Review

Veterinary Pathology
2016, Vol. 53(5) 1018-1029
Electrical Injuries in Animals: Causes, ª The Author(s) 2016
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Pathogenesis, and Morphological Findings DOI: 10.1177/0300985816643371
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C. Schulze1, M. Peters2, W. Baumgärtner3, and P. Wohlsein3

Abstract
Electrical injuries in animals occur most often accidentally. They comprise contact to various forms of currents, including
alternating, rotary, or direct currents. Depending on various parameters of the current (including the type of circuit, voltage,
current and duration of exposure) and conditions of the animal (such as wet or dry hair coat and pathway of current through the
body), lesions may be absent or may include early or localized development of rigor mortis, signs of acute circulatory failure, or
severe thermoelectrical burns. Such burns may present as external current marks, singed hair or feathers, metallization of the
skin, or occasionally internal electroporation injury resulting in muscle necrosis, hemolysis, vascular damage with thrombosis,
injury to brain and spinal cord, or skeletal fractures. Furthermore, lightning strikes occur regularly in grazing animals, which have
greater risk of death from step potentials (ground current) in addition to direct strike and contact injury. Such cases may have no
lesions, external signs of linear or punctate burns, keraunographic markings, or exit burns on the soles of the hooves or the
coronary bands. Besides detailed information about the circumstances at the location where the animal was found, electrical
injuries in animals require a thorough morphological workup, including additional investigations in conjunction with certain
knowledge about the possible lesion spectrum.

Keywords
current, electrocution, current mark, keraunographic marking, lightning strike, thermoelectrical injury

Electricity is the flow of electrons through a conductor. An in dead individuals, indicative lesions may be present. In
object that collects electrons becomes negatively charged, and many fatal cases in livestock, financial compensation is
when the electrons flow away from this object through a con- only paid if the cause of death can be conclusively related
ductor, they create an electric current. The force that causes the to a lightning strike, implying that the diagnostic pathol-
electrons to flow is the voltage. Anything that impedes the flow ogist is familiar with characteristic morphological
of electrons through a conductor creates resistance.48 These findings.26
relationships can be summarized by Ohm’s law: V ¼ I  R This review gives an overview about causes, pathogenic
(V ¼ voltage in volts, I ¼ current in amperes, and R ¼ resis- mechanisms, morphological findings, additional investiga-
tance in Ohms).50 tions, differential diagnoses, and causes of death in various
Electrical currents are regularly applied to animals, such as forms of electrical impact. Some aspects of damage by elec-
electrocution at slaughter or electrocauterization as a surgical tricity and lightning in this review article have deliberately
tool. In addition, contact of animals to electrical currents may been adopted from human legal medicine to provide a compre-
occur accidentally. Damage by electrical currents is influenced hensive overview and alert the veterinary pathologist in this
by current, voltage, heat generated, and duration of the electri- respect even if these findings have not yet been described in
cal flow. Electrical currents entering an animal’s body travel veterinary literature.
normally the shortest path from the source of contact to the
ground contact or exit point. The longer the victim is exposed
to the current, the greater the damage will be. Electrical cur- 1
Berlin-Brandenburg State Laboratory, Frankfurt (Oder), Germany
rents passing through the victim can cause sudden death by 2
Chemisches und Veterinäruntersuchungsamt Westfalen, Arnsberg, Germany
3
disruption of neural regulatory impulses. Furthermore, electro- Department of Pathology, University of Veterinary Medicine Hannover,
thermal injuries may occur at the source and ground contact Hannover, Germany
points and in inner organs.
Corresponding Author:
Besides damage of environmental objects such as trees P. Wohlsein, Department of Pathology, University of Veterinary Medicine
or buildings, cloud-to-ground lightning strikes are a cause Hannover, Bünteweg 17, D-30559, Hannover, Germany.
of death mainly in grazing animals. In surviving as well as Email: [email protected]
Schulze et al 1019

Table 1. Characteristics and Differences of Electric Trauma by Low Voltage, High Voltage, and Lightning.a

Low Voltage High Voltage Lightning

Voltage (V) <1000 >1000 >30  106

Current (A) Usually <240 Usually <1000 On average 30,000
Duration Prolonged Brief ms to ms
Current type AC, DC, RC AC, DC Unidirectional current impulse
Cause of heart failure Ventricular fibrillation Asystole Asystole, ventricular fibrillation
Muscular contractions AC, RC: tetanic, DC: single AC, RC: tetanic, DC: single Single
Thermal injury Uncommon, usually superficial Common, usually superficial and deep Rare, usually superficial
Heat Joule heating Joule heating Short thermal heat >8000 C
Blunt trauma Uncommon Common, fall Common, blast effect, fall
Acute mortality Low Common Moderate (humans), high (animals)
AC, alternating current; DC, direct current; RC, rotary current.
a
Modified after Koumbourlis.48

