HYPOTHERMIA

Mild: 90 to 99F (32 to 35C); weakness, shivering, and lack of mental

alertness.
82 to 90F (28 to 32C); muscle stiffness, low blood pressure, stupor,
and shallow, slow breathing.
Severe: below 82F (28C); fixed and dilated pupils, inaudible
heartbeat, difficulty breathing, and coma.

HYOTHERMIA What to do
If your dogs temperature is below 98F (36.7C), take her to the vet or
emergency care center immediately. Otherwise, you need to raise your dogs
body temperature by applying heat in the following ways:
Warm some blankets on a radiator or in the dryer as quickly as
possible, then wrap your dog in them.
Wrap a hot water bottle in a towel and place it against your dogs
stomach. Do not use an unwrapped bottle, as this may burn your dog.
If your dog is conscious, give her warm fluids to drink.

Heatstroke is defined as a state of extreme hyperthermia (106109 F) resulting in

thermal injury to tissues, which occurs when heat generation exceeds the bodys
ability to dissipate heat.
Pathophysiology

In the initial stages of heat stress, cardiac output increases due to peripheral
vasodilatation and decreased vascular resistance. As hyperthermia progresses,
splanchnic blood pooling occurs and causes a decrease in circulating blood
volume, resulting in hypotension. Cardiac output then starts to decline due to
decreased vascular resistance and hypovolemia. With a decrease in circulating
blood volume, heat loss through the mechanisms of radiation and convection fail,
causing an elevation in body temperature and then heatstroke. Global thermal
injury causes multisystem organ dysfunction; organ damage occurs at temperatures
above 109 F. At these higher temperatures, uncoupling of oxidative
phosphorylation occurs, enzymes are denatured, and cell membrane functions are
distrupted. The coagulation, renal, hepatic, gastrointestinal, and central nervous
systems may all be affected, with mortality rates reported in dogs from 36% to
50%.1,2

What signs will I see?

Panting, sometimes with a rasping noise associated with it

Sweaty feet

Trying to find somewhere cool to lie

Frog-leg position (this is your dog trying to get the bare skin on their tummy
in contact with the cool floor)

Dark pink or red gums

High heart rate or pulse rate

Lethargy

Staggering around

Vomiting or diarrhoea

Your dog may feel warmer than usual when you touch them

TREATMENT
Cooling Methods Methods of cooling include soaking with lukewarm water,
covering the patient with towels soaked with lukewarm water, and placing a fan in
front of patients to maximize heat loss through radiation and convection. Cool- and
cold-water enemas have fallen out of favor, as further constriction of vascular beds
of the gastrointestinal tract can worsen gastrointestinal ischemia and bacterial
translocation.
Fluids & Blood Products In every case of heatstroke, the goal of treatment is to
increase organ perfusion. This is best accomplished through administration of
intravenous fluids. Large doses of crystalloid fluids should be avoided in patients
with altered mentation, as these dogs may be more prone to cerebral edema.
However, cerebral perfusion must be maximized. To achieve perfusion while
preventing tissue edema, both crystalloids and colloids can be used together. The
administration of fresh frozen plasma can help provide needed coagulation factors
in the treatment and prevention of DIC. Many heatstroke patients require multiple
doses of plasma over several days to treat coagulation abnormalities. A dose of 10
to 20 mL/kg/day should be used. PT, aPTT, and platelet levels should be checked
on a daily basis.
Blood Pressure Support Blood pressure should be supported and checked to assure
maximum tissue perfusion. Vasopressors may be necessary in volume-resuscitated
patients to maintain normal blood pressure. Dopamine, norepinephrine,
dobutamine, and vasopressin are examples of medications used to support blood
pressure in hypotensive, volume-resuscitated patients (Table).
Antibiotics If signs of gastrointestinal compromise are present (vomiting,
hemorrhagic diarrhea, ileus), broad-spectrum antibiotics may be administered to
help prevent sepsis from bacterial translocation and may include a combination of
antibiotics effective against gram-positive, A dog with multiple organ failure,
including hepatic and oliguric renal failure, in a semicomatose state secondary to
heatstroke continuesgram-negative, and anaerobic bacteria. Examples include
ampicillin and cefazolin (grampositive and some anaerobes), enrofloxacin (gram-

negative bacteria), and metronidazole (for anaerobes). Nonsteroidal

antiinflammatory drugs and glucocorticoids should be avoided because of the
potential for gastrointestinal ulceration and effects on renal perfusion.
Urine Output Monitoring urine output is important in dogs with signs of oliguria
or anuria accompanied by azotemia. A urinary catheter and closed-collection
system should be placed, and urine should be collected and measured aseptically
every 4 to 6 hours. If oliguria or anuria is present in a volume-resuscitated patient
(urine output < 2 mL/kg/H), diuretics, such as furosemide or mannitol, can be
administered as a constant-rate infusion to help stimulate urine production.
In summary, complications of heatstroke include DIC, acute renal failure, altered
mentation, hepatic failure, and gastrointestinal dysfunction. Mortality ranges from
36% to 50%, highlighting the importance of early, aggressive therapy in dogs
presenting with heatstroke.
FEVER
What Causes a Fever in Dogs?
An infection or inflammation can produce a fever in pets, as their body attempts to
fight it off. They can be internal or external, and include:
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An infected bite, scratch, or cut

Ear infection

Urinary tract infection (UTI)

Infected or abscessed tooth

An ongoing bacterial or viral disease

Infection of organs, such as kidneys or lungs

Ingestion of poisonous materials can also cause fever. These include:

Toxic plants

Antifreeze

Human medications

Human foods that are toxic to dogs, including the artificial sweetener xylitol
Causes of high temperature in dogs can include: Infection The body is designed
to increase in temperature when infection is present. Many bacteria, viruses and
fungi are heat sensitive and cannot survive at the higher body temperature.
Inflammation/allergic response Fever can be associated with these. Toxins
Consuming come poison materials may result in fever. Medication Some
medications may elevate body temperature Vaccination As with infection, the
bodys immune system will often respond to vaccination with a low grade fever.
This fever may last up to 48 hours after vaccination. Fever of Unknown Origin
Sometimes the cause of fever cannot be determined. This is often the case with
immune system abnormalities, blood and bone marrow disorders and cancer.

