This report describes the management of rectal perforation, incision infection, implant failure, sepsis, osteonecrosis, and enterocutaneous fistula formation in a 3-year-old Yorkshire Terrier that was hit by a car. Rectal perforation from displaced pelvic fractures was suspected because of drainage from the incision, and clinical signs, and blood test results indicative of sepsis. Ilial and acetabular osteonecrosis from wound infection were treated with hemipelvectomy without pelvic limb amputation, and full limb function was regained. Primary repair of the rectal perforation and use of a muscle flap were unsuccessful, and a rectocutaneous fistula developed, but the rectum healed after colostomy for fecal diversion. An enterocutaneous fistula subsequently developed at the rectocutaneous fistula site, resulting in weight loss and continued drainage from the incision. Primary closure of the jejunal stoma, appropriate wound management, and nutritional support by enteral feeding resulted in eventual second-intention healing of the fistula and incision.