Right after Indika runs over the last wood board in the windmill, grabbing Ilja's hand. You hear a squal and the game then shows an unneccessarily long closeup of the dog/wolf's head hanging between some gears. Really upsetting.
Also after Indika opens the letter, we see a giant cow getting split in half whenever her mind runs dark. While this szenario seems to only be Indika's imaginagion it still could be mildly disturbing.
There's a large dog in the game and the characters speculate that it was possibly abandoned and left hungry by its owners, but this is never explicitly shown or confirmed.
There is a cut on a character's arm that's predominantly shown in one shot of a cutscene, but the cause of it isn't mentioned and it is never brought up.
There are points where the player can drown and another where they're suddenly emerged in water, but there isn't indication of anyone struggling to breathe--the drownings are instant "game overs" and easily avoidable.
There is a somewhat unsavory depiction of Romani people in flashback scenes but the character is ultimately sympathetic. The character is later referred to in a derogatory way by the Devil.
Yes, Indika cuts Ilja's arm off to save him. You see it very much coming so there's plenty time to look away, although we don't see the actual process. It's a very tense situation though.
First when Indika arrives at tge crashed train a doctor gives a dying man morphine. Later, when Indika checks on Ilja's arm, she gives him probably morphine as well
You hear a squal and the game then shows an unneccessarily long closeup of the dog/wolf's head hanging between some gears. Really upsetting.