Identifying Signs of Animal Abuse

At the end of 2019, the Preventing Animal Cruelty and Torture (PACT) Act was signed into law, strengthening federal laws against animal abuse. In addition, every U.S. state has felony-level animal cruelty laws on the books. Why are these laws important? Because animal cruelty is all around us, and as veterinarians, we may find ourselves on the front lines of these crimes. There is a well-known link between animal abuse and child abuse, domestic violence, and elder abuse, and often crimes against animals are associated with other crimes, such as illegal gambling, firearm violations, and illegal drug use. Therefore, recognizing signs of potential animal abuse is imperative because if we cannot recognize these signs, we will not be able to fully serve our clients, our patients, or our communities.

Animal Abuse Signalment

In terms of abuse as a whole, any animal is susceptible. That said, some characteristics are seen more commonly than others, especially in certain circumstances. For instance, young animals tend to be abused more commonly than older animals, intact animals more than spayed or neutered animals, and male dogs more than female dogs.¹

Dogs are more frequently sexually abused than cats.² Pit bull–type breeds are more commonly abused than other breeds of dogs¹ and are more commonly used in dogfighting. However, regardless of signalment, any animal is at risk.

Animal Abuse Presentation

Animal abuse victims may be presented to a veterinarian in multiple ways. They may be brought in by an animal control officer, law enforcement officer, good Samaritan, or owner. The person who brings in an abused animal may or may not be aware of the abuse. That person may be the abuser or they may be a victim as well, which can be critical when determining how to respond to suspected animal abuse. Depending on the situation, it could be vital to consider staff and client safety in the presence of someone who may be violent. It is equally vital to be compassionate and caring for someone who may be a victim of interpersonal violence. It is possible that the owner may not realize the animal is being abused. In all of these instances, if we do not speak up for the animals, the cycle of violence may continue.

When obtaining a history, veterinarians should ask open-ended questions and be aware of assumptions that they commonly make during the process.³ A suspicion of abuse is formed not by one lesion or client statement but rather by the totality of the evidence. The veterinarian’s job is not to decide if animal abuse has occurred; rather, it is to report suspected cases of abuse. Even in states with mandatory reporting laws for animal abuse (BOX 1),⁴ veterinarians are required only to report cases of suspected abuse; the final determination will be made by the legal system. Often these cases require investigation by animal control or law enforcement to determine the full story. Rarely will the veterinarian have all the necessary investigational information available during the initial examination.

Types of Abuse

The main forms of abuse are neglect, physical abuse, sexual abuse, and emotional abuse. U.S. laws regarding animal abuse vary by state, but they generally cover the first 3 forms, which—along with organized fighting, such as dogfighting—are tracked by the Federal Bureau of Investigations via the National Incident-Based Reporting System (fbi.gov/services/cjis/ucr/nibrs). At this time, although emotional abuse is recognized medically by veterinarians, it is not well recognized by the U.S. legal system and is therefore rarely prosecuted.

Neglect

Neglect is an act of omission and includes failure to provide adequate food, water, shelter, or medical care for an animal. Neglect constitutes one of the most commonly seen forms of animal abuse. Neglected animals may be presented as individuals or as part of a larger group, such as those in animal hoarding situations or puppy mills. Animal hoarding sometimes begins as a legitimate animal rescue that slowly morphs into a hoarding situation. Any animal seen by the veterinarian may be one of a group of hoarded animals. Among hoarded animals, it is not unusual for some to be relatively healthy and others to be severely ill. In the examination room, the veterinarian may notice the client looking unkempt or having a foul odor, regardless of the appearance of the animal. Whether one animal or many, a home or property investigation is often required to determine if a case has reached the level of criminal neglect, which cannot always be determined solely on the basis of examination of the animal. Thus, cases of neglect suspected in the examination room should be reported to appropriate authorities so that investigators can follow up if needed.

Typical signs of neglect include but are not limited to excessive matting, overgrown nails, ingrown collars, malnutrition (thin or emaciated body condition [FIGURE 1]), severe dental disease (e.g., oronasal fistulas), severe upper respiratory signs, excessive external parasites, and diseases for which vaccines are readily and commonly available. Generally, courts prosecute a case as criminal neglect if the signs are such that an average person would be able to identify them as a problem and address them in a reasonable and timely manner with home or veterinary care, especially if there is evidence that the owner had been educated previously and knew better but did not act accordingly.

Figure 1. Emaciated dog with prominent ribs and bony prominences.

Physical Abuse

Physical abuse is an act of commission and can take many forms. Physical abuse includes blunt force trauma (e.g., kicking, punching, and throwing against an object), sharp force trauma (e.g., stabbing), drowning and nondrowning asphyxiation (e.g., suffocating, crushing, strangling, and hanging [FIGURE 2]), burns (e.g., thermal, chemical, microwave, and electrical), and projectile injuries (e.g., gunshot wounds). Because of the variety of abusive actions possible, potential indicators of abuse can range from vague signs of malaise to flagrant signs of trauma and death. Thus, the red flags that often indicate abuse are many (BOX 2).¹

Figure 2. Ligature mark around the neck of a cat.

