Coagulation evaluation including prothrombin time, partial thromboplastin time, platelet count and fibrin split products concentration
should be obtained at presentation and as indicated during therapy. Prolonged coagulation tests, decreased platelet count
and increased fibrin split products suggest disseminated intravascular coagulation. Therapy for disseminated intravascular
coagulation is controversial. Removal of the underlying cause is essential. Symptomatic therapy may include fresh frozen plasma
intravenously and low-dose heparin therapy (100 IU/kg q 4-6 hours) subcutaneously. Alternatively, 20 IU/kg body weight of
heparin incubated with fresh frozen plasma may be administered.
Direct thermal damage and poor visceral perfusion may result in gastrointestinal mucosal sloughing and ulceration. This results
in vomiting and diarrhea that may or may not be bloody. Sucralfate (if vomiting is not present) and H2 blockers will help
treat gastric ulceration. Breakdown of the mucosal barrier may result in bacteremia or endotoxemia. Broad-spectrum antibiotics
should be considered in severely affected animals with severe bloody diarrhea. Small intestinal intussusceptions may develop
in some dogs with heat stroke.
The degree of compromise depends upon the prior physical health of the dog and the degree and duration of the heat insult.
Dogs with multi-organ dysfunction or severe CNS disturbance warrant a more guarded prognosis. Alternatively, some dogs with
severe CNS disturbance, disseminated intravascular coagulation and other organ dysfunction may live without any residual problems.
Severe heat-induced illness is challenging to treat, but with aggressive medical therapy many dogs may respond and do well.
What's your question? Send your pediatric/geriatric related questions to: Pediatric/Geriatric Protocol, DVM Newsmagazine, 7500 Old Oak Blvd., Cleveland, OH 44130. Your questions will be answered by Dr. Hoskins in upcoming columns.
Dr. Hoskins is owner of DocuTech Services. He is a diplomate of the American College of Veterinary Internal Medicine with
specialities in small animal pediatrics. He can be reached at (225) 955-3252, fax: (214) 242-2200, or e-mail: