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.
Subcutaneous emphysema from an axillary wound that resulted in pneumomediastinum and bilateral pneumothorax in a horse. A 5-year-old Thoroughbred gelding was examined because of a small axillary wound sustained 5 days earlier and had resulted in extensive subcutaneous emphysema. Three days after admission, the horse's respiratory rate had increased to 72 breaths/min, and the horse appeared anxious and distressed. Thoracic radiography revealed pneumomediastinum and severe bilateral pneumothorax. Tube thoracostomy was performed on both hemithoraxes. The drains were connected to one-way suction valves and suction devices to decompress the thorax. A nasopharyngeal catheter was inserted, and oxygen insufflation was ...
Hypoglycemia and hepatic ischemic necrosis after small intestinal incarceration through the epiploic foramen in a horse. A 16-year-old stallion was presented to the Louisiana State University Veterinary Teaching Hospital for evaluation of acute abdominal pain. Physical examination and diagnostic procedures indicated a strangulating obstruction of the small intestine. At exploratory celiotomy, a strangulating incarceration of the jejunum through the epiploic foramen was found. The incarcerated small intestine was reduced, then resection of the nonviable bowel and anastomosis performed. After surgery, the horse exhibited clinical signs and laboratory findings associated with hypoglycemia and died in spite of emerg...
Anesthetic management of an incisional dehiscence in recovery following exploratory laparotomy in a horse. A 5-year old Arabian mare fell during recovery from general anesthesia after an exploratory laparotomy. This fall resulted in dehiscence of the abdominal closure, and a substantial amount of intestines were exteriorized. Chemical and manual restraints were rapidly used to prevent trauma to the exposed intestines. A second general anesthesia was initiated to clean the intestines and close the incision. Multiple anesthetic problems were encountered, including arterial hypotension and hypoxemia. The horse recovered from the second general anesthesia and surgery, and all complications gradually re...
Prognostic variables for survival of neonatal foals under intensive care. The costly nature of intensive care for neonatal foals prompted a study of predictive variables for survival in a referral hospital. Applying stepforward logistic regression to parameters that differed significantly (P less than 0.10) between survivors (S) and nonsurvivors (NS) in a retrospective study (n = 56), two variables retained statistical significance [anion gap (AG, P = 0.0047) and venous PO2 (PvO2, P = 0.0342)], thus forming the basis for a predictive equation for survival: the Pn (probability of NS) = eA/(1 + eA) where A = -1.46 - 0.107 (PvO2) + 0.213 (AG). The predictive equation w...
A comparison of end-tidal halothane concentrations measured at proximal and distal ends of the endotracheal tube in the horse. 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...
Standing surgery of the neck and thorax. Many surgical procedures of the head and neck can be safely performed in the standing horse, with easy access to all aspects of the surgical field. Some procedures, such as tracheotomy, are easier to perform with the horse standing with the head in a more natural position than with the horse under general anesthesia. Procedures of the neck and thorax that require evacuation of purulent and necrotic material from confined spaces, such as occur in horses with esophageal ruptures and extensive intrathoracic abscesses, can be done as standing procedures to avoid the risks of general anesthesia on ...
Effects of a highly concentrated hypertonic saline-dextran volume expander on cardiopulmonary function in anesthetized normovolemic horses. 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...
Injuries caused by animals. Injuries caused by animals and treated at the University Hospital of Umeå were analysed. Dogs caused nearly one-half of the injuries, while horses caused one-third of the injuries and the highest number of fractures. The 'cost' of treatment and sickness benefit was fairly evenly distributed between horse-, cattle-, and dog-related injuries. The average 'cost' per injured person was, however, highest in those injured in cattle accidents and moose-car collisions. The impact of animal-related injuries on the health care and social security systems was similar to occupational accidents and car ac...