Table 2. Electrical Parameters and Formulas Relevant for Electrical Accidents.a

Parameter Unit Meaning Formula/Definition Pathophysiological Analogy

Frequency (F) Hertz (Hz) Number of cycles per time usually 1 Hz ¼ 1 cycle/s Acoustic waves
seconds (s)
Charge (C) Coulomb (C) Basic unit of electricity 6.24  1018 electrons Liter of blood
Current (I) Ampere (A) Flow of charge per second 1A ¼ 1C/s Liter per second cardiac output
Current density (J) (A/m2) Flow of charge per second through J ¼ I/area Peripheral versus central blood
each square meter of area stream
Voltage (V) Volt (V) Pressure pushing current V¼IR Blood pressure
Resistance (R) Ohm (Ω) Resistance against current flow R ¼ V/I Blood vessel resistance against the
blood flow
Resistivity (r) Ohm meter Resistance of a certain amount of r ¼ R  (area/length) Resistance of 1 cm arterial wall
(Ωm) tissue against current flow against the blood flow
Power (P) Watt (W) Ability to do work P ¼ V  I ¼ I2  R Product of blood pressure and
cardiac output
Energy (E) Joule (J) Work capacity E ¼ P  s ¼ V  I  s ¼ Thermal or food energy
I2  R  s
a
Modified after Kroll and Panescu.50

Electrical Injuries—General Aspects the heartbeat and leads to reduced cardiac output in a situation
The passage of electricity through the body causes injury via when the myocardium has an increased demand for oxygenated
multiple energy transduction mechanisms.10 However, the blood due to its frequent beating. For example, prolonged car-
pathophysiology of electrical injuries is not well understood, diac capture at rates of >220 heartbeats per minute may lead to
since a multitude of variables take part in the injury processes ventricular fibrillation in pigs.49 A mechanism leading to cell
that cannot be measured or calculated.69 Consequently, the membrane injury is electroporation, which causes disturbances
injury patterns are unpredictable and differ in every single case of cellular functions even when the current flow is too low or
of electrical accident.10,69 too short to induce thermal injury.88,89 The principal lesions in
Electrical accidents are arbitrarily divided at a 1000-V cut- a larger current flow are electrothermal injuries to skin and
off value in low and high voltage (Table 1).69 The flow of internal organs by Joule heating,10,69 and the effects of electro-
accidental currents disturbs physiologic electric processes of poration are easily overridden by heat in the case of typical
the body. Therefore, morphological lesions may not be present electrical accidents involving household, machinery, or over-
in victims dying from disruption of these processes, such as head power lines.50 Elementary parameters and formulae for
ventricular fibrillation, if the current flow is low.98 Established understanding electric injuries are given in Table 2. The most
mechanisms causing death in low-voltage electrical accidents important factor determining the development of electrical
include disturbances of cardiac T-wave, direct introduction of injuries is the amount of current that flows through the body
fibrillation by multiple high-frequency pulses, and long-term or tissue (Table 3). Other important determinants are resis-
high-rate electrical cardiac capture causing sufficient ischemia tance, type of circuit, duration of contact, size of contact area,
to lower the ventricular fibrillation threshold.49 High-rate elec- current pathway through the body, and type of electrical
trical cardiac capture overrides the physiological regulation of contact.32,39,69,98
1020 Veterinary Pathology 53(5)

