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Topic:Emergency Care
Emergency care in horses involves the immediate assessment and treatment of acute medical conditions or injuries to stabilize the animal and prevent further harm. This area of veterinary practice encompasses a range of situations, including colic, traumatic injuries, respiratory distress, and sudden lameness. Emergency care procedures may involve physical examinations, diagnostic imaging, fluid therapy, pain management, and, in some cases, surgical intervention. This topic includes peer-reviewed research studies and scholarly articles that explore the methods, protocols, and outcomes associated with emergency interventions in equine medicine.
Equine ambulatory practice: challenges and opportunities. Current economic conditions make the practice of equine medicine challenging, to say the least. The downward trend in the US economy has had a huge impact on horse owners and equine veterinarians alike. Horses are expensive to keep; as such, economics are the driving factor in the problem of the unwanted horse. Under these conditions, efficient equine ambulatory practices are well-suited to weather the economic storm. As contributors to this issue of Veterinary Clinics of North America note, one can practice high-quality medicine and surgery without the overhead and expense of a large clinic. ...
Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden. The first outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010. Methods: This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post...
[Examination of horses with acute colic: clinical and legal aspects]. The article provides hands-on advice and scientific background information regarding the management of the equine acute colic patient. It summarizes essential information on the patient's history, clinical examination, and legal aspects. The scope of the history is based on the clinical appearance of the patient. In horses with violent and barely controllable signs of pain, it is limited to colic-associated information such as onset, course and severity of colic signs, and the last time of defecation, as well as prior therapeutic intervention. In these patients, the clinical examination is foc...
A review of foal diarrhoea from birth to weaning. Diarrhoea is among the most common clinical complaints in foals. Aetiologies, diagnostic testing and recommended interventions for specific causes of enterocolitis are summarised. Many mild to moderately affected foals can be managed in an ambulatory setting, while others will benefit from more intensive care at a referral centre.
Evaluation and management of the recumbent adult horse. Evaluation and management of recumbent horses are challenging. Familiarity with disorders that can result in recumbency will facilitate more rapid diagnosis and more appropriate formulation of a prognosis. With rapid and appropriate diagnosis, appropriate treatment can be pursued and, with good nursing care, can result in a favorable outcome.
The equestrian sport-related injury workload of a regional doctor-led air ambulance unit. The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport...
A comparison of hypertonic (7.2%) and isotonic (0.9%) saline for fluid resuscitation in horses: a randomized, double-blinded, clinical trial. Hypertonic saline solution (7.2%) (HSS) can quickly replace intravascular volume deficits. HSS more recently has been advocated in the treatment of traumatic brain injury, but its use in dehydrated patients remains controversial. Objective: Hypertonic saline solution will show a significant improvement in both clinical and laboratory hydration parameters as compared to isotonic (0.9%) saline solution (ISS). Methods: Endurance horses eliminated from the 2009 Western States 100-mile (220-km) endurance ride and requiring IV fluid therapy were eligible for enrollment in the study. Methods: Twenty-...
Evaluation of the response to an accelerated immunisation schedule using a canarypox-vectored equine influenza vaccine, shortened interdose intervals and vaccination of young foals. The results of an accelerated immunisation schedule for horses used as part of the emergency response plan to contain and eradicate equine influenza in Australia in 2007 is described. The horses studied were vaccinated with a recombinant canarypox-vectored vaccine (ProteqFlu®, Merial) with a shorter interdose interval. Vaccinated horses included foals aged less than 4 months.
Amputation of finger by horse bite with complete avulsion of both flexor tendons. Amputation of fingers with tendon avulsion occurs through a traction injury, and most occur through a ring avulsion mechanism. Usually the flexor digitorum profundus is torn out with the amputated finger. Replantation usually is recommended only when the amputation is distal to the flexor digitorum superficialis insertion. Animal bites are relatively common, with a decreasing order of frequency of dogs, cats, and humans. Horse bites are relatively infrequent but are associated with crush injuries and tissue loss when they occur. This article describes a 23-year-old man with amputation of his m...
Adipose tissue-derived adiponectin expression is significantly associated with increased post operative mortality in horses undergoing emergency abdominal surgery. Adipose tissue is an important source of inflammatory cytokines (adipokines) and adiposity has been identified as having a significant effect on human morbidity and mortality. Obesity is also an emerging welfare problem in the UK horse population, but the role that it plays in secondary diseases is unclear. Objective: To examine the expression of inflammation-related adipokine genes in retroperitoneal adipose tissue of horses undergoing emergency abdominal surgery and to explore associations with adiposity and post operative survival. Methods: Retroperitoneal adipose tissue samples were obtain...