Poisoning with equine phenylbutazone in a racetrack worker. Phenylbutazone is a potent nonsteroidal, anti-inflammatory drug often used by veterinarians to treat racetrack animals. Its use in human beings is limited because of significant adverse effects and the availability of newer, safer drugs. We report the case of a 24-year-old man who ingested 17 g of equine phenylbutazone over a 24-hour period to treat the pain of a toothache. He developed grand mal seizures, coma, hypotension, respiratory and renal failure, and hepatic injury. Serum phenylbutazone concentration obtained approximately eight hours after presentation was 900 micrograms/mL. The pati...
Mid-metacarpal deep digital flexor tenotomy in the management of refractory laminitis in horses. Deep digital flexor tendon transection at the mid-metacarpus was performed in 20 horses with severe acute or chronic laminitis that was not responsive to conventional treatment. Sixteen horses improved within 72 hours, one horse worsened, and two horses were unaffected by the surgery. Eleven horses survived less than 1 month after surgery and six horses survived longer than 6 months. Three horses surviving longer than 6 months have remained lame and no horse has returned to athletic performance. Transection of the deep digital flexor tendon at the mid-metacarpus may decrease the pain associate...
[The injury pattern in horseback riding]. Injuries are relatively rare in horse riding compared to other sports, but when they occur they are rather severe and dangerous: about 40% of the injured suffer from fractures, for instance and only 15% from sprains. About 20% have to be admitted to the hospital. Roughly 30% of the injuries involve the arm and 7.5%-10% the spine. The head is injured in 20%, the brain in 8% and the lower extremity in only about 20%. That means that the majority of injuries involve the upper half of the body. One quarter of all lethal sport injuries are caused by horse riding.
Supportive therapy in the anesthetized horse. In conclusion, vigilant supportive care is necessary to prevent morbidity and death in the anesthetized horse. Because some of the equipment and drugs are specialized and the consequences of some postanesthetic complications are severe, availability of those items must be confirmed prior to anesthesia. Proper positioning and padding will help to reduce the incidence of postanesthetic myopathy-neuropathy syndrome in these large patients. Adequate tissue perfusion is important and can be achieved by controlling anesthetic depth, increasing intravascular volume with fluid administration, and by a...
Management of anesthesia in the foal. 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 ...
Surgical correction of a traumatic esophageal diverticulum in a horse. A nine-year-old gelding was presented to the Auburn University Large Animal Clinic with discharge of saliva and food material from both nostrils. A diagnosis of esophageal diverticulum was made; treatment is described.
A computer-derived protocol using recursive partitioning to aid in estimating prognosis of horses with abdominal pain in referral hospitals. In order to determine which variables are useful and accurate in estimating prognosis in horses with abdominal pain, data were analyzed from 231 horses presented at a veterinary teaching hospital. Using multiple stepwise discriminant analysis in a recursive partition model, we obtained a decision protocol that identified survivors and nonsurvivors. The prevalence of survivors was 61% in this population. The sensitivity, specificity, and positive and negative predictive values of this model were 71, 83, 87 and 65%, respectively. This decision protocol was validated by Jackknife classification a...
Surgical repair of ruptured trachea in a horse. 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.
Medical treatment and costs of sports-related injuries in a total population. A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. The medical treatment and the services required for the injuries have been calculated and related to the total consumption of medical care in the municipality. A total of 571 injuries (17% of all injuries) occurred in 28 different sports: 65% of the injured were males. Sports injuries accounted for 3% of all acute visits and there were altogether 1,083 outpatient visits, which yields a mean of 1.9 visits per injury. Related to th...
Common injuries in horseback riding. A review. 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 ...
Wounds of the esophagus and trachea. 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.
Management of traumatic tendon lacerations. 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.
Hoof injuries. 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...
[The pattern of riding injuries]. 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...
Rectal tears in the horse: an analysis of 35 cases. 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...
Lethal horse-riding injuries. 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...
[Compilation of experiences with intensive management of newborn foals]. 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.