with Dr Erik Noschka University of Adelaide for Horse SA https://www.horsesa.asn.au https://www.adelaide.edu.au/vet/horses

1. How to get my horse
through bushfire
injuries
Erik Noschka, DVM, MS, PhD
Equine Surgeon, Uni Adelaide

2. Outline
1. General considerations
2. Burn injuries
a) Epithelial surfaces
b) Smoke inhalation and toxins
3. Triage
4. First Aid – Treatment
5. When to call the vet
23/02/2015Dr No, How to get my horse through bushfire injuries

3. General considerations
1. Preparedness
a) Trailer training
b) Trailer access
c) Escape routs, alternate paddocks
d) First aid course
e) Stocking Sedation, Medication and Bandages
f) First responders network
23/02/2015Dr No, How to get my horse through bushfire injuries

4. Burn injuries
Thermal injury vs. Smoke inhalation
barn fires: CO, CO2, Toxins
Complications:
laminitis; lacerations; colic …
23/02/2015Dr No, How to get my horse through bushfire injuries

5. Burn injuries - thermal
Epithelial surfaces
• Skin
• Eyes / Cornea
• Airway
• Nostrils, nasal passages, throat
• Trachea, bronchi
• alveoli
23/02/2015Dr No, How to get my horse through bushfire injuries

6. Burn injuries - thermal
Epithelial surfaces of the Airways
• Heat à cell death
à edema
à partial airway obstruction
à inflammatory cascade
à protein leakage into lungs
à emphysema
• Other organs: microvascular injury + tissue coagulation
à systemic shock (circulatory collapse)
à inflammatory + coagulation cascade
à edema
23/02/2015Dr No, How to get my horse through bushfire injuries

7. Treatment
1. Systemic Shock
a) IV fluids
b) Plasma
c) Anti-inflammatories
2. Pulmonary Edema / Emphysema
a) Diuretics (Furosemide)
b) Antibiotics
23/02/2015Dr No, How to get my horse through bushfire injuries

8. Burn degrees
1st degree
(~sun burn)
2nd degree
Partial Deep
3rd degree
(full thickness)
4th degree
Superficial
epidermis
to basal
layer
Epidermis
+ dermis
Entire Skin lost
(epidermis,
dermis + fat)
Entire skin + muscle
+ bone + fat are
burned
Painful less pain No sensation
Erythema
edema
Heals in
2-2.5
weeks
Heals in
3-4 weeks
50% Fluid and Protein loss
Shock
Infection
Excellent
prognosis
Excellent
prognosis
Guarded
prognosis
Guarded- good
prognosis
Benefits from
grafting
Grave prognosis
Benefits from
grafting
Can develop vesicles and blisters Wounds are life threatening

9. Triage
1. Principles
a) Containment at safe place (experienced personnel)
b) Thorough physical exam
— Problemlist
— Prioritize
— Do I need the vet?
2. Treatment
a) Cool tissues
b) Provide with Fluids
c) Provide with humidified oxygen (lung injury, hypobaric chamber)
d) Anti-inflammatories
e) Analgesia
f) Nutrition
23/02/2015Dr No, How to get my horse through bushfire injuries

10. Treatment
1. Cool tissues
a) Ice cold water
b) Water hose
2. Fluids
a) Offer water (plus electrolytes)
b) IV fluids
— Balanced electrolytes
— Plasma extender (hetastarch)
— plasma
23/02/2015Dr No, How to get my horse through bushfire injuries

11. Treatment
3. Anti-inflammatories / Analgesia
a) NSAID’s
b) Vitamin E (1.000 IU alpha-tocopherol) ameliorate lung injuries
c) DMSO (first 24 hours) if ineffective one dose dexamethasone
d) Pentoxifylline
e) SSD (silver sulfa diazine ointment - Flamazine) topical
f) Opioids / Ketamine
4. Antimicrobials
a) Topical +/- systemic
5. Nutrition
• Highly nutritious food
• burns >30% of body surface à energy expenditure doubles
• Free choice alfalfa hay
• Add vegetable oil
• Gradual grain increase
23/02/2015Dr No, How to get my horse through bushfire injuries

12. Management
1. Life threatening conditions first addressed
a) Systemic shock
— Balanced IV fluids (max. 20l for adult, edema risk)
b) Protein loss
— Max 10-20l plasma
c) Pulmonary edema / emphysema
— Antimicrobials
— Bronchodilation
— Ventipulmin / Albuterol
d) Upper airway obstructions
— tracheostomy
2. Skin lesions
a) Cold water hosing
b) Clipping
c) Cleaning (weak, sterile Chlorhexidine solution) / debridement (loose eschar)
d) Topical applications
— Anti-inflammatory / antimicrobial (SSD, water based, also on eschar) rarely systemic AB
— Dressings
e) IV fluids if > 20% of surface skin burned (max 20l)
23/02/2015Dr No, How to get my horse through bushfire injuries

13. Management
Vesicles and blisters management
• 1st and 2nd degree burns
Ø Leave intact first 24 to 48 hours
Ø Protect raw skin from infection and less painful
Ø After 24 to 48 hours
à partially excise + topical antimicrobial ointment
• Smoke inhalation and facial burns
Ø nutritional considerations
Ø damage to mucosa in the mouth and upper airways
— Water soaked hay
— Ground feeding à airways drainage
23/02/2015Dr No, How to get my horse through bushfire injuries

14. When to call the vet?
1. Cases we can’t safe
a) Unconscious, recumbent, major/ extreme burns
2. What can I do to start …
23/02/2015Dr No, How to get my horse through bushfire injuries
Photo: R. Reid Hanson, DVM, Dipl. ACVS
third-degree burn

15. More time for questions
References: Equine Wound Management; Stashak, Theoret
Dr No, How to get my horse through bushfire injuries