Table 3. Effects of Different Current Intensities.a contrast, AC or RC currents tend to induce muscular tetany,
immobilizing the victim at the contact, thereby increasing the
Current Intensity Effect
duration of the current flow.32,39,69,98
1 mA Tingling sensation The terms entry and exit wounds are often used to describe
1–4 mA Pain electric injuries to the skin. This is true for the unidirectional
6–22 mA Inability to let go current flow in DC accidents. However, the terms source and
16–20 mA Skeletal muscle tetany ground contact points are more appropriate in the case of AC or
50–100 mA Ventricular fibrillation
RC accidents.32
2A Asystole
15–30 A Common household circuit breakers The longer the duration of contact of the victim with elec-
tricity, the more energy can cause electrothermal heating of
a
Modified after Fish.30 tissues. This increases the degree of tissue destruction at the
skin contact points and in inner organs.32,39,69,98
Current and resistance are interrelated by Joule’s first law. The larger the size of the contact area, the less energy acts
When a current flows, the thermal energy that can be generated upon the tissue per square area. The same current producing
is proportional to the resistance and the square of the amperage. thermal necrosis in the skin when the contact is made by a
For a current to flow, the resistance (measured in Ohms [Ω]) of pinpoint electrode may cause no lesions when the contact area
the tissues in contact with the electricity has to be overcome. is large, which is the usual circumstance in electrocution of
The higher the resistance, the higher is the potential for trans- fishes77 or in bathtub accidents in humans.32,39,69,98
formation of electrical into thermal energy. The resistance is The current pathway through the body determines the loca-
determined by the physical and chemical properties of the lization and the type of tissue injuries as well as the degree of
material or tissue itself and environmental factors. Moisture electrothermal heating. Current pathways through the heart or
decreases resistance, and carbonization during burning brain are the most dangerous ones, since they disrupt the vital
increases resistance.29 Skin (keratin) is the main resistor to the physiologic electrical functions of these organs. With high cur-
current flow into the body. In experimental electrocution of rent densities, the tendency of the current to flow through the
rats, a 3-phase response of the current was found.39 In the first tissue with the lowest resistivity is overcome and the body or an
phase, there is a slow rise in current as a result of the progres- extremity functions as a volume conductor with homogeneous
sive destruction of the skin barrier. The second phase is char- resistivity in which current flows through tissues indiscrimi-
acterized by an abrupt current increase after complete nately.69 Joint areas often exhibit the most severe injuries in
breakdown of the skin. The current ceases to flow in the third high-voltage accidents since there is less cross-sectional area,
phase after tissue fluids are volatilized by electrothermal heat, and consequently, current density is higher than in the muscular
resulting in desiccation and carbonization with increasing parts. In addition, the proportion of tissues with higher resis-
resistance. Typical resistance of dry human skin can reach tance (eg, bone, tendons) is higher. The same principle leads to
100 kΩ or more. Under wet conditions (sweating, rain, show- skin burns, when the contact areas are small and the current is
ering, bathing), skin resistance may drop to 1 kΩ. Mucous concentrated at the source and ground contact points.32,39,69,98
membranes of humans have a resistance of approximately There is no rule regarding internal electrothermal injuries.
100 Ω, and internal body resistance is around 300 Ω. The They can occur anywhere along the current path even far away
situation in animals is similar. Resistance of dry skin was found from the skin contact points and are usually noncontiguous
to be 375 kΩ in cattle53 and 350 to 544 kΩ in chickens.94 Wet with normal and injured tissue segments next to each other.10,69
skin has a resistance of 1.1 kΩ in cattle.53 Internal body resis- The length of the pathway between the contact points is inver-
tance was 139 to 437 Ω in cattle,54 644 to 1031 Ω in pigs,58 and sely proportional to the electrical field strength. A high-voltage
500 to 900 Ω in dogs.87 Different resistances exist in tissues: accident with 20 kV (eg, contact with overhead power line) and
bones, fat, and tendons have the highest resistance, followed by contact points at the head and the feet may have a similar field
skin. The lowest resistances are present in blood, nervous tis- strength than a low-voltage accident with 120 V (eg, household
sues, muscle, and mucous membranes. The total body resis- circuit), when the contact points are next to each other (eg,
tance in electrical accidents is equal to the sum of the internal chewing on electrical cords). Despite the same electrical field
resistance and the skin resistances at the contact points both to strength, the amount of tissues at risk for electrothermal injury
the source of the electricity and to the ground.32,39,69,98 differs dramatically in both situations.32,39,69,98
The type of circuit also influences the extent of damage. There are different types of electrical contacts. The danger
Alternating (AC) and rotary (RC) currents are about 3 times of step and touch potentials is discussed in the lightning section
more dangerous than direct current (DC), because they are able of this review. Briefly, step potentials occur when a faulty
to trigger continuous muscle contractions (tetany). Tetany electrical device is grounded and current passes along the sur-
occurs when the muscle fibers are stimulated between 40 and face into the ground from the faulty device to the periphery.
110 times/s. Usual frequencies for household electricity are 50 This grounding results in electrical potential differences along
(Europe, eastern Japan) to 60 (United States, western Japan) the current path, and consequently partial currents may flow
Hz. Consequently, DC currents tend to cause a single muscle through the body of a victim that is in contact with the ground
spasm, often throwing the victim away from the contact. In along the potential gradient.32 Touch potentials occur when a
Schulze et al 1021

