Vol.18, No.

12 December 1996 V HEINZ SYMPOSIUM 1996

Continuing Education Article

Gunshot Wound
FOCAL POINT
Management
★A basic understanding of Tufts University
ballistics helps the veterinarian
select the most appropriate Michael M. Pavletic, DVM
treatment for gunshot wounds.

KEY FACTS

■ The mass, velocity, design,

P rojectiles often cause injuries in humans and animals. A projectile is an
object that is propelled by external force and that continues in motion
by inertia. In veterinary medicine, gunshot wounds are the most com-
mon projectile injuries. The likelihood of a veterinarian seeing such injuries,
however, depends on the location of the practice. In 1985, I conducted an epi-
and composition of projectiles
influence their destructive zootiologic study of gunshot wounds (111 in dogs and 10 in cats) seen as
properties. emergencies at Boston’s Angell Memorial Animal Hospital from 1972 to 1983.
Most of the injuries took place in lower-income neighborhoods, which had a
■ Even low-velocity projectiles can greater incidence of crime. Angell Memorial’s proximity to these areas and its
inflict serious and sometimes established 24-hour emergency service explains the comparatively large num-
fatal injuries. ber of cases seen during this period.1
More animals were shot in the evening and early morning hours than at any
■ High-velocity projectiles can other time of day. In most cases, the animals had been left outdoors unsuper-
cause massive tissue destruction vised. A larger percentage of the shootings occurred over the weekend (Friday
because of their tremendous night through early Monday morning). Handguns were the most common
kinetic energy and the shock weapon documented (n = 95). Three animals that were shot with high-velocity
waves they send through rifle rounds were referred from rural areas. Six animals had shotgun wounds,
adjacent tissue. and 17 had wounds from air-propelled BB or pellet guns. Incidental retained
projectiles discovered on routine radiographs were not included in the study.1
■ Failure to follow correct Many of the injuries were misdiagnosed as vehicular trauma or bite wounds.1
procedures for documenting Because the severity of gunshot wounds varies considerably, a basic under-
and handling forensic evidence standing of ballistics will allow clinicians to select the most appropriate forms
can adversely affect the outcome of treatment. This article reviews the ballistics, pathophysiology, and manage-
of litigation. ment of gunshot wounds.

BALLISTICS
Ballistics is the science of the motion of projectiles in flight—from the point
of initial propulsion to the final path through the target. Kinetic energy is a
means of quantifying the destructive capacity of projectiles. The physics formu-
la for kinetic energy outlines the relationship between projectile mass and veloc-
ity; this relationship explains, in part, the destructive capacity of projectiles:

Kinetic energy = mass × velocity

2

2
Small Animal The Compendium December 1996

Doubling the mass doubles stabilize its flight for greater

the kinetic energy of a pro- accuracy. Shotguns and
jectile, but doubling the ve- many air-powered weapons
locity quadruples the kinetic have smooth bores designed
energy. Other factors, how- for the specific projectiles
ever, influence the severity fired.2,3
of trauma caused by projec- Bullets can be designed to
tiles.2,3 Figure 1—Two .38-caliber rounds retrieved from the brain
help maintain their shape, to
of an aggressive pit bull. The lead core has completely sep- deform in a controlled fash-
PROJECTILE VELOCITY arated from the partial jacket in one bullet. The second ion, or to fragment on im-
Low-velocity projectiles bullet, minus the exposed lead tip, is substantially intact pact. Most bullets are com-
are classified as those that after passing through the skull. posed of lead, with variable
travel less than 1000 feet/ amounts of antimony added
sec; medium-velocity pro- as a hardener. A lead core
jectiles travel between 1000 may be encased in a metal
and 2000 feet/sec; and high- jacket composed of copper,
velocity projectiles travel cupronickel, brass, or soft
faster than 2000 to 2500 steel to limit bullet deforma-
feet/sec. Most handguns are tion from the heat, friction,
considered to be low-veloci- and tremendous pressures
ty weapons. Rifles can gen- that can be generated as the
erate the higher velocities bullet passes through the bar-
Figure 2A
desired for military and rel. A jacket also influences
hunting purposes.2,3 bullet deformation when the
bullet strikes and passes
PROJECTILE CALIBER, through a target. Heavier bul-
DESIGN, AND lets have greater penetration
COMPOSITION than smaller high-velocity
The term caliber refers to projectiles, which rapidly dis-
the diameter of the projec- sipate their kinetic energy.2,3
tile or bore (interior diame- By international law, mili-
ter) of a gun barrel. Caliber tary projectiles must have a
is measured in fractions of full-metal (full patch) jacket
an inch or in millimeters. to limit the additional tissue
Larger caliber suggests greater destruction associated with
projectile mass. Because of bullet deformation and frag-
differing shapes and compo- mentation. Civilians, howev-
sitions of projectiles, howev- er, can purchase nonjacketed
er, the mass and velocity of or partially jacketed bullets
projectiles of a given caliber to be used for hunting and
vary widely.2,3 self-defense. 2,3 In partially
A cartridge, or round, con- jacketed bullets, a portion of
sists of the primer, case, pow- the lead core is exposed,
der, and bullet. When a which allows the nose to par-
weapon’s firing pin strikes tially flatten, or mushroom,
the primer within the base of in a controlled fashion. Al-
the casing, the powder charge though penetration may not
ignites and propels the bullet Figure 2B be as deep as that seen with
forward. For most rifles and Figure 2—(A) Lateral and (B) dorsoventral radiographic fully jacketed bullets, expan-
handguns, spiral grooves views of a paralyzed cat. A BB entered the spinal canal sion of the exposed lead tip
within the barrel (rifling) im- through an intervertebral foramen. Despite its modest ve- enhances the projectile’s im-
locity and mass, this air-powered projectile can inflict seri-
part rotation, or spin, on the pact, destructive capacity, and
ous injury when fired from a weapon at close range.
bullet’s longitudinal axis to killing potential (Figure 1).

