J Forensic Sci, 2016

doi: 10.1111/1556-4029.13074
PAPER Available online at: onlinelibrary.wiley.com

PATHOLOGY/BIOLOGY

Nida P. Intarapanich,1 B.A.; Emily C. McCobb,1 D.V.M., M.S.; Robert W. Reisman,2 D.V.M.;
Elizabeth A. Rozanski,1 D.V.M.; and Pichai P. Intarapanich,3 Ph.D.

Characterization and Comparison of Injuries

Caused by Accidental and Non-accidental
Blunt Force Trauma in Dogs and Cats

ABSTRACT: Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case–
control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after
MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion,
abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, dam-
age to claws, and evidence of older fractures. Odds ratios are reported for these injuries. MVA rib fractures were found to occur in clusters on
one side of the body, with cranial ribs more likely to fracture, while NAI rib fractures were found to occur bilaterally with no cranial–caudal
pattern. Establishing evidence-based patterns of injury may help clinicians differentiate causes of trauma and may aid in the documentation and
prosecution of animal abuse.

KEYWORDS: forensic science, veterinary, animal, dog, non-accidental injury, injury, blunt force trauma, motor vehicle accident

Abbreviations However, clinicians still face many difficulties in identifying

MVA motor vehicle accident
NAI non-accidental injury
FHSA Foster Hospital for Small Animals
ASPCA American Society for the Prevention of Cruelty to
Animals
Following the 1962 publication by Kempe et al. (1) entitled
“The battered child syndrome”, the medical community
acknowledged the prevalence of child abuse and engaged in
extensive research to develop an institutional model for recogni-
tion and reporting. The veterinary community is now at a similar
critical juncture with animal abuse. Health professionals and
politicians have recognized the need to address animal cruelty as
considerable research has documented a correlation between ani-
mal abuse, criminal behavior, and family violence (2–4).
There currently exist general guidelines for identifying suspi-
cious behavior in clients and patients that may signify animal
abuse (5–7). These diagnostic indicators include inconsistent or
discrepant history, previous injuries or deaths in other animals in
the same household (particularly when unexplained), repetitive
injuries, defensive or unconcerned behavior of the owner, and
abnormal behavior in the animal, such as fear (7).
1
Cummings School of Veterinary Medicine, Tufts University, North
Grafton, MA 01536.
2
Forensic Sciences, American Society for the Prevention of Cruelty to
Animals, 520 8th Avenue, New York, NY 10018.
3
Department of Mathematics, Southern Connecticut State University, New
Haven, CT 06518.
Received 18 Feb. 2015; and in revised form 17 Jun. 2015; accepted 30
Aug. 2015.
animal abuse. Animals are unable to speak for themselves, and
some animals’ innate personality and trust will even belie the
cruelty they have suffered. Additionally, the actual cause of
injury often differs from the description provided by the client,
and there is a dearth of in-depth studies on specific patterns of
injury caused by animal abuse (5–7). Determining the true nature
of the incident is important for the successful treatment of the
animal; furthermore, identifying animal abuse and alerting appro-
priate authorities is essential to ensure the safety and welfare of
the animal and all members of the household. Therefore, it is
critical that researchers devise guidelines to aid clinicians in dif-
ferentiating accidental injury from non-accidental injury (NAI).
A 2008 veterinary forensic science textbook noted that motor
vehicle accidents (MVA) in particular are difficult to differenti-
ate from NAI due to lack of data on injuries known to be caused
by physical abuse (7). When an animal presents with skeletal
injuries, skeletal disorders (e.g., osteogenesis imperfecta or meta-
bolic bone disease) and motor vehicle accidents are included in
the differential diagnoses along with NAI. The former are
uncommon, and radiographic examination to establish normal
bones can be used to exclude them. Indications of the latter
include skin abrasions and dirt or oil in the fur (7). A study of
239 cases of MVA in dogs showed the most common injuries to
be long bone fractures, pulmonary injury, pelvic fractures,
hemoabdomen, and soft tissue injury (8). A study of 600 dogs
involved in MVA reported superficial soft tissue abrasions and
lacerations at the extremities of 79% of the dogs and at the head
in 35% of dogs. Skeletal injuries were identified in 59.5% of the
dogs, with the majority (89.6%) of those occurring caudal to the
last thoracic rib. The pelvis was the most frequent site of frac-
tures (17.2%), while skull fractures (6%) and rib fractures (3%)

