Smoke inhalation injury is direct damage to the airways and lung tissue caused by exposure to heat, particulate matter in smoke and the gaseous by-products of fire.
Smoke inhalation injury can be caused by:
Thermal (heat induced) injury to the upper airways
Inhalation of particulate matter that settles in upper airways and the lungs
Asphyxia (suffocation) since the fire reduces the oxygen content in the air that is breathed
Chemical injury, due to chemicals such as carbon monoxide, cyanide, acrolein, hydrogen chloride and aldehydes that are released as gases within the fire
Smoke inhalation injury can lead to bronchospasm and bronchoconstriction (spasm and constriction of the airways), carbon monoxide poisoning, pulmonary edema (accumulation of fluid in the lungs), acute respiratory distress (inability to breathe) and pneumonia. Smoke inhalation can be fatal.
What to Watch For
Bright red mucous membranes (inside of lip and gums)
Dry, unproductive cough
Raspy breathing sounds
Wheezing
Increased respiratory rate
Increased effort of breathing
Irritation of the eyes
Discharge from the eyes or nose
Collapse
Unconsciousness
Respiratory distress
Respiratory or cardiac arrest
Diagnosis
In addition to a thorough medical history and physical examination your veterinarian may recommend the following diagnostic procedures and/or diagnostic tests:
Thoracic radiographs (chest X-rays) are done to look for evidence of injury or pneumonia. Multiple X-rays may be required to document changes in the lungs over a several day period.
Arterial blood gas measurements are taken to determine how well the pet is oxygenating and to determine the need for supplemental oxygen administration.
Carboxyhemoglobin levels. This blood test is done to measure the level of carbon monoxide poisoning.
A complete blood count (CBC) measures the white blood cell count to assess for evidence of infection and/or inflammation.
A biochemistry profile is a blood test that is performed to assess for internal organ damage secondary to smoke inhalation injury or secondary to shock.
Tracheal wash for cytology and culture. This test is performed to look for evidence of pneumonia and to culture the particular bacteria causing the pneumonia. Based on this information, a specific antibiotic can be chosen to fight the infection.
A fluorescein stain of the surface of the cornea (surface of the eye) is performed to document ulcers or erosions caused by smoke.
Treatment
Treatments may include:
Administration of supplemental oxygen to aid cats with difficulty breathing
Placement of an intravenous catheter for administration of medications and intravenous fluids
Bronchodilators such as terbutalline, albuterol, aminophylline or theophylline
Nebulization (humidification of the air the patient breathes)
Pain medication for associated burns
Mechanical ventilation if the patient is unconscious or shows signs of impending respiratory or cardiac arrest
Physical therapy for the chest (frequent position changes and coupage)
Eye medication for eye irritation or ulceration
Home Care
Remove pets from burning buildings and transport to a veterinary hospital as quickly as possible. Do not place your own life at risk by attempting to rescue a pet from a burning building.
If possible, have firefighters or medical personnel at the site of the fire administer oxygen to pets suffering from smoke inhalation injury for 10 to 15 minutes prior to transport. Administering oxygen as soon as possible reduces the amount of carbon monoxide poisoning and may stabilize pets that are at risk of dying prior to reaching the hospital.