victim is touching a faulty electrical device and a part of the (Fig. 3). Using a hematoxylin-eosin (HE) stain, coagulated
current passes over and/or through the body.32 Similar to the collagen fibers of the current mark may show basophilia (Fig.
situation in lightning accidents, 4-legged animals seem to be 4). Epidermal cells and nuclei may display a fishbone-like
more susceptible to the danger of step potentials than elongation (Fig. 4).26
humans.36,62 Low-voltage accidents are usually direct contact The morphology of these wounds has been extensively stud-
situations. In high-voltage accidents, arcing can occur, and it is ied in humans and animal models in the hope of detecting
the most devastating type of injury. An electrical arc involves lesions that could differentiate electrothermal and thermal
passage of electricity through the air. If the arc does not directly wounds.23,68,75,81,86,90 However, the effects of electricity, heat,
contact a victim, indirect injury can result from step and touch freezing, and simple mechanical force can produce similar
potentials or from heat since an arc easily reaches temperatures lesions. Therefore, interpretation of lesions has to be done
>2500 C. When the arc contacts the victim, severe flash fire- cautiously.
like burns may result from the heat of the arc, electrothermal Microscopic particles (beads) of metal from conductors may
heating of the tissues, and formation of flames after ignition of be transferred to the skin (so-called metallization) in electrical
clothing, hairs, feathers, or environmental materials.32,39,69,98 accidents, although not in every victim (Fig. 5).26 The beads
themselves do not offer clues about their origin because it is not
possible to differentiate metallic arc beads formed by electric
Morphological Findings in Electrical Injury arcing from melt beads formed by thermal heating as the result
In general, victims of low-voltage, short-contact accidents tend of fires.6 The presence of metallic beads on the skin of victims
to have milder lesions than those of high-voltage, prolonged of electrical accidents and fires can result from both processes,
(seconds) contact accidents.69 In a case study in humans, elec- as was shown in experiments on animal and isolated human
trical burns were absent in nearly half of the low-voltage vic- skin using red-hot wires.12,13,68,75 However, there seems to be a
tims, which showed only signs of acute cardiac failure or tendency that electrically induced metallizations are concen-
asphyxia at necropsy. 98 Inexplicable early or abnormal trated at the margins of the skin wound, whereas metallization
regional development of rigor mortis (eg, affecting only 1 arm caused by heat is diffusely distributed throughout the
or leg) may hint at electrocution since the tetany from pro- lesion.12,13,25 Tremendous efforts have been made to detect
longed electrical contact usually accelerates development of metallization with different analytical techniques, including
rigor.98 Similar to the situation in humans, accidents in farm atomic absorption spectrometry,1,41 acroreaction test,2 electro-
animals involving low-voltage power lines may produce only graphy,57 chemical reagents sprayed on the skin, 67 laser
signs of acute circulatory failure.60 Raptors and monkeys are microprobe,42 transmission electron microscopy,84 variable-
especially at risk for high-voltage accidents involving overhead pressure scanning electron microscopy (SEM) with an
power lines, and electrothermal lesions are often severe in these energy-dispersive x-ray microanalyzer, 46 histology with
animals (Fig. 1).51,56 energy-dispersive x-ray spectroscopy,82 atom emission spec-
trography,45 and histochemistry.40,68,75 Histochemistry, as a
widely used and available technique in diagnostic pathology
External Injuries laboratories, focuses on the demonstration of metallic ions
External injuries are essentially electrothermal burns and are (usually iron or copper) transferred to the skin from metallic
usually present in high-voltage accidents or in low-voltage conductors. Perl’s Prussian blue for iron and rubenaic acid
accidents with small contact areas and/or prolonged contact technique or dimethylaminobenzylidine-rhodanine method for
durations. Depending on the time and the amount of the current copper are the most commonly used histochemical techniques.
involved, they can be first- to fourth-degree burns.19,69 Identi- Careful interpretation of the results is necessary since these
fication of small skin lesions, so-called current marks, can be reactions may be positive even after simple mechanical contact
difficult, and the use of an alternate artificial light source dur- with metals, such as oxidized copper or iron wires,26,75 and also
ing external inspection of the victim at necropsy may facilitate false-negative results are reported.40,75 However, in case of
their detection.95 Singed hairs, feathers, and skin develop electrocution, metallization reaches deeper parts of the skin
photoluminescent properties absorbing light of a certain wave- (as far as the dermis), whereas in heat-induced lesions or after
length delivered by an alternate light source and emitting light mechanical contact, metallization tends to remain superficially
of a longer wavelength, which can be detected with goggles or in the stratum corneum.45,75 The diagnostic sensitivity of the
cameras equipped with screening filters.95 Current marks are methods using formalin-fixed, paraffin-embedded tissue sec-
described as crater-like elevations of the skin around a sunken tions is low.40 Better results can be obtained with cryostat
center.26 They are macroscopically surrounded by a pale, sections from specimens snap frozen in liquid nitrogen or fixed
porcelain-like or alabaster-colored zone and have a raised bor- in ethanol.75 Animal experiments in rats have shown that his-
der (Fig. 2). Microscopically, dermal collagen of the current tochemistry can also be used on skin biopsies in survivors as
mark appears hyalinized (Fig. 3a) with abnormal staining prop- long as the superficial wound crust is still present (in experi-
erties (eg, using azokarmin-aninilin dye) (Fig. 3b) and loss of ments until day 5).75 In conclusion, metallization of the skin
birefringence under polarized light (Fig. 3c). Intra- and sube- can be found in victims of electrical accidents. However, the
pidermal blister formation (honeycomb pattern) is common results have to be carefully interpreted and other possible
1022 Veterinary Pathology 53(5)