Biosecurity and vaccination strategies to minimise the effect of an equine influenza outbreak on racing and breeding. Three biosecurity and relief-and-recovery initiatives adopted by the NSW horse racing industries reduced the economic and social disruption caused by the disease and subsequent movement controls during the 2007 Australian equine influenza (EI) incursion. The first was the creation of biosecure horse training and racing precincts around the Sydney area to permit racing to continue with healthy horses. Infection was excluded for 3-5 weeks and race meetings were conducted safely during this period. The second was a vaccination program of racehorses at these and other precincts to maintain an ongo...
Insights into the economic consequences of the 2007 equine influenza outbreak in Australia. We estimate and describe the financial costs of the equine influenza (EI) outbreak in Australia, including the costs of emergency response measures and lost income/assets to businesses, associations and private horse owners. Costs to associations, governments and industry are discussed. We identify a lack of reliable data about the financial costs of the EI outbreak to the non-racing sectors of the horse industry.
Role of the New South Wales Department of Primary Industries’ Laboratory Information Management System (LIMS) in the 2007 equine influenza emergency animal disease response. A Laboratory Information Management System (LIMS) was used to manage the laboratory data and support planning and field activities as part of the response to the equine influenza outbreak in Australia in 2007. The database structure of the LIMS and the system configurations that were made to best handle the laboratory implications of the disease response are discussed. The operational aspects of the LIMS and the related procedures used at the laboratory to process the increased sample throughput are reviewed, as is the interaction of the LIMS with other corporate systems used in the management...
High-level coordination and strategy in the 2007 equine influenza outbreak response. The equine influenza (EI) outbreak presented many challenges that required high-level coordination and decision making, as well as the development of new approaches for satisfactory and consistent resolution. This paper outlines the elements of the national coordination arrangements, preparatory arrangements in place prior to the outbreak that facilitated national coordination, and some of the issues faced and resolved in the response.
Equestrian injuries caused by horse kicks: first results of a prospective multicenter study. To analyze horse-related accidents caused by hoof kicks. Methods: Prospective study to evaluate hoof kick-related accidents. Methods: Multicenter study, including 9 trauma centers in Hamburg, Germany. Methods: Patients who were treated as the result of a hoof kick between January 1, 2010, and May 1, 2010, were included in the study. Methods: Horse and rider qualifications, riders' use of protective equipment, location and activity at time of accident, mechanism of injury, injuries sustained, and treatment required for these injuries. Results: Twenty-four equestrians received hoof kicks. The av...
Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population. To characterize pulmonary gas exchange and arterial lactate in horses with gastrointestinal disease undergoing anesthesia, compared with elective surgical horses, and to correlate these variables with postoperative complications and mortality. Methods: Prospective clinical study. Methods: Horses undergoing emergency laparotomy for acute intestinal disease (n = 50) and healthy horses undergoing elective surgery in dorsal recumbency (n = 20). Methods: Arterial blood gas analysis was performed at predetermined intervals on horses undergoing a standardized anesthetic protocol. Alveolar-arterial ox...
Improving agricultural injury surveillance: a comparison of incidence and type of injury event among three data sources. Agriculture ranks as one of the most hazardous industries in the nation. Ongoing injury surveillance is key to identifying and preventing major sources of injury. Objective: The objective of this study was to compare the total number and types of injuries identified from community reporting versus two newly available medical data systems. These new systems are important because they are less time consuming and expensive to maintain. Methods: Farm injury case records from 2007 were collected for 10 NY counties from the following sources: ambulance reports, hospital data, and community surveilla...
The impact of ultrasound during emergency after-hour admissions of horses. Clinical use of diagnostic ultrasound at point-of-care or emergency situations, although common, has not been well documented in veterinary medicine. Medical records of after-hour emergency equine admissions during a 10-year period were reviewed and horses that received ultrasound scans were identified. Data sheets for each ultrasound scan performed during emergency clinical evaluation were collected and reviewed. Data extracted included anatomical region imaged, body system affected, documented ultrasonographic diagnosis and final diagnosis. Six hundred and nine records were available of whic...
