If there is a penetrating wound to the chest associated with difficulty in breathing:

• Do NOT remove any objects sticking out of the chest!
• Make an airtight seal over the wound and around any foreign object by applying a cloth or plastic sheet and holding or taping (not too tight!) around the chest.
• TRANSPORT IMMEDIATELY TO A VETERINARIAN!

• If no pulse or respirations are detected, CPR may be attempted. CPR is a two-phased procedure consisting of mouth-to-nose respiration and heart massage.
• CPR should only be attempted if veterinary care is not immediately or you feel that your Maltese will not survive otherwise.
• Attempt CPR only if your veterinarian has demonstrated for you the proper technique.

Shock is a generally reversible state of massive physiological reaction to bodily trauma, usually characterized by marked loss of blood pressure and depression of vital processes.Signs of shock include:

• Dazed attitude or unconsciousness
• Low body temperature (dogs and cats average between 101 and 102.5 degrees F.)
• Rapid, shallow respirations
• Pale or white gums and tongue

Severely bleeding wounds, deep wounds, and sucking wounds to the chest must be dealt with immediately. Arterial bleeding, the most life-threatening kind of bleeding, is characterized by rhythmic spurting. Venous bleeding is a slower dripping or pooling of blood.

• To control bleeding, apply gentle, steady pressure with clean, absorbent material. Apply a tourniquet loosely only as a last resort.
• Penetrating or sucking wounds to the chest must be tightly covered to help support adequate respiration. Do NOT remove objects from a chest or abdominal wound. Instead, wrap the object at its entry point with plastic wrap to seal the wound and hold or tape in place. Transport immediately to a veterinary facility.
• To clean contaminated wounds, flush gently with a stream of cool water or immerse in a cool tub. Then apply a cold compress to actively bleeding wounds or topical antibiotic and clean bandage to less serious wounds.
• Superficial wounds may be cleaned with 3 percent hydrogen peroxide or salt water (1 tsp. salt in 1 pint warm water is comparable to normal body fluids).
• Lacerations (cuts through the skin) should be closed as soon as possible to maximize healing and minimize infection.
• Major wounds should receive veterinary attention immediately. Minor wounds should be examined within 24 hours. Maltese are particularly prone to infection and often require antibiotics to facilitate healing.

Fractures are cracks or breaks in bones. Suspect a fracture if the animal refuses to put weight on a leg, if a limb is not in a normal position or is dangling limply. Swelling occurs very quickly over a broken bone in any location. Fractures are categorized as open (bone protruding through the skin) or closed. A major goal of First Aid is to prevent a closed fracture from becoming an open fracture.

• If the bone is exposed, cover with a light bandage to keep it as clean as possible.
• Move a limb with a suspected fracture as little as possible. While splinting can be done with many fractures, it is simpler to support the leg with a folded towel or blanket before transporting to a veterinarian.
• Sprains and strains are injuries to the muscles, ligaments, or tendons. Sprains, strains, and dislocated joints can all be difficult to tell from a fracture. Only an X-ray can evaluate this type of injury accurately.

Burns are categorized as thermal, chemical, or electrical.

• For burns that leave the skin intact, wash the area with a gentle stream of cool water or immerse in a cool bath. Then apply a cold compress on the burn to minimize the damage. Do NOT apply oils, creams, or butter to a burn!
• For full-thickness burns (completely through the skin), cover with a dry cloth or towel and transport to a veterinarian immediately.
• Always seek veterinary care for a burn. Often the full extent of the burn will not be apparent for several days and they are very prone to infection.
• Electrical burns may cause only superficial burns in the mouth, but may also cause convulsions or life-threatening heart and lung conditions up to 24 to 48 hours after the incident.

Most allergic reactions seen in animals are due to insect stings, but may also result from foods, vaccines, and other medications. Mild allergic reactions are manifest by moderate pain or itching and localized swelling in the area.

• Remove the stinger if it can be found
• Apply a cold compress to the area
• Administer over-the-counter antihistamines like Benadryl, if recommended by your veterinarian. Severe allergic reactions ("Anaphylaxis") may occur within 30 minutes. In these cases, the signs of mild reactions are followed by swelling of the airway and shock. THESE ARE TRUE EMERGENCIES! Transport your Maltese immediately for veterinary care!

