August

Beat the heat!!

Warm weather is wonderful. However, sometimes you can overdo the warmth - especially if you are active or exercising.

What is heat stroke?
What causes heat stroke?
What are the symptoms of heat stroke?
How is heat stroke treated?
How can heat stroke be prevented?
Dehydration and Heat Stroke

The danger of dehydration and heat stroke:
What is dehydration? What causes dehydration?
What are the symptoms of dehydration?
Treatment for dehydration
How can dehydration be prevented?

How Seniors Can Keep Cool During Summer Heat Waves

TIPS TO Beat the heat!!

Heat Stroke in Dogs & Pets

Unattended Pets
What to Watch For?
Treatment
Home Care and Prevention
What is heat stroke in animals?
Signs of heat stroke in animals
Treatment for heat stroke in animals
What does heat stroke do?
How to avoid heat stroke?
A note from the veterinarian:
Need More Information?

Here are three problems we can have in hot weather. These conditions are largely brought on by heat and dehydration -- and with proper care it is possible to prevent them.

Heat Cramps

Heat cramps are muscle contractions, usually in the gastrocnemius or hamstring muscles (the muscles at the back of the calves). These contractions are forceful and painful.

These cramps seem to be connected to heat, dehydration, and poor conditioning, rather than to lack of salt or other mineral imbalances. They usually improve with rest, drinking water, and a cool environment.

Heat Exhaustion

Although partly due to exhaustion -- and feeling like exhaustion, as the name implies -- heat exhaustion is also a result of excessive heat and dehydration. The signs of heat exhaustion include paleness, dizziness, nausea, vomiting, fainting, and a moderately increased temperature (101-102 degrees F) which, in this case, is not truly a fever, but caused by the heat. Rest and water may help in mild heat exhaustion, and ice packs and a cool environment (with a fan blowing at the sufferer) may also help. More severely exhausted patients may need IV fluids, especially if vomiting keeps them from drinking enough.

Warning signs of heat exhaustion vary, but may include:

heavy sweating
muscle cramps
weakness
headache
nausea or vomiting
paleness, tiredness and dizziness

Heat Stroke

What is heat stroke?
Heat stroke is the most severe form of heat illness and is a life-threatening emergency. It is the result of long, extreme exposure to the sun, in which a person does not sweat enough to lower body temperature. The elderly, infants, persons who work outdoors and those on certain types of medications are most susceptible to heat stroke. It is a condition that develops rapidly and requires immediate medical treatment.

What causes heat stroke?
Our bodies produce a tremendous amount of internal heat and we normally cool ourselves by sweating and radiating heat through the skin. However, in certain circumstances, such as extreme heat, high humidity or vigorous activity in the hot sun, this cooling system may begin to fail, allowing heat to build up to dangerous levels.

If a person becomes dehydrated and can not sweat enough to cool their body, their internal temperature may rise to dangerously high levels, causing heat stroke.

What are the symptoms of heat stroke?
The following are the most common symptoms of heat stroke, although each individual may experience symptoms differently. Symptoms may include:

an extremely high body temperature (above 103° Fahrenheit, orally)
headache
dizziness
disorientation, agitation or confusion
sluggishness or fatigue
seizure
hot, dry skin that is flushed but not sweaty
a high body temperature
loss of consciousness
rapid heart beat
hallucinations

Sometimes a victim's muscles will begin to twitch uncontrollably as a result of heat stroke. If this occurs, keep the victim from injury but do not place any objects in the mouth and do not give fluids. If there is vomiting, make sure the airway remains open by turning on his or her side.

How is heat stroke treated?

It is important for the person to be treated immediately as heat stroke can cause permanent damage or death. There are some immediate first aid measures you can take while waiting for help to arrive.

Get the person indoors.
Remove clothing and gently apply cool (not icy!) water to the skin followed by fanning to stimulate sweating.
Apply ice packs to the groin and armpits.
Have the person lie down in a cool area with their feet slightly elevated (that is, raised above heart level).

In hospital, Intravenous fluids are often necessary to compensate for fluid or electrolyte loss. Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.