Figure 1. Current mark, skin of a toe, raptor. Circumscribed porcelain-like skin lesion with central crater (arrow) caused by high-voltage
accident at an overhead power line. Figure 2. Current marks, skin, pig electrocuted for slaughter. Central lacerations caused by the electro-
cution device, surrounded by an elevated porcelain-like zone, surrounded by a hyperemic rim. Figure 3. Current mark, skin, pig electrocuted
for slaughter. (a) Hyalinized dermal collagen (arrows) adjacent to the skin laceration caused by the electrocution device; intraepidermal blister
(asterisk) and deposition of pigmented material on the wound surface caused by transfer of metallic substances from the electrocution device
Schulze et al 1023

explanations for the presence of metals in the skin (fire, electrocution leads to pyramidal cell loss,52 reduction in Pur-
mechanical contact with metals or metallic dust) have to be kinje fibers,37 leptomeningeal hemorrhages and disruptions,73
ruled out before a final diagnosis is made. In addition to tracing and hemorrhages, disruptions, cavities, and neuronal loss in the
of metallization in the skin lesions, metallic conductors spinal cord.76 Myocardial necrosis and infarction are rare in
involved in electrical accidents can be investigated for the human victims of electrocution69 but have been reported in
presence of DNA from the victim since biological material is cattle.66 Hemorrhages, myocardial contraction bands, myocar-
regularly transferred from the victim to the conductor even in dial necrosis, and vascular thrombosis, especially in the area of
low-voltage accidents. 65 In severe autolytic cases with the atrioventricular node, have been experimentally induced in
detached epidermis, SEM of the dermal surface may help to dogs.96 Changes in cardiac protein expression (eg, Cx43, Ang
detect indicative alterations to the papillary morphology caused II, ET-1, type III collagen, c-fos) have been detected in elec-
by electricity.85 trocuted rats.33,38 Cataracts developed in approximately 6% of
human victims of high-voltage accidents involving the head.69
They have been reported in a great horned owl,24 and lens
Internal Lesions vacuoles followed by anterior subcapsular cataracts were
Internal injuries are rare in low-voltage accidents.69 If present, reproduced in a rabbit animal model.83 Skeletal injuries,
they seem to be caused by electroporation. Osmotic swelling of including femoral fractures due to strong muscle contractions
the tissues, vacuolization, and necrosis of muscle cells develop or from falling, are sometimes seen in humans.31 Fractures of
after structural damage to the cell membranes, and the resulting the lumbar vertebral column are common in electrocuted
edema may be diagnosed in vivo by magnetic resonance ima- fishes,77 as are fractures of the vertebral column, sacrum, pel-
ging.35 Tissue injury by electrothermal heating is often present vis, and femurs in electrocuted pigs.11,34,47,80 However, as in
in various internal organs of victims after high-voltage acci- humans, animals dying from the disruption of vital electrical
dents and prolonged contact durations in low-voltage acci- functions of the body often show only signs of acute circulatory
dents. Their distribution depends on the pathway of the failure at necropsy. Common lesions are acute venous conges-
current. Common complications in survivors are rhabdomyo- tion of shock organs, petechiae, and ecchymoses in the trachea,
lysis and myoglobinuria or hemolysis and hemoglobinuria, heart, and lung, often combined with inexplicable early rigor or
with resulting renal injury and failure. Rhabdomyolysis and bloating of the carcasses.34,60,93 Petechiae have also been fre-
compartment syndromes as a result of vascular ischemia and quently described in humans,43 and they can be reproduced by
muscle edema may develop far away from the skin contact the hypotensive effects of intracardiac electrocution in
points and may be severe even in cases with minimal external rabbits.16
current marks.19,31,69 Since blood is a good conductor of elec- In conclusion, careful investigation of the victim and its
tricity, current tends to flow along the blood vessels, causing environment has to be carried out to make a final or most likely
damage to endothelial cells and myocytes, resulting in throm- diagnosis of electrocution since morphological lesions tend to
bosis. These lesions may develop at any time after the accident, be inconsistently present or even absent depending on a multi-
even after several weeks.30,69 Experimental models have been tude of unpredictable individual, technical, and environmental
developed to study the effects of these vascular factors.
lesions.17,19,55,63 The reduced tissue temperature due to throm-
bosis and ischemia may be of clinical importance as it can be
visualized by infrared thermography, allowing low-stress dis-
Lightning Injuries—General Aspects
tant diagnostics in wild animals like raptors.59 Every year, thousands of farm and wild animals suffer from
In a recent study of local and systemic in vivo responses to lightning strikes worldwide.36 Often the incidents are only
electrocution in rats, first insights were gained into the signal- reported in the daily newspapers. If postmortem investigations
ing networks involved in the response of the body to electric take place, mostly in farm animals, usually the local practi-
injuries as genes involved in dermatological diseases and con- tioner is commissioned to issue a death certificate for an insur-
nective tissue networks were upregulated, whereas genes ance company.15,92 Only few cases are submitted for necropsy
involved in cellular movement networks and signaling and to diagnostic veterinary pathology facilities. This situation
nervous system networks were downregulated.79 results in a relative paucity of articles in peer-reviewed jour-
Central nervous signs are common in victims of electrical nals. Animals are more often affected by lightning than humans
accidents if the current pathway goes through the brain or as they usually remain outdoors even under thunderstorm con-
spinal cord.69 Spinal cord injury after electrocution has also ditions. In addition, they are much more vulnerable to receive
been described in a dog. 72 Animal models show that lightning injuries due to the dangerous potential differences

