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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.
Evaluation of a rapid agglutination method for detection of equine red cell surface antigens (Ca and Aa) as part of pretransfusion testing. Blood typing before transfusion minimizes the risk of transfusion reactions and prevents immunization of the recipient against incompatible RBC antigens. The major RBC antigens that warrant identification before packed RBC or whole blood transfusions in horses are Ca and Aa. Standard blood-typing protocols are time-consuming (2.5-3.0 hours) and impractical in emergency settings. Objective: The purpose of this study was to determine whether equine RBCs could be typed for Ca and Aa antigens using sera from horses with RBC antibodies in a modified rapid (15 minute) blood-typing protocol. Methods:...
[Design of equine serum-based Marburg virus immunoglobulin]. Immunoglobulin (Ig) against Marburg fever (MF) has been obtained from the equine serum. In terms of physicochemical and immunobiological properties, the obtained preparation corresponds to the quality of heterologous commercial immunoglobulins. The application of Marburg virus (MV) Ig with a titer of no less than 1:2048 by the emergency prevention scheme 1-2 hours after intraperitoneal inoculation of guinea pigs with MV in a dose of 20-50 LD50 protected 88-100% of the animals from death. MV Ig is recommended for emergency prevention of human MF.
Management of a gunshot wound in a mare. A 5-year-old, Quarter horse mare was treated for severe cellulitis secondary to a gunshot wound near the right humerus. The bullet was not retrieved due to the risk of damaging the radial nerve or elbow joint. Despite the presence of the bullet, the mare resumed athletic soundness once the infection had resolved. Traitement d’une blessure par balle chez une jument. Une jument Quarter horse âgée de 5 ans a été traitée pour une cellulite sévère à la suite d’une blessure par balle près de l’humérus droit. Le projectile n’a pas été retiré par crainte de léser le nerf radial o...
Multidisciplinary management of a complicated orbital injury inflicted by a horse. This case report describes an unusual and complicated orbital injury inflicted by a horse. Definitive management required multidisciplinary surgical collaboration to prevent significant ocular sequelae. The diagnostic role of good imaging and the potential use of bio-models are highlighted.
Assessment of a point-of-care lactate monitor in emergency admissions of adult horses to a referral hospital. Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point-of-care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses. Objective: It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory-based measurement of [LAC]. Methods: The study included adult horses presented for emergency evaluation. Methods: A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend...
Heart rate response to therapeutic riding in children with cerebral palsy: an exploratory study. The study was designed to document the heart rate response to therapeutic riding in children with cerebral palsy having mild-to-severe disability. Methods: Participants consisted of eight youth riders with cerebral palsy, divided into two groups: ambulatory and wheelchair dependent. The riders received continuous digital heart rate monitoring during 10 weekly 20-minute therapeutic horseback riding sessions. Results: The averaged resting, median, and peak heart rate values, as well as the peak percentage heart rate reserve values, were significantly higher in the wheelchair-dependent group. Con...
Traumatic injuries associated with horseback riding. According to the Center for Disease Control and Prevention (CDC), an estimated 30 million people ride horses each year in the United States. Horseback riding related injuries are common, with an estimated 50,000 emergency room visits annually. The popularity of recreational horseback riding has increased in South Florida and the incidence of associated traumatic injuries is a reflection of this. Methods: Retrospective review of patients admitted to a state designated Level I trauma center that sustained horseback riding associated injuries between January 2000 and December 2003. Information ex...
Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. Methods: All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Results: Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). In...
Equestrian injury prevention efforts need more attention to novice riders. Equestrian injury is commonly seen at trauma centers and the severity of injury is often high. We sought to determine the risk, incidence, and the influence of skill and experience on injury during horse-related activity (HRA). Methods: Members of horse clubs and individual equestrians in a three-state region (Oregon, Washington, and Idaho) were recruited via mailings and community advertisements to take a survey regarding their horse contact time and injuries over their entire riding career. Serious injury (SI) was defined by hospitalization, surgery, or long-term disability. Results: There w...
Fire and smoke inhalation injury in horses. Although not common in horses, fire and smoke inhalation trauma may require veterinary assistance at several levels. Most commonly, the equine clinician is called on to provide care of potentially complex and emotionally charged cases. Thermal injury, along with smoke inhalation, can cause local and diffuse lesions. Massive tissue edema may occur, which can be a challenge to manage as well as creating organ dysfunction at distant sites. Further complications of severely affected patients are varied and include life-threatening sepsis. This article reviews some of the important features of this...