How can heat stroke be prevented?
There are precautions that can help protect you against the adverse effects of heat stroke. These include:

Drink plenty of fluids during outdoor activities, especially on hot days. Water and sports drinks are the drinks of choice; avoid tea, coffee, soda and alcohol as these can lead to dehydration.
Wear lightweight, tightly woven, loose-fitting clothing in light colors.
Schedule vigorous activity and sports for cooler times of the day.
Protect yourself from the sun by wearing a hat, sunglasses and using an umbrella.
Increase time spent outdoors gradually to get your body used to the heat.
During outdoor activities, take frequent drink breaks and mist yourself with a spray bottle to avoid becoming overheated.
Try to spend as much time indoors as possible on very hot and humid days.

If you live in a hot climate and have a chronic condition, talk to your physician about extra precautions you can take to protect yourself against heat stroke.

Your sweat is your body's main system for getting rid of extra heat. When you sweat, and the water evaporates from your skin, the heat that evaporates the sweat comes mainly from your skin. As long as blood is flowing properly to your skin, extra heat from the core of your body is "pumped" to the skin and removed by sweat evaporation. If you do not sweat enough, you cannot get rid of extra heat well, and you also can't get rid of heat as well if blood is not flowing to the skin. Dehydration will make it harder for you to cool off in two ways: if you are dehydrated you won't sweat as much, and your body will try to keep blood away from the skin to keep your blood pressure at the right level in the core of your body. But, since you lose water when you sweat, you must make up that water to keep from becoming dehydrated. If the air is humid, it's harder for your sweat to evaporate -- this means that your body cannot get rid of extra heat as well when it's muggy as it can when it's relatively dry.

The best fluid to drink when you are sweating is water. Although there is a little salt in your sweat, you don't really lose that much salt with your sweat, except in special circumstances; taking salt tablets may raise your body's sodium level to hazardous levels. (Your doctor can tell you whether or not you need extra salt.) "Sport drinks" such as Gatorade® will also work, but water is usually easier to obtain.

It's also important to be sensible about how much you exert yourself in hot weather. The hotter and more humid it is, the harder it will be for you to get rid of excess heat. The clothing you wear makes a difference, too: the less clothing you have on, and the lighter that clothing is, the easier you can cool off. Football players are notoriously prone to heat illness, since football uniforms cover nearly the whole body, and since football practice usually begins in late summer when the temperature outside is highest. Therefore, football players should pay extra attention to the fluids they drink and lose: teams should consider limiting practice and wearing light clothing for practice on very hot days, and athletes should be able to drink all the water they want during practice.

Dehydration and Heat Stroke

The danger of dehydration and heat stroke:
Dehydration and heat stroke are two very common heat-related diseases that can be life-threatening if left untreated.

What is dehydration?
Dehydration can be a serious heat-related disease, as well as being a dangerous side-effect of diarrhea, vomiting and fever. Children and persons over the age of 60 are particularly susceptible to dehydration.

What causes dehydration?
Under normal conditions, we all lose body water daily through sweat, tears, urine and stool. In a healthy person, this water is replaced by drinking fluids and eating foods that contain water. When a person becomes so sick with fever, diarrhea, or vomiting or if an individual is overexposed to the sun, dehydration occurs. This is caused when the body loses water content and essential body salts such as sodium, potassium, calcium bicarbonate and phosphate.

Occasionally, dehydration can be caused by drugs, such as diuretics, which deplete body fluids and electrolytes. Whatever the cause, dehydration should be treated as soon as possible.

What are the symptoms of dehydration?
The following are the most common symptoms of dehydration, although each individual may experience symptoms differently. Symptoms may include:

thirst
less-frequent urination
dry skin
fatigue
light-headedness
dizziness
confusion
dry mouth and mucous membranes
increased heart rate and breathing

In children, additional symptoms may include:

dry mouth and tongue
no tears when crying
no wet diapers for more than 3 hours
sunken abdomen, eyes or cheeks
high fever
listlessness
irritability
skin that does not flatten when pinched and released

Treatment for dehydration:
If caught early, dehydration can often be treated at home under a physician's guidance. In children, directions for giving food and fluids will differ according to the cause of the dehydration, so it is important to consult your pediatrician.

In cases of mild dehydration, simple rehydration is recommended by drinking fluids. Many sports drinks on the market effectively restore body fluids, electrolytes, and salt balance.