KINETIC ENERGY ■ PROJECTILE CHARACTERISTICS ■ JACKETS

The Compendium December 1996 Small Animal

Commercially available trauma to tissue and the re-

hollow-point bullets and ex- gional circulation. Fractured
ploding bullets, which are bones, torn vessels, ruptured
intended for security or self- bowels, and massive contu-
defense purposes, are de- sions can occur without di-
signed to rapidly deform rect contact with the projectile.
and fragment to enhance Edema and vascular throm-
absorption of the projectile’s bosis progress for hours after
kinetic energy. Some indi- injury and can result in a
viduals flatten the ends of greater volume of tissue
bullets and score crossed necrosis than was originally
grooves on the surface (so- estimated at initial wound
called dumdum bullets) for assessment. 2–4 Traumatized
2,3
similar purposes. Figure 3A tissue, vascular compromise,
Exploding and “prefrag- foreign debris, and the inoc-
mented” projectiles were ulation of bacteria into the
more recently introduced depths of the wound increase
for use against skyjackers the risk of infection.2–4
and other criminals. The The specific gravity of the
projectiles impart a “knock- tissues struck also influences
down” effect on the person the nature and severity of
struck by maximizing ab- the wound. Rigid structures
sorption of kinetic energy. (e.g., cortical bone) can
In addition, they reduce the shatter on impact, whereas
dangers associated with the softer cancellous bone (e.g.,
round exiting the body and distal femur) is less prone to
striking the plane’s fuselage fragmentation. Low-velocity
or passengers inside the bullets can punch through
pressurized airplane cabin. soft cancellous bone. Frag-
Depending on the composi- Figure 3B ments of cortical bone or
tion and design of the ex- Figure 3—Two examples of .177-caliber air-rifle pellets. the projectile can become
ploding bullet, undetonated The pointed pellet (A) is designed to deeply penetrate tis- secondary projectiles, en-
rounds retained in the body sue, whereas the waisted pellet (B) is designed to flatten hancing regional tissue in-
can pose a hazard to the sur- and rapidly decelerate on impact. jury.2–4 Elastic tissues, such
geon removing the projec- as lung and muscle, can
tile. Body temperature or stretch to a variable degree,
jostling of the bullet can cause unstable bullets to ex- thereby better maintaining their architectural integrity
plode during removal. A projectile of unknown type and reducing the amount of tissue destruction. In con-
should be handled gently during removal and storage.2,3 trast, the liver, with a specific gravity similar to muscle,
is less cohesive and resilient. The liver fractures rather
DESTRUCTIVE CAPACITY OF PROJECTILES easily on impact.2–4
Tissue in the immediate path of a bullet is lacerated
and crushed. The damage that the shock waves released PROJECTILE WEAPONS
by high-velocity projectiles cause to adjacent tissues can Compared with most handguns, rifles can accurate-
be more difficult to conceptualize. Soft tissue and bone ly fire large, high-velocity projectiles. Although most
balloon outward from the path of the passing projec- handguns are considered to be low-velocity weapons,
tile, thus briefly creating a cavity. This phenomenon, rounds from a more powerful handgun can exceed
termed cavitation, can produce a temporary cavity that 1000 feet/sec (medium-velocity range) and cause
is up to 30 times the diameter of the bullet. considerable tissue destruction. Lower-velocity
During cavitation, a vacuum forms. This vacuum can weapons, including air-powered weapons, can pro-
draw contaminants and surface debris from both the en- duce serious and lethal wounds in humans and ani-
try and exit sites into the temporary cavity. The crushing mals, although they do not produce extensive tissue
and compression effect of cavitation results in extensive trauma.

