Pet First Aid Module 4

Treatment of Burns, and Choking

In this module you will learn:

Causes and types of burns, and appropriate treatment burns

How to deal with incidents of choking

Symptoms, causes and first aid treatment for shock

Artificial respiration and CPR for pets of all sizes

Behavioural changes that may indicate underlying medical issues

Animals can injure themselves in a variety of ways, whether it is eating things they should not, chewing dangerous objects, or getting themselves into unsafe situations.

Burns are one of the most traumatic, painful, and disfiguring injuries they can experience. They can be caused by various things: spillages of hot water or oil, chemicals, fire, candles, or exposed wires. Rapid treatment is essential to limit the damage, as untreated burns can become fatal.

Another serious problem is choking. Like humans, dogs can survive without oxygen for just a few minutes, so knowing how to administer appropriate first aid is vital. Choking can be caused by swallowing a piece of toy or bone, or by something becoming tight around their neck. Rapid action could save their life.

Whatever the cause of an injury or accident, going into shock is a possibility. While the word shock may not sound particularly serious, it is a life threatening condition that requires an immediate reaction and medical attention. In the most serious cases, animals may cease to stop breathing, or even become lifeless. In these circumstances, an owner’s knowledge and response could easily mean the difference between life and death.

4.1 Burns

A burn is classed as damage to tissue caused by dry heat.

A scald is caused by wet heat. Whatever the cause, the resulting burn will look the same and requires treatment. Unlike other injuries, burns continue to do harm after the initial accident, as the heat destroys the tissue. They can also cause animals to go into shock, and are prone to infection. For these reasons, treatment should be administered as soon as the owner realises their pet has been injured.

Burns are categorised into four levels of severity, although many people are familiar with only three.

The severity of the burn is judged by the spread, depth, and location of the burn, and the age of the pet will be taken into account. Treatment will depend upon severity, and range from a simple dressing, through to medical removal of dead tissue (debridement), and skin grafts. Older pets will typically heal more slowly due to slower tissue regeneration.

A burn affecting more than 25 percent of the body has an uncertain prognosis. Once covering more than 50 percent is considered extremely serious, and is often fatal.

First degree burns

First degree burns are the least serious. They affect only the skin and typically present as redness without blistering, although they may be accompanied by swelling or inflammation, and pain. Sometimes the skin may begin to peel, or look dry as it heals. First degree burns generally heal within 7-10 days and do not leave permanent scarring.

Second degree burns

Also known as a ‘partial thickness burn’, these penetrate to the second layer of skin tissue. They present with redness and blistering, and are very painful. If the blister bursts, the wound will become wet. Over time, the skin may develop a thick, scab-like texture, known medically as fibrinous exudate. Second degree burns take around a month to heal, and may result in a change in the pigmentation of the skin, rather than scarring.

Third degree burns

Third degree burns are severe and penetrate through every layer of skin, and may also be known as ‘full thickness’ burns.

While people often believe that third degree burns are the most painful, in many cases the affected areas lose sensation, because of the damage to the tissues and nerve endings.

As well as numbness, typical indicators of a third degree burn may be charring and blackening of the skin or, alternatively, a waxy, white colouring (dependent on the cause of the burn); blisters that do not develop; and a raised, leathery texture.

Third degree burns affect blood circulation and cut off the immune response to the area. They may also affect the pet’s electrolyte balance, and can lead to hypothermia due to heat loss from the injury.

For these reasons, they can be life-threatening and require immediate, professional medical intervention. No home treatment should be attempted.

Fourth degree burns

Fourth degree burns not only include all of the damage associated with third degree burns, but also extend into the underlying fat, muscle, soft tissues, and bone. The wound will appear dry and the damage means that there will be no pain experienced.

How not to treat a burn

There are certain things that should never be used to treat a burn.

Traditionally, it was believed that applying oils, fats or butter to a burn would help. This can actually do more harm, as the grease acts as an insulator and prevents the release of heat from the skin, allowing more tissue damage to take place.

Conversely, applying ice might seem like a sensible idea, but this can damage the delicate epidermal tissue, and cause frostbite if it is left in contact with the wound for too long. It may damage the surrounding tissue and slow down the healing process. In addition, as mentioned above, serious burns can lead to hypothermia, and the use of ice may contribute to the lowering of the body temperature.

Common causes of burns

These include:

• Spillages in the kitchen, including water and oil
• Steam
• Hot stoves
• Hot metal surfaces such as radiators and wood stoves
• Candles or fires
• Electric heating pads
• Heat lamps
• Hot air dryers
• Hot semi-liquids (such as tar)
• Exposed electrical wires
• Household cleaning products and chemicals

4.2. Types of burns and recommended treatment

Burns may be caused in different ways, and these have different names.
Treatment for the type of burn may vary.