Figure 3. (continued) (arrowhead). Hematoxylin-eosin (HE). (b) Almost total loss of staining of the hyalinized dermal collagen (arrows) with
an azokarmin-anilin-dye. Azan stain. (c) Loss of birefringence of the hyalinized dermal collagen (arrows) under polarized light. HE under
polarized light. Figure 4. Current mark, skin, pig electrocuted for slaughter. Severely hyalinized dermal collagen showing increased basophilia
(asterisks). HE. Inset: Fishbone-like elongation of epidermal cells and nuclei. HE. Figure 5. Current mark, skin, calf electrocuted for slaughter.
Metallization (iron deposition) at the laceration site of the electrocution device (arrows). Perl’s Prussian blue.
1024 Veterinary Pathology 53(5)

Table 4. Frequency of Different Mechanisms of Injury in Human Step Potential

Lightning Victims.a
The step potential or ground current is the most common lightning
% hazard in 4-legged animals. When lightning strikes the earth, cur-
rent passes along the surface and into the ground from the strike
Direct strike 3–5
Touch potential 3–5 point to the periphery. This results in electrical potential differences
Upward streamer 10–15 along the current path, and consequently partial currents may flow
Side flash 30–35 through the body of a victim, which is in contact with the ground
Step potential 50–55 along the potential gradient. These currents enter the body at 1 pair
Blast Unknown of feet and leave at the other in a cranio-caudal or latero-lateral
a
Modified after Price and Cooper.69 direction. Thereby, they usually flow through the heart in 4-legged
animals in contrast to humans and may induce arrhythmias, ven-
tricular fibrillation, or asystole.36,69,71 Usual lightning currents of
(step potential) that may be built up between their feet in the 20 kA may cause a step potential difference of 1.5 kV over a step
event of nearby lightning.36 Lightning accidents in humans length of 50 cm at 10-m distance from the point where the lightning
result in a mortality rate of 10% to 30%.69,71 The mortality rate hits the ground, resulting in 2- to 3-A current flow through the body
in animals compared to humans is unknown. However, in the for a 10-ms period.10 Accidents caused by step potentials can occur
case of a group of children struck by lightning, dogs sleeping in at up to a 200-m distance from the ground strike point.99
the same tent as the children had a considerably higher mortal-
ity rate of 57% (4 of 7) versus 14% (4 of 28).18
Blast
Mechanisms of Lightning Injury Lightning generates a shock wave (thunder), which can reach a
pressure greater than 100 bar,10 by massive expansion of air in the
Lightning causes injuries principally in 6 different ways (Table 4): lightning channel creating primary (ruptured tympanic mem-
direct strike, side flash, touch potential (contact injury), upward branes, traumatic injury of inner organs) or secondary (blunt
streamer, step potential (ground current), and blast.36,69,71 trauma from falling) blast traumata in the victim. In a case study
on human lightning victims, primary blast injuries typically
Direct Strike included uni- or bilaterally ruptured tympanic membranes in 17
of 21 (81%), aortic injury in 3 of 45 (6.7%), cardiac injury in 4 of
If victims are directly hit by the lightning flash, the entire
45 (8.9%), and head injury in 4 of 45 (8.9%) victims, respectively.97
current may pass over and/or through the body, which is often
In an experimental study on rats, similar primary blast injuries
fatal.36,69,71
to inner organs could be reproduced by the concussive effect
of water vaporization due to flash over lightning in wet animals.64
Side Flash When lightning strikes, a very large potential difference
A side flash involves currents jumping from nearby objects between the body and the ground is established (Table 1), result-
struck by the thunderbolt onto the victim. Under such instances, ing in a brief, massive current flash over and/or through the body
the entire lightning current or a part of it may pass over and/or and in induction of secondary electrical currents around the
through the body.36,69,71 magnetic field pulse of the lightning. The duration of the pri-
mary lightning current and the secondary electrical currents is
generally too short to cause skin breakdown and lesions by
Touch Potential Joule heating, as is characteristic for electrical injuries.10,22,71
A touch potential or contact injury occurs when lightning However, it is sufficient to damage the cells by other electrical
strikes an object, which the victim is touching, and a part of mechanisms such as electroporation and electroconforma-
the lightning current may pass over and/or through the tional changes to membrane proteins and lipid bilayers,10,89
body.36,69,71 This seems to be the usual cause of a lightning resulting in unregulated leakage of ions through the damaged
accident in farm animals kept indoors in stables.4 cell membrane and ultimately cell death when membrane
repair mechanisms fail.71 Since cell length is directly propor-
Upward Streamer tional to transmembrane potential, skeletal muscle and nerve
fibers are especially susceptible to electroporation due to reor-
Thunderbolts carry large amounts of usually negative charges ganization of cell membrane lipids into pores as a consequence
to the ground, creating intensive electrical fields in their vici- of the imposed transmembrane potential.71
nity. In response, many objects in the surrounding area send
positively charged electrical streamers toward the negatively
charged electrical field of the thunderbolt for potential equal-
ization, which may give rise to electrical currents passing
Morphological Findings in Lightning Injury
through the body of a nearby victim and may cause paralysis The presence or absence of lesions in victims of lightning
or even (depending on the heart cycle) cardiac failure.36,69,71 accidents cannot be predicted because of the multitude of
Schulze et al 1025