EXPLODING PROJECTILES ■ TISSUE DAMAGE ■ CAVITATION

Small Animal The Compendium December 1996

Air-Powered Projectiles tight cluster but disperse as

In contrast to convention- they move down range in a
al handgun and rifle car- widening, funnel-like pat-
tridges, in which projectiles tern. The muzzles of shot-
are propelled by gases re- guns can be modified in
leased from exploding gun- design (choke) to vary the
powder, BB and pellet guns pattern or dispersion of the
primarily rely on com- shot over a given distance.2–4
pressed air that is released Shotguns can also fire
from a chamber to propel heavy lead projectiles called
the lightweight BB or pellet. deer slugs. The hollow base of
Air rifles can achieve veloci- the slug expands to seal the
ties comparable to many Figure 4A bore of the shotgun on deto-
handguns, but the rounds nation of the charge. Because
rapidly lose velocity over shotguns have smooth bores,
comparatively shorter dis- angular grooves etched on
tances because of their shape the outer surface of the deer
and lighter weight.2–4 slug impart a spin on this
BBs (.175 caliber) and projectile to stabilize its
pellets (.177, .20, and .22 flight.2,3 A variation, called
calibers) are currently used sabots, are solid projectiles
for target practice and hunt- cased in plastic sleeves that
ing of small animals. Unlike seal the barrel. The sleeves
the round BB, pellets come are shed during flight.
in various shapes, which When a shotgun is fired
modify their performance at close range (within 15
(Figures 2 and 3). yards), the dense cluster of
Figure 4B pellets, presented in a com-
Retained pellets and BBs
are common incidental pressed surface area, results
findings on radiographs. in massive tissue destruc-
They rapidly decelerate over tion. When the shotgun
relatively short distances as is fired at very close range,
a result of air resistance. the cardboard or plastic
They slow down further on wadding that is used to sep-
impact with the elastic skin. arate the pellets from the
Thus, BB and pellet pene- powder charge in the shell
tration often is limited to can also be driven into the
the hypodermis and under- wound. When shotguns are
lying musculature.2–4 When used beyond their effective
fired at close range, howev- hunting range (20 to 40
er, they can penetrate deep yards), the pattern of pellets
into the body. Figure 4C is more widely dispersed,
Figure 4—(A) High-velocity rifle round that entered the up- pellet velocity is greatly re-
Shotguns per right facial area of a dog that was referred from a rural duced, and the capacity for
Shotguns are smooth- area. (B) The mandible and maxilla were shattered into mul- the pellet to inflict life-threa-
bore, long-barreled guns tiple fragments. Extensive soft tissue destruction secondary to tening injury diminishes.2,3
designed to fire a grouping cavitation and fragmentation of the bone and portions of the
of spheres. These pellets bullet are evident. (C) There was a large, explosive exit MANAGEMENT OF
(“shot”) vary in size and wound on the left side of the head. Radiographs demonstrat- PROJECTILE WOUNDS
number, depending on the ed a small trail of lead fragments, with the bulk of the high- Management of gunshot
velocity round exiting the body despite passage through
bore of the shotgun and the wounds varies according to
dense bone. These findings are characteristic of a high-veloci-
game hunted. The pellets ty rifle round, probably a partially jacketed hunting round. the type of weapon, the ki-
emerge from the muzzle in a netic energy of the projec-