[Acute coronary syndrome due to abnormal fibrous tissue growth after Aubert-Imai modification for transposition of the great arteries]. We report a female infant with acute coronary syndrome after Aubert-Imai modification for transposition of the great arteries. Two months postoperatively, she visited the emergency room because of perspiration and tachypnea. She was diagnosed with acute coronary syndrome by blood chemistry examination. Cardiac catheterization revealed Aubert route stenosis, and emergency operation was performed. The lumen around the aortopulmonary window was almost totally occluded by fibrous tissue extending from the equine pericardial patch. This fibrous tissue was completely resected and the aortopulmonary ...
Fluid therapy in equine patients: small-volume fluid resuscitation. Fluid therapy is an important component of resuscitation and treatment of critically ill equine patients. However, the decision of which fluid type to use in certain critical situations is somewhat controversial. This article focuses on the potential benefits of performing small-volume resuscitation in critically ill horses by combining hypertonic saline with a colloid (e.g., hetastarch).
The equine neonatal intensive care laboratory: point-of-care testing. Rapid evaluation and intervention is a requirement and a characteristic of patient management in neonatal intensive care units, and this applies for equine neonates also. Appropriate interventions are based on solid knowledge of age, maturity, and species-specific differences in reference ranges. Point-of-care (POC) testing devices speedup decision making regarding treatments and interventions. However, there are potential limitations of these devices when applied to age groups and species beyond those they were specifically developed for. This article discusses the age-specific differences in...
The hidden menace of non-equine horses. An emergency department audit of horse-related injury presentations alerted researchers to a hitherto uninvestigated source of childhood harm: non-equine horses. A search for the term "horse" in the database of the South Australian Injury Surveillance and Control Unit was performed for presentations of horse-related injuries to a paediatric emergency department of an Australian tertiary teaching hospital over a 5-year period. After all equine-related episodes were extracted, the remaining presentations were herded together and conclusions were jumped to. When legitimate science and research te...
Anaphylaxis and systemic inflammatory response syndrome induced by inadvertent intravenous administration of mare’s milk in a neonatal foal. To describe the diagnostic procedures, therapeutic management and successful outcome of a case of anaphylaxis induced by the inadvertent intravenous (IV) administration of mare's milk to a neonatal foal. Methods: A 3-day-old Thoroughbred colt was presented for treatment of bilateral flexural limb deformities of the forelimbs. Because the foal was unable to ambulate initially, mare's milk was administered via nasoesophageal tube feedings during treatment of the musculoskeletal disorder. Anaphylaxis resulted after unintentional administration of a bolus of 150mL of mare's milk through a jugular ...
Bilateral internal carotid and vertebral artery dissection after a horse-riding injury. Blunt cerebrovascular injuries, defined as blunt injuries to the internal carotid or vertebral arteries, are uncommon and usually occur in victims of high-speed deceleration motor vehicle crashes. A blunt cerebrovascular injury after an equestrian accident is an extremely unusual presentation. In recent years, advances in screening and treatment with pharmacologic anticoagulation before the onset of neurologic symptoms have improved outcomes for these patients. Endovascular stenting and embolization, although unproven, offer a new potential approach for these complex injuries. We present a uni...
Equestrian sport-related injuries: a review of current literature. Equestrian sports continue to grow in popularity in the Unites States and abroad, with an estimated 30 million people riding horses annually in the United States alone. Approximately one in five of these riders will suffer a serious injury during their riding career, requiring medical care and potentially hospitalization. Riding carries with it an implicit risk of injury associated with the unpredictability of the animals, the rider's head being positioned approximately 9 feet off the ground, and traveling unrestrained at speeds up to 40 mph. This article reviews common equestrian injuries, ep...
Needlestick and infection with horse vaccine. This report describes a case of accidental needlestick injury involving a live equine vaccination, Equilis StrepE. A vet presented herself to the Emergency Department having accidentally injected herself with an equine vaccination. Her left thumb (injury site) was inflamed and had lymphangitis progressing proximally along her left arm. Her inflammatory markers were not raised. The swelling, erythma and lymphangitis had improved markedly with intravenous antibiotics. She had no sequelae at follow-up. Equilis StrepE is a vaccine for submucosal administration containing a modified live avirulent ...
First aid for the laminitic foot: therapeutic and mechanical support. The goals of mechanical treatment during the acute phase of laminitis are to preserve the lamellar interface by reducing the forces that are compromising its integrity and to make the horse more comfortable. Early decision making is important in managing acute laminitis. This article helps the practitioner to identify some of the commonly used and accepted methods of protecting the laminitic foot. The materials available and the theories behind their use are also described. The laminitic foot needs to be understood before determining methods for its support. Most treatment options involve shif...
