Pet First Aid Module 6

Home Care and Treatment for Hypothermia, Drowning and Bites

In this module you will learn:

Treating hypothermia

Signs, symptoms and treatment of frostbite

First aid and preventative care for drowning and near drowning

Infection and abscesses

Insect, snake bites and bee stings

Bloat in dogs

Because pets have fur coats, it is easy to assume that they are protected from the harsh effects of winter. However, this is not true. While some breeds, such as huskies, St Bernard, and Malamutes were bred to grow thick coats that were suited to the cold environments they lived in, most types of dog were not. Hypothermia can be caused by prolonged exposure to wet or cold conditions, snow and sleet, and some need additional help to stay warm in cold weather.

Frostbite is another risk in cold weather. This very painful condition can, in extreme cases, result in the loss of limbs. Knowing the signs and how to respond promptly and effectively can save pets with frostbite or hypothermia.

Dogs have a natural instinct to swim, and many enjoy it. However, pet owners should always be vigilant when around bodies of water, such as ponds, lakes, and swimming pools, as dogs can drown, or experience near-drowning. Near-drowning happens when water enters the lungs but the pet survives.

Even when a pet seems fine after an incident, if there is a suspicion that they have inhaled water, medical treatment should be sought. The signs of water inhalation may only appear a few days later, and will have already caused damage. Infection can lead to abscesses. Abscesses, or sacs of pus, dead skin, and white blood cells, are formed when bacteria festers under the skin, but is unable to escape. They are extremely painful and, if left untreated, can lead to a much more serious infection, such as sepsis. Abscesses can be the result of bites or scratches, and so any injuries from fighting must be taken seriously.

While in the UK there are few dangerous animals, insect bites and stings can be painful and irritating, and, in some cases, lead to dangerous conditions such as Lyme disease and heartworm. Owners should be aware of how to handle bites and stings from different insects. Adder bites are uncommon in the UK, but can still happen. While they rarely cause serious injury in humans, in dogs they can easily become fatal, and should be treated by a vet as soon as possible.

Bloat may sound harmless, but it is one of the most dangerous conditions that a dog can experience that is not related to an accident. There is nothing that an owner can do to treat the problem, and the only option is to rush the dog to the vet’s.

6.1 Hypothermia

Despite the protection of fur, dogs, as well as other pets, are vulnerable to drops in body temperature in extremely cold weather conditions.

Known as hypothermia, this abnormal drop interferes with the functioning of the body. The cold body temperature disrupts the flow of blood, and can lead to organ failure and, eventually, death.

The severity of the effects of hypothermia, and the chances of full recovery, depend upon the extent to which the temperature drops. If the rectal temperature falls below 82 degrees Fahrenheit (28 degrees Celsius), it may be that normal body function is never regained. The treatment for hypothermia is the application of heat externally to raise the core temperature.

Causes and symptoms of hypothermia

Hypothermia is more commonly seen in dogs that are small or short-haired, and puppies and older dogs, as they are less able to retain heat. In these cases, using dog coats or clothes, and boots, can help prevent hypothermia occurring.

Common causes of hypothermia include:

• Prolonged exposure to cold, freezing conditions
• Submersion in cold water
• Wet fur or skin in colder weather
• Shock
• Anaesthesia
• Hypothyroidism
• Diseases affecting the hypothalamus

Symptoms of hypothermia:

• Shivering
• Lethargy and weakness
• Slow, weak pulse
• Difficulty breathing
• Gums may appear pale and bluish in colour
• Fixed and dilated pupils accompanied by stiff muscles
• Unconsciousness

First aid for pets suffering from hypothermia

For mild hypothermia (90-99 degrees Fahrenheit, or 32-35 degrees Celsius):

• Move the pet to a warm, dry area immediately. Lay them on a blanket, bed or other warm surface to prevent them having contact with cold floors.
• Place a blanket on the radiator or clothes dryer to warm them before wrapping your pet in them. Be careful not to overheat the blanket, to prevent burning.
• Apply an insulated heat pack (wrapped in a towel) to body areas which are prone to heat loss including the head, neck and legs.
• If the pet is wet, use a hair dryer on the lowest setting.
• Offer them warm fluids to drink, sweetened with honey or sugar. Add two tablespoons to one cup of water.
• Check the body temperature every ten minutes. A temperature below 98 degrees Fahrenheit (3degrees Celsius) requires professional attention. Once the temperature is above 100 degrees Fahrenheit, or 37.8 degrees Celsius, remove the heat packs.
• If the pet is observed to be mildly hypothermic, pet parents can give it a short, warm water bath. If your pet is going to be transported to the vet, do not bath them, as this will cause them to lose more body heat.