BB GUNS ■ PELLET GUNS ■ SHOTGUNS

Small Animal The Compendium December 1996

tile, and the location of the a Labrador retriever with ele-

wound(s). The nature of the vated lead blood levels and
wound can help determine clinical signs compatible
the weapon used. If a bul- with plumbism (without evi-
let is retained in soft tissue dence or history of lead con-
without striking bone, it can sumption). This dog had
be surmised that the round numerous retained birdshot
was low velocity. However, if pellets in the thoracic area.
the round struck and shat- The exposed surface area
tered dense bone of a large- of a retained lead projectile
breed dog and had sufficient and the location of the pro-
energy to exit the body, a jectile in the body can in-
high-velocity rifle round or fluence the degree of lead
more powerful handgun Figure 5A absorption. Lead has greater
should be suspected4 (Figure solubility when exposed to
4). synovial fluid. When such
The size and shape of exposure occurs over long
entry and exit wounds can periods, lead poisoning has
be somewhat misleading. occurred in humans.5,6 Un-
Although exit wounds are deformed, fully jacketed
generally larger than entry bullets expose little of the
wounds because of the out- surface area of the lead core,
ward or explosive egress, exit thus limiting the risk of
wounds may be smaller than plumbism. Therefore, con-
entry wounds if velocity and cern over lead poisoning
projectile mass are dimin- seldom justifies removal of
ished at the point of exit lead projectiles.5,6
from a body region. A tum- In wounds from high-
bling projectile that present- velocity projectiles, the sig-
ed its long side at entry also Figure 5B nificant tissue destruction
can produce a comparatively Figure 5—(A) A .22-caliber gunshot wound to the head of (especially when bone has
large entry wound and en- a cat. The projectile passed through the nasal cavity and been struck) usually re-
hance tissue destruction the maxillary bone, destroying adjacent teeth. It then quires wound exploration
within its path. At very close passed through the oral cavity and fractured the left and debridement. When
range, explosive gases re- mandible before exiting the left lateral facial skin. The tissue viability cannot be
leased at the muzzle can bal- metallic probe demonstrates the pathway of the bullet. determined immediately,
loon the entry wound.3 Soft tissue trauma was exacerbated by bone fragmentation. many of these wounds re-
(B) The wounds were opened, explored, and debrided.
Low-velocity projectiles quire variable periods of
Free fragments of bone and broken teeth were removed.
that have not entered a joint The maxillary defect was closed by apposition of viable open wound management
or struck an important body mucosa bordering the surgical site. The mandibular and staged debridement.2–4
structure can create wounds wound was handled similarly, and drainage was estab- The more powerful low-
that can be treated by local lished. Broad-spectrum systemic antibiotics were adminis- velocity projectiles can also
cleansing and lavage of the tered. The patient recovered completely. shatter bone, thus necessi-
entry and exit sites. Wound tating wound exploration,
debridement may be limited debridement, fracture stabi-
to the skin and underlying lization, and drainage.
fascial tissues. A topical dressing is applied to the wounds. Gunshot wounds to the abdominal cavity should be
Systemic antibiotics may be advisable in selected cases explored as early as feasible because of the significant
(Figure 5). Easily accessible bullets can be removed, but risk of peritonitis secondary to bowel perforation4 (Fig-
attempts to explore for deeply retained projectiles simply ure 6). From an historical perspective, 90% of Civil
to retrieve the round should be discouraged.4 Lead poi- War patients with abdominal gunshot wounds died of
soning (plumbism, saturnism) secondary to retained pro- peritonitis.7 During the Vietnam War, rapid evacuation
jectiles is rare in humans and animals. Only once did I see of patients from the combat field to the surgical suite