Contact burns

Contact burns are caused by direct contact with open flames, hot liquids, hot surfaces, and sunburn. They are very painful, appear hard and dry, and can vary in severity, although they are usually second or third degree. The symptoms usually take 24-48 hours to appear, and may be hidden by the animal’s fur.

If the burn is caused by flame or an appliance, extinguish the flame or turn off the appliance first.

The ideal treatment is to soak it in cool water for 5-10 minutes.

Dependent on your pet and the location of the injury, this may not be possible. Running cool water over the burn or applying a clean towel dipped in cold water as a compress are alternatives. Be careful not to burst any blisters. If necessary, muzzle your pet to avoid being bitten.

Electrical burns

The most common cause of electrical burns is pets chewing on live electric cables. For this reason, electrical burns are most commonly seen in the mouth area, including the lips, tongue, gums, and palate. It is also the reason that dogs, especially puppies, are most likely to suffer an electrical burn.

Electrical burns can be identified by a main area of necrosis (dead tissue), surrounded by a wider area of tissue damage. The size of the area of dead tissue will depend upon the severity of the burn.

Extra care must be taken when going to the aid of a pet that has suffered an electrical burn. The animal may still be in contact with the live wire, and touching them would result in a shock to the owner.

The owner should immediately switch off the current or, if not possible, find a non-conductive item, such as a broomstick, to move the cable away from the pet.

As an electric shock can cause significant harm, and may even be fatal, owners should begin by checking their pet’s breathing and heartbeat. Try to drop some cool water into your dog’s mouth before wrapping them in a blanket and taking them immediately to the vet.

Chemical burns

A pet may suffer chemical burns if it comes into contact with a corrosive substance. They are usually categorised as second or third degree burns, with third degree the most common.

As chemical burns are often necrotic (leading to tissue death), and erosive in nature, it may take up to 48 hours for the burn to fully develop. Where a pet has thick or long hair, it may be difficult to spot the injury.

It is important to try to ascertain what chemical has caused the burn. Burns caused by an acid can be treated with a solution of baking soda. A vinegar dilution can be used for alkaline burns.

Begin treatment by flushing the area with warm water. It is a sensible precaution to also wash around the burn. If the chemical that caused the burn is a dry substance, make sure that all of it is carefully brushed away, and disposed of. Be careful to ensure that you protect both your eyes, nose and mouth, and those of your pet.

Do not apply ice, butter, or oil to the wound. If your pet needs veterinary attention, try to take the chemical’s container with you.

Sunburn

It may seem odd that creatures covered in fur can suffer sunburn, but it is not unusual in dogs that have certain characteristics: dogs with white fur, as they usually have fair skin underneath; dogs with thin hair, or ones that have had their coats shorn; and hairless breeds. Certain areas of animals are vulnerable to burn, such as noses, especially if they are pink, ears, and underneath the belly.

As with humans, sunburn is caused by prolonged exposure to the sun. While painful, it is usually classed as first degree, and is not life threatening. Owners may not spot it, but it does usually heal quickly.

Owners can take preventative steps to minimise the likelihood of sunburn, by keeping their pets away from exposure to sunlight.

Sun screen is available for dogs. If the sun is strong, then owners can apply pet friendly sunscreen, which should contain PABA (Para-amino-benzoic acid), but not zinc. The cream should be liberally applied to vulnerable areas.

Radiation burns

Radiation burns are very rare, but may be suffered by animals going through radiation therapy for certain cancers. The tissue damage caused by radiation can slow down wound healing. Such burns may be classed in severity anywhere from first to fourth degree.

Radiation burns may not be visible to the eye, but may be indicated by changes in your pet’s behaviour.

A bad odour may become apparent, caused by necrotic fluid. This may require debridement, which often reveals a deeper wound beneath that is likely to require extended care and attention.

4.3 Smoke inhalation

If your pet is exposed to a fire, he may suffer from smoke inhalation. Smoke inhalation affects the respiratory system, and can damage the respiratory tract. In addition, it can result in carbon monoxide toxicity, known as hypoxia. Carbon monoxide competes with oxygen for space in red blood cells, reducing the oxygen in the pet’s body.

In addition to normal fires, your pet can be exposed to enough smoke to harm them through inhaling noxious fumes from burning rubber, plastic, or other synthetic substances. These substances can release carbon monoxide and dioxide; particulate matter; and cyanide, all of which can cause lung damage.

