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.
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: