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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-related neurosurgical trauma: a prospective series of 30 patients. Thirty million Americans ride horses; 50,000 of these riders are treated in emergency rooms annually. Equestrian activities are uniquely dangerous because the participant is unrestrained, often helmetless, and riding large, unpredictable animals capable of 40-mph speeds and kicking with up to 1 ton of force. Neurologic injuries in equestrians constitute the majority of severe injuries and fatalities. We prospectively studied all patients admitted to the University of Kentucky Medical Center with equine-related neurosurgical trauma from July 1992 to January 1996. Eighteen of 30 patients were ma...
Severe nasal hemorrhage in an anesthetized horse. An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indi...
Heart rate variability in the horse by ambulatory monitoring. Using a microprocessor controlled Ambulatory Monitoring System (AMS) developed by one of us (LvD), we have been studying the changes in and control of heart rate in the resting horse. The system provides us with InterBeat Intervals (IBI in milliseconds), motion sensing, and a time domain measure (mean successive differences: MSD) of heart rate variability for periods up to 72 hours. Thoracic impedance is also available but parameters for the equine chest are not currently available. The system is completely noninvasive, small, and carried on a surcingle worn by the subject. The equine subject ...
Preventing equestrian injuries. Locking the stable door. The medical and sports literature databases were searched for equestrian sports-related injury published in English since 1980, together with conference abstracts and discussions with equestrian sporting bodies. This literature was critically reviewed, with emphasis on measures to prevent or control injury i.e. countermeasures. While there is considerable literature available on the epidemiology of injury incurred in most equestrian sports, there is little on the prevention of these injuries. Case-control or other studies evaluating the effectiveness of the countermeasures suggested by authors...
Penetrating wounds of the thorax in 15 horses. Clinical features, treatment and outcome of 15 horses with penetrating thoracic wounds are described. The most common cause of trauma was collision with an object (10 horses). Concurrent clinical findings included subcutaneous emphysema (12 horses), pneumothorax (12 horses), haemothorax (5 horses) and pneumomediastinum (6 horses). Axillary wounds were present in 5 horses. Foreign bodies were identified and removed from 2 horses. Wounds were sutured (6 horses) or packed (7 horses). Air was evacuated from the pleural cavities of 11 horses. Eleven horses (73%) were discharged from the hospital. A...
[Expert opinions about a case of injury which by a failure of a restraining device caused a life-threatening injury to a breeding stallion]. A stallion got fatal injuries by kicks of a maiden mare because a so called "panic hook" untied spontaneously. The use of such hooks to secure mares during mating should therefore not be recommended.
Horseback-riding-associated traumatic brain injuries–Oklahoma, 1992-1994. Each year, traumatic brain injury (TBI) is associated with 52,000 deaths and accounts for one third of all injury deaths in the United States; in addition approximately 80,000 persons who survive TBI incur some loss of function, residual disability, and increased medical-care needs because of these injuries. Major causes of TBI are motor-vehicle crashes, falls, assaults, and sports and recreational activities. During 1992-1993 in Oklahoma, horseback riding was the leading cause of sports-related TBI. To further characterize horseback-riding-associated TBIs, the Oklahoma State Department of Hea...
Risk factors for history of previous colic and for chronic, intermittent colic in a population of horses. To identify risk factors for recurrent colic and chronic, intermittent colic in horses. Methods: Case control study. Methods: The population included 768 horses examined by veterinarians for emergencies other than colic (control group). Methods: Horses with colic that had history of colic (n = 232) were compared with those without such history (n = 536), using logistic regression analysis to identify risk factors for history of previous colic and to determine odds ratios (OR) for these associations. Among the 232 horses in the history of colic group, 58 horses that had chronic, intermittent co...
Accidents with horses: what has changed in 20 years? Horse riding is a dangerous pastime with more accidents occurring per hour than during motor-cycling. Since a prospective survey of horse-related injuries conducted at a major centre in 1971-1972, equestrian groups and the medical profession have encouraged improvements in training and protective riding wear. By conducting a similar study at the same centre 20 years later we hoped to assess the effects of these measures on the pattern of injuries resulting from contact with horses. Patient and injury details were recorded prospectively for all those presenting to the Accident Service at Oxford...
