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.
Pediatric farm-related injuries: a series of 96 hospitalized patients. Ninety-six children were admitted during a 9-year period to a pediatric level 1 trauma center for treatment of farm-related injuries. The age range was from 6 weeks to 17 years (median, 7.5 years; mean, 7.6 years; standard deviation, 4.4). Thirty-nine patients (40.6%) had an animal-related injury, including 36 children (37.5%) who had an injury associated with a horse. Amish children had an increased risk of horse-related injury when compared with non-Amish children (p=0.04; RR=2.09, 95% CI: 1.18<RR<3.70). Thirty-seven patients (38.5%) had farm machinery-related injuries, including 14 ch...
Cardiac emergencies and problems of the critical care patient. Cardiac disease and dysfunction can occur as a primary disorder(ie, with pathology situated in one or more of the cardiac structures) or can be classified as a secondary problem when it occurs in patients with another primary problem that has affected the heart either directly or indirectly. Primary cardiac problems are encountered in horses presented to emergency clinics; however,this occurs much less frequently in equine critical patients than cardiac problems arising secondary to other conditions. Nevertheless,if primary or secondary cardiac problems are not identified and addressed, they c...
Critical peripartum disease in the mare. The variety of diseases that occur in the peripartum mare require the examining veterinarian to evaluate the patient and the historical information carefullly so as to make an accurate diagnosis and begin appropriate therapy. An understanding of equine behavior, reproduction. mechanisms of shock,and gastrointestinal and reproductive physiology is requisite for accurate interpretation of the myriad of clinical signs of diseases present in this population. Attention to the unique metabolic and physiologic needs of the pregnant and lactating mare can aid the critical care clinician in providing o...
Monitoring the critically ill equine patient. Measurements of physiologic parameters, such as blood pressure or lactate concentration, are useful to detect occult derangements, such as tissue hypoxia and dysoxia. These tools are also useful in determining the effects of therapy. Monitoring techniques are now widely available for the intensive management of critically ill horses and foals. A number of these have evolved into noninvasive or minimally invasive devices and procedures and provide information that can be used for earlier and more dynamic therapeutic intervention. The goal of increased monitoring is to improve the level of care ...
Anesthesia of the critically ill equine patient. There is a plethora of information regarding anesthetic management of horses; however, controlled studies of the critically ill equine patient are few. These patients should be managed like any equine anesthetic candidate but much more stringently:I. Preoperative evaluation and appropriate therapy may represent the difference between life and death during the intraoperative and recovery periods. 2. The anesthetic induction and maintenance protocol should be based on the individual situation of the veterinary facility and personnel("comfort zone"). 3. Appropriate monitoring and intraoperative s...
Treatment of peritonitis. In summary, peritonitis in the horse is a potentially life-threatening disease that must be treated promptly and aggressively. Therapy should be aimed at reducing systemic shock and hypovolemia, correction of the primary cause, antibiotic and anti-inflammatory therapy, and abdominal drainage and lavage. The prognosis depends on the ability to diagnose and treat the underlying cause and prevent the development of complications. Mortality rates can be as high as 59.7%, with horses developing postoperative peritonitis having a 56% mortality rate. Long-term complications like adhesion formation or...
Factors affecting the severity of horse-related injuries. Horse riding and handling are uniquely dangerous. Knowledge of the risk factors of horse-related injuries is essential to prevent them. We aimed to define the factors that affect the severity of horse-related injuries and the length of hospital stay. A number of 231 patients (136 females and 95 males) with horse-related injuries were studied. A generalized linear model was used to test the effect of age, sex, cause of injury, complexity of the mechanism of injury, year, place of injury and profession of the injured, on the injury severity score (ISS) and the hospital stay. Fall from a horse wa...
Pattern of equestrian injuries presenting to a Sydney teaching hospital. Equestrian activities are associated with a high rate of injury. Attempts to reduce the incidence and severity of injury require accurate characterization of risk factors and pattern of injury. The present study was performed to analyse the injuries seen at an Australian centre where a large number of equestrian injuries present. Methods: Data were collected prospectively over a 3 year period on all equestrian injuries presenting to the Prince of Wales -Hospital complex. These data were compared against and combined with retrospectively collected data over the preceding 3 years at the same cen...
Dystocia in a referral hospital setting: approach and results. Dystocia in the mare is an emergency in which duration has a profound effect on survival of the foal. Specific examination of the effects of dystocia duration on foal survival provides information to enable horse care personnel and veterinarians to manage these cases more effectively and maximise the chances of obtaining a live foal. Objective: Dystocia duration would have a negative impact on foal survival while method of dystocia resolution would not have an effect on foal survival. Additionally, we were interested in determining the effects of dystocia on subsequent fertility. Results: In t...
Diagnostic decision rule for support in clinical assessment of the need for surgical intervention in horses with acute abdominal pain. A prospective survey of horses with colic referred to a university hospital was undertaken to elaborate on a simple clinical decision support system capable of predicting whether or not horses require surgical intervention. Cases were classified as requiring surgical intervention or not on the basis of intraoperative findings or necropsy reports. Logistic regression analysis was applied to identify predictors with the strongest association with treatment needed. The classification and regression tree (CART) methodology was used to combine the variables in a simple classification system. The pe...
