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.
Parry BW.The clinical, surgical and/or necropsy diagnosis of 79 horses admitted to a referral clinic for evaluation of colic are reported. Twenty-one horses were presented with conditions amenable to medical treatment and all were subsequently discharged. Exploratory laparotomies were performed on 44 horses during the present study, in some cases as a diagnostic procedure preceding euthanasia. In general, in surgical cases the mortality rate was highest for problems involving the small intestine, followed by those affecting the large colon and then the small colon. Postoperative sequelae included perit...
Bernhang AM, Winslett G.In brief: It has always been assumed that participants in equestrian sports are at high risk of serious injury and that minor injuries are common. This study of American Horse Shows Association and United States Pony Clubs horse shows tried to determine if shows are as safe as or safer than other sports, what the accident rate is for horse shows, if any factors influence the accident rate, and what types of accidents and injuries occur. There were 290 reported injuries and two deaths in the 984 responding shows. The accident rate per entry was 0.0003. There was no statistically significant rel...
McIlwraith CW.The postoperative management of the surgical colic patient varies according to the complications experienced. Many of these complications can be related to the time at which surgery is performed
relative to commencement of the problem, the condition of the patient at the time of surgery, the particular condition, and, last but not
least, the surgeon's performance. Some of the points have been discussed elsewhere in the symposium. The maintenance of asepsis, attention to minimizing trauma to the bowel, and appropriate attention
to visceral and parietal closures are all important principles. ...
Frauenfelder HC, Fessler JF, Latshaw HS, Moore AB, Bottoms GD.External cardiac massage and concomitant respiratory support were used successfully 6 of 8 anesthetized ponies sustaining unexpected cardiac arrest while being used in a study of shock. Approximately 20 thoracic compressions/min maintained systolic and diastolic aortic blood pressures in excess of 50% of the corresponding base-line values in 5 ponies. The high success rate was attributed to early recognition of the problem, the small size of the patient, and the relatively short duration of cardiopulmonary resuscitation (average, 2.9 minutes). It was concluded that external cardiac message can...
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...
Goldstein MA, Schwark WS, Short CE, White KK.Depression of the cardiopulmonary system of the horse during anesthesia is not an uncommon event. In many situations simple approaches for improving the function of the horse are necessary to avoid loss of life. This study has been completed utilizing an anesthetic approach frequently used in horses and a cardioresuscitative technique which can be utilized by the practicing veterinarian. Severe depression to arrest were produced experimentally and each animal was resuscitated through support of ventilation and circulation.
Riebold TW, Evans AT, Robinson NE.Arterial blood gas values, rate of pulmonary nitrogen washout, respiratory rate, arterial blood pressure, heart rate, and cardiac output were determined during ventilation of six anesthetized horses, with a demand valve. The horses were allowed to ventilate spontaneously, or intermittent positive pressure ventilation was utilized. When compared with spontaneous ventilation, intermittent positive pressure ventilation caused a significant increase in the rate of pulmonary nitrogen washout and a significant decrease of arterial carbon dioxide. It was concluded that intermittent positive pressure ...
Smith DF.The pathophysiology, diagnostic evaluation and medical management of the horse with intestinal obstruction is outlined. Emphasis is on early and accurate determination of the need for surgery and on providing optimal preoperative medical support.
Pearson H, Pinsent PJ, Polley LR, Waterman A.Four cases of fatal diaphragmatic rupture in the horse are described. In 2 cases there was no history of injury but the other 2 animals had sustained recent thoracic trauma. Three of the horses had signs of colic and bowel obstruction complicated, in 2 cases, by respiratory embarrassment; the fourth died rapidly, presumably of shock. Previously published cases are reviewed and the causes, clinical effects, diagnosis and treatment of the disorder are discussed.
Keller P, Hudders L, Decloedt A.Complementary and alternative veterinary medicine (CAVM) is increasingly popular in horses. As CAVM usage could have risks, client-veterinarian communication about CAVM is crucial. Objective: Evaluating equine veterinarians' attitude towards CAVM, their CAVM usage and veterinarian-client communication about CAVM. Methods: Cross-sectional study. Methods: A telephone survey was conducted among equine veterinarians providing ambulatory care on a daily or weekly basis. The first section of the survey included questions about the veterinarians' attitude towards CAVM and their CAVM usage. The second...
Laverty S, Lavoie JP, Pascoe JR, Ducharme N.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...
Giacchi A, Marcatili M, Withers J, Knottenbelt D.A 12-year-old Warmblood mare was presented with an acute onset left hindlimb lameness associated with generalised soft tissue swelling of the entire limb and medial saphenous vein (MSV) thrombophlebitis. A presumptive diagnosis of extremity compartment syndrome (ECS) was made. Due to the clinical deterioration, emergency fasciotomy of the crural fascia and biopsy was performed. Histological and immunohistochemical examination of the samples confirmed a diagnosis of leiomyosarcoma likely originating from the tunica media of the MSV. This report is the first to describe an unique combination of ...