Gunshot injuries in horses: 22 cases (1971-1993). Twenty-two horses were examined because of firearm injuries. Nine had been shot with .22-caliber bullets, 2 with BB pellets, 6 with buckshot, 1 with a .35-caliber bullet, and 1 with an airgun pellet. Injury was confined to the skin or skeletal muscles in 8 horses. Of these, 7 returned to their previous use. In 14 horses, injuries to additional structures were incurred, including the sinus and pharynx (n = 2), mandible (n = 1), tooth (n = 1), aorta (n = 1), eye (n = 3), tibia (n = 1), gastrointestinal tract (n = 3), joint (n = 1), and trachea (n = 1). The 3 horses that had only eye injuries wer...
[Injuries in horseback riding–incidence and causes].
Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin
This article presents the examination of 78 accidents in horseback riding, referring to their origin and kind of injury. It was found that 76% of all injuries did not occur during the active phase of riding, but in the time just before and right after it. Children without any experience in horseback riding were most susceptible to injuries. Referring to lesions occurring before and after the active phase, the longer extremity was predominantly involved (40%); furthermore, the skull was injured in 18% and the hand in 14% of all lesions. During the active phase of horseback riding, skull injurie... Traumatic carotid and vertebral artery dissection in a professional jockey: a cautionary tale. Jockeys accept bony fractures and soft tissue injuries as occupational hazards. An average National Hunt jockey falls once in ten races with an injury rate of 4.25%. Head injury is a common cause of morbidity and the benefit of helmets is well recognized. Neck injuries are also common and usually musculoskeletal. Although rare, trauma to the neck arteries may go unnoticed yet have catastrophic consequences. Internal tears can allow arterial blood to dissect the layers of the arterial wall and obstruct the lumen. Severe obstruction may lead to cerebral ischaemia and infarction. An appreciation ...
Confidential enquiry of perioperative equine fatalities (CEPEF-1): preliminary results. The Confidential Enquiry into Perioperative Equine Fatalities (CEPEF-1) is an observational multi-institutional prospective study of recovery outcome at 7 days post operatively, as called for by Steffey (1991). Data from 6,255 general anaesthetics (February 91-March 93) were submitted confidentially by 62 clinics. The outcomes of 333 cases which were subjected to euthanasia and which were not classified 'alive' or 'died' at 7 days, were excluded from the analysis. The remaining 5922 cases were analysed to identify risk ratios (RR) between survivors and nonsurvivors for a variety of factors. Th...
Pediatric equestrian injuries: assessing the impact of helmet use. To assess the impact of helmet use on the pattern, and severity of pediatric equestrian injuries. Methods: A prospective observational study of all children less than 15 years of age who were brought to the University of Virginia children's Emergency Department with horse-related injuries. Results: During the two-year period of the study, 32 children were evaluated. Two children were injured when a horse stepped on them. Thirty children fell from or were thrown from a horse. Of these, 20 were wearing a helmet. Head injuries were more frequent in those patients not wearing helmets. The mean Mod...
Development of a colic severity score for predicting the outcome of equine colic. Thirty-two physical examination and laboratory variables were recorded during examination of 165 horses admitted for acute abdominal disease. Univariate analyses were performed to determine which of the variables were significantly different between horses that lived or died. Stepwise logistic regression was performed to identify variables with the best predictive value. Four variables (heart rate, peritoneal fluid total protein concentration, blood lactate concentration, and abnormal mucous membrane) remained significant when entered into the model. Histograms for each significant variable we...
Fluid therapy. Fluid therapy is an integral part of treatment of the equine emergency patient. In this article, general principles of fluid therapy are discussed, including formulas for calculation of fluid volumes, fluid types and their indications, and specific therapy for several emergency conditions.
Approach to the emergency equine patient. Often in emergency situations minimal data are collected, decisions are made, manipulations are performed, and therapeutics are administered without the collection of complete data sets that would indicate a detailed history and laboratory analysis. The incomplete clinical analysis may lead to occasional mistakes, but most often expediency is necessary and admirable. This article presents a clinical approach to emergency patients that requires minimal data collection in the face of the need for timely decision development. Medicolegal considerations are addressed briefly.
