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EQUINE VETERINARY EDUCATION / AE / APRIL 2018
Day 10
Day 28
6 months
Day 8
Day 28
6 months
Fig 7: Case 2: Coronary band/hoof wall separation over time.
focused on barn fires. For example, significant issues at the scene of the fire, such as lack of water and infrastructure, meant we did not have facilities to cool the limbs. Also, a local human burn specialist we consulted following the fire suggested that we apply SSD cream to the burned skin and wrap the legs with cling wrap for the initial immediate treatment to preserve the skin and reduce contamination (J.E. Greenwood, personal communication 2015). Our initial treatment of i.v. fluid therapy could have been
started as soon as the horses arrived at the clinic, but this was in the middle of the night and we were limited at that stage with personnel and had to concentrate on getting the horses accommodated. We were surprised to see that even the worst of the horses were eating and drinking. Having had a previous experience from a fire where no horses were burned, but many horses got post-stress colic from transportation out of the path of the fire, we only offered small amounts of food for the first 2 days. It was only later that day we realised that many of the horse’s injuries were worse than initially thought. The extent of burns on the horses was far greater than
the predicted survival rate in the literature (Hanson et al. 2013). On a visit to see the horses, the human burn specialist suggested that the classification of the wounds on these two horses’ extremities would be deep second and third degree burns in many areas. He expected we would be doing skin grafts to achieve final resolution. This was not
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the case which might highlight potential differences in classification of burns in man. Our criteria for euthanasia were uncontrollable pain and loss of appetite. Despite the extent and depth of burns and intravascular haemolysis in the peripheral tissue, Case 1 did not stop eating and was very vocal in the morning when food was distributed. Only one horse showed any respiratory signs from smoke inhalation, which resolved in 24 h. While we heard of horses with respiratory compromise from this fire, we ourselves did not see any. In comparing cases from another interstate practice with a similar fire 1 month following this fire, they found it was rare to have respiratory compromise. Perhaps, this is due to a fast-moving fire and strong winds that sweep away smoke and ash. Current published literature suggests that infection can
be a significant problem (Geor and Ames 1991; Kemper et al. 1993; Marsh 2007). We found that infections were only problematic if the horse had significant penetrating wounds, such as in Case 2, and that SSD cream and honey were both satisfactory for dressing the legs. However, SSD cream has somewhat fallen out of favour in the human burn literature because SSD has been shown to slow down healing (Al-Waili 2004; Malik et al. 2010; Bischofberger et al. 2011; Heyneman et al. 2016). The use of Acticoat dressing antimicrobial bandages did allow us to increase the interval between dressing changes, but because we did not experience significant infections, the
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