When I first met Napoleon (not his real name, but it would have suited him well) he was in shock. Literally. The five-year-old Chihuahua had been “attacked” by a “Pit Bull.” I’ll come back to the quote marks in a moment.

Shock, for the purposes of this article, has nothing to do with winning the lottery or discovering on Maury that you are not actually the father of your child. I’m talking about real shock: a physiological state in which the circulatory system cannot deliver blood, oxygen, and nutrients to the body. In Napoleon’s case, shock had set in as a result of massive trauma.

The normally feisty (according to his owners) Chihuahua was conscious but clearly dazed. His eyes stared blankly ahead. His gums were pale pink and his pulses were weak. To my surprise he was breathing in a normal fashion; however, I was not able to listen to his lungs because the skin had been ripped from the forward 40 percent of his body. Subcutaneous tissue and muscle were exposed from his neck to his mid-abdomen. A deeper puncture wound was present overlying the right side of his chest. It made a sucking noise every time he breathed.

That sucking wound was on the verge of killing Napoleon. It was causing a condition called pneumothorax, in which the lungs collapse and cannot deliver air to the blood stream.

When you have lost 40 percent of your skin and it’s not your biggest problem, you are in major trouble.

The technicians placed an IV catheter and began fluids, pain killers, and antibiotics. I placed a lubricated sterile latex glove over the sucking wound to stop the progression of pneumothorax. We monitored blood pressure and attempted to stabilize Napoleon for emergent surgery.

I could guess at first sight exactly what had happened. And when I talked to the owners my suspicions were confirmed. Napoleon hadn’t been attacked; rather, he had lost a fight. It was a fight that he had started. He had been off-leash, and had decided to try to kick a larger, on-leash dog’s ass. The other dog may or may not have been a Pit Bull — whenever a small dog loses a fight with a bigger dog (and the small dog always loses), the bigger dog automatically becomes a Pit Bull in the minds of the witnesses. In my experience Pit Bulls are no more likely than any other breed to be involved in fights.

The “Pit Bull” grabbed Napoleon, bit, and shook. The bite caused the life-threatening sucking wound. The shake had skinned Napoleon alive (this type of injury is called degloving).

This type of thing happens all the time. Every day that I go walking (which is every day), I see small dogs off-leash, or at the ends of 20 foot flexileads with inattentive owners texting away or chatting with neighbors. These dogs frequently try to get in the face of my pal Buster (weight: 65 pounds). I am fortunate to own a dog who is gentle in the extreme; he wouldn’t hurt a flea, let alone a Chihuahua. Nonetheless, I have developed a routine: Whenever a small dog tries to pick a fight with Buster, I admonish my pal (loud enough for the other owner to hear) not to help the little fellow commit suicide. By this time I no doubt have a reputation in my neighborhood for being passive-aggressive, but at least no little dogs have come to harm in my dog’s jaws.

There is a name for this syndrome in veterinary medicine: It is called big dog-little dog, or BDLD. The small dog can suffer injuries including broken bones, brain damage, proptosed eyes, ruptured spleens, broken backs, and, as we have seen, pneumothorax and degloving injuries. The initial injuries often are the just the start; crushing damage to tissues can take days to fully manifest, and many dogs with BDLD injuries die after several days in veterinary ICUs.

We were able to stabilize Napoleon and take him to surgery. My highest priority was the sucking wound, which was repaired using a multiple layer, resorbable suture technique (I had significant concern that a massive chest infection would occur, but the pneumothorax was by necessity my priority). A chest tube was placed, and I did my best over the next two hours to patch the skin back together. Napoleon made it through the night and the next several harrowing days, and ultimately was able to go home.

I had the privilege of seeing Napoleon for a second time two weeks later. His chest had not become infected, and to my surprise and delight much of the skin wound had healed; a small (which is a relative term — it covered perhaps 10 percent of his body) portion of skin was devitalized and was healing naturally with the assistance of bandaging. His owners were right about him being feisty: He tried to bite me as I evaluated him and changed his bandage.

Last I heard, Napoleon was alive, well, and walking only on-leash. Unless you are very attentive and your dog has absolutely perfect recall, I recommend that your dog walk only on-leash as well. Especially if he is small enough to fit in the mouth of a “Pit Bull.”

Got a question for Dr. Barchas? Ask our vet in the comments below and your topic might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)

Read more by Dr. Eric Barchas:

• Why Do Some Dogs Keep “Showing Their Lipsticks”?
• Let’s Talk About Dogs and Euthanasia: When Is It Time? Should You Be Present?
• What to Do Before You Get to the Vet in 12 Emergency Dog Situations
• 12 Dog Emergencies That Need Immediate Veterinary Attention
• Just How Dangerous Is It to Falsely Call a Pet a Service Dog?