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Heat Stroke in Dogs - From the Doctors’ Files
By Trevor W. Ashley, DVM
Theo's Heat Stroke
It was a busy Tuesday evening. It had been a sunny day, with a high of 85 degrees, so I was looking forward to heading home. Wouldn't you know it - an emergency walked in.
The owners were in exam room 2 filling out new client forms and thought their pet was having heat stroke because it had happened before. I immediately went in to check on the patient. “Theo” was a 73 lb, 3-year-old, neutered, male English Bulldog. He was in obvious respiratory distress, his skin color was bluish and he was lying down. After a quick evaluation, I had the owners rush him back to our surgery room to be put on oxygen.
Theo’s rectal temperature was rising quickly - to over 105 degrees. We put Isopropyl (rubbing) alcohol on the pads of all four of his paws and got some cold wet towels to dampen the pet's coat. I measured Theo’s oxygen saturation and determined it to be less than 75%. Due to his severe brachycephalic airway syndrome - a condition in short faced breeds which includes narrowed nostrils, elongated soft palate and a narrow windpipe - even with 100% oxygen provided, he was still blue and in obvious respiratory distress. I tranquilized/sedated him in order to get more oxygen in. I gave him Diazepam and Torbugesic. Fairly quickly the drugs began to take effect and he became much more sedated than is typical for this drug combination. I put a tube in his airway and continued monitoring his pulse ox.
We placed an IV catheter to begin IV fluids while we drew a blood sample to check a blood cell count, electrolyte level and internal organ function (all were within normal limits). After setting up our secondary anesthesia cart in the treatment area, we transferred Theo to the dental sink to continue trying to cool him down with cold water. Often there is the urge to use ice to cool down a pet quickly, however, it should be avoided because it can make it more difficult for the patient to cool down and can cause shivering which actually creates heat by the muscles.
At this time, I was able to connect the pet to an electrocardiogram. The EKG showed extra abnormal heartbeats. I administered Lidocaine and the problem resolved. However, Theo also had a significant slow heart beat. I gave him Atropine and his heart rate increased and stabilized.
Once Theo’s temperature reached 103 degrees, we began drying him. Often these patients will lose too much heat and their core body temperature drops. By this time, the pet's oxygen saturation had been holding steady, the EKG abnormalities had resolved and the sedatives should have been wearing off. But Theo remained unconscious. We attempted to stimulate him and we got some response, but still somewhat diminished.
Since it was past our closing time and Theo was stabilized, I recommended transfer to a local emergency clinic for continued observation overnight. Other possible complications of heat stroke include blood clotting problems, seizures, and an excess accumulation of water in the brain. I was concerned about his delayed recovery from sedation.
After another 30 to 45 minutes, Theo started chewing on the tube and began standing. I removed the tube and after making sure that his respiratory distress did not return, I discharged him to his owner for transfer to the emergency clinic.
While I was stabilizing Theo and treating him, the owners informed me that this had happened previously. They lived in Long Island, N.Y., and had a home in Orlando, Fla., where they had travelled to one week prior in their car. Their regular veterinarian had prescribed Acepromazine for the trip. On the way down they had given it prior to getting in the car and Theo had done fine. They forgot to administer it on the trip back north and Theo had become agitated and wound up like he did when he came to us.
I advised them that this is a common problem in the breed due to the airway syndrome and informed them that there are surgical procedures that can help correct the problem with upper airway obstruction that might help prevent respiratory distress in this pet in the future. They were very appreciative.
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