Initial treatment of colic is aimed at maintaining hydration and acid-base balance, controlling pain and reestablishing peristalsis. A poor response to medical treatment in the first 12-18 hours suggests the need for laparotomy. Other indications for surgery include: rising pulse rate, exceeding 60/minute for several hours; congested mucosae; delayed capillary refill; silent abdomen; gastric reflux; distended or displaced loops of bowel on rectal examination; intractable pain; and adverse laboratory findings. Postoperative care should consist of hand-walking for 30 days, followed by confinemen...
Elghoul N, Jalal Y, Bouya A, Zine A, Jaafar A.Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle s...
Marchese GA, Crystal J, Louro LF.Prevalence and risk factors of severe hypoxemia in anesthetized horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxemia ( PaO2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single center retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariable ...
van den Wollenberg L, Pellicaan CH, Müller K.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...
François I, Lepage OM, Schramme MC, Salciccia A, Detilleux J, Grulke S.To report findings, outcome and determine variables associated with survival in horses with acquired inguinal hernia (AIH). Methods: Retrospective study. Methods: A total of 98 cases in 97 horses. Methods: The medical records (2005-2020) of horses diagnosed with AIH were reviewed. Retrieved data included signalment, history, clinical variables, surgical aspects, postoperative complications, and short- and long-term outcomes. Logistic regression analyses were used to determine factors associated with short-term survival (p < .05). Results: Manual reduction was attempted in a third of the...
Dybdal N, Horgan M, Costa L, Davis E, Lucero S, Nieves S, Quiroz V, Weberg K, Madigan JE.Challenges and issues related to the use of pentobarbital euthanasia and disposal of animal remains within the US have recently been reviewed. Environmental and public health challenges increasingly necessitate consideration of alternative methods such as gunshots, an American Veterinary Medical Association (AVMA) "acceptable with conditions" method, for the humane euthanasia of horses. A recent study reported a correctly aimed gunshot provides a humane option for euthanizing horses. However, although aiming guidelines exist, studies examining bullet trajectories in animals euthanized by gunsh...
Lu KG, Sprayberry KA.Selected conditions affecting broodmares are discussed, including arterial rupture, dystocia, foal support with ex utero intrapartum treatment, uterine prolapse, postpartum colic, the metritis/sepsis/systemic inflammatory response syndrome complex, and retained fetal membranes. Postpartum colic beyond third-stage labor contractions should prompt comprehensive evaluation for direct injuries to the reproductive tract or indirect injury of the intestinal tract. Mares with perforation or rupture of the uterus are typically recognized 1 to 3 days after foaling, with depression, fever, and leukopen...
White NA, Elward A, Moga KS, Ward DL, Sampson DM.There is no current veterinary information with regard to data entry on a website. We therefore completed a prospective study on use of analgesics in relation to the need for abdominal surgery using a web-based survey instrument. Objective: To establish an internet-based data entry system that could be used to record prospective data on horses with colic. Objective: Failure of horses to respond to the initial administration of an analgesic is an indicator of the need for abdominal surgery. Methods: A survey was developed to determine if the response to administration of an analgesic during a v...
Sprayberry KA, Lu KG.Selected emergency conditions of male and female reproductive tracts in horses are described, including injuries affecting the external genitalia of male horses and emergent conditions arising during gestation in mares. Conditions affecting male horses are discussed in the context of breeding stallions, but kicks or other mechanisms of trauma in the groin can also affect geldings. Priapism, paraphimosis, trauma to the scrotum and testicles, and penile injury are discussed. In mares, traumatic vestibular injury, placentitis, hydropsic conditions, prepubic tendon and abdominal wall compromise, a...
Puolakkainen T, Marttila E, Thorén H, Snäll J.Patients with equine-related injuries (ERI) have high rates of hospitalization and often require surgical treatment. This study aimed to clarify the injury profiles of patients sustaining ERI-related craniofacial fractures and their relationship with other severe head and neck injuries.This retrospective study included all patients with craniofacial fractures admitted to a tertiary trauma center during 2013 to 2018. Out of 3256 patients, a total of 39 patients were included in the study (1.2%). Demographic and clinically relevant variables were reported and statistically evaluated.Males repres...
Bienert-Zeit A, Müller JM, Feige K.The article provides hands-on advice and scientific background information regarding the management of the equine acute colic patient. It summarizes essential information on the patient's history, clinical examination, and legal aspects. The scope of the history is based on the clinical appearance of the patient. In horses with violent and barely controllable signs of pain, it is limited to colic-associated information such as onset, course and severity of colic signs, and the last time of defecation, as well as prior therapeutic intervention. In these patients, the clinical examination is foc...