ENTRY WOUNDS ■ EXIT WOUNDS ■ WOUND THERAPY

The Compendium December 1996 Small Animal

reduced the mortality rate to the area until ligation or re-

9%.7 I have seen severe peri- pair can be performed. In
tonitis in several animals in the interim, judicious intra-
which abdominal explo- venous fluid support should
ration was not performed. be provided.
Most of these patients ap- Gunshot wounds to the
peared stable on presentation brain are associated with a
but developed massive peri- high mortality rate in hu-
tonitis from bowel perfora- mans and animals. After a
tion a few days after injury. careful physical and neuro-
Unlike penetrating ab- logic examination, specific
dominal wounds, many tho- diagnostic tests (including
racic gunshot wounds may computed tomography and
not require exploration. Ex- Figure 6A magnetic resonance imag-
ploration is required, how- ing) can be selected. In hu-
ever, if hemorrhage is life mans, carotid arteriography
threatening, air leaks are un- is commonly performed
responsive to thoracostomy to assess the integrity of the
tube insertion and continu- blood supply to the brain.10,11
ous suction drainage, or the Fortunately, dogs have ex-
esophagus or other adjacent cellent collateral circulation
vital structures are impacted to the brain, even when
(Figures 7 and 8). Projectiles both carotid arteries are lig-
can pass through the chest ated.
and into the abdominal cav- Gunshot wounds to the
ity, thus necessitating ab- human brain usually are ex-
dominal exploration.2–4 plored to remove possible
Pellets or BBs that enter sources of infection (debris,
the eye can elicit a severe contaminants, and bone
foreign-body reaction. In Figure 6B fragments). Although this
these cases, the projectile Figure 6—(A) Air-powered BB gun injury to the abdomen approach may be justified at
must be removed. Closure of of a Siamese cat. At presentation, the cat was depressed times in small animals, data
the scleral or corneal perfo- and had abdominal pain. (B) Laparotomy revealed multi- regarding the management
ration may be complicated ple perforations of the bowel wall. The probe illustrates of gunshot wounds to the
by the ragged entry wound one of the perforating wounds to the small intestine. Note brain in animals are lacking.
created by the pellet or BB. the small BB retrieved from the bowel site. (From Pavletic Retained projectiles may be
MM: Atlas of Small Animal Reconstructive Surgery.
Occasionally, projectiles pass difficult or impossible to
Philadelphia, JB Lippincott Co, 1992. Reproduced with
through the eye and into the permission.) approach without causing
orbit. Extensive hemorrhage more serious injury to the
may occur in the retrobulbar brain. There are reports of
space, or the optic nerve may be struck. More powerful humans surviving and functioning satisfactorily with re-
projectiles may enter the brain through the thin orbital tained projectiles in the brain. The same is true for small
bone.8,9 Radiographs and computed tomography help animals that have sustained low-velocity gunshot
define the location of the projectile. Complete destruc- wounds.12,13 Careful evaluation of the injury and patient
tion of the ocular architecture necessitates removal of are required to determine the best approach to the
the eye. emergency medical and surgical management of in-
Gunshot wounds involving the maxillofacial area tracranial projectile trauma.
may threaten the patient’s ability to breathe if extensive The neck is especially prone to serious injuries be-
hemorrhage and swelling obstruct the upper airway. cause of the concentration of vital structures in this
Suction of blood and saliva may provide temporary re- small anatomic region. The larynx, trachea, spinal cord,
lief, but an emergency tracheostomy may be the best cranial nerves, carotid and jugular vessels, pharynx, and
way to ensure a patent airway. Bleeding may be con- esophagus are among the vital structures susceptible to
trolled temporarily with moderate external pressure to projectile trauma. Major problems in the management

PERITONITIS ■ THORACIC WOUNDS ■ EYE WOUNDS

Small Animal The Compendium December 1996

Figure 7A Figure 8A

Figure 7B
Figure 7—(A) Pneumothorax secondary to shotgun pellets.
(B) A thoracostomy tube was inserted and connected to a
chest drainage system. The patient recovered completely.

of cervical gunshot wounds are the difficulty in diag-

nosing some deeper wounds and the possible resultant
delay in repair, which could result in serious complica- Figure 8B
tions. Cervical gunshot wounds in humans are often Figure 8—(A) Cardiac tamponade secondary to shotgun
explored because of the risk of esophageal perforation pellets penetrating the pericardium. (B) Pericardiocentesis
and major vascular injury. In dogs, major esophageal was followed by pericardiectomy. The patient recovered
perforation (which could result in cervical and anterior completely.
mediastinal infection) may be ruled out by esopha-
goscopy and radiographic contrast examination.4,11–19
Cervical exploration is also warranted in the presence of amputation may be advisable in some cases (Figure 10).
profuse or persistent bleeding, expanding hematomas, Bullets can migrate through fascial planes or gravitate
wounds to the larynx or trachea, serious spinal cord in- in the thoracic and abdominal cavities. Projectiles can
juries, or unstable vertebral fractures11,14–19 (Figure 9). enter the vascular system and embolize to distant
Gunshot wounds to bones are treated by internal or ex- anatomic locations. Projectiles in humans also have
ternal stabilizing devices. Because management of exten- been documented to enter a bronchus and then be
sive orthopedic injuries can be difficult and costly, limb coughed up or swallowed.2,3 A pellet that entered the