Flood injury in horses. There is no way to prepare for every situation that arises in a disaster. By working closely with other producers and agricultural leaders, however, horse owners can lessen the impact of a disaster on their operation. Preparation and detailed planning are the most important aspects of flood-related injury prevention. Encouraging animal owners and caretakers to have an evacuation plan and dispersing knowledge about local and regional disaster authorities are critical for a successful disaster response. Educational programs on future disaster response empower communities to care for their people...
Management of equine poisoning and envenomation. Acute poisoning and envenomation often represent a diagnostic and therapeutic challenge. Although identification ultimately may benefit the affected animal, treatment frequently must commence before an etiologic diagnosis is established. Therefore, the goals for the management of acutely intoxicated horses must be focused on emergency intervention and stabilization of the patient, prevention of further exposure, and aggressive decontamination. This article reviews the treatment steps that should be considered during the management of horses experiencing poisoning or envenomation.
Neonatal foal resuscitation. Cardiac arrest in foals is generally secondary to other serious systemic diseases. Although it can often be anticipated, a clear plan is vital to success. Establishing cardiac output through chest compressions is the most important first step. This step should be followed by ventilation, drug therapy, identifying the nonperfusing cardiac rhythm, and following a preplanned treatment algorithm. Birth resuscitation requires special treatment considerations. The clinician should be prepared to perform resuscitation any time a birth is attended.
Thoracic trauma in horses. Thoracic trauma represents an important cause of morbidity in mortality after injury in human beings and animals. After any form of suspected chest wall trauma, initial emergency management should include assurance of a patent airway and adequate ventilation, along with treatment for shock if present. As with any open wound, tetanus prophylaxis should be instituted. Types of trauma to the thoracic region of the horse include pectoral and axillary lacerations, penetrating chest wounds, flail chest, fractures of the ribs, blunt thoracic trauma, and several potential sequelae that include pneumot...
Ophthalmic emergencies in horses. The emergency clinician is frequently in the position of receiving, evaluating, and initiating treatment on horses with ophthalmic emergencies or orbital trauma. In the best of circumstances, an ophthalmologist is available to guide initial therapy and ultimately assume responsibility for the management of the patient during the remainder of its hospitalization, but this is not always the case. The information presented here is meant to provide the emergency clinician with basic guidelines for the initial assessment and management of horses sustaining ocular injuries or presented with an ophth...
Field fracture management. Emergency management of distal limb and skull fractures in horses is vital to the successful outcome of these cases. Distal limb fractures, in particular, require careful assessment and counseling of the owner as well as adequate stabilization or coaptation of the fracture. Horses with limb or skull fractures may also have concurrent pain, blood loss, and other fluid losses that can result in shock requiring fluid therapy before definitive treatment of the fracture. Proper emergency fracture stabilization, initial treatment in the field, and patient transport are discussed.
Detection of rib trauma in newborn foals in an equine critical care unit: a comparison of ultrasonography, radiography and physical examination. Previous studies have shown that in man ultrasonography is more accurate than radiography for detecting rib fractures. Objective: To describe clinical, radiographic and ultrasonographic findings related with rib fractures in newborn foals in an equine critical care unit; and to compare diagnostic accuracy of ultrasonography to radiography. Methods: A prospective ultrasonographic study was performed on 29 foals presented to the emergency unit. This study was performed at the Centre Hospitalier Universitaire Vétérinaire (CHUV), University of Montreal. Physical examination as well as radiograph...
Thoracic trauma in horses. Thoracic trauma represents an important cause of morbidity in mortality after injury in human beings and animals. After any form of suspected chest wall trauma, initial emergency management should include assurance of a patent airway and adequate ventilation, along with treatment for shock if present. As with any open wound, tetanus prophylaxis should be instituted. Types of trauma to the thoracic region of the horse include pectoral and axillary lacerations, penetrating chest wounds, flail chest, fractures of the ribs, blunt thoracic trauma, and several potential sequelae that include pneumot...
The effect of inotropic and/or vasopressor support on postoperative survival following equine colic surgery. To determine the effects of dobutamine and phenylephrine on intra- and postoperative survival in horses undergoing emergency abdominal surgery. Methods: Retrospective case analysis. Methods: A total of 637 client-owned horses undergoing colic surgery. Methods: Clinical details of horses admitted for colic surgery were recorded on a computer database. Information collected included history, clinical variables observed before surgery, anaesthesia and surgical details, and postoperative survival and morbidity rates. Details of specific importance for this study were those recorded during anaesthe...