© 2016 American Academy of Forensic Sciences 1

2 JOURNAL OF FORENSIC SCIENCES
were much less common (9). In contrast, a study of veterinarians
in the United Kingdom surveyed about NAI found that in the
147 suspected cases of NAI in dogs that could be misattributed
to MVA, there was only 1 pelvic fracture (0.7%) but 21 cases
with skull fractures (14.3%) and 23 cases with fractured ribs
(15.6%) (10). Similar findings were reported in a study that sur-
veyed veterinary practitioners in Ireland (11).
Because of the aforementioned differences, we hypothesized
that motor vehicle accidents and non-accidental blunt force
trauma cases would present with different patterns of skeletal
and soft tissue injury. The objective of this case–control study
was to directly compare the primary differential diagnosis of
MVA with NAI to aid clinicians in differentiating causes of
trauma. In addition, this study establishes evidence-based pat-
terns of non-accidental injury for veterinary patients that will aid
in the documentation and potential prosecution of animal abuse.
Methods
Criteria for Selection of MVA Cases
All dogs and cats admitted for vehicular trauma during a 4.5-
year period (January 1, 2009 to June 30, 2013) to the Foster
Hospital for Small Animals (FHSA) at the Cummings School of
Veterinary Medicine at Tufts University were eligible for study
inclusion. Appropriate cases were identified using a keyword
search of the hospital’s electronic medical record system; search
terms were “hit by car,” “HBC,” and “vehicular trauma.” The
FHSA acts as a primary emergency facility and regional referral
hospital. Cases were excluded if a physical examination and 2-
view thoracic radiographs were not performed (e.g., animals that
presented dead on arrival or animals that were euthanized after
the physical examination without further diagnostics), if the acci-
dent occurred more than 7 days before presentation, if the ani-
mal had a history of a prior MVA, or if other causes of trauma
were suspected.
Criteria for Selection of NAI Cases
Dogs and cats were selected for study inclusion from Excel
(Microsoft Office 2010, Microsoft Corporation, Redmond, WA)
database files containing all legal cases at the Humane Law
Enforcement Division of the American Society for the Preven-
tion of Cruelty to Animals (ASPCA) in New York, NY. All
dogs and cats admitted for blunt force trauma during the same
4.5-year period were eligible for study inclusion. Cases were
excluded if they were determined to not be criminal or if they
were the result of a motor vehicle accident. A criminal case was
defined as one in which an arrest warrant was issued.
Procedures
Medical records were reviewed and data were collected by
use of a standard data collection sheet. Variables recorded were
species, breed, weight, age, sex, whether the animal was neu-
tered/spayed, outcome, and whether the following injuries were
present: older healing fractures; skull fractures; teeth fractures;
vertebral fractures; rib fractures (if present, the number and loca-
tion of fractures were noted); scapular fractures; fractures of the
humerus; fractures of the radius and/or ulna; fractures of the car-
pus, metacarpus, and/or manus; fractures of the pelvis and/or
sacrum; fractures of the femur; fractures of the tibia and/or
fibula; fractures of the tarsus, metatarsus, and/or pes; sacroiliac
luxation; coxofemoral luxation; vertebral luxation; pneumotho-
rax; pulmonary contusion; diaphragmatic hernia; abrasions;
degloving injuries; damage to claws (tattered or broken, ref
Munro (7)); and scleral hemorrhage.
Statistical Methods
Data were analyzed by use of SPSS 21 (IBM Corporation,
Armonk, NY). Categorical variables were analyzed using the
chi-square test and continuous variables were compared between
two groups by use of the independent samples t-test. The central
limit theorem states that the distribution of the sample means for
any population will be approximately normally distributed,
regardless of whether the source population is normal or skewed,
provided that the sample size is sufficiently large (generally con-
sidered to be ≥30) (12). The sample size of both MVA and NAI
groups was sufficiently large, and therefore, nonparametric tests
were not necessary. Values of p < 0.05 were considered statisti-
cally significant. Odds ratios with 95% confidence intervals were
calculated for the variables shown to be statistically significant.
To identify rib fracture patterns in MVA versus NAI cases,
the number and location of rib fractures were subjected to a sta-
tistical method called exploratory factor analysis, consisting of
principal components factor analysis followed by varimax rota-
tion to make the results more understandable. As is customary,
the number of extracted factors was determined using the Kaiser
criterion, which states that the eigenvalues that are greater than 1
will determine the number of factors for consideration and possi-
ble rotation.
Results
The keyword search of the FHSA medical record system iden-
tified 1622 cases that presented for vehicular trauma. Of those,
63 cases were excluded because the incident occurred more than
7 days ago, 98 were excluded because the cause of trauma was
not definitively known, and 1035 cases were excluded because
radiographs were not available. The remaining 426 motor vehicle
accident cases (47 cats, 379 dogs) from the FHSA and the 50
criminal blunt force trauma cases (19 cats, 31 dogs) from the
ASPCA met the inclusion criteria for this study. Criminal cases
were defined as those in which an arrest warrant was issued.
Of the 426 MVA cases, 67 (15.7%) were intact males, 179
(42%) were castrated males, 37 (8.7%) were intact females, and
143 (33.6%) were spayed females. Of the 50 NAI cases, 22
(44%) were intact males, 6 (12%) were castrated males, 16
(32%) were intact females, and 6 (12%) were spayed females.
When MVA and NAI cases were compared, NAI cases were
more likely to be intact (v2 = 58.0; p < 0.001), but no signifi-
cant difference was noted between the number of males and
females.
When MVA and NAI cases were compared, cats comprised a
higher proportion of NAI cases than MVA cases (v2 = 27.2;
p < 0.001). The most common breeds in MVA cases were Lab-
rador retrievers (10.3%), domestic short hair cats (8.2%), Labra-
dor retriever mixes (5.6%), golden retrievers (4.5%), and
German shepherds (3.1%). The most common breeds in NAI
cases were domestic short hair cats (32%), pit bulls (18%), Chi-
huahuas (10%), and Yorkshire terriers (6%).
Data were stratified by species, and then age and weight were
compared between groups. The mean age for dogs involved in
MVA cases was 4.5 years (median = 3 years; standard deviation
(SD) = 3.8 years), while the mean age for dogs involved in NAI
 INTARAPANICH ET AL. . AI VERSUS NAI IN DOGS AND CATS 3

