Moderate heat injury is present when the signs of heat stress are present, as well as weakness, distress, and uncontrolled panting (i.e. the patient cannot reduce or stop panting when exposed to a noxious inhalant), but central nervous system (CNS) abnormalities, such as change in mentation, are not present.

Treatment of moderate heat injury is the same as for heat stress, but more aggressive cooling measures are often necessary. (See Table 1.)

The patient must be removed from the source of heat and all activity must be stopped.

Cooling by use of fans or movement to an air-conditioned area should be done if possible. For moderate and severe heat injuries, thoroughly and continuously soak the hair coat with tepid water (60 to 86°F or 15.6 to 30°C) to reduce core body temperature.16,17,18

Intravenous fluid therapy should be initiated. (See Table 1.)

Close monitoring for several hours ensures heat exhaustion does not progress or rebound hypothermia does not develop.