CERVICAL WOUNDS ■ BONE WOUNDS ■ BULLET MIGRATION

Small Animal The Compendium December 1996

Figure 9A Figure 10A

Figure 9B Figure 10B

Figure 9—A dog that had been shot in the neck with a Figure 10—(A) A gunshot wound to the right humerus and
handgun was presented with extensive subcutaneous em- scapulohumeral joint of a cat. (B) Because of the extensive
physema and pneumomediastinum. (A) Manual compres- soft tissue and orthopedic trauma, the limb was amputat-
sion of the skin highlights the extensive air accumulation. ed. The exact weapon was unknown, although a .22-
(B) A hole in the trachea at the level of the thoracic inlet caliber round was suspected.
was identified and sutured closed. The subcutaneous em-
physema rapidly decreased within 72 hours after surgical
correction. The patient recovered completely.
LEGAL CONSIDERATIONS
Forensic evidence of a shooting may be requested by
urinary bladder of a Labrador and later caused acute owners, game wardens, and attorneys.20–23 Veterinarians
urethral obstruction has been documented4 (Figure 11). must be able to document such evidence or request as-
When the pathway of projectile(s) cannot be clearly sistance from an experienced pathologist. Basic proto-
documented, multiple radiographs of the body should cols and responsibilities involved with handling foren-
be taken to determine the pathway and to rule out bul- sic evidence must be followed, or legal cases will be
let migration. contested easily. Detailed records should include notes
Retained projectiles from a previous shooting can cre- of all conversations.
ate confusion in the diagnostic evaluation of trauma pa- A complete set of quality radiographs and color pho-
tients. Clinicians may mistakenly conclude that an injury tographs of the entire animal should be taken to illus-
is a gunshot wound if a bullet is visible on the radiograph. trate the general position of the injuries. This will help
The patient must be inspected carefully for entry wounds orient those reviewing the case. Close photographs of
and whether the presenting wounds or clinical signs are individual injuries should include an area 15 cm
compatible with a gunshot wound2–4 (Figure 12). around the wounds. A metric ruler should be included

RETAINED PROJECTILES ■ FORENSIC EVIDENCE ■ DATA COLLECTION

The Compendium December 1996 Small Animal

in the photographs to indi- to a piece of rigid material,

cate scale. The photographs and then frozen for analysis
are labeled with the date, to determine the presence of
case number, and examin- propellant and projectile
er’s initials. Projectiles residue. This tissue specimen
should be photographed in should not be washed or
situ before their removal.20 placed in formalin.20
Flexible plastic probes or Careful examination and
catheters can be used to collection of tissues surround-
highlight the course of a ing the path of a projectile
projectile. Metallic probes are useful in determining
should not be used because whether game has been ille-
they can separate tissues gally killed by a gun during
during insertion and possi- Figure 11—Lateral radiograph of a Labrador retriever with restricted bow-hunting sea-
bly scratch the surface of a acute urinary tract obstruction secondary to migration of a sons. Some hunters insert a
retained projectile, thereby .20-caliber Sheridan pellet, which lodged at the os penis. broad-head arrow into a gun-
disturbing rifling marks on The dog had been shot in the urinary bladder; a small scar shot wound to mask the na-
its outer surface.20 was noted in the skin where the projectile originally en- ture of the weapon. Flesh
When feasible, an experi- tered the abdominal cavity. A urethrotomy successfully re- along the path of the bullet
enced, board-certified vet- moved this air-powered pellet. can be collected to recover
erinary pathologist should particles of lead released by
perform the detailed post- frangible projectiles. Lead
mortem examination. Other preexisting medical or residue can be identified by atomic absorption spec-
physical conditions may have affected the circum- trophotometry in tissue surrounding the tract. Tissue sam-
stances of the animal’s demise.
Tissue samples are taken
to confirm the presence of
any suspected diseases, de-
termine the age of a wound,
and help distinguish entry
from exit wounds. Tissue
samples occasionally are
taken for more detailed test-
ing and analysis by law-
enforcement officials.
Information commonly
requested in court relates to
the number and location of
wounds, features of the
wounds and related tissue
areas, course of the projec-
tiles, angle of fire, projectiles
and foreign debris recov-
ered, cause and time of death,
and details pertaining to the
handling and disposition of
specimens collected.20 Entry
wounds are closely inspect-
Figure 12A Figure 12B
ed to determine the proxim-
ity of the weapon to the Figure 12—(A and B) Two radiographic views of a fractured femur in a cat. This comminuted
animal. A 15-cm square fracture was not caused by a gunshot wound, as the admitting clinician originally suspected.
The retained BB was an incidental finding. No entry wound was present, and this air-pow-
around entrance wounds
ered projectile was not capable of this degree of orthopedic trauma.
should be removed, pinned