For moderate dehydration, intravenous fluids may be required, although if caught early enough, simple rehydration may be effective. Cases of serious dehydration should be treated as a medical emergency, and hospitalization, along with intravenous fluids, is necessary. Immediate action should be taken.

How can dehydration be prevented?
Take precautionary measures to avoid the harmful effects of dehydration, including:

Drink plenty of fluids, especially when working or playing in the sun.
Make sure you are taking in more fluid than you are losing.
Try to schedule physical outdoor activities for the cooler parts of the day.
Drink appropriate sports drinks to help maintain electrolyte balance.
For infants and young children, solutions like Pedialyte will help maintain electrolyte balance during illness or heat exposure. Do not try to make fluid and salt solutions at home for children.

How Seniors Can Keep Cool During Summer Heat Waves

SACRAMENTO - California Department of Aging urges caregivers and families of frail elderly and adults with disabilities to take extra precautions to help them stay cool and safe during hot summer months.

"We want to get the word out to families, friends, neighbors and caregivers to ensure that older and more vulnerable Californians are safe and comfortable during summer heat waves," said Terry. "For some seniors and adults with disabilities, high temperatures can lead to serious illness, hospitalization and even death."

Two common problems caused by exposure to excessive heat are heat stroke and heat exhaustion. CDA Director Lunn Daucher offers these easy tips for keeping cool:

Eat lightly and drink plenty of fluids. Non-caffeine and non-alcoholic beverages help prevent dehydration.
Wear lightweight, light colored and loose fitting clothing.
Keep a container of cool water nearby and use wet washcloths to pat the wrists, face and back of neck or, for a quick cool down, wrap ice cubes in a washcloth or use blue cooler packs.
Use small battery operated hand-held fans and misters for a cooling break.
Schedule outside activities before Noon or in the evening.
Wear a wide-brimmed hat when in the sun.
Stay in the coolest part of the house - usually on the lowest floor - as much as possible.
A shady spot outdoors may be cooler than the house, especially if there's a breeze.
Mobile seniors may want to spend a few hours at the library, in a movie or at a mall or restaurant that is air-conditioned to stay cool, enjoy a social outing and conserve energy.

Below are tips for cooling the home:

Use portable and ceiling fans in frequently used rooms to substitute for or assist the air-conditioner.
If it is safe to do so, leave windows open at night. Open windows on two sides to create cross ventilation.
Place a piece of cardboard covered with aluminum foil in sunny windows to reflect sunlight and heat away from the house.
Close shades or draperies on sunny windows.
Vacuum, clean or replace air filters regularly for maximum cooling efficiency.
If affordable, install outdoor awnings or sunscreens.

TIPS TO Beat the heat!!

Keeping cool this summer may be a challenge, but a little creativity and taking advantage of the wonderful facilities and services offered by our government and community might just provide that cooling breeze we are searching for:

Take a ride on the Lawndale Beat: the fare is low (free for seniors 62 years and older and disabled) and the motor coaches are air conditioned.
Check out the Los Angeles County Library/Lawndale branch: comfortable seats, cooling air, and a plethora of materials to feed the imagination.
Lawndale Parks have big green trees with lots and lots of shade! And cooling, soft, green grass. An added bonus for youngsters 3 to 5 years: Jane Addams Park has a wading pool!
The beach is not too far by bus or car….
Stroll the wonderful shopping emporiums along Hawthorne Boulevard: visit one of the unique restaurants for an iced beverage.
Come on down to the Lawndale Community Services Recreation Center. The facilities are air conditioned and there is always something exciting going on!
Invest in a small ‘personal' water cooler: a spray bottle filled with cold, tap water can help cool a body down or use a small, battery powered, hand held fan.
If you are traveling with your pets, make sure that you bring cool, fresh water along for them. Their needs can be more acute than humans' needs, and they depend on their owners to take care of them. DON'T LET THEM DOWN!
Our local communities are filled with museums—all air conditioned.
Take in an afternoon matinee at one of the local, air conditioned movie theaters. As an added incentive, matinee prices are usually discounted and offer senior prices as well.
Remember summers past: sit in the shade of your yard with a cooling drink. Play in the sprinklers.
Eat lightly and drink plenty of fluids. Non-caffeine and non-alcoholic beverages help prevent dehydration.
Wear lightweight, light-colored and loose fitting clothing—natural fibers like cotton are best.
Keep a container of cool water nearby and use wet washcloths to pat the wrists, face and back of neck or, for a quick cool-down, wrap ice cubes in a washcloth.
Schedule outside activities in the early mornings or in the evenings.
Stay in the coolest part of the house - usually on the lowest floor - as much as possible.
Use portable and ceiling fans in frequently used rooms to substitute for the air conditioner.
If it is safe to do so, leave windows open at night. Open windows on two sides to create cross ventilation.
Place a piece of cardboard covered with aluminum foil in sunny windows to reflect sunlight and heat away from the house.
Close shades or draperies on sunny windows.
Air out hot cars before getting into them.
Carry your own shade: use an umbrella, parasol, or wide brimmed hat.
Avoid baking (using your indoor oven) during the heat of the day.
Take a cool shower, bath or sponge bath.