Examination of the equine patient with gastrointestinal emergency. Clinical examination of the equine patient with acute abdominal pain should identify the affected body system and yield a provisional diagnosis. Determination of signalment, history, physical examination, and basic laboratory tests should assist in classification of the gastrointestinal disorder and direct the therapeutic plan. Determination of the definitive diagnosis of abdominal pain based on clinical examination is not crucial. For a successful outcome, efforts should be directed toward early recognition of the need for surgery and treatment of cardiovascular compromise in horses with seve...
Antimicrobial therapy of adult horses with emergency conditions. In emergency conditions, antimicrobial treatment is subordinate to truly life-supporting measures. Antimicrobial treatment should be formulated rationally for each patient and should not simply be a matter of following a recipe. This article presents principles for guiding rational therapeutic decision-making and examples of conditions in which those principles can be applied.
Ocular emergencies. Most ocular and orbital injuries or acute ocular inflammation in horses result in similar signs of adnexal swelling, photophobia, blepharospasm, and lacrimation. It is hoped that detailed examination and the suggestions in this article will enable veterinarians attending horses having ocular emergencies to arrive at a correct diagnosis and appropriate therapy.
Soft tissue emergency in adult horses. Equine practitioners are frequently called to attend to soft tissue injuries. The majority of these cases are routine and straightforward; however, a certain percentage may present as a life-threatening situation with potentially serious complications. Client communication, adequate preparation, patient stabilization, accurate injury assessment and appropriate wound preparation are key factors to expedite recovery and achieve a favorable outcome. Understanding the limitations of field therapy and deciding when to transport the case to a clinic or referral center plays an important role in the ...
Emergency analgesia and chemical restraint in the horse. Clinical examination of the equine patient with acute abdominal pain should identify the affected body system and yield a provisional diagnosis. Determination of signalment, history, physical examination, and basic laboratory tests should assist in classification of the gastrointestinal disorder and direct the therapeutic plan. Determination of the definitive diagnosis of abdominal pain based on clinical examination is not crucial. For a successful outcome, efforts should be directed toward early recognition of the need for surgery and treatment of cardiovascular compromise in horses with seve...
[Equestrian accidents in children and adolescents]. The rate of pediatric equestrian injuries is relatively low, but the severity of injuries is greater than in many other pediatric sport activities. In a 4-year period the charts of 109 patients up through the age of 15 years, who were admitted for equestrian-related injuries were reviewed. Falls from horses are the most frequent cause of injuries and responsible for their anatomic localization and type of injury. In our study the upper extremity was the most common (38%) area injured and head injuries comprised the second largest group with 36%. Forty percent of all injuries were fractures, 72...
Medical and surgical emergencies of the nervous system of horses: diagnosis, treatment, and sequelae. Trauma to the nervous system in horses may involve the brain, brainstem, spinal cord, or peripheral nerves. Trauma may occur to any part of the nervous system with or without a fracture.
Respiratory emergencies in the adult horse. Responding to an equine respiratory emergency requires rapid localization of the problem and appropriate choices for therapy. Localizing the cause of respiratory distress is aided by history and thorough physical examination. When examining the patient, one must focus on the presenting signs as indicators of URT or LRT dysfunction. Table 3 summarizes the characteristic presenting signs based on respiratory tract location and suggests the initial treatment course indicated. Respiratory distress in the absence of signs related to the pulmonary system suggests inadequate oxygen delivery secondary...
Reproductive emergencies in the mare. This article briefly reviews the clinical management of emergency conditions likely to be encountered by veterinarians responsible for the reproductive health of mares. The article discusses rectal tears, breeding injuries, uterine torsion, placental hydrops, and prepubic tendon rupture. A major component discusses a recommended approach to dystocias, and the management of such complications as uterine rupture and prolapse and postpartum hemorrhage. Management of retained fetal membranes and septic metritis is addressed.