cases was 2.5 years (median = 1.5 years; SD = 2.6 years). Dogs
involved in NAI were significantly younger than dogs involved
in MVA (t = 4.0; p < 0.001).
The mean age for cats involved in MVA cases was 5.4 years
(median = 3.2 years; SD = 5.1 years), while the mean age for
cats involved in NAI cases was 1.9 years (median = 1 year;
SD = 2.5 years). Cats involved in NAI were also significant
younger than cats involved in NAI (t = 3.7; p = 0.001).
The mean weight for dogs involved in MVA cases was
22.0 kg (median = 21.6 kg; SD = 12.6 kg), while the mean
weight for dogs involved in NAI cases was 7.9 kg (me-
dian = 5.6 kg; SD = 6.6 kg). Dogs involved in NAI weighed
significantly less than dogs involved in MVA (t = 10.4;
p < 0.001).
The mean weight for cats involved in MVA cases was 4.5 kg
(median = 4.3 kg; SD = 1.1 kg), while the mean weight for cats
involved in NAI cases was 3.0 kg (median = 3.6 kg;
SD = 1.3 kg). Cats involved in NAI also weighed significantly
less than cats involved in MVA (t = 4.2; p < 0.001).
Outcome was classified as dead on arrival, died in hospital
despite ongoing medical care, euthanized, and survived to dis-
charge. Of MVA cases, 91.1% survived, 7.5% were euthanized,
and 1.4% died during treatment. Of NAI cases, 60% survived,
10% were euthanized, 8% died during treatment, and 22% were
dead on arrival. MVA cases tended to survive, whereas NAI
cases had a higher percentage of nonsurvivors (v2 = 108.3;
p < 0.001).
The skeletal injuries significantly associated with MVA cases
were pelvic/sacral fractures and sacroiliac luxation. In contrast,
the skeletal injuries associated with NAI cases were skull frac-
tures, teeth fractures, rib fractures, and vertebral fractures. Addi-
tionally, older fractures were significantly associated with NAI.
The internal injuries associated with MVA cases were pneu-
mothorax and pulmonary contusion, while scleral hemorrhage
was associated with NAI. Externally, the injuries associated with
MVA were abrasions and degloving injuries, while damage to
claws was more associated with NAI cases (Fig. 1 and Table 1).
Odds ratios with 95% confidence intervals were then calculated
for the injuries found to be statistically significant (Table 2).
Cases with rib fractures were then further analyzed to identify
rib fracture patterns. There were 38 MVA cases and 14 NAI
cases that presented with rib fractures. Of the MVA cases, 35
(92.1%) had fractures on one side of the body and 3 (7.9%) had
fractures on both sides. In contrast, of the NAI cases, 9 (64.3%)
had fractures on one side of the body, while 5 (35.7%) had frac-
tures on both sides of the body. NAI cases were significantly
more likely to have rib fractures on both sides of the body
(v2 = 6.1; p = 0.014). The average total number of rib fractures
was 3.71 for MVA cases and 4.93 for NAI cases. The average
total number of fractured ribs was 3.53 for MVA cases and 4.79
for NAI cases. However, these results were not statistically sig- FIG. 1––Sites of significant skeletal and soft tissue injuries in 426 motor
nificant. vehicle accident (MVA) cases and 50 non-accidental injury (NAI) cases. The
chi-square test was used to determine which of the skeletal and soft tissue
Exploratory factor analysis was used to identify rib fracture
injuries listed in Table 1 were significantly associated with either MVA or
patterns (Table 3). Exploratory factor analysis is a procedure NAI: (A) MVA cases. (B) NAI cases.
used to identify invisible factors that represent the hidden organi-
zation of data. The correlation coefficients between the variables
(the rows in the table) and factors (the columns in the table) are loadings with magnitude less than 0.3 are considered too small
called factor loadings. The numerical value of these factor load- to be significant. Factor 1 is the primary descriptor of the data,
ings indicates how each factor is associated with the observable followed by Factor 2, and so on.
variables: A positive factor loading means that the observable In this application of exploratory factor analysis, the variables
variable can be used to “describe” that factor, while a negative were the number of fractures on each individual rib. Principal
factor loading means that the factor has the opposite characteris- component analysis, a procedure used for factor extraction, was
tic of whatever that variable measures. By convention, factor first conducted to reduce the 13 variables (i.e., the 13 ribs) to 4
4 JOURNAL OF FORENSIC SCIENCES