A crucial consideration for veterinarians is whether the history provided supports the examination findings. For example, certain patterns of injury have been shown to be more common for abused cats and dogs than for those involved in motor vehicle accidents, including but not limited to skull fractures (FIGURE 3), vertebral fractures, rib fractures, and scleral hemorrhage.⁵ A number of radiographic features should raise the suspicion of nonaccidental injury, such as multiple fractures and fractures at different stages of healing (BOX 3).⁶

Figure 3. Depression fracture of the skull (frontal and parietal bones) of a dog, caused by nonaccidental head trauma. The specimen has been macerated.

Although not commonly encountered, Munchausen syndrome by proxy deserves mention.⁷ People with this syndrome invent or cause symptoms in a proxy, such as an animal, to seek emotional gratification in the form of attention from medical professionals. In a 2001 report, clinical signs of 9 cases of Munchausen syndrome by proxy in dogs and cats ranged from no apparent injuries to abdominal bruising, limb fracture, postoperative trauma, head trauma (crushed skulls), and death.⁷ Its close cousin, malingering by proxy, is the harming of an animal to gain tangible goods, such as drugs (e.g., opioids) or money (e.g., social media fundraising accounts).

Sexual Abuse

Any species of animal can be a victim of sexual abuse, but among the most commonly sexually abused species are dogs. Findings of potential animal sexual abuse vary widely from no physical sign of harm to severe injury or death.⁸ Signs of saliva or ejaculation may be found around the vulva, prepuce, anus, or other areas of the animal and may appear as spiked or clumped hair. Because some of these findings will be difficult to identify under normal light conditions, use of an alternate light source is highly recommended.⁸

In addition, signs of restraint may be evident on animals subjected to sexual abuse. Petechia or hemorrhages may be seen on the pinnae and/or tail if those were held harshly to restrict movement. Bruising of the ventral abdomen from restraint has also been reported.⁹ Types of physical restraint can include tape, rope, or wire, often applied to the legs or muzzle; therefore, it is important to look for tape residue, fibers, abrasions, or cuts in these locations. Animals may also be chemically restrained, so collecting blood and urine for toxicology screening can be useful.

As soon as animal sexual abuse is suspected, it is imperative that the veterinarian look for and collect any potential DNA evidence (e.g., hair, semen, saliva, blood). Because forensic investigators will be looking for human DNA associated with these acts, the veterinarian should wear personal protective equipment (e.g., gloves, mask, cap) when collecting samples.

Dogfighting

Patterns of injury for dogs used in organized fighting may differ from those typically seen after a spontaneous fight between 2 dogs of similar size.¹⁰ The wounds of fighting dogs are often concentrated on the face, neck, chest, and front legs. They may be in various stages of healing, from fresh wounds to scars. Pit bull–type breeds are commonly used for fighting, but other breeds may be used as well. Commonly, fighting dogs do not receive regular veterinary care, including vaccinations, heartworm prevention, and routine dewormings. Dogs that are used in organized fighting are also more likely than the average population to be infected with Babesia gibsoni and may be anemic.¹¹

Differential Diagnosis of Animal Abuse

There is no pathognomonic sign for animal abuse. Although a common sign for abuse is injuries in multiple stages of healing, signs may vary; therefore veterinarians need to be alert as to when to include abuse in their rule-out considerations. In addition, veterinarians evaluating any animal for suspected abuse should consider diseases and syndromes that can mimic abuse. For instance, substantial injury can occur when a dog or cat is hit by a car or falls from a high-rise building. High-rise syndrome in cats often includes facial injuries, thoracic injuries (pulmonary contusions and pneumothorax), and limb fractures.¹² Bite wounds and gunshot wounds can look similar. Using personal experience as an example, one author of this article recently saw a case for which the injuries were thought by the attending veterinarian to have resulted from a shotgun projectile, but postmortem examination revealed these to be dog-bite injuries. The other author had just the opposite experience, in which wounds thought by shelter staff to be caused by a cat fight were actually gunshot injuries. Coagulopathies, including congenital deficiencies such as factor VIII or IX, and anticoagulant rodenticide toxicity can appear similar and lead to significant and unexpected hemorrhage. Osteogenesis imperfecta and metabolic bone disease may lead to repeated bone fractures. Severe, chronic respiratory disease can cause unexplained fractures of the ribs in older cats.¹³ Being familiar with conditions that can mimic abuse will help the veterinarian keep an open mind as to the possibilities of disease and abuse.

Conclusions

Veterinarians have many tools available for evaluating animals suspected of having been abused: forensic clinical examinations, blood testing, urinalyses, cytology, diagnostic imaging, and forensic postmortem examinations. For veterinarians presented with a case they suspect might result from abuse, numerous resources, including internet sites (BOX 4) and textbooks, are available and may prove useful as guides for examination.

Unfortunately, animal abuse is not uncommon and diagnosis can be challenging. Because veterinarians interact with both animals and owners, they are in a unique situation. Being able to identify potential signs of abuse will enable veterinarians to better serve not only their patients but also the patient’s owners.