When My Horse is in a Fire...

While a barn fire is uncommon, there is nothing more devastating-with more complicated consequences-than a horse's becoming a burn victim. But it does happen. The first steps when confronted with a barn fire are obvious-remove the animal from the structure if possible. Once the horse is away from imminent danger, call your veterinarian. He or she can advise you on what to do (and what not to do) before medical help arrives.

For example, you might be instructed to remove any coverings-including halters and blankets-as these items can retain heat and promote continued heat damage. Adhered fabric should be cut at the margin of the adhered area because forceful removal will cause even more tissue damage. Although cooling the skin with room temperature water or saline is recommended for human patients (and applies to horses as well), burns result in a reduced ability to regulate body temperature. Thus, attempts should be made to keep the patient warm once the burning process has been stopped because heat loss can be significant, especially in smaller equine patients and during cold weather.

In addition to the skin damage, the most immediate considerations are the lungs and the kidneys. Burns to the airway or inhalation of hot gases can cause the airway to swell, which might require placement of a tube directly into the trachea. Damage to the lungs can result in constriction of bronchi and in fluid collection (pulmonary edema) requiring such supportive measures as bronchodilators, diuretic agents, and oxygen therapy. If these early complications are not rapidly treated, they can be fatal. Additionally, since the lungs are susceptible to secondary bacterial infection following smoke and heat exposure, broad-spectrum antibiotic therapy might be indicated.

Because of the massive tissue damage resulting from burns, the kidneys can be overwhelmed with the by-products of this damage. Early supportive therapy in the form of intravenous fluids and agents that promote diuresis is essential for maintaining kidney function and minimizing damage.

Another serious side effect of burns is damage to the eye. The cornea is vulnerable to damage from the heat, from trauma associated with escape from the burning building, and from deposits of burning particles onto the surface. Immediate cleansing of the cornea by your veterinarian and application of protective ointments will help to minimize the development of irreversible eye damage.

A critical aspect of treatment during the initial days, along with lung and kidney support, is pain management. Burns are painful, and dealing with the extreme discomfort can interfere with normal behavior and body function including eating, drinking, and bowel movements. Some agents, such as the non-steroidal anti-inflammatory agents, can, unfortunately, worsen kidney malfunction and might not provide adequate pain relief. These agents, while useful, should only be used once kidney function appears to be adequate based on ongoing laboratory testing. Opioids (i.e. narcotics) are beneficial in the first days after the burn occurs. One opioid is now available in a transdermal (through-the-skin) slow release form that might provide adequate pain control for one to two days without the need for frequent repeated intramuscular or intravenous injections.

Another potential complication of burns is laminitis, commonly known as founder. Laminitis is a complicated disease with many potential causes and can develop in varying degrees of severity. Stress, secondary infection, and the massive tissue damage associated with burns can contribute to this potentially life-threatening complication. Although there is no specific prevention for or treatment of laminitis, conservative use of non-steroidal anti-inflammatory agents, hoof support, hydrotherapy to encourage blood flow to the foot, and intravenous fluids to assure hydration might help to minimize the risk of laminitis.

Once the acute complications of massive burns in horses have been managed, the skin lesions become a major part of treatment. Daily hydrotherapy to remove the dead tissue combined with local therapy to protect the underlying new skin is imperative. Ointments that moisturize and help prevent secondary infection are ideal. Burn wounds should be treated until a healthy granulating tissue bed is established in the injured areas. Once healing begins, critical evaluation of the wounds by your veterinarian to assess the need for skin grafting is indicated. Skin grafting might be necessary when the burn area is massive or located in an area that can interfere with normal motion when the scar tissue begins to shrink. Depending on where you live, such specialized care might only be offered by a primary care facility such as a university teaching hospital or private referral practice.

Burn injury in horses can result in many serious and even life-threatening complications including respiratory failure, kidney failure, permanent eye damage, laminitis, and skin damage (which can lead to lost range of motion). If your horse becomes a burn victim, seek immediate veterinary care to increase his chances of survival and return to full function. Remember that recovery will be slow and will take a long-term commitment.

About the Author

Janyce L. Seahorn, DVM, MS, Dipl. ACVA, Dipl. ACVIM

Janyce L. Seahorn, DVM, MS, Dipl. ACVA, Dipl. ACVIM

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