TABLE 1––Comparison of prevalence of skeletal and soft tissue injuries TABLE 2––Odds ratio in favor of non-accidental injury (NAI) for injuries
between motor vehicle accidents (MVA) and non-accidental injury (NAI). found to be statistically significant through chi-square analysis.

Injury MVA (%) NAI (%) v2 p Value Odds Ratio

NAI MVA in Favor 95% Confidence
Skull fracture* 3 32 65.5 <0.001 Injury (n = 50) (n = 426) of NAI Intervals
Teeth fracture* 5 26 31.5 <0.001
Vertebral fracture* 4 10 4.7 0.03 Skull fracture 16 13 15:1 (6.64, 33.64)
Rib fracture* 9 28 16.7 <0.001 Teeth fracture 13 20 7:1 (3.29, 15.48)
Scapula fracture 1 0 0.8 0.4 Vertebral fracture 5 15 3:1 (1.06, 8.77)
Humerus fracture 2 4 0.7 0.4 Rib fracture 14 38 4:1 (1.97, 8.01)
Radius/ulna fracture 6 4 0.4 0.6 Pelvic/sacral fracture 4 96 0.3:1 (0.10, 0.85)
Carpus/metacarpus/manus fracture 1 4 3.4 0.07 Sacroiliac luxation* 0 48 0.077:1 (0.0047, 1.27)
Pelvic/sacral fracture* 23 8 5.7 0.02 Abrasions 5 310 0.041:1 (0.016, 0.11)
Femur fracture 9 14 1.2 0.3 Degloving injury* 0 36 0.11:1 (0.0064, 1.75)
Tibia/fibula fracture 7 4 0.5 0.5 Damage to claws 6 19 3:1 (1.11, 7.70)
Tarsus/metatarsus/pes fracture 4 2 0.4 0.5 Scleral hemorrhage 14 34 4.5:1 (2.20, 9.12)
Sacroiliac luxation* 11 0 6.3 0.01 Pneumothorax 3 122 0.16:1 (0.048, 0.52)
Coxofemoral luxation 12 6 1.4 0.2 Pulmonary contusion 12 186 0.41:1 (0.21, 0.80)
Vertebral luxation 4 4 0.006 0.9 Older fractures 11 1 120:1 (15.08, 953.06)
Abrasions* 73 10 78.8 <0.001
Degloving injury* 9 0 4.6 0.03 *Haldane correction (adding 0.5 to each cell) was applied to calculate a
Damage to claws* 5 12 5.1 0.02 finite odds ratio.
Scleral hemorrhage* 8 28 19.8 <0.001
Pneumothorax* 29 6 11.8 0.001
Pulmonary contusion* 44 24 7.1 0.008
Diaphragmatic hernia 4 0 1.8 0.2 previously noted in both child (20) and animal (7,16,21) abuse
Older fractures* 0.2 22 86.3 <0.001 cases, older, healing fractures were strongly associated with
*Statistically significant at p < 0.05. NAI.
These patterns of skeletal injury are supported by previous lit-
erature. A study of 600 motor vehicle accidents in dogs reported
factors, or components, for MVA, and 3 for NAI. This was fol- that the greatest number of skeletal injuries occurred caudal to
lowed by varimax rotation, which is a procedure that makes the the last thoracic vertebra, with the pelvis being the most fre-
output of factor extraction more understandable. Significant posi- quently injured skeletal structure and sacroiliac luxation the sec-
tive factor loadings showed which ribs were likely to fracture, ond most common luxation, behind coxofemoral (9). A study of
while significant negative factor loadings showed which ribs 239 motor vehicle accidents in dogs reported pelvic fractures as
were unlikely to fracture. the second most common skeletal injury, behind long bone frac-
A clear pattern is seen for rib fractures caused by MVA: Frac- tures (8). Both studies showed much lower rates of skull, verte-
tures tend to occur in clusters, with ribs 1–4 most likely to frac- bral, and rib fractures (8,9). However, a study of 147 suspected
ture, followed by ribs 4–7, then 7–10, and lastly 11–13. In cases of NAI in dogs that could be misattributed to MVA