Here are the most common signs:

Red eyes

Lethargy/lack of energy

Warm ears

Warm, dry nose

Shivering

Loss of appetite

Coughing

Vomiting
Lethargy Shivering Loss of appetite Rapid heart rate Dehydration Panting
Vomiting Coughing Nasal Discharge
DIAGNOSIS

The veterinarian will need a history of the pets symptoms, any medications, recent
events and any allergies. A physical examination will look for swollen lymph
nodes, abdominal swelling, pain in the joints, and other signs of infection or
systemic abnormalities. Laboratory diagnostics that can be useful in determining
cause of fever include a complete blood cell count, biochemistry profile and
urinalysis. These tests examine the function of the metabolic and endocrine
systems and can indicate infections or other causes of elevate body temperature.
Radiographs can identify abnormalities in organ systems, cancer, or infections.

SEPTECEMIA

Symptoms of Septicemia and Bacteremia in Dogs Bacteremia symptoms can

include: Vomiting Diarrhea Lack of appetite Lethargy and possible depression If it
progresses to septicemia. Types Bacteremia can be temporary, causing little or no
symptoms, or more aggressive, leading to a case of septicemia.
Septicemia can affect several different organ systems. Inflammation may occur in
the kidneys, brain, heart, lungs, bones, joints, urinary tract, pancreas, or intact sex
organs.
Septicemia is life-threatening, as it can quickly progress to septic shock, and lead
to
complete
organ
shutdown.
Sepsis in dogs most commonly originates from the GI tract (e.g., canine parvoviral

enteritis), followed by the respiratory tract (e.g., bacterial pneumonia), severe

dental disease, chronic urinary-tract disease and contaminated wounds.
Gram-negative bacterial infections predominate, with E. colibeing the most
common isolate. However, any bacterial, fungal, parasitic or viral organism may
cause sepsis.
Sepsis is diagnosed based on the presence of an underlying infection and
identification of systemic inflammatory response syndrome (SIRS). Bacteremia
often is not identified and therefore a negative blood culture does not rule out the
presence of existing sepsis.
Definitions:
Systemic Inflammatory Response Syndrome (SIRS): a clinical
syndrome caused by systemic inflammation of infectious (i.e., sepsis) or
non-infectious origin. In dogs, the diagnosis of SIRS is based on
fulfillment of at least two of these criteria: tachycardia, tachypnea,
hypothermia or hyperthermia and leukocytosis, leukopenia or greater than
3 percent band neutrophils.
Sepsis: the systemic inflammatory response to infection
Severe sepsis: the systemic inflammatory response to infection associated
with organ dysfunction and manifestations of hypoperfusion or
hypotension
Septic shock: the systemic inflammatory response to infection with
hypotension refractory to volume expansion
Bacteremia: the presence of bacteria in the blood stream
Pathophysiology
The sequence of events leading to sepsis is complex and not completely
understood. In the initial phases of infection, microbial products (e.g., endo-toxin
from gram-negative bacteria; exotoxins, peptidoglycans and super antigens from
gram-positive bacteria; and fungal cell-wall material) induce systemic
inflammation through activation of immune cells, resulting in an imbalance
between pro-inflammatory mediators (e.g., TNF) and anti-inflammatory mediators
(e.g., IL-10).
Tumor necrosis factor (TNF), IL-1 beta, IL-6, IL-8 and leukotrienes are examples
of important pro-inflammatory mediators contributing to the pathologic effects of
sepsis in dogs. Ultimately, induction of pro-inflammatory mediators leads to

inflammatory cell infiltration, altered thermoregulation, vasodilation, vascular

leakage and coagulation.
Clinical effects
Dogs can have either a hyper-dynamic or hypodynamic response during sepsis.
The hyperdynamic response is characterized by fever, brick-red mucous
membranes, tachycardia and bounding pulses. With disease-process progression, a
hypodynamic response characterized by hypotension, pale mucous membranes and
hypothermia can be observed.
Often dogs will have GI or respiratory signs associated with the sepsis. Possible
serum chemistry profile abnormalities may include hyperglycemia or
hypoglycemia, hypoalbuminemia, azotemia, hyperbilirubinemia and elevated
serum ALT and/or ALP.
Coagulation abnormalities are common. Anticoagulant proteins (protein C and
antithrombin) are significantly decreased and PT, PTT and D-dimer concentrations
are significantly increased in naturally occurring sepsis in dogs.
Altered microcirculation and tissue hypoxia may lead to metabolic acidosis in
septic dogs. Little is known about the prevalence of organ dysfunction or failure
during canine sepsis, although hemodynamic derangement, renal failure and
respiratory failure are recognized.
symptoms
: Fever Shaking Chills Pale gums Rapid pulse Rapid panting or shallow breathing
Low blood glucose Disorientation These symptoms may appear gradually or very
quickly, depending on the location of the infection