Allergies to pollens and molds, flea allergies, and bronchial asthma are somewhat common in Maltese. See your veterinarian for assistance in their management.

While many snakes are nonvenomous, rattlesnakes, copperheads, and water moccasins can cause painful tissue reactions, infection, or shock. Suspect a snakebite if:

• Extreme swelling and pain occurs suddenly, especially when it involves an extremity like a nose or a paw
• Fang-marks are found on the surface of such a wound (they may or may not be evident)

Maltese cannot sweat like people do to effectively dissipate body heat. Instead, they must pant, a mechanism which works well when the outside temperature is below their normal body temperature. Heatstroke occurs when the outside temperature exceeds the range of 101 to 102.5 degrees F. and is more common when humidity is high.

Heatstroke causes a reduction of blood circulation which compromises kidney function, swelling of the brain, and a general overheating of body tissues. It has a very high mortality rate and requires immediate attention.Suspect heatstroke if:

• Extreme panting and salivation is observed
• Your Maltese has an anxious or panicky expression
• Collapse follows the above symptoms
• Rectal temperature exceeds 105 degrees F.
• Your Maltese has been in an enclosed area with poor air circulation such as an enclosed car or room, has been in direct sunlight without access to fresh water, or has been exercising excessively on a hot day

Cold exposure or hypothermia is most likely to affect your Maltese if it were to lose body temperature quickly. Especially susceptible are puppies and small breeds such as a Maltese. Frostbite can occur without suffering serious hypothermia. Areas most prone to frostbite are the tail, tips of the ears, and the footpads.To treat cold exposure cases:

• Warm your Maltese slowly by wrapping in a blanket and placing a hot water bottle or a heating pad under the blanket, not directly on him or her.
• A hair dryer may be directed toward your Malese for passive warming
• If your Maltese does not quickly show signs of consciousness and a normal shivering mechanism, it can be placed in a tub of warm (105 to 110 degrees F.) water until veterinary care is available.
• Frostbitten tissues appear leathery and hair may appear white; handle these fragile tissues gently. The extent of the damage may not be obvious for several days.

If drowning occurs:

• Hold your Maltese upside down and squeeze the chest gently but firmly until fluid stops draining.
• If your Maltese has no pulse or respiration and veterinary care is not immediately available, institute CPR and transport.

Seizures may be "grand mal" where the whole body is affected or "petit mal" where only a part of the body is affected. Seizures are the result of abnormal nervous impulses which cause uncontrollable twitching and erratic behavior.

Causes of seizures include:

• Poisoning
• Head injuries
• Severe infections
• Tumors
• Epilepsy

Dogs have a very efficient vomiting mechanism. Vomiting may be a sign of a very minor problem or a very serious one. Vomiting may or may not be associated with diarrhea. Causes of vomiting include:

• Sudden changes in diet
• Intestinal parasites (worms)
• Bacterial or viral infections
• Motion sickness
• Foreign body ingestion
• Poisoning
• Kidney failure or other metabolic disorders
• Special types of stomach or intestinal disorders
• Pancreatitis (inflammation of the pancreas gland)

The eyes of your Maltese are very fragile and subject to a variety of maladies. If you suspect an injury or an infection in an eye, seek veterinary care immediately. Common eye problems could include:

• Conjunctivitis (infection of the lining of the eyelids)
• Corneal abrasions or ulcers
• Foreign bodies between the eye and eyelids or in the eye itself
• Glaucoma (increased pressure within the eyeball)
• Proptosis of the eyeball is frequently the result of trauma to animals with protruding eyes. The eyeball is actually forced partially out of its socket by the sudden change in pressure. Proptosed eyes must be treated immediately to hope to salvage vision and retain a cosmetically pleasing eye.

• Broken toenails are more painful than dangerous. Controlling resultant bleeding with a styptic powder is usually all that is necessary
• Broken teeth should be seen by a veterinarian within 24 hours if adequate repair is to be accomplished
• Nosebleeds may be caused by trauma, foreign bodies, bleeding disorders or intranasal tumors. Keep your Maltese quiet with its nose elevated until the bleeding stops or you can see the veterinarian for evaluation.