San Luis Rey Fire Survivors: What Trainers Should Be Looking For

Over the years, fires involving horses have made the news, but none has been as horrifying as the one on Dec. 7, when California’s Santa Ana winds swept a wildfire through San Luis Rey Downs in Bonsall. Forty-six racehorses died in the blaze, despite the efforts of heroic horsemen who freed hundreds of Thoroughbreds from their burning barns.

Two major threats to horses in a fire are burn wounds and lung damage from heat and smoke inhalation. For competitive athletes, like the ones who survived the San Luis Rey fire, damage to their lungs may be career-ending. Even those that escape the inferno unhurt may suffer from equine post-traumatic stress disorder (PTSD) that could psychologically affect their ability to race.

Now for the good news: with the excellent veterinary care available today, the prognosis for horses surviving a fire is better than ever.

As a 3-year-old, the ironically named gelding Keep On Smokin was burned in a fire that claimed the lives of 25 horses at an East Texas training center in 2011. Veterinarians treated his injuries with traditional medicine and hyperbaric oxygen therapy.

Keep On Smokin raced again seven months later and continued his career through his 6-year-old season, adding 51 starts and $44,423 to his record. During his 5-year-old year, he earned the highest Equibase Speed Figure of his career and his best record (2-2-2), and his annual earnings were the highest since resuming his career after the fire.

Dr. Jennifer Schultz cared for the horse at Lone Star Park Equine Hospital immediately after the fire. Later, Dr. Fairfield Bain, then Chief of Medicine at Equine Sports Medicine & Surgery in Weatherford, Texas, treated Keep On Smokin with hyperbaric oxygen therapy. Bain, who is board certified in internal medicine, veterinary pathology, and emergency and critical care, is now a professional services veterinarian for Merck Animal Health.

Bain said the prognosis for horses that survive a fire depends, of course, on the extent of their injuries.

“Some of those who are treated early on and aren’t as severely injured by the heat — say, the ones that got out of the barns the earliest or broke out of the barns or weren’t exposed to as much heat and as much smoke — may have a better chance to come back,” he said.

The days immediately after the trauma are the most critical. Lungs may develop pneumonia secondary to damage from smoke and fumes that injure the airway lining. Loss of protein due to plasma oozing from extensive burn wounds to skin and underlying structures can result in shock and organ failure. Both conditions could be fatal.

For burns, the veterinarian’s primary goal is to minimize cell death that causes the skin to slough off, exposing a raw wound. This type of heat-induced skin injury is different from immediate burn injuries to the skin from the fire. It occurs when the blood supply to the tissue is damaged and the skin eventually dies.

“Injuries to the capillaries in the skin can cause that type of reperfusion injury from the heat of the fire, so this is something to pay attention to,” Bain said. “You have some opportunity to salvage that skin if you’re proactive with hyperbaric oxygen therapy.”

Hyperbaric oxygen therapy enhances the healing process by stimulating granulation tissue and enhancing the epithelium covering the wound.

“There’s a word for the burn crust, it’s a coagulated material called eschar,” Bain said. “Sometimes you’ll leave that as a bandage, because when you have the big, raw wound surface, it is losing protein in the plasma that is oozing from it, and if it’s a large enough area, they can lose a lot of protein. So for a while you might allow that to remain as a protective layer. Then gradually, as it starts to slough, you gently rinse it with saline to remove that dead debris.”

Sheets of amniotic membrane, nanofiber scaffolding, and extracellular matrix from pig bladders are modern alternatives to skin grafts, which are still used in some cases.

Horses that suffer a loss of protein may be treated with plasma transfusions if the plasma protein loss is severe enough. As they recuperate, a higher protein diet can support their long-term recovery.

Hyperbaric oxygen therapy helps heal the horse’s damaged lungs by decreasing white blood cell accumulation in the capillaries of the lungs so they can breathe better.

Depending on the extent of the horse’s injuries from the fire, recovery could take several weeks to several months. One major problem is the extent of scar tissue that forms where the skin was burned, especially if it is an area where the tack sits. Scar tissue also may interfere with the ability of the horse to stretch out when it runs.

Bain warned that even after the burn wounds heal, horsemen need to protect those areas from the sun because they are susceptible to developing squamous cell carcinoma — skin cancer.

“So if you start to see a non-healing wound many months later in the burn area, you should consider that it might be early skin cancer,” he said.

Psychological Trauma

Dr. Nicholas Dodman is a Professor Emeritus at Tufts University and the former head of the Tufts Animal Behavior Clinic. His particular interest is horses. Dodman said horses who are fire survivors could develop an equine form of PTSD.

“Horses are frightened of fire intuitively, so if they’re in a captive situation where they can’t escape, they could experience panic, and they would pick up on the panic around them, people running around shouting,” he said. “The degree of terror that they experienced will have an impact on how they cope subsequently.”

Dodman explained that some horses, like humans, have an innate resilience that allows them to persevere after trauma out of sheer mental toughness.

“Others live with an extremely fearful, life-threatening image that is burned into their brains,” he said.

Horses with PTSD will avoid anything that is even remotely linked to the event—the sight of flames, the smell of smoke, the particular location where it occurred. Because the San Luis Rey fire was in a racetrack setting, the psychological trauma could affect their performance.

Horses with PTSD will be on red alert constantly, making them spooky and skittish. In humans, sleep disturbance is an issue, and Dodman said horses may even have nightmares of the event.

The problem with getting a horse over PTSD is that it can’t lie on a couch and talk with a psychiatrist about it. So gentle handling and compassionate understanding are the keys to helping them, along with gradual desensitization to things that trigger their fear.

Some severe cases of PTSD would require mood-stabilizing drugs similar to Prozac in humans. Horses that are laid up for months while they recuperate from their physical wounds could benefit from these medications, but these types of drugs are not permitted on the racetrack.

Most of the horses stabled at San Luis Rey race primarily in California. Dodman advised tracks in the state to ban fireworks displays during special events because the sights and smells might panic horses that survived the fire.

 

First Aid for the Burn Victim

  1. Burns are best treated by veterinarians, but there are some preliminary things you can do and, even more importantly, things you should not do:
  2. Do not treat burns with oil, grease, butter, baking soda, flour, charcoal, lysol, iodine, or any other irritating substance.
  3. Use gauze soaked in warm saline solution (1 teaspoonful of salt to one pint of boiled water) to loosen charred debris from the burn.
  4. Clean burns with mild soap and water.
  5. Use gauze to rinse them gently with warm saline solution.
  6. Apply tannic acid jelly available in your pharmacy (warm, strong tea is a good substitute) or another approved burn salve or spray.
  7. Cover burns with layers of sterile gauze, if possible.

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