Signs that can indicate smoke inhalation include:

• Breathlessness or open-mouthed breathing (especially in cats)
• Swelling, burns, or inflammation of the eyes, mouth or skin
• Visible skin or ocular burns
• Weakness or lethargy, especially when walking
• Distinct odour of smoke in the fur or on the skin
• Squinting
• Seizures
• Foaming at the mouth

The first action an owner should take is to remove the pet from the situation and get them into clean air. A wet towel wrapped around the eyes and nose can help to reduce the inhalation of noxious substances, while placing them near to a humidifier can help to increase moisture levels in the lungs.

Smoke and carbon monoxide detectors will help to ensure that everyone in the household gets out safely in the event of an emergency. Knowing where your pets like to hide when they are frightened and need comforting is also useful, as pets often become very scared of fire and smoke. Being able to locate them quickly will speed up the evacuation.

4.4 Choking

Pets can choke on a number of common items. These include bits of toys, bones, balls that are too small, or any foreign object that they may pick up. Choking happens when the object becomes lodged in the respiratory channel. It is a serious emergency and pet owners need to react immediately.

The following signs may indicate that your pet is choking:

• Sudden difficulty in breathing
• Pawing at the mouth
• Rubbing their faces on the ground
• Bulging eyes
• Bluish colour of the lips and tongue
• Making retching, gagging or choking sounds
• Agitation and distress

If you can lift your pet

If the owner is able to physically lift the pet, they may try the following methods to dislodge the obstruction, in this order:

• Check to see if you can see the object. If you can, use a pair of tweezers to reach into the throat and pull it out carefully and gently. You may need to use a penlight for clearer visibility. If you cannot see an object, do not put anything in the throat, as this can cause more damage, or push the obstruction further down the windpipe.
• Hold the dog in a sitting or standing position and give five sharp blows on the back between the shoulder blades. Now, check the mouth again and sweep your fingers from side to side to see if the object has been dislodged.
• Place two fingers under the Adam’s apple of the animal and pull upward gently in order to dislodge the object (this process is called ‘milking’). This is the best option for something rounded, such as a small ball or rounded rawhide chew.
• Pull the dog toward you so that his spine is resting on your chest. Place both hands under the waistline of your pet, under the last rib, and clench your hands together to form a fist. Now perform what is known as ‘abdominal thrusts’ or Heimlich manoeuvre by pulling your fist in and upward about five times, using quick and firm movements. This method should be used only when necessary, as it can cause trauma to the ribs.
• If the object is still not dislodged, lift your dog and hang him with his head pointed downwards. Check the mouth again to see if the offending object has been dislodged.

If you cannot lift your pet

If you have a larger dog, you may not be able to lift them. If this is the case, you can follow these steps:

• Place your dog in a standing position. Stand behind the dog so that you are bending over them and wrap your hands under his ribcage. Make a fist with one hand and wrap your other hand over the fist.
• Give five sharp abdominal thrusts to the dog, as described above. Sweep your fingers in the dog’s mouth to check if the object has been dislodged. If the object is still not dislodged, then follow the next step.
• Place your hands behind the dog’s hind legs and raise him so that his head hangs down towards the floor. Again, sweep your fingers from side to side in the mouth, checking to see if the object has been dislodged.
• Hold your dog in a standing position (you may require two people to execute this step) and give five sharp blows between the shoulder blades.
• If the pet is unconscious, lay it on its side, with the legs pointing towards you. Place both hands flat, one on top of the other, palms down, just below the last rib. With a firm movement, push downwards five times.

Whatever the size of the dog, repeat the above relevant steps until the item is dislodged. Once it is removed, perform a check known as ABC – airways, breathing, circulation. This means checking that the animal is breathing and, if not, checking for a pulse. If your animal is unresponsive, you may need to perform CPR, which is covered in detail later in this module.

It is always best to consult a vet once the immediate danger is over, as choking can cause trauma to the throat and chest. The cause of the blockage should be taken with you to the consultation.

4.5 Shock

Shock is a medical condition caused by insufficient blood flow and oxygen to vital organs. Without adequate blood flow and volume, the heart cannot continue beating, and the organs will be damaged. When shock occurs, the body attempts to manage it by restricting the blood vessels (to reduce fluid waste), making the heart beat faster, and reducing urine output. The body will continue to react this way unless treated, and it is considered a lifethreatening condition.

