working group to develop trauma guidelines for operational K9s.
In 2019, a second K9 trauma guidelines were then developed by the newly created Canine Tactical Combat Casualty Care Committee (K9TCCC), DoD, as an affiliate of the Committee on Tactical Combat Casualty Care (CoTCCC). Their intent was to develop the best K9TCCC trauma guidelines specific to the TCCC three stages of care in a combat environment. The K9TCCC guidelines focus on simple, evidence-based, field-proven medical interventions to eliminate preventable K9 deaths and to improve survival. Customized for the battlefield, K9TCCC adapts the TCCC guidelines for canine anatomical and physiological differences. For example, tourniquets for K9s are not recommended as a first-line intervention for controlling extremity hemorrhage. K9s have a significantly lower muscle mass in their limbs and are less prone to massive hemorrhage from extremity wounds. Consequently, human commercial tourniquets work poorly for extremity wounds, due to the tapered narrow limb. Previous research shows that direct pressure alone was sufficient in K9 limb hemorrhage. The initial K9TCCC guidelines were published in the Journal of Special Operations Medicine in 2020, and was recently updated in May 2023 (Note: deployedmedicine.com remains in the public domain, but now requires you to setup an account to access TCCC and K9TCCC trauma guidelines and supporting materials).
Initially, there were many limitations for point-of-care K9 management since veterinary personnel are not part of the military or civilian tactical teams. Moreover, in the DoD it is not uncommon for a military veterinarian to be responsible for 20 to 30 operational K9s scattered up to thousands of miles in a combat environment. Consequently, when operational K9s are injured, care often falls to the K9 handler, or a combat medic, who historically had little to no training in K9 first aid or trauma care.
The knowledge gap of trauma and first aid training for K9 handlers also holds true for most civilian owners who enjoy taking their K9s into the wilderness for pleasure and recreation. Fortunately, today, based on the principles of civilian and military K9 trauma guidelines, there are many opportunities to take civilian K9 courses in basic and advanced first aid, wilderness first aid, and trauma management for use in any urban or austere environments. Thus, our intent is to bring awareness to these training opportunities that were developed based on military lessons learned.
Canine (Pet) First Aid
The American Veterinary Medical Association (AVMA) states that knowing basic pet first aid and being prepared for emergencies can help to lessen the feelings of panic in these situations. The AVMA points out that first aid care is not a substitute for veterinary care, but it may save your pet’s life with some basic skills. It is recommended in case of an emergency to have phone numbers of your veterinarian, the ASPCA Poison Control Hotline (888-426-4435), and a 24-hour emergency veterinary hospital in the area where you live or travel.
K9 or pet first aid courses have been available for years so owners become prepared to be first responders for managing common injuries in the home. These courses range from basic first aid skills either from an online source (non-fee), an online course, or an in-classroom course for a fee. The instructors are either veterinarians, vet techs, or EMS personnel trained in canine skills, and anatomy and physiology. More recently, there are canine wilderness medicine courses (see Table 2) that are geared for owners/handlers going into remote settings, where if an injury occurs, there will be long delays getting the dog evacuated to a regional veterinarian offices or animal emergency rooms. Since there are no minimal standards for these courses, it is recommended to investigate course content, course duration, hands-on skills and instructor credentials in advance to pursuing an online or classroom course.
It is recommended to develop a canine or pet first aid kit for home use from items you have already. There are many commercial canine first aid kits that range from very basic with a few items to a much larger hip pack or daypack kits. See Table 1 for a recommended household canine first aid kit content from the AVMA. It is suggested to keep a canine first aid kit in your household as a minimum, but consider adding one to your vehicle during travel so it is readily available to place is your daypack along with water, food, toys for wilderness activities.
Table 1: AVMA recommended items for a basic pet first aid kit
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Important phone numbers (veterinarian, emergency hospital, poison control, animal control, nonemergency police)
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Scissors with blunt ends for safely cutting bandage materials
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A copy of your pet’s medical record, including any medications your pet is receiving
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Disposable gloves to protect your hands
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Digital thermometer to take your pet’s temperature
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Small flashlight for examining eyes, wounds, etc.
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Muzzle to prevent bites (DO NOT muzzle your pet if they are vomiting.)
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Tweezers to remove small foreign objects
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Spare leash and collar
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Eye dropper (or large syringe without needle) to give oral treatments or flush wounds
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Gauze roll for wrapping wounds or muzzling an injured animal
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Sterile lubricating jelly to protect wounds/eyes
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Clean towels for restraining cats, cleaning, or padding
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Activated charcoal to absorb poison (Use only if instructed to do so by your veterinarian or a poison control center.)
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Nonstick bandages or strips of clean cloth to control bleeding or protect wounds
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3% hydrogen peroxide to induce vomiting (Always contact your veterinarian or poison control center before inducing vomiting. Do not give more than one dose unless otherwise instructed by your veterinarian. Do not use hydrogen peroxide on wounds.)
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Self-adhering, nonstick tape for bandages
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Saline solution for cleansing wounds or flushing eyes (Saline solution sold for use with contact lenses works well for most purposes.)
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Adhesive tape for securing bandages
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Pet/K9 Trauma and First Aid Resources:
There are many resources available in communities or online that can offer awareness of first aid and trauma care, to more basic and advanced online and classroom courses. The topics listed in the Table 2 are an assortment, not an exhaustive list, of these courses. They are provided here solely for your awareness of what is available for free online advice/ recommendations, and courses with some certifications. We recommend you conduct an online search for what is available in your community, and to seek out additional online K9 resources.
Table 2: Pet/K9 trauma and first aid resources:
Implications for the Wilderness Provider
The two trauma guidelines, one for the military K9s, and the other for civilian law enforcement K9s, are both based on the military trauma guidelines approved by the CoTCCC, but they are adapted to the specific K9 anatomy and physiology and used in different operational environments. Therefore, these two K9 trauma guidelines are highly applicable, if needed, for any person’s canine injured at home or in the wilderness setting.
It is advisable to that you first take an advanced first aid or one of the many wilderness medicine courses for managing your personal injuries and those to others. Clearly, the same rationale exists for taking a K9 or pet first aid course as it does for a human course. You will be better prepared as the first responder for managing minor canine injuries occurring in the home and the wilderness setting, and then knowing when injuries or illnesses are more severe and require a veterinarian. These courses will help owners and handlers to lessen your anxiety and sense of helplessness, and be prepared to respond for the unexpected pet injuries in the wilderness setting.