Spectrophotometric assessment of peritoneal fluid haemoglobin in colic horses: an aid to selecting medical vs. surgical treatment. In a case-control study in colic horses the ability of spectrophotometric measurement of the haemoglobin concentration in the peritoneal fluid supernatant and visual assessment of the colour of peritoneal fluid supernatant to differentiate between surgical and medical treatment of colic was assessed. Based on previous studies, which have found anda association between peritoneal fluid colour and the kind of treatment required, our hypothesis was that the peritoneal fluid haemoglobin concentration would be higher in horses requiring surgical intervention than in horses amenable to medical treat...
A changing pattern of injuries to horse riders. To describe the demographics and nature of injuries occurring on or around horses, to examine the nature of protective clothing in relation to these injuries, and to compare our data with previously published work in this area. Methods: Patients were identified using the term "sports injury-horse riding" from the departmental database for one calendar year from February 2000. Data were collected regarding demographics, injuries, protective clothing, and outcome. The data were then analysed and compared with the previously published literature. Results: 260 patients' records were analysed. The ...
Predictive values, sensitivity and specificity of abdominal fluid variables in determining the need for surgery in horses with an acute abdominal crisis. To determine the predictive values, sensitivity and specificity of abdominal fluid variables associated with the need for surgery in horses with an acute abdominal crisis. Methods: Retrospective study. Methods: Two-hundred and thirty-six horses examined for signs of abdominal pain between January 1993 and June 1999. Methods: Breed, age and gender of the horse and colour, total protein concentration and total nucleated cell count of an abdominal fluid sample were recorded. Colour of the abdominal fluid was classified as normal if it was yellow and transparent. Turbid fluid or fluid that was ser...
Non-surgical management of rectal tears in two mares. Two mares presented with life-threatening rectal tears were successfully treated with intensive medical management. Although surgery has been regarded as mandatory for grade 3 or 4 rectal tears in the past, recent reports have indicated the value of medical management alone. The case reports presented in this article detail the use of antibiotics, flunixin meglumine, laxative diets and faecal softeners in the medical management of two mares presented with grade 3 rectal tears.
Horse-related injuries in children. To identify the frequency, spectrum and outcome of horse-related injuries in children. Methods: Retrospective case series of horse-related injuries in children admitted to the Children's Hospital at Westmead (CHW) from January 1988 to December 1999, the John Hunter Children's Hospital (JHCH) from January 1991 to December 1997 and deaths reported to the New South Wales Paediatric Trauma Death (NPTD) Registry from January 1988 to December 1999. Methods: Circumstances of injury; helmet use; adult supervision; type and number of injuries identified. Results: 232 children were admitted with horse-r...
Rodeo related large animal injury: is protective head-gear warranted? To compare rodeo associated large animal injuries to large animal associated trauma from other aetiologies in order to determine whether mandatory protective head-gear during rodeo is warranted. Retrospective analysis related to injury involving large animal admissions between 1 January 1990 and 31 December 1995. The setting is at the University of New Mexico Health Science Center, a level 1 trauma centre. All patients admitted with Injury Severity Scores of 1 or higher following large animal associated injuries. There were 140 admissions for which mechanism of injury was known. Thirty-nine oc...
[Intoxication with propylene glycol in two horses]. Two horses were accidentally administered propylene glycol instead of mineral oil. After discovery of the mistake intensive medical therapy with intravenous fluids, etc. was started, and both animals recovered fully from their clinical symptoms. Veterinarians use propylene glycol as well as paraffin routinely for the treatment of their patients. Mistakes are likely to be made because both medicines and sometimes their packing have a similar appearance. Several incidents have been reported in other countries. A large amount of propylene glycol given to a horse, but also to other animals, can be...
Laparoscopic intra-abdominal ligation of the testicular artery following castration in a horse. A 364-kg (800-lb) 1-year-old mixed-breed horse was admitted for treatment of uncontrolled bleeding after castration. Multiple attempts to ligate the testicular artery through the scrotal incisions prior to referral had been unsuccessful. Because of the owner's concerns about cost, an attempt was made to control the bleeding by applying pressure to the inguinal region and administering formalin IV. However, hemorrhage continued. A decision was made to use laparoscopy to ligate the testicular artery. The horse was anesthetized and positioned in dorsal recumbency, and a routine ventral laparoscop...
Mechanisms and patterns of injuries related to large animals. Injuries from encounters with large animals represent a significant health risk for rural communities. We evaluated our regional trauma centers' experience with large-animal injuries to determine whether certain mechanisms and patterns of injury predicted either major head/craniofacial or torso (chest/abdomen/pelvis) trauma. Methods: The hospital courses of 145 patients with injuries related to large animals were reviewed retrospectively to determine patterns of injury, specific injury mechanisms, species-specific injuries, and predictors of multiple body region trauma. Results: Seventy-nine p...