REQUIRED PHOTOGRAPHS ■ TISSUE SAMPLES ■ WOUND DESCRIPTION

Small Animal The Compendium December 1996

ples taken from a separate, uninvolved body region of the present at the necropsy. An indelible marker should be
carcass serve as a control.20 Examination of gastric contents used on the container or on a nonremovable label.20
can also help the pathologist determine the circumstances The projectiles should be secured from tampering or
of the incident.20–23 access by other individuals. Projectiles are turned over
The lands (elevated borders) and grooves of a rifled only to a qualified law-enforcement officer. Any per-
barrel embed marks on jacketed and nonjacketed bul- sons receiving the specimens must add the time and
lets. Occasionally, the lead core separates from the out- date of the transfer and their initials to the container.20
er jacket. Retrieval of the jacket is of greater impor- Owners often ask for the projectiles. Such requests
tance because the rifling marks are scored on its outer should be denied because the projectile could be al-
surface. Bullets should be handled carefully because tered or lost, thus reducing the credibility of the evi-
scratching the surface can damage the rifling marks dence gathered.
used to help identify the weapon. Forceps can be Errors in collecting data and recording pertinent in-
padded with tape to avoid this problem. The bullet formation can adversely affect the outcome of a case,
should be washed with water and alcohol and then al- despite the best intentions of the veterinarian. There-
lowed to air dry. The washing removes blood and tis- fore, careful attention to the legal issues discussed in
sue fragments.20 The bullet can be marked on its base this section will help clinicians avoid the embarrassing
(bottom) to ensure that it can be identified later. errors and pitfalls associated with inappropriate case
Close-up photographs of the bullet ensure its identifi- preparation in a court of law.
cation.
All projectiles should be wrapped in facial tissues
and placed in vials or containers that can be sealed About the Author
with tape. The body region from which each projectile Dr. Pavletic, who is a Diplomate of the American College
was retrieved must be clearly identified, and each pro- of Veterinary Surgeons, is Professor and Head of the
jectile must be placed in a separate, marked container. Department of Small Animal Surgery, School of Veterinary
The container is identified with the date, time, case Medicine, Tufts University, North Grafton, Massachusetts.
number, and owner’s name and it is initialed by those

REFERENCES
1. Pavletic MM: A review of 121 gunshot wounds in the dog

Interested in and cat. Vet Surg 14:61–62, 1985.

2. Pavletic MM: Gunshot wounds in veterinary medicine: Pro-
jectile ballistics—Part I. Compend Contin Educ Pract Vet
writing for 8(1):47–60, 1986.
3. Pavletic MM: Gunshot wounds in veterinary medicine: Pro-
jectile ballistics—Part II. Compend Contin Educ Pract Vet
COMPENDIUM? 8(2):125–134, 1986.
4. Pavletic MM: Atlas of Small Animal Reconstructive Surgery.
Philadelphia, JB Lippincott Co, 1992, pp 92-108.
For small animal articles, please contact 5. Dillman RO, Crumb CK, Lidsky MJ: Lead poisoning from
a gunshot wound. Am J Med 66:509–514, 1979.
Dr. Douglass Macintire (email macindk@ 6. Leonard MH: The solution of lead by synovial fluid. Clin
vetmed.auburn.edu; phone 334-844-6032). Orthop 64:255–261, 1969.
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iofacial injury. J Oral Maxillofac Surg 41:609–612, 1983.

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15. Popovsky J: Perforations of the esophagus from gunshot Neck Surg 109:56–59, 1983.
wounds. J Trauma 24:337–339, 1984. 20. Green PD: Protocol in mediolegal veterinary medicine. II.
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wounds to the neck. J Trauma 25:238–246, 1985. Can Vet J 21:343–346, 1980.
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Am J Surg 145:263–265, 1983. College of District Attorneys, 1986.
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geal injuries: 12 Year experience at Henry Ford Hospital. trict Attorneys, 1986.
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