Heat Stroke in Dogs & Pets

UNATTENDED PETS
Leaving a pet alone in a vehicle has a number of potential risks. Always be conscious of the effects of heat buildup in a vehicle because it only takes a few minutes for the internal heat to increase forty degrees above the outside air temperature... especially in direct sunlight. Even a dog's body heat (expired air in the dog's breath is 102 degrees and has 100% humidity!) will act like a heater inside an enclosed space. Leaving windows open slightly at the top surely helps IF there is a breeze. However, that opening also invites children to poke their fingers in or unkind folks to tease the dog with sticks. Pets left in cars are at a severe disadvantage when it comes to being able to dissipate heat from their bodies. Even in the shade, and especially in humid conditions, dogs need to inhale air cooler than their normal body temperature of 102 degrees. In fact, even 80 degree air temperatures can be dangerous. Heat stroke is a dire emergency and one from which many pets do not recover. And you'd be shocked to find out just how fast it can occur. If you ever find your pet distressed from overheating in a vehicle, get to the nearest animal hospital immediately... don't even call first; just GO!

HEAT STROKE! It might only be ten minutes... and the dog or cat will be near death. And sometimes even if heroic treatment measures are taken the animal will die from massive intravascular clotting, hemorrhaging, cerebral edema and kidney failure. It is a gruesome thought but every day dogs and cats suffer from heat stroke due to inattention by their caretakers. In most cases, the pet is left "for just a minute"... but for various reasons the pet's owner is distracted by something unusual, or delayed beyond what was expected... and returns to the vehicle to see their pet collapsed, salivating, panting uncontrollably and loosing consciousness. Don't let it happen to your pet.

Animals at greatest risk for heat-related illness include:

Puppies and kittens up to 6 months of age
Overweight dogs and cats
Pets that are overexerted during exercise
Pets that are ill or receiving certain medications
Dogs with short, wide heads like pugs, English bulldogs, Boston terriers
Pets with airway obstructive diseases
Pets with pre-existing fever
Pets that are dehydrated
Pets with heart disease
Pets with poor circulation due to cardiovascular or other underlying disease
Older pets (large breed dogs over 7 years of age, small breed dogs over 14 years of age)

What to Watch For?

Noisy breathing that may indicate upper airway obstruction
Excessive panting
Bright red mucous membranes (gums, conjunctiva of the eyes)
Weakness
Collapse
Coma

Treatment

Intensity of treatment depends upon the cause and severity of the heat illness.

Mildly increased temperature (less than 105 F) may only require rest, a fan to increase air circulation, fresh water to drink and careful observation.
Temperatures of 105 to 107 F should be hospitalized on intravenous fluids and other medications.
Markedly increased temperature (greater than 107 F) must be treated more aggressively. Cooling can be promoted externally by immersion in cool water, or internally by administering a cool water enema.
Underlying aggravating conditions, such as upper airway obstructive diseases, heart disease, pulmonary disease and dehydration may be treated with appropriate medications, supplemental oxygen or fluid therapy.
Treatment with cortisone-like drugs such as short-acting forms of dexamethasone or prednisone may be recommended.

