I can't say how many animals are brought into any ER on any given day where the owners have no clue what happened to their pet and the pet cannot talk to tell the vet where it hurts.

Many times a final diagnosis is not determined until the following day or even later. If the vets wait for a diagnosis, many animals would be lost. Pets in an ER are triaged, and the more severe cases are treated in that order.

ABC's (airway, breathing, circulation). Internal bleeding will usually show as swelling in the abdomen, and pale gum color. With a GSW (gun shot (pellets) wound) or IFO (Impalement with a Foreign Object), alot of times sounds worse than it is. Depending on the sharpness and speed of the object doing the penetration, not every organ in the body is necessarily affected. Organs have the ability to move out of the way of incoming foreign invaders, and small internal wounds can heal on their own, the blood will clot given time. Fluids and an abdominal wrap are supportive care. The fluids can treat shock and repressurize the circulatory system from blood loss, the abdominal wrap prevents extensive blood loss by stopping the abdomen from expanding further. Like using the dog's own body as a pressure bandage.

If a vet cuts open a dog without first trying to control some of the bleeding from multiple injuries in this manner, the dog will more than likely bleed out. If the liver is wounded, that may require surgical intervention, if the dog is still showing signs of internal bleeding.

A collapsed lung will be found on the initial exam, can be reinflated and monitored. If it continues to collapse, over a period of some time, it may need surgical repair. I've seen a dog (Hit by Car) whose lung was reinflated 4 times before it held. That was not his only problem, but at the time surgery was too risky due to his other injuries.

I also was working one night when a dog came in with symptoms af HGE. All tests pointed to HGE, and initial treatment for HGE was started. After an hour, the dog was not improving as expected. The vet said something else had to be going on. He suspected rat poisoning. Toxicology tests take time, and the dog would have been dead before the results were back. The treatment was a high dose of Vitamin K, IV. But, if it was not rat poisoning, the Vit K alone would kill him. I'm sure with his experience, he knew what to do. But he asked me what I thought. At the rate this dog was losing blood out of his butt, he would die if we did nothing and continued to treat for HGE. I told him I thought he should give him the Vit K. He did, and the dog began to improve. The owner had no idea how the dog could have gotten into rat poison.

Just saying, yes, alot of treatment goes on without knowing absolutely what is wrong with an animal. Mainly it's about getting an animal stabilized, trying to control symptoms, and making decisions based on the dog's responses to what is done, and keeping the animal stabilized. Anything that is not immediately life-threatening is put off until the animal is in a better condition to handle further treatment, if in fact it is needed.

The dog's collapsed lung was not diagnosed upon initial examination. Entry wound was not examined for a possible bullet or other foreign object that could have been causing internal bleeding. The dog was l left on an IV, pain medication and O2 until morning. Unacceptable. That is not stabilization. No one cuts into a body without the necessary tests being done to determine the point of entry and any foreign objects inside the body. This animal had an obvious undetermined entry point of a foreign object that was left unattended. Lungs by the way are part of the respiratory system and kind of important. Could sustain permanent injury by being left for hours without being attend to. It would be a law suit for for sure in a human ED and some severe dressing down of the attending physician.
This poor dog was not given emergency care and the owner is quite blessed to still have the animal. They should not be charged for emergency treatment.

Airway, breathing and circulation are standard exam points of an emergency patient. O2 and IV fluids are standard procedure for a trauma patient Upon arrival at an "emergency" facility care should go far beyond that. Any human left in that condition until morning is unthinkable. If vets you know treat their trauma patients in such a casual way it is way below the standard of care. Arrive at emergency facility and wait for further tests until morning??? Unthinkable.

Not the treatment I would have wanted for my dog! but here is what the OP posted:

My niece recently had to take her wolf mix pup to the emergency vet. She let her out is the backyard, and when she checked on her she was laying in the grass. She called her and she didn't even seem to hear her so she went to get her and found her side was bleeding and she "wasn't acting right". This was probably around 8:30pm or so she called me and I gave her the number for the closest vet to her that had emergency services

The bolded part made me think that this was just a "general vet" that had emergency hours. So I don't think was very skilled in emergency vet care. Certainly I did not get the impression, this person went to a fully equipped emergency hospital.

I would like to also support the idea that this dog/wolf hybrid get seen by a specialist and soon. Leaving a pellet in so close to the spine, has to have attendent risks to it. I would want an "expert" opinion on the pros and cons of this, as well as the risks etc for surgical removal.

Actually, the OP's post is just heresay from the neice's mom, and if she's not in the field of medicine, sometimes vets only relay what they think is important to the person they're talking to, and how much that person will understand. I can't say how many times I've interupted a vet in the middle of a discussion to say "This person is in the health field" and they tone it up a bit and will discuss the more technical side of the treatment that has been done or he's planning to do on their pet.

The owner would have to request the records from the pet's file to see what was done and make a decision from there.

Sometimes dogs are sent home too early due to financial problems. Many vets expect payment up front for emergency services and the treatment the dog gets is based on the ability to pay. Anyway, I hope the pup recovers from his injuries.

A dog came into the humane society having bb pellts all over its body.

If I remember correctly this was years ago the vet volunteering there plucked most of them out with like long tweezers and said to wait a couple days to wash the dog for scabs to cover and to just dab tge wound with idodine I think it was.

Anyways days later the dog was actually shaced as it was so matted and twice as many bb holes were found.

Apparently the bbs traveled inside all over and numerous surgical procedures were done to remove them.

Its sad that often $ dictate the quality of treatment, or how overwhelmed the vet is at the time.

Did your neice take him back in to have it removed?

I dont know if they always travel, but my uncle has a bb in his wrist from childhood that's never been removed and he has bever taken the time to have a Dr remove it, so many its selective as to the placenent of it.

The old BB guns were bad enough in their time but some of the air guns and others on the market today can cause horrible damage to animals and humans.
I would certainly take the poor dog to a specialist to have the retained pellet looked at more closely.

No she didn't. I think shes more afraid of having it removed than of leaving it in. I rather doubt she'll take it to a specailist either... I'm kind of surprised she managed to pay for the original vet bills. Shes one of those impulse puppy people. Saw a free puppy and jumped on it :/ The only way I could help is to dip into our emergency vet account, but then what would I do if something happened to Yumi you know?