Figure 6. Linear lightning mark, haired skin, horse. Equine lightning victim with curled hairs at the cranial aspect of the right hind limb (arrows).
Figure 7. Lightning mark, feathered skin of the right wing, barnacle goose (Branta leucopsis). Lightning victim with severe tissue loss and singeing
of feathers (arrows). Figure 8. Lightning mark, skin, barnacle goose. Intraepidermal blister formation (asterisks). Hematoxylin and eosin (HE).
Figure 9. Lightning mark, skin, barnacle goose. Elongation of epidermal cells (arrow) adjacent to a subepidermal blister (asterisk). HE. Figure
10. Lightning mark, artery, horse of Fig. 6. Severe vacuolization of vascular myocytes (arrowheads) in a dermal artery from right hind limb. HE.
Figure 11. Keraunographic marking, grass. Fern-like keraunographic marking (Lichtenberg figure) on the grass after lightning strike. Courtesy of
TechEBlog.

individual and environmental influencing factors. Conse- side flashes, or blast trauma tend to have lesions, whereas
quently, identical injury patterns do not exist, and the death by step potential may produce only signs of acute
lesions, if present at all, are different in every single case.10 circulatory failure and sometimes secondary blunt traumata
In general, victims injured by direct strike, touch potentials, from falling.
1026 Veterinary Pathology 53(5)