For moderate hypothermia (82-90 degrees Fahrenheit, or 28-32 degrees Celsius), in addition to the above, place hot water bottles or heat pads, wrapped in towels, on areas of the body with less fur

For example
The armpits or groin.
Fur can act as an insulator and prevent heat from reaching the body.

Pets with severe hypothermia (below 82 degrees Fahrenheit, or 28 degrees Celsius), may need immediate administration of intravenous warm fluids, warm water enemas, and oxygen. As the pet recovers and begins to warm up, they may experience pain and may also attempt to bite at the painful areas.

If the pet stops breathing before it reaches the vet, owners will need to administer CPR, as described in Module 3.

However, CPR is unlikely to be successful in certain circumstances:

• If the pet has been under water for a period of more than one hour
• There is a formation of ice in the airway
• The chest wall is stiff and does not respond to compression
• If the body core temperature has dipped below 60°F

Precautions when treating hypothermia

Take the following steps:

• Avoid placing hot items directly on the skin or fur. Make sure that they are wrapped in a towel or something similar.
• Any fluids given must be warm.
• Do not put a severely hypothermic dog animal in a warm bath.
• Do not administer any drugs; the liver and kidney functions are weakened, and so unable to process the medication. Toxins will accumulate in the body as it warms.
• Even if your pet seems to be beyond resuscitation, this may not be the case. Seek immediate medical attention, and it is possible that your pet could recover.

6.2 Frostbite

Even a thick coat of fur is sometimes not enough to stop frostbite. Frostbite may appear alongside hypothermia, or may not, but is also caused by very cold temperatures. It usually affects the extremities of the body, such as toes, paws, ears, nose, tail, and scrotum. This is because, in cold weather, the body protects its core temperature and vital organs by reducing the blood flow to the extremities, to prevent heat loss. When the blood vessels constrict, this lack of warm blood can cause the tissues to freeze and die. The severity of frostbite will vary dependent on the length of exposure.

Signs of frostbite

Frostbite itself can look very similar to a burn initially, before becoming black and brittle.

As obvious signs of frostbite may take several days to appear, other symptoms that can indicate frostbite include:

• Shivering or shaking (to try to generate heat)
• Ice on parts of the body
• A pale, grey, or bluish discolouration of the skin, caused by lack of blood circulation
• Pain when touched
• Coldness or brittleness in the area
• Swelling
• Blisters or skin ulcers
• Areas of blackened or dead skin
• A foul smell or pus discharge due to secondary, bacterial infections.

Blisters, ulcers, pain and swelling are typical signs of second degree frostbite. Third degree frostbite may be indicated by the swelling, scaling, or peeling of the skin accompanied by a red colour, after first aid treatment is provided. At this stage, there will be obvious demarcation between the discoloured and dead tissue, and the healthy tissue.

First aid for frostbite

Owners should consider muzzling their pet. This will prevent it licking the wound. Do not rub or massage the affected area as this can release toxins into the bloodstream.

Take the following steps:

• Move your pet to a warm, dry area. Do not treat the frostbitten area until you are able to do so, as the tissues may refreeze, which will cause more damage.
• If your dog has hypothermia or a depressed core body temperature, treat this first, as described above.
• Wash the affected area with water that has a temperature of 104-108 degrees Fahrenheit (40-42 degrees Celsius). If you do not have a thermometer, ensure that you are able to comfortably place your hand in the water. Water that is too hot could cause more injury. You may apply the water using compresses, or soak the affected area in a bowl of warm water.
• Pat dry with a warm towel, making sure that it is completely dry.
• Wrap the pet in a warm blanket or towels for transporting to the vet.

Important don’ts for treating frostbite

• Do not use a hair dryer or dry heat on the skin. This can burn and cause further injury.
• Do not give the dog any painkillers or other medication, unless advised by your vet.
• Do not overheat your car during the journey to the vet’s.

