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.
Bixby-Hammett D, Brooks WH.The most common location of horse-related injuries is the upper extremity (24% to 61%) with injuries to the lower extremity second in frequency (36% to 40%). The head and face sustain 20% of horse-related injuries. The most common type of injury is a soft tissue injury (92% to 1%), followed by a fracture (57% to 3%). Concussion is the third most common type of injury (63% to 2%). The most frequent cause of hospitalisation is concussion (38% to 4%) with fracture second. The most common injury which leaves residual impairment is injury to the central nervous system. The age at which most injury ...
Freeman DE.Wounds of the esophagus and trachea are uncommon, but closed wounds can be difficult to diagnose and treat. Esophageal wounds are the more serious and can be life-threatening; however, appropriate surgical and medical treatment applied without delay can be successful in some cases, especially in full-thickness longitudinal wounds. Tracheal wounds are usually less severe, but the high risk of iatrogenic injuries to the trachea should be recognized. Also, tracheal injuries can limit the athletic potential of a horse.
Spurlock GH.This article deals with the diagnosis and treatment of tendon lacerations. Tendon healing, with its implications relative to treatment, is discussed. The various pros and cons of suturing severed tendons are addressed as well as methods of immobilizing the injured limb. The need for prompt diagnosis and aggressive treatment of tendon sheath injuries is also discussed.
Fessler JF.Major surgery for wounds of the foot, compared with other parts of the body, requires a more detailed preparation and a more persistent aftercare. To approach severe hoof wounds with a routine applicable to drainage of a subsolar abscess is doomed to failure! Yet, in dealing with referral cases of hoof wounds, particularly those that have become chronic, the author has observed that the principles have been ignored and/or the routines inadequate. The hoof has a suitable capacity to heal, with complete reformation of hoof structures, if a healing environment is maintained for a long enough peri...
Juul SM.During the period from 1.1. to 31.12.1988, 104 patients with injuries resulting from riding or other forms of direct contact with horses were examined and treated in a casualty department in the County of Vejle. Antecedent data from these patients were collected. The majority of injuries occurred on falling from the horse and involved particularly the upper part of the body. The commonest injuries were bruises which did not require special treatment. The relationships between concussion, fracture of the humerus and fracture of the clavicle and riding were investigated by odds ratio. Much fewer...
Watkins JP, Taylor TS, Schumacher J, Taylor JR, Gillis JP.The records of 35 horses with Grade 3 or 4 rectal tears, presented to the Veterinary Medical Center at Texas A & M University over a five year period, were reviewed. Grade 3 tears were sub-classified according to whether the remaining tissue was serosa (Grade 3a) or mesorectum (Grade 3b). Five horses were destroyed on presentation and 30 were treated by primary suture closure (8 horses), faecal diversion alone (9 horses) or in combination with suture closure (11 horses) and packing of the tear with medicated gauze sponges (two horses). Faecal diversion was achieved with a temporary indwell...
The Journal of traumaJanuary 1, 1989
Volume 29, Issue 1 25-30 doi: 10.1097/00005373-198901000-00005
Ingemarson H, Grevsten S, Thorén L.Riding accidents can be of a serious nature. Knowledge of risk factors is of essential value in the prevention of injuries. From the years 1969 through 1982 a series of 53 lethal riding injuries is analysed with reference to the rider, the horse, and the environment. Craniocerebral injuries dominate in this series, indicating the importance of adequately protecting helmets. Among the victims the female sex is dominating before the age of 25 and the males above this age. Older horses are less frequently involved in these accidents than younger ones. A long training period for riders under surve...
Dudan F, Hirni H.Since 1980 techniques specifically designed to treat human neonatal diseases have also started to be applied to ill or premature equine newborns. These techniques will be described and their application to the most common equine neonatal disorders will be discussed. Such techniques include: post-natal cardiopulmonary resuscitation, exogenous thermal support, administration of broad spectrum antibiotics after diagnostic studies, supplemental oxygen therapy and mechanical ventilation, intravenous fluid and electrolyte therapy, blood component transfusion and total parenteral nutrition.
