Management of thermal injuries in large animals

The pathophysiology and histopathology of thermal burns in large animals is very similar to that in humans. Burns are classified as first degree, superficial and deep second degree, third degree, and fourth degree, depending upon the depth of thermal injury. Most severe burns will produce a local and a systemic response--both of which must be properly treated to increase the patient's chances for survival. The systemic response is mainly characterized by hypovolemia, fluid and electrolyte loss, protein loss, pulmonary edema, increased caloric requirements, and depressed immune responses. The local response is one of inflammation, vasospasm fluid accumulation, and electrolyte shifts depending upon the extent of the thermal injury. In all burn cases, the total patient should be evaluated. There is a tendency to focus on the wound, and systemic problems may be overlooked. In many cases, the thermal wound cannot be accurately evaluated for a few days, especially in large animals. An attempt should be made to estimate the depth of the burn, because treatment will vary accordingly. The treatment method must consider several problems. These include evaporative fluid and electrolyte loss, protection against mechanical injury, prevention of bacterial invasion and infection, maintenance of body temperature, and removal of nonviable tissue while leaving viable germinal tissue for healing. Thermal injuries in large animals present several additional problems. Many burns in large animals involve a large surface area, which increases the fluid, electrolyte, and caloric losses. Because most veterinary hospitals are not equipped to control the patient's surroundings, extensive bacterial contamination of the burn is of major concern. Patient restraint must also be a consideration to prevent further injury of the healing wound. Many patients are pruritic, and proper measures must be taken to prevent self-mutilation. There is also a lack of technically trained personnel to monitor and properly treat burn patients.