External Injuries coronary bands and soles since they are points of minor elec-
trical resistance compared to the horn capsule.
External injuries, so-called lightning burns or marks, are often
Singed hairs or feathers following the path of the current
present in lightning victims along the path of the current flash
flash over the body are regularly found in human and animal
over the body in humans and animals (Fig. 6). In a human case
lightning victims.3,27,92,100 The use of an alternate light source
study,97 91% of the victims had burns. In animals, external
emitting variable wavelengths of 400 nm, 450 nm, 485 nm, 530
lesions seem to be less frequent, occurring in only 43% of
nm, 570 nm, and 700 nm during macroscopic investigation of
lightning fatalities.92 Lightning burns can be divided into 4
the body surface may increase the detection rate in victims with
categories; however, combinations may occur.22
subtle changes.95
Linear burns are usually first- or second-degree burns found
in wet areas (Fig. 7). They seem to be caused by steam origi-
nating from vaporization of sweat and rainwater. Histopatho- Internal Injuries
logically, the epidermis may show blister-like intraepidermal
Acute internal injuries may involve nearly every organ in
cavities (Fig. 8) or separation from the dermis, and volar ker-
humans but mainly the central nervous system and the heart.
atin may be vacuolized, indicating that vaporization of water
However, due to the short exposure time to the lightning flash
represents the main mechanism of skin destruction. Typical
(Table 1) internal lesions are rare (in approximately 3% of vic-
nuclear elongations in epidermal cells, indicative of electro-
tims) compared to high-voltage electrical accidents, where they
thermal injuries, are only sporadically present (Fig. 9). Arterial
regularly occur.22 In a sheep model,3 it was shown that lightning
myocytes show elongated wavelike nuclei, cytoplasmic vacuo-
may enter the cranial orifices, leading to a passage of the current
lization (Fig. 10), and single karyopyknotic cells.
directly into the brainstem and causing periaxonal ballooning of
Punctate burns are multiple circular burns resembling cigar-
the myelin sheaths at the floor of the fourth ventricle in the
ette burns and may be of first to third degree but are usually too
region of the respiratory control centers. In the heart, wrinkling
small to require skin grafting.
of the myofibrils and patchy foci of necrosis were induced in the
Thermal burns originate from ignited clothing or heated
same model.3 In another lightning model in pigs,44 surviving
metal.
animals had similar small to transmural necrotic foci in the
Keraunographic markings are regarded as pathognomonic
myocardium and were suffering from ventricular or supraven-
lightning skin lesions in humans (syn.: Lichtenberg figures,
tricular extrasystoles. For the other pigs in the study, the cause of
erythematous branching patterns, arborization, ferning, feather-
death was cardiac asystole and/or ventricular fibrillation.44 Sim-
ing burns, etc).20,21,70,97 However, they may also rarely be present
ilar to the situation in electrocution, pigs often acquire vertebral
in victims suffering from high-voltage accidents.5,98 Kerauno-
or pelvic fractures,9,15,27,91 which were speculated as being
graphic markings were found in about 33% of human lightning
caused by strong muscular contractions resulting in a ‘‘jackrab-
victims.97 The nature of these lesions is not understood. They
bit’’ takeoff during the shock.74 Similar fractures of the vertebral
develop within 1 hour of the strike, are painless pink-red to
column have been reported in koi carp struck by lightning.7
brownish markings, and usually fade and ultimately disappear
However, only signs of acute circulatory failure may be found
within 24 to 48 hours after the incident in survivors and on
at necropsy15,27,92 since the most common form of lightning
corpses, leaving no residual lesions.20,21,70 Keraunographic mark-
injury in animals are step potentials, leading to death by disrup-
ings are not associated with histological lesions and do not corre-
tion of the physiologic electric functions of the body.36
spond to vascular or neuroanatomic patterns of the skin.21,70,97
Delayed internal injuries seem to be common in humans,
However, they can be reproduced in animals and seem to follow
mainly involving the central, peripheral, and autonomic ner-
the lines of the surface flashover in lightning experiments.22 They
vous system, eyes, and ears.22 However, conflicting evidence is
are easy to identify in humans with fair, sparsely haired skin, but
reported by other authors.61 In animals, central nervous and
they are rarely reported in animals.4 Recognizing them when the
other disturbances are frequently seen in survivors.15,27,36
skin is pigmented, densely haired, or feathered may require skin-
These may include vestibular signs,8 corneal edema,28 and cer-
ning of the whole carcass. Furthermore, victims need to be
ebrocortical necrosis with visual impairment.14
necropsied within the first few hours after death, and suitable light
In conclusion, the statement of Brightwell15 is still true that
may be necessary to detect these markings because of their tran-
in cases of lightning strike, diagnosis has to be based on a
sient nature.20 Keraunographic markings may also be found on
combination of strong circumstantial evidence such as dam-
the ground (Fig. 11) near human or animal victims, suggesting
aged trees or keraunographic markings on the ground near the
lightning as a probable cause of death.78,97
victims, search for indicative morphological lesions, and elim-
Discrete entry and exit wounds of lightning currents are
ination of other disease processes by thorough necropsy of
uncommon in humans22 and animals, having usually been
well-preserved carcasses. Sometimes when animal carcasses
found on the soles of the hooves.4,15,27,91 The hooves are the
are too autolysed for necropsy or found in remote areas of the
most likely transfer points of a current passing through the
wilderness, where in-depth pathological examination is not
body of an animal into the ground and therefore need to be
possible, the diagnosis has to rely on typical findings at the site
carefully examined in suspected cases of lightning injury or
of death (eg, circumstances at the death scene and kerauno-
electrocution.91 Special emphasis should be given to the
graphic markings in the environment).78 Consideration of
Schulze et al 1027

lightning location data in countries where meteorological ser- 14. Boeve MH, Djajadiningrat-Laanen SC, Grinwis G, et al. Visual impairment
vices register these incidents may further increase the diagnos- after suspected lightning strike in a herd of Holstein-Friesian cattle. Vet Rec.
2004;154(13):402–404.
tic specificity.92
15. Brightwell AH. Lightning stroke in livestock. Can Vet J. 1968;9:186–188.
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production of lung petechiae and their possible significance in the sudden infant
Concluding Remarks death syndrome. Pathology. 1980;12:181–188.
17. Carmeliet P, Moons L, Stassen JM, et al. Vascular wound healing and neointima
Investigations of electrical and lightning injuries are relatively
formation induced by perivascular electric injury in mice. Am J Pathol. 1997;
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trum of lesions caused by electrical currents and lightning Int J Care Injured. 2003;34:367–371.
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Declaration of Conflicting Interests 12:211–225.
The author(s) declared no potential conflicts of interest with respect to 24. Dees DD, MacLaren NE. Presumptive electric cataracts in a Great Horned owl
the research, authorship, and/or publication of this article. (Bubo virginianus). Vet Ophthalmol. 2013;16:73–76.
25. Dettmeyer R. Forensic Histopathology: Fundamentals and Perspectives.
Berlin, Germany: Springer; 2011.
Funding 26. Dettmeyer RB, Verhoff MA, Schütz HF. Forensic Medicine. Berlin, Germany:
The author(s) received no financial support for the research, author- Springer; 2014.
ship, and/or publication of this article. 27. Drommer W. Über Blitzschäden bei Tieren. Dtsch tierärztl Wschr. 1966;73:
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