6.3 Winter care for your dog

Prevention is better than cure. These simple tips will help to ensure that your pet avoids painful and dangerous conditions:

• Do not allow your dog to spend too much time outdoors in freezing weather.
• If they are outside, put blankets or mats down so that they are not lying directly on the ground.
• Dress them in jumpers or coats, and consider buying them protective boots.
• Ensure that they have enough food. In cold weather, they will use more energy to stay warm.
• If your pet has sore paws, try washing them after walks, as chemicals used to thaw ice and snow may be irritating them. You can also use a paw balm to prevent them becoming dry and sore.
• Keep them out of winter storms.

Owners may wish to ensure that they are prepared for any severe weather.

They will require the following:

• A complete first aid kit, as detailed in Module 1.
• An adequate supply of dry and canned food.
• Torch and replacement batteries, kept in a safe, easily accessible place.
• Adequate supplies of any prescribed medications.
• Contact numbers at hand for your veterinary clinic, that of the closest clinic, and an after-hours clinic.
• Clean water.
• Clean litter trays and bedding for cats and smaller pets.

6.4 How to respond, and provide first aid for drowning and near drowning

While dogs have a natural swimming instinct, and many enjoy swimming, they can also drown.

If the dog survives it may experience near-drowning, which is when the pet becomes unconscious due to lack of oxygen, and their organs start to shut down.

Common causes of drowning include:

• Exhaustion
• Inability to climb out of the water, for example, due to steep bath sides
• Falling through ice and becoming trapped underneath
• Strong undercurrents
• Underwater obstructions
• Becoming trapped under a swimming pool cover

Puppies, older dogs, and certain breeds such as Pekingese, dachshunds, bulldogs and pugs, are more susceptible to drowning. Dogs who suffer from health conditions such as blindness, arthritis, and seizures are also more at risk.

First aid for drowning and near-drowning

The first step is to remove the animal from the water. This may not be easy, and should not be attempted if it will put you in danger too. This is particularly important if the situation involves thin ice or strong undercurrents.

If your pet is conscious, it may not be clear if it needs first aid.

Signs that it does are:

• Pale, colourless gums, eyelids, and skin
• Abdominal swelling
• Coughing
• Breathing problems
• Vomiting

If the pet is unconscious, urgent first aid is required.

Steps to follow:

• If the pet is small enough, hold it by its back legs, and give it 3-4 firm downward shakes. This is to drain the water from its lungs.
• If the pet is too large to pick up, lay it on its side, with the head lower than the body. Place the heel of the hand on his side, in the dip behind the last rib. Give 3-4 thrusts in a forward direction, in a modified Heimlich manoeuvre. Wait for a few seconds to allow the water to escape, then repeat.
• This will often restart the breathing process but, if the lungs appear to have cleared of water, and your dog is still unresponsive, check for a pulse and start CPR or rescue breathing as appropriate, as detailed in Module 4.

If no water is expelled, it could be that your dog is experiencing dry drowning.

Dry drowning is when the respiratory muscles become paralysed, often through fear, or triggered by cold. There is no water in the lungs, but the pet is still unable to breathe.

As with above, check for a pulse and perform rescue breathing or CPR as required.

Once your pet is breathing again, it must be taken to a vet for further treatment and evaluation.

Near-drowning

As mentioned above, near-drowning is when water is inhaled into the lungs to the extent that it affects the flow of oxygen to the brain, and causes carbon dioxide to build up in the body.

While your pet may seem to be fine once the water has been expelled from its lungs, it is vulnerable to several health risks, including:

• Pneumonia, caused by contaminated water or vomit entering the lungs.
• Pulmonary oedema (when the air sacs in the lungs fill with fluid, preventing oxygen entering the bloodstream), or atelectasis (lung collapse), caused by water lodged in the lungs.
• Cerebral oedema due to lack of oxygen. This can present as disorientation, seizures, and coma.
• Spasms of the larynx, leading to suffocation.
• Shock or coma.

Your pet should be checked by a vet anyway, but especially if they start coughing or having breathing problems. This may be accompanied by their lips turning blue or purple, or fluid coming from the nose or mouth. In later stages, loss of consciousness may occur, and vital signs may be affected. It can take up to three days for these symptoms to appear.

