Thermal Burns in Cats

Cats

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Despite our precautions, accidents can happen and our pets may suffer resultant burns. Some causes include your dog reaching up onto a hot stove, walking across hot pavement, too much sun or getting too close to the barbeque grill.

The skin is considered the largest organ in the body and can suffer serious illness if it is burned, even as little as 15 percent. Most information regarding burn care and healing is extrapolated from human medicine. In recent years, huge advances in burn care in human medicine have benefited our pets.

There are a variety of causes of thermal burns including:

  • Fire/flames
  • Hot liquid
  • Hot metals
  • Heating pads
  • Heat lamps
  • Hair dryers
  • Walking across a hot stove top
  • Scalding water
  • Radiation

    As in human medicine, burns are classified. However, the classification for animals relies on the depth and extent of the injury. The classification is as follows:

  • Superficial partial thickness (similar to first degree burn). There is reddening of the skin, pain and swelling.

  • Deep partial thickness (similar to second degree burn). Signs include blisters, redness, pain and swelling.

  • Full thickness (similar to third degree burn). There is swelling under the skin, loss of skin and an absence of pain.

    What to Watch For

  • Missing hair
  • Red skin
  • Blisters
  • Exposed skin

    All burns are serious and should be considered emergencies. Prompt veterinary attention is crucial to a positive outcome. If your pet has been burned, he is susceptible to infection, dehydration and shock.

    Diagnosis

    The diagnosis of a thermal burn is based primarily on a history of exposure to a hot item. If the actually burning is not witnessed, skin damage due to burning is characteristic and can be diagnosed by an experienced veterinarian.

    Your veterinarian will perform a thorough physical examination as well as ask you several questions.

  • What caused the burn?
  • How long ago did the burn occur?
  • What treatments have you done at home?
  • How long was the pet exposed to the hot item?

    The primary goal of diagnosis is to determine the depth of the burn. Regardless of cause, thermal burns are treated similarly.

    Treatment

    Cooling is essential but the cooling must be done over a 30 to 40 minute period. It is very tempting to rapidly cool the burnt pet with ice or ice packs, but don't do it. Ice and ice packs can result in over-cooling, low body temperatures and, at worst, frostbite.

    The treatment of burns is based on the depth of the burn.

    Superficial partial thickness burns respond well to topical treatment with antibiotic creams and wound cleaning.

    Deep partial thickness burns over 15 percent of the body need more significant treatment including:

  • Hospitalization
  • Intravenous fluids
  • Wound cleaning
  • Daily bandage changes
  • Antibiotics

    Some deep partial thickness burns eventually require skin grafts.

    Full thickness burns require extensive prolonged treatment that can be quite expensive. Expect your veterinarian to discuss the severity of the situation and the long-term recovery as well as costs. Some owners of pets with extensive full thickness burns choose euthanasia.

    The treatment for full thickness burns may include:

  • Hospitalization for several days to weeks
  • Intravenous fluids
  • Plasma or blood transfusions
  • Antibiotics
  • Daily bandage changes
  • Pain medication
  • Feeding tubes
  • Extensive nursing care
  • Multiple skin graft surgeries

    Home Care and Prevention

    For very small superficial partial thickness burns, carefully apply cool water to stop additional burning. Topical antibiotic creams can help healing.

    For all other burns, immediate gentle cooling with cool water and then immediate treatment by a veterinarian is recommended. There is no home care for most burns. Do not use ice or ice packs. Do not apply butter or any product to the burn. Do not place any clothing or anything on the burn other than cool water.

    Many burns are true accidents and cannot be prevented. To help reduce risk, keep your cat indoors and keep your pet away from all hot items or potential burn situations.

  • In human medicine, burns are divided into various degrees. This type of classification does not exactly fit with how animal skin reacts to burns so a different system is used.

    Burns are divided based on the thickness of the burn.

  • Superficial partial thickness burns are similar to first-degree burns. Only the top layer of skin is involved. The hair may still be attached to the skin. The skin appears red and no blisters are seen.

  • Deep partial thickness burns are similar to second-degree burns. The surface layer and some deeper layers of skin are involved. Unlike in humans, these burns infrequently have blisters. The skin is red and some layers of the skin may be exposed.

  • Full thickness burns are similar to third-degree burns. The burn extends through all layers of skin and may even include tissue beneath the skin. Immediately after the burn, the skin may look like leather or the surface of the burn may appear white.

    In animals, the hair coat acts as an insulator and protects the skin. For this reason, areas of the body with less hair are prone to greater damage than areas with a thick hair coat.

  • Diagnosis

    A thorough physical examination is very important to determine the extent of the burns and to find any other injuries. Examination inside the mouth is essential. If soot is found in the mouth, inhalation burn injury as well as potential burning of the airways is to be suspected. This can make recovery even more difficult and prolonged.