Specht TE, Colahan PT.Medical records of 48 equids (47 horses, 1 pony) with surgical sand colic were reviewed. The diagnosis of sand colic was made if a sand impaction(s) was palpated during exploratory abdominal surgery or if a large quantity of sand was found during colotomy. Most equids did not experience a previous episode of sand diarrhea or sand colic. Clinical findings and results of clinicopathologic determinations were not diagnostic. Rectal palpation findings in 40 of 46 horses were compatible with large-colon and/or cecal distention. Impactions were palpable per rectum in only 7 horses, but emergency abd...
The Journal of traumaAugust 1, 1988
Volume 28, Issue 8 1255-1259 doi: 10.1097/00005373-198808000-00020
Landercasper J, Cogbill TH, Strutt PJ, Landercasper BO.A survey of all American Veterinary Medical Association members in Minnesota and Wisconsin was conducted by questionnaire to document injuries resulting from animal treatment. Of 995 respondents, 64.6% had sustained a major animal-related injury. Seventeen per cent were hospitalized within the last year. Of those hospitalized, 25.3% required a surgical procedure. Hand injuries were most common in a veterinarian's career (52.6% of respondents), followed by trauma to the arms (27.6%), and the head (20.8%). The thorax (8.3%), genitalia (3.9%), and intra-abdominal viscera (2.8%) were injured less ...
Grandy JL, Hodgson DS.The physiologic changes that take place in horses presented for emergency abdominal surgery and the effects of these changes on the horse's anesthetic management are discussed.
Fischer AT.After surgical correction of the underlying abdominal disorder, careful postoperative care is the most important factor resulting in increased survival rates. Intensive care of the postoperative patient can be done practically and economically.
Markel MD.Peritonitis and adhesions in the horse are best managed through prevention. Perioperative antimicrobial therapy, nonsteroidal anti-inflammatory therapy, experienced personnel, and good surgical techniques should minimize complications after surgery. Despite preventative measures, some horses still develop peritonitis after surgery. Immediate, intensive treatment is necessary to enhance their chances for survival.
Ducharme NG, Lowe JE.Based on the clinical impression and the current knowledge of the clinical variables (rectal examination, abdominal distention, abdominal fluid, intractable pain) most likely to differentiate between medical and surgical cases, three decision trees are provided as a guide to making the management decision in a horse with abdominal pain. Prior elimination of horses with limited life expectancy because of age or function or where financial constraints are present is understood. It must be emphasized that most of the information presently available originates from referral centers where the preva...
Humber KA.After becoming entangled in safety lines and being submerged in a chlorinated swimming pool, a 2-year-old Thoroughbred gelding was evaluated and treated successfully. Treatment included antimicrobial agents, anti-inflammatory drugs, bronchodilators, diuretics, humidified oxygen, and surfactant transplant. The results of follow-up examination of the gelding 120 days after hospitalization were normal.
Lloyd RG.All horse-related injuries presenting to an Accident Service over a two-year period were investigated. 237 patients presented. The injuries were not considerable in absolute number but were in severity. There was a high morbidity with 22% of all patients requiring admission to hospital, 50% of all admissions because of head injuries. At least seven life-threatening injuries were identified and there were other severe pelvic and spinal injuries. The wearing of protective head gear remains the most important safety measure.
Harvey RC, Gleed RD, Matthews NS, Tyner CL, Erb HN, Short CE.Isoflurane was compared with halothane as an anesthetic agent for emergency colic surgery in a series of 38 juvenile and adult horses. After presurgical stabilization with fluids and supportive medications, anesthesia was induced by intravenous xylazine and/or diazepam followed by ketamine. Anesthesia was maintained with isoflurane or halothane in oxygen with controlled ventilation. Heart rates (HR), arterial blood gases, mean arterial pressures (MAP), rate pressure products (RPP), requirements for cardiovascular support medications, and recovery times to standing were compared using nonparame...
Whitlock MR, Whitlock J, Johnston B.A retrospective study of horse riding injuries in Berkshire was undertaken over a one year period from November 1983. The information was obtained from the Ambulance Service, the Jockey Club and the St. John Ambulance Brigade. There was a total of 103 injured persons with no deaths. Information from the Jockey Club was compared with the other two groups, the former sustaining more limb injuries and the latter more head injuries. A questionnaire was sent to all 42 ambulance patients. Thirty-eight had radiographs taken, 16 of which showed a fracture. Forty-one were wearing some form of hard hat,...