contrast, no clear pattern is seen for rib fractures caused by NAI. reported 0 sacroiliac luxations and only 1 pelvic fracture (0.7%),
This was verified using several rotation methods other than vari- but 21 cases with skull fractures (14.3%) and 23 cases with frac-
max rotation, which is an orthogonal rotation method; one obli- tured ribs (15.6%) (10). A similar study of 58 cases of suspected
que rotation method (promax) and two other orthogonal rotation NAI—53 dogs, 4 cats, 1 rabbit—reported 4 instances of multiple
methods (quartimax and equamax) were also applied, and the limb fractures, 2 of skull fractures, and 1 of rib fractures, while
results of each rotation method confirmed that no cranial-to-cau- no pelvic fractures were noted (11). A recent study of fractures
dal pattern could be identified for NAI cases. in dogs reported that fractures caused by NAI were more likely
to occur on the cranial skeleton than fractures caused by MVA
(21).
Discussion
Previous studies about cats also showed the same pattern of
Motor vehicle accidents and non-accidental blunt force trauma skeletal injury: A study of MVA in cats reported the pelvis to
cases present with different patterns of injury. Skeletal injuries be the most commonly injured skeletal structure (17.9%), fol-
tend to be more caudal in MVA cases (pelvic/sacral fractures, lowed by the femur (11.6%), mandible or maxilla (7.1%), and
sacroiliac luxation) compared to NAI cases (skull, teeth, rib, and tail (7.1%) (22). However, a study of 121 NAI cases in cats
vertebral fractures). This difference in injury location may reflect reported 17 skull fractures but only 5 pelvic fractures (10).
the tendency of dogs and cats to try to escape when approached Limb fractures were reported to be frequent in previous stud-
by a moving vehicle (which would then hit them toward their ies of both MVA (8,9) and NAI (10), which supports our finding
rear) and the tendency of animal abusers to aim for the animal’s that there was no statistically significant difference between the
head and chest. Regarding rib fractures in particular, ribs are frequency of limb fractures in cases of MVA versus NAI.
highly resilient and therefore difficult to break (13–16), particu- Similar to the tendency of skeletal injuries in NAI to be
larly in young animals (16–19). Rib fractures may occur more located in the cranial skeleton, the internal injury associated with
frequently in NAI than MVA because the surface area of the NAI (scleral hemorrhage) is also located more cranially than the
body to which force is applied is generally smaller in cases of injuries associated with MVA (pulmonary contusion and pneu-
NAI than in MVA (16), as the animal is usually punched, mothorax). In the study of NAI in dogs conducted by Munro
kicked, hit with a wieldable object, or swung into or thrown and Thrusfield, there were 14 cases of scleral/conjunctival hem-
against an object. Force spread over a smaller area means the orrhage, but only 5 of pneumothorax and 2 of intrapulmonary
energy of impact is less efficiently absorbed and dissipated, hemorrhage (10). In contrast, in the study of MVA in dogs con-
resulting in more severe tissue disruption (19). Additionally, as ducted by Kolata and Johnston, there were 0 cases of scleral or
 INTARAPANICH ET AL. . AI VERSUS NAI IN DOGS AND CATS 5

