Best Treatment Options for Heat Stroke

With summer in full swing, clinics are seeing more and more victims of heat stroke, and some of the most common causes include:

• Being left in a hot car
• Exercising outside in warm weather
• Prolonged, unattended use of a dryer after bathing
• Being left outside with no water or shade

Brachycephalic breeds are pre-disposed to heat stroke due to their anatomy, and older and overweight animals are more susceptible to heat stroke as well.

What Happens With Heat Stroke

Severe hyperthermia is so dangerous because it can lead to multi-organ failure due to inflammation. Neurologic signs such as collapse, ataxia and seizures can be seen due to decreased blood flow to the brain.

Renal failure is a relatively common sequela to heat stroke because of decreased blood flow to the kidneys. Severe hyperthermia can lead to myocardial necrosis; arrhythmias can be seen due cardiac hypoperfusion, and the pulmonary endothelium can be damaged, leading to pulmonary edema.

Blood flow can also be compromised to the gastrointestinal tract leading to hemorrhagic gastrointestinal signs, bacterial translocation and sepsis. Disseminated intravascular coagulation (DIC) can occur as well.

How To Help The Patient

If a patient presents to you with significant hyperthermia, stabilize the patient first and then get a history. Typically, IV fluids and thermoregulation are very important. Fans, cool towels, an icepack on the fluid line, and water on the paw pads can be helpful to get the temperature under control.

Often these patients are in shock and need fluid resuscitation. Because pulmonary edema can be seen with heat stroke, patients may need oxygen support as well. Once the patient is stabilized, then blood work and other supportive measures can be performed. Symptomatic and supportive care may include gastroprotection, antibiotics, mannitol and dextrose. 

When taking a history from the owners, ask about any situations mentioned above where the patient could have been at risk for heat stroke. Because prolonged seizures can also lead to hyperthermia, it is important to ask if the patient’s signs started with seizing.

There are a few products that can lead to hyperthermia as a result of a toxicity so asking about any possible exposures can be helpful as well. Products that can lead to severe hyperthermia include hops (humulus lupulus), 5-htp, marijuana, methylxanthines such as caffeine and chocolate, and any product that can cause serotonin syndrome.

The prognosis for patients with heat stroke tends to be guarded. If the patient presents hypoglycemic, has prolonged clotting times, develops renal failure, or develops DIC, then prognosis is poor.

If you believe a toxicity is causing your patient’s signs, treatment recommendations can be obtained from the ASPCA Animal Poison Control Center at 888.426.4435.