6.5 Infection and Abscesses

An abscess is a collection of pus usually caused by a bacterial infection. They feel squishy and hot, and occur when bacteria enters the body and is attacked by the white blood cells. Some of the tissue dies and creates a hole, which then fills with a mixture of dead tissue, white blood cells and the bacteria. Abscesses can develop anywhere in the body, including in and between organs.

Bites, puncture wounds, skin abrasions, and scratches from fights are common causes of infections and abscesses. This is because animals carry bacteria under their claws and in their mouths. Cats are more prone to abscesses as they more independent, and owners may not be aware that they have been in a fight or have injured themselves. Unneutered pets can be more aggressive than those that have been neutered, and so can be more likely to fight.

Abscesses in the mouth may develop due to rotting teeth, which are also infected with bacteria. Ruptured anal abscesses can be misdiagnosed as rectal bleeding.

Abscesses can be extremely painful, and may cause your pet to become withdrawn and depressed. An abscess in the mouth may prevent him from eating as normal. For pets covered in fur, it may be difficult to locate the site.

Typical symptoms of an abscess include:

• Swelling and pain – abscesses harden over time and the wall presses against other tissues and nerves
• Redness
• Hot skin over the abscess
• Hair loss
• Loss of appetite and fever
• Oozing sore with foul smelling discharge
• Limping, if the abscess happens to develop near a limb
• In cases of anal abscesses, pets may drag themselves across the floor to try to relieve the irritation
• A tooth abscess may be indicated by a swelling under the eye

As abscesses get larger, they may rupture, allowing the pus to escape into the bloodstream, and so travel around the body. This can cause wider infection, and even sepsis, a life threatening condition.

Abscesses can resolve on their own, but usually require medical attention.

Prevention and home treatment for abscesses

You can prevent abscesses by:

• Keeping your pet’s teeth clean
• Ensuring that they don’t chew on items that can hurt their mouths, for example, sticks that can splinter
• Cleaning any wounds when they occur. Small wounds can be treated with an antibacterial ointment. Larger wounds should be treated by a vet.

If your dog develops an abscess, it can be treated at home if it does not seem too serious, although it is always advisable to have it checked by a vet.

Home treatment:

• Ensure that your hands are clean, and preferably sterilised with antibacterial hand wash. This will help to prevent spreading the infection.
• Keep the area around the abscess clean. Salt water or antibacterial ointment can be used.
• Apply warm compresses to the area three to four times a day for between five and ten minutes. This will help improve the flow of blood, and so white blood cells, to the area.
• A solution of Epsom salts. This should be boiled and cooled.
• As far as possible, restrict your pet’s movements. While walking it, avoid situations where it is likely to get into a fight with other animals.
• Pet owners can try applying a solution of warm and cooled Epsom salts and water.
• Use a medical cone to prevent your pet from licking or chewing the wound.
• Never attempt to prick or pierce an abscess yourself. This should only be done by a vet.

6.6 Insect bites and bee stings

Pets can be bitten or stung without showing any obvious symptoms. The normal signs of an insect bite are redness, swelling, and itching. However, some pets have more extreme reactions, which can include breathing difficulties, vomiting, anaphylactic shock, and collapse. Dogs with short or thin body hair are more vulnerable to bites and stings, as their coats offer less protection.

First aid treatment for insect bites and bee stings

If your pet is stung, make sure that the sting is not in the wound. If it is, use something like a credit card to scrape it out, keeping the card parallel to the skin surface to prevent the sting being pushed further inside.

A cold compress or ice pack (wrapped in a towel), can be applied to reduce swelling. A solution of baking soda and water can neutralise the acidic venom.

Common insect bites

Flea bites are itchy bumps surrounded by a red halo. It looks like a red welt, and becomes larger if licked or scratched. It may become a blister or a wound after a few days. Flea bites are most commonly found in the head, neck, and tail areas. If left untreated, bites can lead to rashes, allergies, or even anaemia. Owners can identify if their pet has fleas by looking for droppings, which are usually on a dog’s tail or a cat’s back. Flea repellents and regular vacuuming can help prevent infestations.