TABLE 3––(A) Exploratory factor analysis for rib fractures in motor vehicle cranial ribs are fractured more easily than caudal ribs because
accident (MVA) cases. (B) Exploratory factor analysis for rib fractures in cranial ribs are stiffer and have less extensive costal cartilage
non-accidental injury (NAI) cases.
than the caudal ribs. A study of stiffness and kinematic trends in
Component
the human rib cage reported decreasing stiffness with higher rib
(A) numbers, as well as decreased stiffness in the costochondral
Rib 1 2 3 4 junction compared to bone (23). For a given impact with a cer-
1 *0.9 0.09 0.05 −0.05
tain amount of kinetic energy, a stiffer target object will move a
2 *0.9 0.1 −0.04 −0.1 smaller distance, so the point of impact will receive a higher
3 *0.9 0.2 −0.1 −0.1 average force. Higher force translates to more severe tissue dis-
4 *0.4 *0.7 −0.1 −0.1 ruption, so a stiffer point of impact will be more likely to frac-
5 0.2 *0.8 0.07 −0.04 ture.
6 −0.1 *0.9 0.3 −0.1
7 0.02 *0.7 *0.5 −0.1 Additionally, although differences were not statistically signif-
8 0.3 0.3 *0.8 −0.02 icant, this study also found that the average number of rib frac-
9 −0.1 0.1 *0.9 0.1 tures and the average number of fractured ribs were both higher
10 −0.1 0.04 *0.8 0.07 in NAI cases with rib fractures when compared to MVA cases
11 −0.06 −0.04 0.2 *0.9
12 −0.06 −0.1 0.1 *0.9
with rib fractures. This can be explained by the same reasoning
13 −0.1 −0.1 −0.1 *0.8 used for the increased presence of rib fractures in NAI cases:
The surface area to which the force is delivered is generally
Component smaller in NAI, so the energy is absorbed and dissipated less
(B) efficiently, thus leading to more severe tissue disruption (19).
Rib 1 2 3
Demographic differences were also evident in this study.
1 −0.3 −0.2 *0.7 While more dogs than cats were present in both MVA and NAI,
2 *0.8 0.1 −0.05 there was a higher percentage of cats in NAI. Similarly, in a
−
3 *0.5 * 0.5 −0.2
4 *0.8 0.001 0.3 study of 1000 dogs and cats that presented with trauma, 8.3% of
5 *0.8 *0.3 0.2 NAI cases were cats, compared to 4.4% of MVA (24). Multiple
6 *1 −0.1 −0.03 studies have demonstrated that cats are abused more often than
7 *0.9 −0.1 −0.06 dogs. One study reported that of 18 subjects who tortured dogs
8 *0.7 *0.3 0.2
9 *0.6 *0.5 −
*−0.3
or cats, 12 specifically tortured cats, 5 tortured cats and dogs,
10 −0.03 *0.9 −0.06 and only 1 specifically tortured dogs (25). In another study,
11 0.2 *0.8 −0.01 interviews with 84 prisoners showed that the greatest variety of
12 *0.6 *0.3 *0.7 cruelties involved cats compared to all other types of animals,
13 0.2 0.09 *0.9 and cruelties to dogs were also less severe (26). The large num-
Factor loadings, rounded here to one significant digit, were considered ber of dogs compared to cats in the two surveys of veterinarians
significant if their absolute value was greater than 0.3 (a customary cutoff). about NAI (10,11) may be due to the tendency of cat abuse to
Significant positive factor loadings, shown in bold and with an asterisk, indi- result in disappearance and/or death of the cat rather than pre-
cate which ribs are likely to be fractured, while significant negative factor sentation to a veterinarian (26).
loadings, also shown in bold but with a negative sign preceding the asterisk,
indicate which ribs are not likely to be fractured. Factor 1 is the primary
Several factors have been suggested to influence the type of
descriptor of the data, followed by Factor 2, and so on. Rib fractures in animal that an individual chooses to physically abuse, including
MVA cases exhibited a clear pattern of clusters, with cranial ribs more likely availability and behavior of the species, social attitude toward
to fracture than caudal ribs (A). In contrast, no clear pattern is seen for rib that species, and suitability of physical features for abuse (26–
fractures caused by NAI (B). 28). Interestingly, abusers do not seem to preferentially select
dangerous species (26). Dogs and cats are both well-populated
conjunctival hemorrhage recorded, but 28 of pneumothorax and and live in close proximity to people, but there may be a differ-