Common causes of shock include:

• Trauma caused by accidents, such as being hit by a car
• Fights with other dog
• Choking
• Allergic reactions to food, insect stings, etc., called ‘anaphylactic shock.’
• The onset of life threatening infections, also known as ‘septic shock’
• Damage to the nervous system, known as ‘neurogenic shock’
• Prolonged diarrhoea and vomiting and consequent dehydration, leading to low blood volume, which is referred to as ‘hypoglycaemic shock’

Signs and symptoms of shock

The following signs can indicate the early stages of shock:

• Rapid heart beat
• Anxious or agitated
• Bright red gums
• Shallow breathing
• Pulse is still easy to find

Middle stages of shock

These signs indicate the middle stages of shock:

• Heartbeat rises further
• Gums turn pale or blue
• Pulse becomes difficult to find
• Dog sinks into lethargy, seems weak
• Respiration usually becomes rapid and shallow (although it may remain normal)
• Low rectal temperature (however, it may elevate or remain unchanged)

Late stages of shock

These signs indicate the late stages of shock:

• Gums seem almost white or may be mottled
• Heart rate normally elevates or appears irregular, but may remain normal or below normal as the dog’s heart muscle starts to fail
• A weak pulse, difficult, if not impossible, to locate
• Change in respiration: may be slow and shallow or rapid and deep
• The eyes appear to glaze over and become unfocused
• The dog slips from lethargy to stupor to coma
• Rectal temperature drops to a critical low (below 99 degrees Fahrenheit / 32 degrees Celsius)

How to administer first aid for shock

Follow these steps:

• Position the dog so that the head is slightly lower than the rest of the body. This will facilitate blood flow.
• Keep the dog as quiet and relaxed as possible.
• Check the airways for foreign objects, blood, mucus or vomit, and clear if necessary
• Stop the bleeding, using the techniques described in Module 3
• Cover the pet in a blanket to prevent heat loss from the body
• If the dog is not breathing, administer artificial respiration (described later in the module)
• If there is no heartbeat, administer CPR
• Take your pet to the vet as soon as possible

What not to do

There are a number of things you should not do, as it can delay recovery.

These are listed as follows:

• Do not allow the dog to move around. Unnecessary movement can increase internal bleeding, and the movement will cause blood flow to the muscles, leading to a loss of valuable body energy. This can prove fatal to a pet who is suffering from shock.
• Avoid the use of a heating pad, as it could cause burns. It could also result in dilation of blood vessels, which would lead to increased blood flow from an already weakened cardiovascular system.
• Do not allow the dog to have water or food. These could cause asphyxiation (lack of oxygen supply), which again could prove fatal.
• Do not administer any medication, unless advised to do so by your vet.
• Use a muzzle only if absolutely necessary, as this could impair breathing.

4.6 Artificial Respiration and CPR (Cardiopulmonary Resuscitation)

Artificial respiration is the act of assisting your pet breather, or stimulating its breathing.

It is also known as mouth-to-mouth resuscitation.

A range of incidents may cause your pet to stop breathing including accidents, injuries, choking, and drowning. It usually happens before cardiac arrest, as the lack of oxygen causes heart failure, leading to death. In the absence of a heartbeat, chest compressions must be administered to keep blood flowing and the heart pumping.

CPR or Cardiopulmonary Respiration is the administration of chest compressions and artificial respiration in tandem with each other. Timely application of CPR has the potential to save your pet’s life.

Before beginning artificial respiration or CPR, undertake the ABC check:

• Airways – use your fingers to check for obstructions in the windpipe. For long-nosed dogs, a torch may be needed.
• Breathing – check for the rise and fall of the chest.
• Circulation – check for pulse or heartbeat.

4.7 Artificial respiration

If your pet has a heartbeat but is not breathing, artificial respiration, also known as rescue breathing, should be performed.

Use this method:

• Lay your pet on a firm, flat surface, preferably on its right side.
• Lift the chin so that the throat is straightened upward. Check the airway to verify that it is clear of foreign objects. Sweep your fingers, very gently, from side to side inside his mouth to feel for mucous, blood or foreign objects. Remove if there is anything; remove it using your fingers, tweezers or pliers.
• Ensure that breathing has indeed stopped by watching the ribs, or placing your palms on the side of them to feel for movement. Alternatively, feel for breath on your hand or face. Inadequate oxygen supply may result in the appearance of bluish gums.
• If there is no breathing, feel for a pulse in the femoral artery, as described in Module 3. If you are unable to detect a pulse within 10-15 seconds, begin CPR, as described in the following section. If there is a pulse, complete the following steps.
• Keeping the chin lifted so that the throat is straightened, close the mouth tightly shut so that the tongue is inside. Leaning down to the dog, cover the nose with your mouth, inhale, then blow slowly and softly into its nose as you exhale. Blow just hard enough to cause the chest to rise. Larger dogs will require you to breathe harder.
• Wait until the air has been expelled and the chest has deflated before you blow again.
• Administer gentle breaths roughly every three seconds so that you blow 20 breaths every minute. Continue to do this until the dog is able to breathe on its own.
• Make sure that you continue to check for a heartbeat.