Baker SM, Drummond WH, Lane TJ, Koterba AM.A follow-up study was conducted on 131 foals that were less than 7 days old when admitted to the University of Florida Veterinary Medical Teaching Hospital between 1981 and 1983. Of the 71 foals (54%) that survived to be discharged, 39 (55%) were alive at follow-up evaluation, 19 (27%) could not be located, and 13 (18%) had died. The owners of surviving foals were sent questionnaires and 72% responded. The horses were visited and examined, if geographically possible, and an age-matched stablemate or a sibling also was evaluated and used as a control. Thirteen foals (10% of total admitted) died...
Kellagher RE, Watney GC.Unexpected cardiac arrest occurred in two horses during routine surgical anaesthesia. Both were successfully resuscitated. The aetiology of these occurrences and their possible relationship to second degree heart block is discussed.
The Journal of traumaJune 1, 1986
Volume 26, Issue 6 559-560 doi: 10.1097/00005373-198606000-00013
Busch HM, Cogbill TH, Landercasper J, Landercasper BO.During the past 6 years 134 patients were admitted as the result of bovine (cow) and equine (horse) trauma. The mechanism of injury was fall from horse in 45 patients, animal assault in 42, animal kick in 39, and animal-drawn vehicle accident in eight. Injury Severity Score (ISS) ranged from 1 to 41 and was greater than or equal to 25 in 11 patients. One hundred seventeen operative procedures were performed by ten groups of surgical subspecialists. Mortality was nil. Ideal management of these injuries includes treatment in a regional trauma center and an educational program of preventive measu...
Moens Y, De Moor A.The carbon dioxide content of respiratory gases may be monitored by the use of an infra-red carbon dioxide analyser. The technique allows continuous and non-invasive recording of important information concerning the ventilatory, circulatory and metabolic states of the anaesthetised horse. Some of the monitoring capabilities of a carbon dioxide analyser (capnograph) are reviewed with illustrations from cases anaesthetised in the authors' clinic. Technical faults in the anaesthetic apparatus and the connections with the "patient" could be readily detected and emergency situations immediately rec...
Bookbinder L, Prisk A.Gastrointestinal colic is the most common primary care equine emergency and affects nearly one of four horses per year. Colic is a significant welfare concern for equine patients and a financial and emotional burden for owners. The primary care practitioner is instrumental in identifying critical cases quickly and making appropriate management recommendations to improve patient outcomes.
Hassel DM.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...
Shaver J, McRoberts D, O'Byrne B, Morgan B, Krall K, Surjan C, Mayberry J.Agriculture is an inherently dangerous industry. We sought injury data for use with the Idaho Time Sensitive Emergency (TSE) system to formulate goals and track improvements. Methods: Registries in southern Idaho were queried for ICD-9-CM diagnoses related to agriculture in 2014. Injuries known or likely to have occurred on properties intended for farming, ranching, animal care, or milk production, and relating to those activities were included. Results: Among 72 patients, injuries were related to horses (31%), machinery (17%), ATVs (17%), and hay bales/haystacks (13%). Average age was 45 (3-8...
Glanville RJ, Christie B.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.
Eggleston RB.Distal limb wounds in horses heal substantially different than trunk wounds, commonly resulting in exuberant granulation tissue and exposed and sequestered bone. Surgical intervention of severe rectovaginal lacerations in the mare should be delayed until the tissues have heeled and scar tissue has remodeled. Wounds resulting in severe hemorrhage require appropriate emergent fluid therapy and potentially transfusion therapy.
Tucker ML, Wilson DG, Barber SM.To document marked hemorrhage as a complication of inguinal cryptorchidectomy and its successful treatment with a novel chitosan-based hemostatic agent. Methods: Case report. Methods: One healthy 5-year old quarter horse cryptorchid. Methods: The horse was presented for routine unilateral cryptorchidectomy after prior hemicastration. An inguinal approach was made to the abdomen, and the right external pudendal artery was lacerated at the level of the internal inguinal ring, requiring multiple anesthetic events over a 2-week period in attempts to control hemorrhage. A chitosan-based hemostatic ...