41 of pulmonary contusion (9). ence in availability, as outdoor ownerless cats are much more
As expected based on current literature (7,9), abrasions and common than ownerless dogs. Additionally, cats are socially
degloving injuries were found to be associated with MVA. Inter- independent and resistant to training, while dogs generally react
estingly, however, damage to claws—an injury often grouped submissively to mistreatment and continue to seek attention (27).
with abrasions and road debris as indicators of MVA—was Subjects who abused cats typically admitted prejudice against
found to be associated with NAI. Tire marks and road debris them (26); cats were reportedly seen as sneaky, eerie, selfish,
were not studied because many MVA cases presented to another and cruel (26–28). In contrast, subjects who abused dogs often
veterinary hospital prior to coming to the FHSA, so marks and did so to influence or control the pet’s behavior, rather than due
debris may have been cleaned. to categorical hatred of dogs (26). Lastly, feline physical features
A clear difference in rib fracture patterns was also demon- have been described as suitable for certain types of abuse (26).
strated. Rib fractures caused by NAI tended to be on both sides In this study, NAI cases tended to be smaller and younger
of the body, as previously noted (16), and there was no dis- than MVA cases; weight and age are not entirely independent,
cernible cranial–caudal pattern (Table 3B). Rib fractures caused so these findings are reported together. NAI cases may be
by MVA tended to be on one side of the body only and in dis- younger because there is an extremely high rate of turnover for
crete groups, with ribs 1–4 being most likely, followed by ribs animals in abusive households, with many animals dying,
4–7, then 7–10, and lastly 11–13 (Table 3A). The scattered nat- discarded, or running away before they reach maturity. The
ure of NAI fractures may be due to multiple impacts, whereas majority of pets in abusive homes are under 2 years of age (29).
MVA tend to result in a single application of force due to the Younger animals may also be more frequent targets of abuse
vehicle, with an occasional secondary impact from being flung because they are less manageable (10), more prone to exploring,
onto the car and/or landing on the ground (16). It is possible that more fragile, and less able to defend themselves or escape (30).
6 JOURNAL OF FORENSIC SCIENCES
One study of NAI in dogs and cats reported that the proportion
of dogs and cats under 2 years of age (63% and 71%, respec-
tively) was significantly greater than the proportion of dogs and
cats under 2 years of age in the general dog and cat population
(24% and 21%, respectively) (10). Another study of NAI in cats
reported that cats younger than 2 years were the most frequent
victims of abuse (66% of NAI cases) (30). In contrast, two stud-
ies of cats involved in MVA reported the mean age to be
4 years (22) and 4.05 years (31).
Apart from being younger, NAI cases may also weigh less on
average because smaller animals may be easier to physically
abuse. However, it is possible that NAI cases are smaller in this
study because smaller animals are better suited to apartment liv-
ing in New York City, compared to central Massachusetts,
which was the source of the MVA cases.
In this study, NAI cases also tended to be sexually intact
when compared to MVA cases. Similar patterns of intact versus
neutered animals have been reported in the literature: A study of
NAI in dogs and cats reported 77.2% of animals were intact
(10), whereas one study of MVA in dogs and two studies of
MVA in cats reported 67.4% neutered (8), 88.7% neutered (22),
and 92.2% neutered (31), respectively. As most owned dogs and
cats are spayed or neutered (with the exception of breeding ani-
mals), this could suggest that physically abused animals are
more poorly cared for. Neutering rates are influenced by factors
including socioeconomic status of the owners, education level of
the owners, and the availability of low-cost neutering programs
(31). It is possible that the difference in intact versus neutered