    The extent of the burn affects prognosis and can indicate the possibility of severe organ dysfunction. Burns that affect more than 20 percent of the body usually cause severe metabolic illness. Deep partial thickness and full thickness burns that cover over 50 percent of the body have a poor chance of recovery and euthanasia should be considered.

    In addition to surface burns, shock can occur. In patients with over 20 percent of the body burned, shock can occur within 1 to 2 hours.

    Blood work is frequently done throughout hospitalization, especially in cases of deep partial thickness and full thickness burns. Abnormalities associated with electrolytes and kidney values may occur. Various complications can occur and organs can fail. Blood tests can help determine if an organ is failing, if infection is occurring, if the pet is becoming anemic or if electrolyte disturbances are occurring.

    Radiographs (x-rays) of the chest are done to determine the presence of associated smoke inhalation, fluid accumulation in the lungs, pneumonia or lung damage.

    Treatment

    The treatment is based on the extent of the burn. Immediate cooling of the area is crucial. Use only cool water and slowly cool the area over 30 to 40 minutes. Do not use ice or ice packs. This may result in low body temperature or even frostbite.

  • Superficial partial thickness. For these burns, the hair is carefully shaved from the burned area in order to ease treatment and better monitor healing. The wound is gently cleaned with povidone iodine or chlorhexidine. Topical creams such as silver sulfadiazine are quite effective in burns. Most superficial partial thickness burns can be treated on an outpatient basis with the remainder of treatment and care done at home. Most of these burns heal within 3 to 5 days.

  • Deep partial thickness. For these burns, hospitalization is necessary. Intravenous fluids are started to provide hydration and needed electrolytes. The wounds need to be cleaned daily with povidone iodine or chlorhexidine. Topical cream such as silver sulfadiazine is used to treat and prevent superficial infection.

    If over 15 percent of the body is burned, skin grafts may eventually be required. These burns typically heal within a few weeks.

  • Full thickness burns. These burns require extensive hospitalization and nursing care. All the treatment listed for deep partial thickness is also done for full thickness burns. Hospitalization is typically significantly longer than hospitalization for deep partial thickness burns.

    Intravenous fluids are important in full thickness burns. Shock can occur within 1 to 2 hours of the burn. Additionally, the exposed tissue begins weeping fluids. If not treated, this can result in significant fluid and protein loss. To counteract the loss of fluids, plasma transfusions are necessary. Urine output must be monitored in severe cases. Kidney failure can occur due to poor blood flow to the kidneys. Continued intravenous fluids help maintain adequate kidney blood flow.

    Antibiotics are used topically to the burn and may be used systemically. Initially, antibiotics are avoided to prevent the development of resistance bacterial strains. Once stabilized, injectable or oral antibiotics may be started.

    Anemia can occur from blood loss or early red blood cell destruction. In severe cases, blood transfusions may be needed. The percentage of circulating red blood cells will be monitoring throughout hospitalization.

    Nutritional support is crucial in the severely burned pet. Burn patients require a significant increase in calories to sustain a higher metabolic rate during healing. It is difficult for a severely burned painful pet to consume the necessary calories. For this reason, feeding tubes are commonly used.

    Pain medications are very important. Burns are painful and many burned pets are given morphine, buprenorphine or butorphanol throughout their recovery. Anti-inflammatories are also helpful. The most commonly used one is ketoprofen. Steroids are not recommended and are usually avoided.

    Wound care is the most intensive part of burn patient care. The wound needs to be repeatedly cleaned to reduce the severity of infection. Repeated bandages and topical antibiotic ointments are necessary. Up to three times daily, surgical removal of dead or infected tissue needs to be done until the wounds appear to be healing. Multiple skin graft surgeries are also necessary for complete recovery.

    Throughout treatment, various complications can occur which would make recovery difficult or may end the pet's life. These include:

  • Profound anemia
  • Kidney failure
  • Electrolyte imbalances
  • Dehydration
  • Starvation
  • Infection
  • Sepsis

  • Burn patients require extensive and prolonged nursing care. Bandage changes and wound cleaning, as well as continuing nutritional support, are crucial. Some severe wounds can take months to completely heal. During the first 1 to 2 months of healing, the wounds must be monitored carefully. Scars can cause limitation of movement so daily physical therapy, including passive range of motion, exercise or swimming, is needed to prevent severe scabbing or tightness when the scars form.

    Repeated veterinary visits are very important. Detecting and treating complications early will help hasten recovery.

    Repeated blood tests are necessary to make sure the rest of the body is functioning normally.

    Multiple surgeries may be required to completely heal the burn.

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