The need for additional treatments depends on the severity of heat stroke and secondary complications that may arise. Complications of heat stroke may include:

Disseminated intravascular coagulation (DIC)
Liver failure
Acute kidney failure
Muscle breakdown
Low blood pressure (hypotension)
Low blood sugar (hypoglycemia)
Convulsions (seizures)
Secondary infections (including pneumonia)
Gastrointestinal problems including bleeding and absorption of bacteria or toxins from the intestine with development of systemic infection (sepsis)

Home Care and Prevention

There are several things you can do to prevent heat related problems for your pet:

Monitor outdoor temperature and minimize your pet's activity on hot, humid days.
Limit sun exposure during the hours of 11 AM to 3 PM on hot days.
Walk or exercise your dog in the morning or evening.
Keep your pet in a comfortable environment (air-conditioned room or partially open windows with a breeze) during extremely hot weather.
NEVER leave your pet in a car (even with the windows partially rolled down) for any reason at any time. Leaving dogs in a car during warm weather is the most common cause of heat stroke.
Provide your pet with plenty of fresh water and plenty of shade. Take extra care with puppies and kittens.
If possible, allow your pet to acclimate gradually to high temperatures. Heat illness is common in the spring when the animal has not had sufficient time to acclimate to the warmer temperatures.
After traveling to a warmer climate, allow your pet several days to become acclimated before allowing any vigorous exercise.

WHAT IS HEAT STROKE IN ANIMALS?
Living cells have temperature tolerance limits. Go beyond those limits and the cell breaks down, looses functional capacity, releases chemicals within itself that cause more adverse reactions, and eventually ceases to function and dies. Tolerance to higher than optimum temperatures for mammals breaks down at about 107 degrees. And the death of the cell (that state where the traumatized cell cannot recover from the heat injury) occurs when time and temperature factors combine to terminate the cell's integrity. The longer the cell is above the 107 degree level the less chance there is for the cell to recover. The higher the temperature becomes above 107 degrees the faster the cell death occurs. In pets confined to a space where the ambient (surrounding) temperature and humidity are above tolerable levels the animal's body will begin to acquire heat from the environment faster than it can dissipate that heat. In overheated humans we begin to sweat, which evaporates (unless the humidity is 100 percent), and cools the skin surface and assists in dissipating that heat buildup. In fur covered dogs and cats that have very few sweat glands to begin with the only means of dissipating excess body heat is via panting. This movement of air over the moist tongue and airway surfaces increases evaporative cooling (again, unless the ambient humidity is 100 percent). Unfortunately, panting is a rather inefficient means of dissipating body heat and actually generates some heat due to the muscle activity involved. Keep in mind that as an animal is confined to a closed space the expired air, which is at 100 percent humidity and 102 degrees, will eventually increase the ambient humidity and temperature of the animal's space. Plus, especially with larger animals such as Great Danes and St.Bernards, their body heat will increase the ambient temperature in the vehicle. It should be readily obvious that leaving an animal in an enclosed space, even if the vehicle is in the shade and even if the outside temperature is only in the seventies, will cause a buildup of temperature and humidity in that vehicle. Time and temperature and humidity are critical factors in the development of heat stroke in pets. And once the animal's cells reach 107 degrees it is crucial for any chance of recovery to lower that temperature as fast as possible. Otherwise death will result no matter what you do to try to save the animal.

SIGNS OF HEAT STROKE IN ANIMALS
Signs of heat stroke are intense, rapid panting, wide eyes, salivating, staggering and weakness. Advanced heat stroke victims will collapse and become unconscious. The gums will appear pale and dry. If heat stroke is suspected and you can take the animal's temperature rectally, any temperature above 106 degrees is dangerous. The longer the temperature remains at or above 106 degrees the more serious the situation. If you return to your car or the area in which the animal was confined and find your pet seems to be highly agitated, wide-eyed and panting uncontrollably... start for the nearest animal hospital right away with the air conditioning at full blast. Otherwise get the dog to a cool area and begin the treatment for heat stroke.

TREATMENT FOR HEAT STROKE IN ANIMALS
Take the pet's temperature rectally if possible. A body temperature of about 105 degrees or higher is probable evidence for heat stroke. Place your pet in a tub of cool running water or spray with a hose being sure the cool water contacts the skin and doesn't simply run off the coat. Thoroughly wet the belly and inside the legs. Run the cool water over the tongue and mouth. Take a rectal temperature if possible to know when to stop cooling. A safe temperature is about 103 degrees. A small dog will cool down much faster than a large dog. Once the temperature gets to 103 or 104 degrees do not cool the pet any further because the cooling effects will continue to bring the temperature down even further. Seek veterinary attention as soon as possible.