Mellish MA, Adreani CM.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...
Matthews NS, Hartsfield SM, Cornick JL, Jacobson JD, Williams JD.Measurements (n = 126) of end-tidal halothane concentrations were taken from 21 horses anesthetized for routine and emergency surgery. One hundred five paired values allowed comparison of gas samples taken near the oral end of the endotracheal tube (Y1) to samples obtained at the cuffed end of the endotracheal tube (Y2). Twenty-one paired readings were assessed to compare samples taken 25 cm beyond the cuffed end of the tube (Y3) to samples from Y1. Measurements were made at all locations at 15-minute intervals starting 30 minutes after beginning halothane. All measurements were made in tripli...
Tirosh-Levy S, Tatz A, Kelmer G.A 6-month-old Arabian filly escaped its handler while being led and slipped on pavement. The referring veterinarian recognized severe, soft tissue damage to the filly's lower jaw and referred the filly to the Veterinary Teaching Hospital for surgical management. Blessure de dégantage mandibulaire chez une pouliche arabe. Une pouliche arabe âgée de 6 ans s’est échappée de son préposé pendant qu’il la menait et a glissé sur la chaussée. Le vétérinaire traitant a reconnu des dommages graves aux tissus mous de la mâchoire inférieure de la pouliche et a recommandé la pouliche à l...
Kirker-Head CA, Jakob TP.An Arabian mare was referred with traumatically induced complete transection of the trachea. A temporary airway was established through the open wound at the site of the rupture. Resection of devitalized tissue including 3 tracheal ring segments, and anastomosis of the tracheal ends was subsequently performed under general anesthesia. Wound healing was complicated by a peritracheal abscess, which responded successfully to drainage and antibiotic administration.
Merkt H.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.
Dudan F, Hirni H.Since 1980 techniques specifically designed to treat human neonatal diseases have also started to be applied to ill or premature equine newborns. These techniques will be described and their application to the most common equine neonatal disorders will be discussed. Such techniques include: post-natal cardiopulmonary resuscitation, exogenous thermal support, administration of broad spectrum antibiotics after diagnostic studies, supplemental oxygen therapy and mechanical ventilation, intravenous fluid and electrolyte therapy, blood component transfusion and total parenteral nutrition.
Moon PF, Snyder JR, Haskins SC, Perron PR, Kramer GC.Conventional fluid resuscitation is unsatisfactory in a small percentage of equine emergency surgical cases because the large volumes of fluids required cannot be given rapidly enough to adequately stabilize the horse. In anesthetized horses, the volume expansion and cardiopulmonary effects of a small volume of highly concentrated hypertonic saline-dextran solution were evaluated as an alternative initial fluid choice. Seven halothane-anesthetized, laterally recumbent, spontaneously ventilating, normovolemic horses were treated with a 25% NaCl-24% dextran 70 solution (HSD) at a dosage of 1.0 m...
Spurlock GH.This article deals with the diagnosis and treatment of tendon lacerations. Tendon healing, with its implications relative to treatment, is discussed. The various pros and cons of suturing severed tendons are addressed as well as methods of immobilizing the injured limb. The need for prompt diagnosis and aggressive treatment of tendon sheath injuries is also discussed.
Viljoen A, Saulez MN, Carstens A, Gummow B.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...
Koterba AM, Drummond WH.Provision of adequate nutritional support to the sick neonatal foal is a vital part of intensive care; frequently, however, it is very difficult to accomplish. In this article, current recommendations concerning both enteral and parenteral nutrition are discussed.
Chesnel MA, Aprea F, Clutton RE.A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered. Gestion de l’anesthésie générale d’un cheval avec un pneumothorax d’origine traumatique. Nous décrivons le cas d’une jument présentée avec un important déficit de la paroi thoracique d’origine traumatique, une perforation pulmonaire...
Muñiz Fontán M, Moure González JD, Mirás Veiga A, Rodríguez Núñez A.Children's equestrian activities in the domestic, play activities, sports and educational areas are relatively frequent, and are not exempt from risks. Nevertheless, there is a lack of data on horse-related injuries, their circumstances and the key points for their prevention. Methods: Retrospective and descriptive study of pediatric equestrian injuries admitted to Hospital between July 1997 and September 2008. Results: A total of 17 patients with ages between 4 and 17 years were analyzed. There were 14 accidental falls, 2 kicks and 1 bite, and 8 patients had lost consciousness after the accid...