Equine perioperative fatalities associated with general anaesthesia at a private practice–a retrospective case series. To determine the fatality rate of horses undergoing general anaesthesia at a private equine referral practice using a limited number of anaesthetic protocols. Methods: A retrospective analysis of records (n = 17 961) from all horses undergoing general anaesthesia for surgical procedures from 1997 to 2001 at Rood and Riddle Equine Hospital, Lexington, Kentucky, USA. Results were reported as percentage of the population, and as crude mortality rates for each procedure (deaths per 1000). Results: The prevalence of equine fatalities directly related to anaesthesia was 0.12% (n = 21) and this rose ...
Retrospective study of dystocia in mares at a referral hospital. The period between the onset of dystocia and its resolution has an important bearing on fetal outcome. There are few published data on which to base decisions regarding optimum management of cases in practice. Objective: To evaluate and compare the effects of a coordinated dystocia management protocol (CDMP) with that of a previous protocol of random management on time to resolution and outcome in both an emergency dystocia referral population of mares (referred emergency cases: EM) and in a population of mares residing in hospital due to high risk pregnancy (HRP) concerns that then experience...
Changes in central venous pressure and blood lactate concentration in response to acute blood loss in horses. To evaluate selected hemodynamic, blood gas, and biochemical responses to mild to moderate acute blood loss in standing, awake horses. Methods: Prospective study. Methods: 7 healthy mares. Methods: Each horse was restrained in standing stocks, and its head was maintained in a neutral position; sedatives and tranquilizers were not administered. During a 1-hour period, blood was collected into collection bags by use of a suction pump. The rate of blood collection was approximately 16 mL/kg/h (7.3 mL/lb/h). Thirty minutes after blood collection, the blood was readministered at the same rate. Cent...
Five year analysis of Jockey Club horse-related injuries presenting to a trauma centre in Hong Kong. Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who presented to a trauma centre in a teaching hospital in Hong Kong. Methods: Information from the trauma centre database was analysed retrospectively. The database includes trauma patients who had sustained potentially severe injuries that warranted initial assessment and resuscit...
Enteritis and colitis in horses. Enteritis and colitis remain challenging and life-threatening diseases despite many recent advances. Successful treatment is largely dependent on early recognition and directed therapy, which is facilitated by obtaining a complete history and physical examination. A number of new therapies and methods of monitoring critically ill patients have become integral components of treatment success. The critical monitoring of equine foals and adults continues to be an exciting and emerging field.
Equine gastrointestinal motility–ileus and pharmacological modification. Colic is a common problem encountered in equine practice. Alteration of gastrointestinal motility is often the underlying cause for abdominal pain. Gastrointestinal motility can be measured as myoelectric activity, mechanical activity, and transit of intraluminal contents. Regulation of motility is based on a complex interaction between central innervation, autonomic innervation, and the enteric nervous system. Various humoral and neurochemical substances are required to interact flawlessly to allow propulsive motility. Ileus is defined as the absence of propulsive aboral movement of gastroint...
Dentoalveolar and mandibular body fractures caused by a horse kick: report of a case. A rare case of multiple mandibular fractures and severe facial laceration is presented. The cause was a horse hoof kick to an unmounted equestrian. The pertinent literature is reviewed and the maxillofacial injuries associated with animal interaction are discussed.
Non-fatal horse related injuries treated in emergency departments in the United States, 2001-2003. To characterise and provide nationally representative estimates of persons with non-fatal horse related injuries treated in American emergency departments. Methods: The National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) is a stratified probability sample comprising 66 hospitals. Data on injuries treated in these emergency departments are collected and reported. NEISS-AIP data on all types (horseback riding and otherwise) of non-fatal horse related injuries from 2001 to 2003 were analysed. Results: An estimated 102,904 persons with non-fatal horse related injuries (35...
Initial clinical impressions of the U.C. Davis large animal lift and its use in recumbent equine patients. The U.C. Davis Large Animal Lift (LAL) is a lightweight sling developed to help lift horses in clinical and rescue situations. Here we report on its first use in 16 recumbent horses with neurologic, muscular and musculoskeletal disorders. For each horse, history, sedation, ease and time of LAL application and hoisting, standing ability, LAL tolerance and outcome were recorded. The LAL was easily and safely applied in all horses in less than five minutes and the procedure was well tolerated with minimal to no sedation. While 10 horses were able to stand in the LAL after being hoisted, 6 horses ...
