Above image of a burnt possum paw courtesy of Dr Derek Spielman

 

Burns obviously affect the skin and paws. Animals may have also inhaled smoke and have respiratory distress

 

General supportive care:

  • IV fluid therapy should be provided where needed.
  • Systemic antibiotic therapy may be required in cases of smoke / heat –induced pneumonia (Gillett and Hanger, 2019). Discussed further below.
  • Minimize handling, strange noises and smells, when possible
  • provide best quality food

 

Skin burns:

Types of burns

First degree burn damages the epidermis / upper layer of the skin

Second degree burn damages the epidermis and deeper dermis

3rd degree burns damages epidermis, dermis and deeper structures

 

In animals with extensive, full-thickness burns, euthanasia is usually indicated (Gillett and Hanger, 2019)

 

How to treat skin burns  – they are very painful. Provide analgesia.

 

The problem What to do
Loss of outer layer of skin – loss of this layer is very serious – patient loses body water they can dehydrate and infections can set in quickly Cover the affected area with bandage
Dead tissue and damaged blood supply – microbes like the dead tissue and the body’s protective mechanisms such as the white blood cells cannot get to the dead tissue Remove the dead tissue to reduce areas for bacteria to hide. Regularly flush area to get rid of microbes with water. THIS IS PAINFUL TO THE PATIENT _ provide analgesia prior to procedure. Consider general anaesthesia to perform this.
Destruction of the skins’ other microbial protective mechanisms. Non-burnt skin contains antimicrobial peptides (AMPs), enzymes called lysosomes that also digest microbes, disruption to the normal skin microbes that also protect the skin.  These protective mechanisms are lost when the skin is burnt. Topical wound cream is very important. The best burn wound cream contains silver. Silver sulfadiazine cream/ointment is a superior anti-infective for wounds. It has activity against gram-positive and gram-negative bacteria
What to do with blisters? Thin walled blisters should be aspirated (a needle put into the blister) or debrided (the top surface removed), while thick blisters may be aspirated and left in place.

 

THIS IS PAINFUL TO THE PATIENT -provide analgesia prior to procedure. Consider general anaesthesia to perform this.

 

Burn wounds heal best in a moist but not wet environment that promotes new cells and prevents cellular dehydration.

 

BURNS ARE VERY PAINFUL  –  nerve endings in the skin are exposed to air and this induces pain For those animals that eat eucalyptus leaves….. non-steroidal anti-inflammatories other-wise known as NSAIDs have too short an action to be helpful in these species.  For koalas and possums they will need an opioid injection for analgesia. You will need to get these from your veterinarian.

 

The dead and dry skin causes itching Consider anti-histamines and using moisturisers if does not stress patients
As the skin heals there is scarring and contraction of tissues and a resultant lack of mobility Encourage regular daily movement / provide physiotherapy
Are systemic antibiotics necessary There is no evidence that systemic antibiotics improve the response of skin burns if the above actions are carried out for the patient.

 

 

 

How to treat smoke inhalation – damage to breathing

 

Smoke inhalation should be suspected when animals have burns to the face, singed whiskers and respiratory signs such as  fast, shallow breathing, fast heart rate, mouth breathing

 

A bronchodilator will help – see the vet for this

Systemic antibiotics are warranted. For eucalypt leaf eaters (koalas or possums) or herbivores (grass eaters) give by antibiotics by injection, not orally

Oxygen supplementation of breathing may help… but this is too expensive for most wildlife carers to maintain for their patients

 

Remember damaged lungs are an anaerobic environment (anaerobic means no oxygen) – thus antibiotics are required to kill  anaerobic bacteria as well as gram positive and gram negative anaerobic bacteria !

Also need those drugs that can penetrate into the respiratory system. Some are better than others. Some of the common antibiotics used in animals:

 

  1. Enrofloxacin – Baytril® is effective against gram positive and gram negative bacteria but not affective against anaerobes. So need to add another drug that is effective against anaerobes such as amoxicillin (e.g. Clavulox®) – give by injection
  2. Amoxicillin – Clavulox® – will be effective against gram positive aerobes and anerobes and has some activity against gram negative activity  –  combine with enrofloxacin for increased gram negative activity  – give by injection
  3. Pradofloxacin – Veroflox® is effective against gram positive and gram negative bacteria and anaerobes, but is only available as an oral suspension
  4. Chloramphenicol is a broad spectrum antibiotic that will penetrate the lungs will have some activity against gram positive and gram negative bacteria aerobes including anerobes – give by injection
  5. Doxycycline is a broad spectrum antibiotic that will penetrate the lungs will have some activity against gram positive and gram negative bacteria including anerobes – give by injection
  6. Cefovecin  Convenia ® – this is a third generation cephalosporin  – has good activity against gram positive aerobes and some anaerobes and gram negatives aerobes and gram negative anaerobes.  ONLY HAS AN EFFECTIVE DURATION OF HOURS rather than days in the koala.   Some Pseudomonas aeruginosa are resistant. Only available as injection
  7. Ceftiofur – Excede®-  this is a third generation cephalosporin  – has good activity against gram positive aerobes and some anaerobes and gram negatives aerobes and gram negative anaerobes. Some Pseudomonas aeruginosa are resistant. Only available as injection
  8. Ceftazidime – Fortaz ® used to treat Pseudomonas aeruginosa infections. Only available as injection. Not as efficient as other antibiotics to kill  Staphylococci infections.

 

Antibacterial induced dysbiosis (gut shut-down)

 

Some antimicrobial drugs may disrupt the normal intestinal flora of some Australian marsupials. Such disruption can lead to loss of appetite, loss of body condition, weakness  and death.

DO NOT ADMINISTER BY ORALLY / BY  MOUTH to the eucalyptus leaf eaters  –  Tetracyclines or macrolides – such as tetracycline, doxycycline, azithromycin, clarithromycin and erythromycin

 

USE of an antifungal when using antibiotics in marsupials:

 

Use of antibiotics in marsupials can lead to gut problems such as diarrhoea, loss of appetite, weakness

The antifungal nystatin (up to 50 000 IU/kg PO, without food) is recommended to be administered concurrently with antibiotics to prevent candidiasis along with administration of probiotics on completion of the course of antibacterials in marsupials  McCracken (2001).

 

References

  • GILLETT, A. & HANGER, J. 2019. 32 Koala In: L, V. & T, P. (eds.) Current Therapy in Medicine of Australian Mammals. Melbourne: CSIRO.
  • MCCRACKEN, H. 2001. Husbandary and veterinary care of orphaned ,marsupial pouch young: hand-rearing native fauna. Workshop Proceedings, July 2001, Veterinary Conservation Biology: Wildlife Health and Management in Australia Proceedings. Taronga Zoo: Sydney, NSW.