When administering artificial respiration, owners should carefully monitor how much the chest rises. If it inflates too much, it can cause damage. If the chest does not rise, there may be a blockage in the windpipe.

4.8 Administration of CPR

CPR should be administered only if there is no heartbeat, as it can cause trauma to the chest and ribs.

CPR is designed to keep blood moving around the body, so that the brain and vital organs continue to receive oxygen. It is far easier to perform if there are two people. Where there are two people, one should provide artificial respiration, while the other performs chest compressions.

CPR for medium to large animals (over 30 pounds)

Technique is as follows:

• Lay the animal on its right side on a firm, flat surface. Position yourself behind the pet with their legs pointing away from you.
• Place one hand over the widest part of the rib cage but not over the heart. This will be slightly behind the level of the dog’s elbow. Place your other hand on top, with fingers interlocked or cupped. Your elbows should be straight and keep your body over the pet for added power.
• Push down firmly, using your entire top half. The speed should be 100-120 compressions per minute, or around the tempo of the Bee Gee’s hit Staying Alive. The compressions should go to a depth of one third to one half of the chest.
• Administer thirty chest compressions, and then give two rescue breaths as above.
• When administering breaths, ensure that the head and neck are still straight and extended. Observe to see if you are able to notice the chest rising and falling. If not, check for blockages again.
• Continue this pattern, checking for signs of life every two minutes.

CPR for smaller animals

The technique for administering CPR to smaller animals is slightly different:

• Place the animal on a flat, firm surface on its right side, and position yourself behind them.
• Place one hand underneath the dog, and one hand on top; around the chest area. For puppies and kittens, wrap your hands around the ribs, with the thumbs on top.
• Now squeeze both hands, pressing down to about one inch. Squeeze and release in a rhythmic pattern at a speed of 100-120 compressions per minute, and perform thirty chest compressions followed by two rescue breaths, as for larger animals.
• Continue, checking for signs of life every two minutes.

Any pets that have required resuscitation must be taken to the vet’s for a check-up.

4.9 Understanding how your pet communicates to help identify potential problems

It is easy to dismiss unusually poor behaviour as naughtiness. However, it can be a sign that your animal is suffering from something that requires medical attention. Knowing your pet and their normal personality and characteristics helps you to form a closer bond, and identify when there may be a problem.

Simple things, such as a change in facial expressions, body posture, physical responses, eating, or toileting can indicate the onset of medical problems.

For example
If your naturally boisterous Labrador retriever suddenly becomes quiet and lethargic, you may need to take a closer look.

The following changes in behaviour can indicate underlying problems:

Aggressive behaviour

Pain and discomfort can lead to aggression.

For example
Your pet is unable to get away from a younger animal that wants to play, or because they are anxious or nervous about being handled or moved.

This is particularly likely where the pain is ongoing and constant, such as arthritis, or undiagnosed dental problems.

Changes in toileting habits

Pets that have been fully housetrained and clean for years may suddenly begin having accidents in the house. Conditions that cause mobility problems, such as arthritis or hip dysplasia, can result in an inability to reach their toileting area quickly enough. Rectal muscles can become weak, leading to accidental defecation when trying to stand up. Bowel disease, hormonal incontinence, or diabetes can also cause problems with controlling bladder or bowel movements. Kidney or liver problems, which can cause a build-up of toxins, may change frequency.

Owners should also observe their pet’s posture when they are toileting. Some animals have peculiar methods normally

For example
Some female dogs will also raise a leg when urinating

So understanding what is normal for your pet, is important. Sudden changes may indicate a muscular or skeletal problem.

Decrease in response to sights, sounds and stimuli

This could indicate a problem with eyesight or hearing, which is frequent in older animals as it is in humans.

Increase in barking, howling or growling

As dogs are unable to explain that there is a problem, they may try to communicate by becoming more vocal than usual. If they are unable to move freely, they may indicate this by barking or howling, to attract their owner’s attention and try to summon them.

Nocturnal restlessness or pacing

A need to toilet, pain, or a loss of cognitive function (such as dementia), can cause pets to become restless at night. Other reasons may include appetite changes, loss of sensory perception, or neurological problems.

Well Done!