Treatment of heat stroke must be individualized and based on the severity of the condition and other factors that must be analyzed by your veterinarian. Treatments may include: If your dog has mild heat illness (rectal temperature of more than 102.5 F but less than 105 F), therapy may entail rest, increased air circulation using a fan, fresh water to drink and careful observation. With temperatures between 105 to 107 F, hospitalization and aggressive medical therapy likely will be recommended. If complications (arrhythmias, kidney failure, liver failure, gastrointestinal bleeding, cerebral edema, and/or disseminated intravascular coagulation) have occurred, additional treatments will be necessary.
Dogs with temperatures greater than 107 F should be treated more aggressively. Cooling can be accomplished externally with cool water baths, application of alcohol to the footpads, enhanced air circulation using a fan, and careful placement of ice packs over areas with large superficial blood vessels (neck, groin, armpit). Internal cooling methods include intravenous administration cool electrolyte solutions, cool water enemas, lavage of the stomach with cool water, or peritoneal dialysis with cool electrolyte solutions (instillation of cool electrolyte solutions into the peritoneal cavity by means of a catheter). These methods are rarely necessary.
Underlying conditions, such as heart disease, respiratory disease and dehydration should be treated with appropriate medications, oxygen delivery and intravenous administration of electrolyte solutions. Fluid therapy is often started to treat the shock that may accompany heat stroke.
Close monitoring of your dog is necessary to guide treatment. You and your veterinarian will have to evaluate your dog's rectal temperature, heart rate and rhythm, respiratory rate, blood pressure, urine output, level of consciousness, pinpoint hemorrhages on the gums or bruising of the skin, vomiting, diarrhea or gastrointestinal bleeding.
The anti-clotting medication heparin may be recommended to prevent disseminated intravascular coagulation (DIC) or if your dog is in the early stages of this life-threatening complication. Plasma that has been frozen soon after collection (fresh frozen plasma) may be administered to provide clotting factors in cases of DIC after your pet has been treated with heparin to prevent ongoing coagulation. Sometimes heparin is mixed in with the fresh frozen plasma.
Mannitol may be used to reduce cerebral edema if it is suspected.
The drugs dopamine and furosemide may be used to dilate blood vessels to the kidneys and to increase urinary excretion of salt and water, respectively. These treatments are given when acute kidney failure due to heat stroke is suspected.
Sucralfate is a coating agent that can be used to limit gastrointestinal bleeding.
Cimetidine and omeprazole are drugs that can be used to decrease acid secretion by the stomach and reduce the risk of gastrointestinal bleeding.
Antibiotics may be administered to treat suspected bacterial infection.
Dextrose (sugar) may be added to your dog's intravenous electrolyte solution to prevent or treat low blood sugar concentration (hypoglycemia).
The short-acting anti-convulsant agent diazepam may be recommended for seizures. Other seizure medications such as Phenobarbital may also be needed if diazepam is ineffective.
The anti-arrhythmic agent lidocaine may be used to treat certain heart rhythm disturbances (rapid ventricular tachycardia).
The prognosis is variable. The prognosis depends on the severity of the clinical signs, response to treatment and secondary complications. Pets that are extremely mentally depressed or that have active signs of hemorrhage have a poorer prognosis.