If you are near an animal hospital, go there right away. At the animal hospital they may administer oxygen, cortisone and dextrose to help protect the traumatized cells. The staff can provide proper cooling measures and monitor the dog's temperature, heart rate and provide oxygen which some evidence indicates may help protect stressed body cells. Providing intravenous fluids and anticoagulants may be utilized as well.

WHAT DOES HEAT STROKE DO?
In severe cases, the elevated body temperature triggers chemical reactions in the cells of the body... highly active cells such as brain, intestinal and liver cells are at greatest risk for heat trauma. The metabolic disturbances brought on by excessive heat instigate the release of chemicals within the cells that cause the ultimate destruction a breakage of the cell. Most heat stroke victims are dehydrates, as well, and their blood thickens to the point that the heart has severe stresses placed on it in trying to pump the abnormally viscous blood through the blood vessels. The result is stagnation of blood, blood clotting and eventual death of tissues due to what is termed ischemic necrosis. Wherever a clot forms, the tissues nourished by that clogged vessel die from metabolic starvation. The dying cells give off chemicals that further damage surrounding tissues and a point is reached beyond which no recovery is possible. In some unfortunate situations where the heat stroke victim has experienced a dangerously high body temperature for a length of time such that too many brain and other body cells have been damaged, no matter what life saving measures are employed and bioprotective medications are administered, death will result.

HOW TO AVOID HEAT STROKE?
Always be careful about leaving pets in vehicles or tied out in the direct sunlight during warm, sunny days... even a few minutes can be critical. And flea markets and other outdoor activities are often the worst place to bring a dog on a hot summer day. Factors that increase an animal's risk of developing heat stroke include:

* water deprivation
* enclosed space
* excessive humidity
* obesity

* exercise
* age
* cardiovascular disease
* lack of acclimatization

Short faced (brachycephalic) breeds such as Boxers, Pekingese, Pugs and dogs with heavy coats are at greater risk for heat stroke than some other breeds. Also age, heart trouble, and physical condition such as being overweight all contribute to a lesser efficiency in dissipating heat buildup in the body. Any animal or human when faced with the ambient conditions of high temperature, high humidity and time to build up heat within the body faster than heat can be dissipated, can face the tragedy of being a victim of heat stroke. All it takes to avoid this serious problem it diligence and common sense. Older pets have less resistance to stresses such as traveling, heat, noises, and unusual activities. Excitement or discomfort brings on panting and elevated metabolic rate which elevates the animal's temperature; and if the animal cannot remove that heat buildup within its body it may be just a matter of a few minutes before the dog or cat get into some serious medical difficulty.

A NOTE FROM THE VETERINARIAN: One of my "pet peeves", and pardon the pun, is to see people bringing their dogs to summertime activities oriented for humans. I can never comprehend why people insist on having their dogs with them at events such as flea markets, Art In The Park, craft shows, car shows, parades and carnivals. Dogs don't care about arts and crafts, parades or carnivals! And quite honestly they would have a much better day if left behind in the safety and shelter of their homes. Most of these events are crowded enough with people and children, and distractions and activities abound that have no relevance to the dog's enjoyment; so why subject the animals to the heat and excitement of these human activities?

Be mindful, too, that your dog's pads can suffer heat trauma from contact with hot asphalt or other summer-scorched surfaces.

Casey was treated to some shady rest and relaxation during a very hot afternoon walk along Lake Superior in Bayfield, Wisconsin. Considering the fact that there were lots of distractions and interesting things for Casey's owners to do, they took time out to make sure Casey was safe and comfortable.

There are times when you need to consider if the wisest decision might be to leave the dog at home if you won't be able to provide it frequent relief from the heat and humidity.

For more information on heat-related illnesses, a good source is Extreme Heat: A Prevention Guide to Promote Your Personal Health and Safety, at the United States Centers for Disease Control and Prevention Web site.

Other informative web sites for people and pets are:

http://www.pet-sitters.biz/pets_and_summer_heat.cfm

http://www.nws.noaa.gov/om/heat/index.shtml

City of Lawndale, CA

August