Tick bites have been covered in Module 2. These must be treated promptly to prevent problems such as Lyme disease.

Mosquito bites cause itching and inflammation. While mosquito bites are usually annoying but harmless, a bite from an infected mosquito can cause heartworm, a potentially fatal infestation of the animal’s body that leads to coughing, breathing difficulties, and vomiting. Fortunately, there has not yet been a reported case of heartworm that has originated in the UK.

There are a number of spiders in the UK that bite, although none are poisonous. The most common is the False Widow spider, which looks similar to the Black Widow Spider. Spider bites leave puncture marks, and can cause redness, swelling, and pain.

Symptoms of insect bites and bee stings:

• Swelling of eyelids, ear flaps and nose
• Swelling of the muzzle and facial area
• Hives or raised, red welts on the skin
• Weakness, muscular pain and fainting
• Unconsciousness

Home treatment

Most bites and stings can be safely treated at home:

• For stings, apply aloe vera gel. It will soothe the pain and burning sensation.
• Apply a cold compress to reduce swelling.
• For bumps and sores, apply a paste of baking soda and water several times a day.
• Irritation can be treated with milk of magnesia, calamine lotion, or hydrocortisone cream. The first two can be applied as frequently as required. The hydrocortisone cream should be applied in accordance with the instructions on the packet.
• A mixture of one teaspoon of Epsom salts to two cups of water (around 470ml) that has been boiled and cooled can be stored in the fridge and dabbed on itchy and irritated paws.

Snake bites

There is only one poisonous snake in the UK: the adder. Although it can be found across the UK, it is more prevalent in the south and south west of England, west Wales, and Scotland. Adders rarely bite and, when they do, it is in direct response to a perceived threat. Adders can be found in all sorts of habitats, but they particularly like open ground, such as moors. They hibernate between October and spring, and re-emerge when the weather is warm enough.

While adder bites are uncomfortable for humans, they can be very serious for dogs. Dogs are most likely to be bitten on the face or front paws and legs, and most cases occur between April and July.

The symptoms of adder bites appear within two hours of being bitten. In all cases, there will be swelling, pain, bruising and bleeding at the injury site.

Two thirds of dogs will experience the following:

• Lethargy
• Fast heartbeat
• Rapid breathing
• Drooling
• Vomiting
• Wobbliness

In around 5 percent of cases, dogs will have severe symptoms, including:

• Breathing problems
• Collapse
• Convulsions
• Kidney failure
• Liver damage
• Blood clotting problems
• Shock
• Abnormal heart rhythm

In the event of a snake bite, owners should:

• Carry their dog, as walking can enable the poison to travel around the system more easily.
• Bathe the wound in cold water to reduce swelling.
• Do not attempt the open the wound up or suck the venom out, as this increases the flow of venom into the body.
• Phone your vet, advise them of the situation, and give them an approximate arrival time.
• Keep the dog calm and warm.

6.7 Bloat

Bloat is technically known as Gastric Dilation and Volvulus, or GDV for short. It can also be referred to as gastric torsion, and is a life threatening condition where the stomach twists and distends with gas. In some cases, it does not twist, but just expands.

Bloat is the most serious medical emergency not caused by trauma that a dog can experience.

GDV is most likely to occur in deep-chested as breeds such German Shepherds, setters, Basset Hounds and Great Danes. It is thought that this is because there is more room for organs to move.

It is unclear what causes GDV. It is thought that it may be due to excess air swallowing when the dog is nervous, or foods that give off gas at an abnormal rate.

Gastric dilation can become fatal within hours due to:

• Inadequate flow of oxygen around the body
• Excessive pressure on other organs
• Breathing difficulties
• Rupture in the stomach wall

Common symptoms of GDV are:

• Restlessness, and discomfort when lying down
• Excessive drooling
• Dry heaving and gagging
• Pale gums
• Rapid heartbeat
• Shortness of breath
• Weakness and collapse

There is no first aid that can be administered for GDV, and dogs should be rushed to the vet’s immediately. Owners can take preventative measures to reduce the risk:

• Large dogs should be fed two to three times a day
• Owners of susceptible breeds should be particularly observant of symptoms
• Avoid strenuous exercise and excitement immediately after a meal
• Keep the feeding bowl at a slightly raised level

Well Done!