animals between MVA and NAI cases can be explained by the
high visibility of low-cost spay/neuter programs in Mas-
sachusetts, but the possibility of a difference in owner population
should also be considered.
Males presented more frequently than females in both MVA
and NAI cases, but the difference was not statistically significant
in this study. Several other studies have found that male animals
were more likely to be abused (10) or hit by cars
(9,22,24,31,32). The prevalence of abuse of male animals could
be due to preference of male animals by abusive owners as well
as inherent differences in the behavior of male and female ani-
mals. Male animals may be less manageable and therefore more
likely to provoke owners into violence (10). Male animals also
wander more (24,32), which could explain their increased
involvement in both abuse and motor vehicle accidents.
There were several limitations to the current study. Studies
conducted in different populations of dogs and cats with MVA
or NAI may yield different results. MVA cases were selected
from central Massachusetts, while NAI cases were obtained from
New York City, and the sample size of NAI cases was also
much smaller than MVA cases. Per the inclusion and exclusion
criteria stated in the Methods section, MVA cases were excluded
if no radiographs were taken, which meant that animals that pre-
sented dead on arrival and animals that were euthanized after the
physical examination were not included. This may mean that
some cases excluded were more severe. MVA cases were also
excluded if radiographs were only taken at the referring veteri-
nary clinic (and therefore not available on the digital database),
but it is unclear whether there is a difference between owners
who brought their pet to the referring veterinarian first compared
to owners who brought their pet straight to the FHSA. The
FHSA is also open when general practices are not; it is unclear
whether MVA that occur in the evening, night, and on weekends
are significantly different than those that occur on weekdays in
the daytime.
Cats may also have been underrepresented in MVA cases for
several reasons. Many cases had to be excluded because the
cause of injury was uncertain—for example, outdoor cats return-
ing home injured. Many injured cats may also not have been
found and brought to a veterinarian. Lockwood posits that dog
owners are more likely to search for missing dogs, while cat
owners may assume their cats have chosen to not return (27).
Dogs are also more likely to solicit care from people when
injured, whereas injured cats tend to hide (27).
Additionally, it is possible that certain types of injury were
underreported. For example, pulmonary contusion may not have
been visible in cases that presented less than 24 hours after the
incident. Abrasions and claw damage may not have been
recorded in medical record charts of severe MVA cases that
received a limited physical examination due to necessity of
immediate medical intervention. Some skeletal injuries also may
not have been visible due to positioning in radiographs. As
inclusion criteria required only two-view thoracic radiographs, it
is possible that more cranial and caudal injuries were missed,
but it is likely that these injuries were suspected on physical
examination and noted in the medical record, and that clinicians
would have recommended the necessary radiographic views.
Conclusion
We found that motor vehicle accident cases and non-accidental
blunt force trauma cases in dogs and cats present with different
patterns of both skeletal and soft tissue injury. Evidence-based
patterns of non-accidental injury for veterinary patients will help
clinicians differentiate causes of trauma and aid in documenta-
tion and prosecution of animal abuse.
Acknowledgments
We wish to thank Dr. Margaret Slater and Dr. Randall Lock-
wood for their guidance in the preparation of this manuscript.
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Additional information and reprint requests:
Emily C. McCobb, D.V.M., M.S.
Department of Clinical Sciences
Cummings School of Veterinary Medicine at Tufts University
200 Westboro Road
North Grafton, MA 01536
E-mail: Emily.McCobb@tufts.edu