Divers TJ, Radcliffe RM, Cook VL, Bookbinder LC, Hurcombe SDA.Blood products, crystalloids, and colloid fluids are used in the medical treatment of severe hemorrhage in horses with a goal of providing sufficient blood flow and oxygen delivery to vital organs. The fluid treatments for hemorrhage will vary depending upon severity and duration and whether hemorrhage is controlled or uncontrolled. Methods: With acute and severe controlled hemorrhage, treatment is focused on rapidly increasing perfusion pressure and blood flow to vital organs. This can most easily be accomplished in field cases by the administration of hypertonic saline. If isotonic crystallo...
Tranquilli WJ, Thurmon JC.Several unique pharmacologic and physiologic factors must be considered when attempting to anesthetize premature or neonatal foals. Juvenile foals are similar to adults in their physiology and metabolism. Anesthetic drug and protocol selection should reflect the differences between these two age groups. Neonates are best anesthetized using an inhalation technique, whereas older foals can be safely anesthetized with either parenteral or inhalation anesthetic agents. Careful monitoring is absolutely essential when anesthetizing foals. The clinician should plan to routinely administer fluids and ...
Lightfoot KL, Frost E, Burford JH, England GCW, Freeman SL.Behavioural models are widely used within human medicine to understand beliefs and intention associated with major health interventions. Objective: To investigate horse-owner beliefs and practices associated with emergency colic planning. Methods: Cross-sectional study. Methods: An online survey incorporating the Trans-Theoretical Model of behaviour change and the Theory of Planned Behaviour was developed to assess owner intention to adopt three areas of emergency colic planning: (1) prevention/recognition, (2) involvement of others and (3) personal preparation. Participants were recruited usi...
Hall S, McElligott S, Sadek AR, Griffith C, Waters R, Nader-Sepahi A. Accidents during sporting activities are a common cause of head injury, particularly in children and young adults. Whilst most sporting head injuries are minor, there remains a proportion which is associated with high morbidity and mortality. The epidemiology of sports associated head injuries is variable based on geographical region so the aim of this study was to review the management and outcomes of sporting head injuries managed by a single neurosurgical unit in the South of England. A retrospective review of the Trauma Audit and Research Network database was conducted for all patients ad...
Baus MR.The horse owner not only expects outstanding care for their horse; they also recognize and appreciate a well-run equine practice. They expect their veterinarian to show up on time for appointments; they expect to receive decipherable invoices and statements on a regular basis and they appreciate an assistant who enhances the services that their veterinarian provides. A well-managed ambulatory equine practice supports the ideals of both high standards of care and mobility. In fact, a poorly managed practice will ultimately impact the care that an equine veterinarian attempts to provide the hors...
Lutter JD, Cary JA, Stephens RR, Potts LB.Determine the relative stiffness of 3 bandage/splint constructs intended for emergency fracture stabilization. Methods: Experimental model. A single plane free end deflection model was developed to simulate the forces placed on a bandage/splint construct during stabilization of a complete mid-metacarpal bone fracture. The total deflection of the model in one plane was measured following application of 3 different bandage/splint combinations including a classic, 3 layered Robert Jones Bandage (RJB) with a splint placed on the outside of the bandage (RJB-3), an RJB with splint placed after the f...
Gandini M, Giusto G.Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. Methods: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from an...
Marolf V, Mirra A, Fouché N, Navas de Solis C.A 3-day-old Swiss Warmblood colt was diagnosed with uroabdomen after urinary bladder rupture. The foal had classical electrolyte abnormalities (hyponatremia, hypochloremia and hyperkalemia) on presentation. The foal was supported prior to surgery with intravenous fluids and the electrolyte abnormalities were treated with physiologic saline, glucose and insulin. Urine could not be drained from the abdomen prior to surgery because the omentum was continuously occluding the drainage cannula and due to progressive abdominal distension, it was decided to pursue surgery without further correction of...
Mudge MC, Bramlage LR.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.
