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138 Burns

• Avoid exposure to dogs with infectious SUGGESTED READING AUTHOR: Elizabeth Rozanski, DVM, DACVIM,
respiratory diseases (e.g., infectious tracheo- Rozanski E: Canine chronic bronchitis. Vet Clin DACVECC
EDITOR: Megan Grobman, DVM, MS, DACVIM
bronchitis), and maintain vaccination for
VetBooks.ir • Do not allow the pet to become overweight North Am Small Anim Pract 44(1):107-116,
these contagious infections.
2014.
on glucocorticoid therapy.

Burns Client Education
Sheet

BASIC INFORMATION limb ischemia, or compression severe enough Etiology and Pathophysiology
to cause ventilatory compromise or abdomi- • Localized wound inflammation results in
Definition nal problems. release of inflammatory mediators and
• Burns result from exposure to flame, extreme Electrical burns (p. 292): capillary leakage, causing extravasation of
heat, scalding, inhalation, and chemical or • High-voltage burns: associated with com- fluid.
electrical trauma. partmental syndromes and ischemia • If systemic inflammation or vasculitis occurs,
• Eschar: a thick, coagulated crust or slough • Low-voltage burns: seldom associated with fluid losses may be severe and result in
that develops as a result of a burn complications hypotension or cardiac collapse.
• Compartmentalization: a condition associated Chemical or tar burns: • Due to large volume of dead tissue, impaired
with third- and fourth-degree burns in which • Usually involve the superficial dermis layers blood supply, and impaired antimicrobial
swelling within tissue compartments creates and may be delayed in appearance by 3-4 delivery, large burn areas are at high risk for
strictures that can decrease thoracic wall days after contact infection. Initial organisms are normal flora,
motion (leading to hypoventilation) or cause including gram-positive cocci, but in 3-5
ischemic injury to limbs HISTORY, CHIEF COMPLAINT days, gram-negative bacteria colonize the
• Burn event may or may not have been wound. Debridement and topical antibiotics
Epidemiology witnessed. With acts of malicious intent, are essential to treatment.
SPECIES, AGE, SEX history may be unknown. • Sepsis may result from wound infection,
All animals are susceptible to burn injury. • Recent anesthetic procedures should prompt nosocomial infection due to the presence of
suspicion of heating blanket or heating lamp multiple invasive catheters, or pneumonia.
RISK FACTORS burn. • Systemic inflammation may result in coagu-
Temperature and duration of exposure con- lopathy, including disseminated intravascular
tribute to the degree of thermal injury. PHYSICAL EXAM FINDINGS coagulopathy.
Common causes of companion animal burns • Physical examination findings depend on • Inhalation injury (p. 919)
include heating pads, hot water bottles, fire, the location and extent of the burn.
exhaust systems, and hot pipes. Scalding water • Burns from contact may not initially be DIAGNOSIS
can also produce severe burns. Debilitating apparent until rapid skin and hair loss occur
comorbid conditions increase risk for fatal 2-3 days later (e.g., chemical burns, heating Diagnostic Overview
complications. pads), although the animal may be inexpli- Often, history suggests or is conclusive for
cably painful when the area is touched. thermal injury; attempt to ascertain time from
ASSOCIATED DISORDERS • Thermal burn resulting from a heating and duration of injury. Determining the severity
Bacterial infections, smoke inhalation, carbon blanket or lamp will present as a defined of the burn and appropriate treatment course
monoxide poisoning injury reflective of the size and positioning requires examination of the lesion, including
of the animal during recumbency. For 2-4 underlying and surrounding normal tissue. The
Clinical Presentation days, skin is firm but not ulcerated, making full extent of burns may not be apparent
DISEASE FORMS/SUBTYPES delayed identification common. immediately after the injury. Diagnostic testing
First-degree (superficial) burns: • Animals with extensive burns may present for related disorders (e.g., smoke inhalation)
• Affect the epidermis in hypotensive shock or with hypothermia. is applied on a case-by-case basis.
• Typically thickened, erythematous, and • The presence of singed whiskers or burn
desquamated debris in the mouth is strongly suggestive Differential Diagnosis
• Typically painful of inhalation (p. 919). • Severe bacterial pyoderma
Second-degree (deep, partial-thickness) burns: • Respiratory distress can occur rapidly from • Severe drug eruption
• Affect the superficial layers of dermis pharyngeal and laryngeal edema, progressive • Toxic epidermal necrolysis
• Typically edematous and erythematous upper airway obstruction, pulmonary edema,
• Typically wet and very painful inhalation of burn debris, or carbon mon- Initial Database
Third- and fourth-degree burns: oxide toxicity. • CBC, including a manual platelet count:
• Affect the superficial layers of dermis (third • Corneal ulceration may be present (p. 209). thrombocytopenia is common.
degree) and subcutaneous layers, tendon, Repeat fluorescein stain 24 hours after • Serum biochemistry profile: hypoalbu-
and bone (fourth degree) admission if negative initially to rule out minemia and electrolyte disturbances are
• Typically waxy and leathery in appearance corneal trauma. common.
• Typically less painful than first- or second- • Neurologic signs (seizures, loss of conscious- • Urinalysis
degree burns ness, ataxia [p. 1136]) can result from carbon • Coagulation profile (p. 1325)
• Third- and fourth-degree burns carry a greater monoxide or cyanide intoxication immedi- • Survey radiographs: thoracic radiographs for
risk of wound sepsis, coagulation disorders, ately or after a delay. all thermal burn patients and other areas as

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