Jockey injuries in the United States. In the sport of horse racing, the position of the jockey and speed of the horse predispose the jockey to risk of injury. Objective: To estimate rates of medically treated injuries among professional jockeys and identify patterns of injury events. Methods: Cross-sectional survey from data compiled by an insurance broker. Information on the cause of injury, location on the track, and body part injured was evaluated. Methods: Official races at US professional racing facilities (n = 114) from January 1, 1993, through December 31, 1996. Methods: A licensed jockey population of approximately 2700 pe...
Injuries to polo riders: a prospective evaluation. To assess prospectively the incidence, nature, and severity of injuries to polo riders competing in the 1996 Argentine High Polo season. Methods: Assessment, documentation, and provision of care for all injuries sustained during the 1996 season by one of the authors. Riders were also surveyed retrospectively for their previous polo injuries. Results: 34 riders took part in the study. Nine injuries were sustained prospectively and 55 injuries were reviewed retrospectively (64 total). The injuries were categorised as minor (10), moderate (13), and major (41). Twenty five (39%) injuries occurred ...
Predictors of arterial oxygen tension in anesthetized horses: 1,610 cases (1992-1994). To identify factors associated with various arterial partial pressures of oxygen (Pao2) in anesthetized horses. Methods: Retrospective study. Methods: 1,450 horses anesthetized a total of 1,610 times with isoflurane or halothane. Methods: Anesthesia records, particularly results of blood gas analyses, were reviewed, and horses were grouped on the basis of lowest Pao2. Results: For horses with lowest Pao2 < 120 mm Hg, those with low pulse pressure, that underwent anesthesia on an emergency basis, or that were males were more likely to have Pao2 < 80 mm Hg. For horses with lowest Pao2 <...
Dietary and other management factors associated with colic in horses. To determine whether dietary and other management factors were associated with development of colic in horses. Methods: Prospective matched case-control study. Methods: 2,060 horses examined by veterinarians in private practice in Texas for colic and noncolic emergencies. Methods: Each month for 12 months, participating veterinarians were sent forms to collect information on 1 horse with colic and 1 horse that received emergency treatment for a condition other than colic, information collected included signalment, farm management and characteristics, diet, medical and preventive medical factor...
Injuries to riders in the cross country phase of eventing: the importance of protective equipment. To determine the distribution of injuries in the eventing discipline of equestrian sports and the effectiveness of the protective equipment worn. Methods: Data on all injuries sustained in the cross country phase over fixed obstacles were collected from 54 days of competition from 1992 to 1997. This involved 16,940 rides. Results: Data on a total of 193 injuries were collected, which included two deaths. This represents an injury rate of 1.1%. Head and facial injuries represented the largest group (31%), with one third of these requiring treatment in hospital. All riders were wearing protectiv...
Equestrian injuries in the paediatric age group: a two centre study. This study's objective was to examine the nature, cause and frequency of injury resulting from equestrian sport in paediatric patients attending two accident and emergency departments. We recorded the attendances of patients aged less than 16 years with equestrian-related trauma in 1 year. Demographic details, injury, mechanism of injury, rider experience and use of protective equipment were noted. There were 41 attendances (39 female, two male, median age 12 years). Thirty-one were injured while mounted, 10 while dismounted. The commonest group of injuries were soft tissue injuries of the low...
Rider injury rates and emergency medical services at equestrian events. Horse riding is a hazardous pastime, with a number of studies documenting high rates of injury and death among horse riders in general. This study focuses on the injury experience of cross country event riders, a high risk subset of horse riders. Methods: Injury data were collected at a series of 35 equestrian events in South Australia from 1990 to 1998. Results: Injury rates were found to be especially high among event riders, with frequent falls, injuries, and even deaths. The highest injury rates were among the riders competing at the highest levels. Conclusions: There is a need for skilled...
[Evaluation of the portable blood analyser i-STAT]. The purpose of this study was to compare the results of horse blood examinations on a portable blood analysis system, i-STAT SDI, with conventional laboratory equipment and to verify the accuracy and precision. The precision within run was high and the coefficients of variation ranged from 0 to 3.85%. The comparative analysis of patient samples with routine methods showed a very strong positive correlation with correlation coefficients above 0.96 for blood gases, pH, glucose, urea, hemoglobin, hematocrit, sodium and potassium, with the exception of chloride where it was 0.867. The i-STAT syste...
[Animal bites at the casualty department of the Oslo City Council]. During a 2-year period all Casualty Department data charts with the diagnosis "animal bite" were reviewed as part of internal quality control. Of 1,051 recorded episodes, 503 (48%) were women and 147 (14%) children under 16 years of age. 951 (90%) wounds were treated without closure. Half of the patients were not given antibiotics on the first visit, whereas one third were given penicillin. Tetanus status had been evaluated on 1,015 (97%) charts. Most bites were caused by dogs (76%), cats (17%), and horses (2%). Children were the victims of 118 (15%) dog bites, eight (4%) cat bites, and ten (5...