- Remove the animal from the source of heat and ensure they have a patent airway. Apply cool water to burns – this decreases pain and minimises further tissue damage.
- If the burn involves only a small area of the body you can, if need be, immerse the animal in a cool bath. If it involves a large area this is not recommended as it can lead to shock. Simply run cold water directly over the affected areas and/or apply cold compresses.
- If possible, place a sterile, non-stick gauze or pad, or a clean moist cloth, over the burned area. Do not apply any ointments or creams.
- Seek veterinary attention immediately.
WHAT IS IT?
Thermal burns are burn wounds associated with exposure or contact with excess heat. Burn wounds are categorised according to the depth of the burn and percentage of the body surface area affected.
CLINICAL SIGNS
The full extent of burn wounds may take up to 3 days to fully develop as heat dissipates slowly from burned skin. During this time, thermal burn injuries and tissue damage can continue to progress. Burn injuries appear differently according to the depth and extent of the burn.
- Reddened, blistered skin with swelling and inflammation
- Hair may be singed, yielding a distinctive smell
- Painful to touch
- Recent burn injuries may be hot to touch
- Charred and sloughing skin
- Discoloured skin (black or yellow-white)
- Superficial burns are very painful whereas third degree or full thickness burns may lead to less pain sensation as superficial nerves are damaged
- Formation of a thickened, pie-crust type scab (Escher)
- Shock
In cases of severe burns, an Escher will form within 7-10 days. An Escher appears as a clack, firm, thick movable crust with clearly defined borders from normal skin around it and is actually full thickness degenerated skin with pus-like discharge beneath it, which will eventually slough off.
CAUSES
The most common sources or causes of thermal burn injuries in veterinary patients are burned paw pads from jumping on a stovetop (cats), electric heating pads, exposure to fire (for example in a house fire), scalding water, stove tops, radiators, heat lamps, automobile mufflers, and in hospital with inappropriately grounded electrocautery units and radiation therapy.
TREATMENT
Burns are classified as superficial partial thickness, deep partial thickness or full thickness. Different type of burns warrant different treatment. However, some burns may take up to 3 days to fully declare and some animals may have a combination of burns of different severities so management may be complicated. Severe burns are challenging cases to manage and often require long term nursing and wound management until full recovery.
If your animal is presented within 2 hours, your vet may apply some chilled saline on the wound. Minor burns covering <15% of the body usually require wound dressings and antibiotics to prevent skin infections and aid healing, as well as pain relief.
Burns covering 15-50% of the body can cause shock, and affected animals usually require intravenous fluids support and supplemental oxygen are recommended, as well as pain relief.
Burns to over 50% of the body require all of the above and often prolonged intensive care.
Wound management generally involves pain relief, antibiotics, silver sulfadiazine cream (silver based antimicrobial ointment) and/or silver based antimicrobial dressings. In moderate to severe burns, a general anesthetic for debriding and removing dead or dying tissues or eschar may be required once the full extent of the burn is clear. Dressing changes are initially frequent and may require sedation or anaesthesia.
Nutrition requirements are up to triple the normal amount in burn patients. If the patient is not eating well, or if the burns are around the face and it is too uncomfortable to eat, a feeding tube should be considered to ensure adequate caloric intake.
REFERENCES
Garzotto CK (2009) In: Small Animal Critical Care Medicine. Ed. Silverstein DC & Hopper K. Missouri, USA: Saunders Elsevier.
House A (2013) Medical and Surgical Management of Burns in Companion Animals. Webinar organised by Lort Smith Animal Hospital, Melbourne, Australia, hosted by Vet Education