Can you see all the bruises on this cat? What, you can’t? I guarantee you that they are there. This cat was rescued from a situation where a big dog was chewing it and a person (I use the term loosely) was hitting it with a stick. There are no broken bones, no obvious wounds, no apparent bleeding. Circulation is good, so probably no internal bleeding. Lungs sound okay with the stethoscope. He must be un-injured, then, right? Wrong. He didn’t want to eat, he didn’t want to move. That is, he wouldn’t eat until we gave him some pain control medication. I wouldn’t call him perky at that point, but he did get up and eat. After three days of rest (and pain medication) he was behaving pretty normally.
We are accustomed to seeing discoloration when we think of a bruise. A visible bruise means that the tissue has been damaged enough by blunt trauma that blood vessels are leaking blood into the tissue. This produces the lovely colors. On a pet, the skin is usually concealed by the fur, so you just don’t see that very often, even when it is there. Sometimes the hairless belly of a dog will show a purple spot, but if the pet has a dense coat, you’d have to shave them to find the bruises.
As a teenager, one of my more foolish decisions resulted in a motorcycle crash that sent me rolling quite a ways across the pavement. Fortunately, I did not collide with a vehicle, and I was wearing new Levis, leather jacket, boots, gloves and helmet. I did not have any visible bruises or scrapes, but my whole body felt like one big "charley-horse". I felt like someone had beaten me like a xylophone from one end to the other. I was stiff and sore and hurt everytime I moved for several days, this despite having no visible injuries.
Last week I was presented with a little dog who had been bitten in the head by a big dog. His owners couldn’t understand why he was acting so sadly. He just had this small wound on top of his head. Of course, that wound was produced by the big dog’s fang punching through the scalp while the whole head was getting crunched between the jaws. This dog did not have a lot of visible injuries, but he had received the equivalent of having your head smashed in a car door while somebody stabs your scalp with a screwdriver. Even with pain medication, you are going to be pretty sore for a while.
Sometimes we have to use a little intuition, combined with our history, combined with my usual question, "If this were me, would I be hurting?"