Page 124 - JSOM Winter 2022

An Ongoing Series

Identification of Potentially Preventable Traumatic Injury
Among Military Working Dogs Deployed
During the Global War on Terror

Jennifer D. Cwikla, DVM, PhD, MPH *; Thomas H. Edwards, DVM, MS ;
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James T. Giles III, DVM, MS ; Stephanie Kennedy, DVM ; Brian Smith, DVM ;
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David Gimeno Ruiz de Porras, PhD, MS ; Laura L.F. Scott, PhD, MPH, MS 7
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ABSTRACT
Background: Prevention of deployment-related injury is criti- Introduction
cal for readiness of US military working dogs (MWDs). This Prevention of deployment-related injury is critical for the
study evaluated deployment-related injuries to determine if combat readiness of US military MWDs as they continue to
they were potentially preventable and identify possible abate- serve alongside US Servicemembers, most recently through-
ment strategies. Methods: Data were collected on 195 MWD out the Global War on Terrorism. Miller et al. estimated that
injury events that occurred between 11 September 2001 and over 2,000 MWDs were deployed in support of Operation
31 December 2018. Injuries were reviewed by a panel of vet- Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). 1
erinarians and categorized into groups based on panel consen- Because MWDs face the same combat hazards as US Ser-
sus. The panel also established which interventions could have vicemembers, they are also at high risk of experiencing trau-
been effective for mitigating injuries. Multipurpose canine matic injury during deployment. In one mortality study of
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(MPC) and conventional MWD injury event characteristics US MWDs deployed during OEF/OIF, the majority of deaths
were compared to identify meaningful differences. Results: Of (~77%) were due to traumatic injuries. Despite being a lead-
1
the 195 injuries, 101 (52%) were classified as preventable or ing cause of death, traumatic injury among US MWDs remains
potentially preventable. Most (72%) of the potentially prevent- insufficiently investigated, which, in turn, hinders efforts to
able injuries occurred in conventional MWDs, with penetrat- understand and prevent deployment-related injuries.
ing injuries (64%) being the most common type of trauma. For
the preventable/potentially preventable injuries, the most com- The existing literature on combat-related injury and death
mon preventative intervention identified was handler training in the US Servicemember population offers an approach that
(53%) followed by protective equipment (46%). There were can be used to investigate these same outcomes among US
differences between MPCs and conventional MWDs for in- MWDs. 3–11 In 2017, the US Department of Defense (DoD) es-
jury prevention category, type of trauma, mechanism of injury, tablished a military trauma mortality review (MTMR) process
and preventative intervention (all p < .001). Conclusion: The to evaluate traumatic injury data and identify opportunities
application of a preventable review process to MWD popula- for improvement within the trauma care system, with the ulti-
tions may be beneficial in identifying potentially preventable mate goal of achieving zero preventable deaths after injury. 7,12
injuries and preventative intervention strategies.
Death preventability is considered an important metric, as it
allows for the identification of areas that need improvement in
Keywords: military working dogs; traumatic injury; injury pre- trauma prevention and care. More notably, the concept factors
vention, canine
in improvements for protective equipment, supply logistics,
medical procedures, and other tactical issues that are essential
*Correspondence to Jennifer.d.cwikla.mil@army.mil
1 Dr Jennifer D. Cwikla is a veterinarian affiliated with the University of Texas Health Science Center at Houston (UTHealth) School of Public
Health in San Antonio, San Antonio, TX, and the US Army Veterinary Corps, Joint Base San Antonio–Fort Sam Houston, TX. Dr Thomas H.
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Edwards is a veterinarian affiliated with the US Army Institute of Surgical Research, Joint Base San Antonio–Fort Sam Houston, TX, the Lin-
coln Memorial University College of Veterinary Medicine, Harrogate, TN, and BluePearl Veterinary Specialists of Stone Oak, San Antonio, TX.

3 Dr James T. Giles III and Dr Stephanie Kennedy are veterinarians affiliated with BluePearl Veterinary Specialists of Stone Oak, San Antonio,
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TX. Dr Brian Smith is a veterinarian affiliated with the US Army Institute of Surgical Research, Joint Base San Antonio–Fort Sam Houston, TX.
6 Dr David Gimeno Ruiz de Porras is a scientist affiliated with the Southwest Center for Occupational and Environmental Health (SWCOEH), De-
partment of Epidemiology, Human Genetics, and Environmental Sciences, the University of Texas Health Science Center at Houston (UTHealth)
School of Public Health in San Antonio, San Antonio, TX, CIBER Epidemiología y Salud Pública, Madrid, Spain, and the Center for Research in
Occupational Health (CISAL), Universitat Pompeu Fabra, Barcelona, Spain. Dr Laura L.F. Scott is a scientist affiliated with the US Army Institute
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of Surgical Research, Joint Base San Antonio–Fort Sam Houston, TX.
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