Dallap Schaer BL, Linton JK, Aceto H.Recommendations for antimicrobial prophylaxis for surgery are well-described in human medicine, but information is limited for veterinary practice. Objective: To characterize antimicrobial use in horses undergoing emergency colic surgery. Methods: A total of 761 horses undergoing emergency colic surgery (2001-2007). Methods: Retrospective case review. Antimicrobial dose and timing, surgical description, and duration of treatment were collected from medical records. Associations between antimicrobial use and the occurrence of fever, incisional inflammation or infection, catheter-associated comp...
McQueen C, Crombie N, Cormack S, George A, Wheaton S.The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands followi...
Jamieson CA, Baillie SL, Johnson JP.Transfusion medicine is a crucial part of equine intensive and critical care. Blood transfusions can save lives in both acute and chronic cases of anemia, hemorrhage, and hemolysis. It is vital to have a comprehensive theoretical and practical understanding of the techniques, implications, risks, and complications. This review covers the physiology and pathophysiology of conditions requiring transfusion, as well as step by step guidance for practitioners of all experience levels. This review is designed to serve as a practical reference for those who are treating horses in either the field or ...
Lucas M, Day L, Shirangi A, Fritschi L.A high injury prevalence has been reported among veterinarians. Studies describing the factors associated with injury have been limited. Objective: To describe the characteristics of serious injuries and the use of safety precautions at the time of injury in Australian veterinarians. Methods: Graduates in veterinary medicine from Australian universities completed questionnaires asking about injuries during their professional career including type of injury and circumstances during which injury occurred. Results: A total of 2188 significant injuries were reported. Injuries were most frequently ...
Lyon RM, Macauley B, Richardson S, de Coverly R, Russell M.Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Methods: Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 20...
Sandoval C, True C.Clients want dependable veterinary care and to understand how the services will benefit and meet their horse’s needs. Wellness visits provide ambulatory practitioners with great opportunities to strengthen the doctor-client-patient bond; effective communication with clients during wellness visits, where new literature or facts can be presented, can offer opportunities for demonstrating the value of having the veterinarian maintain a primary role in disease control. The criteria for selecting vaccines, interpreting FECs, and diagnosing dental pathology require the continued need for veterinar...
Peters BC, Fields BE, Erdman EA.Objective: The use of equine movement as a therapy tool in a plan of care, or hippotherapy, has grown considerably over the past three decades. However, there is little evidence of safety rates and related practice patterns to guide key stakeholders such as clients, therapists, the health care team, and third-party payers. The purpose of this article is to describe the safety and practice patterns of contemporary use of hippotherapy. Design: A survey was distributed to occupational therapy (OT), physical therapy (PT), and speech-language pathology clinicians who incorporate hippotherapy into t...
Ferreira JF, Albuquerque ALH, Amorim RM, Ferreira RS, Takahira RK, Borges AS, Oliveira-Filho JP.In this retrospective study, clinical records of nine horses with a diagnosis of Bothrops envenomation were investigated. The accidents were classified as severe (5/9), moderate (2/9), or mild (2/9) according to the adapted bothropic snakebite severity score (BSSS). All snakebites were on the head region. The main clinical signs were local edema, blood coagulation disorders, and respiratory distress. The whole-blood clotting time (WBCT) was prolonged in all horses, and five horses presented with uncoagulable blood. All horses received specific snake antivenom according to the BSSS (six vials f...
Shirazi-Beechey SP.Equine colic, a disorder manifested in abdominal pain, is the most frequent cause of emergency treatment and death in horses. Colic often requires intestinal surgery, subsequent hospitalisation and post operative care, with a strong risk of complications arising from surgery. Therefore strategies that explore approaches for preventing the condition are essential. To this end, a better understanding of the factors and mechanisms that lead to the development of colic and related intestinal diseases in the horse allows the design of preventive procedures. Colic is a multifactorial disorder that a...
Graves MT, Anderson DE, DeNovo RC.Large animal teaching hospitals often struggle to maintain consistent teaching caseloads, which are affected by seasonal variations, economic pressures, increased abilities of local large animal practices to hospitalize large animals, and client intolerance for the operational needs of an academic mission. Non-academic large animal practices enjoy a more consistent caseload but suffer from a lack of emergency relief and a limited ability to share emergency duties, which may have adverse effects on work-life balance. An academic, on-farm, large animal emergency relief service can combine multip...
Ivancic PC.We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients' diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury f...
Bidwell LA, Bramlage LR, Rood WA.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 ...
Gierup J, Larsson M, Lennquist S.A prospective one-year study of horse-riding accidents was performed in an area with a very high frequency of amateur riding. Totally 174 patients with riding injuries were registered--66% children--making an incidence of only 0.7 per thousand riding occasions. However, many of these injuries were of a severe nature, one leading to death and 27 of the patients reporting persisting symptoms at follow-up one year after the accident. Eleven per cent of the accidents lead to cerebral injuries and 44% to fractures, mainly of the upper extremities. Eleven per cent required hospitalization and 17% op...
Hofmeister S, Becker M, Böckenhoff G.Objective to this field study was to find an alternative to rolling a colic patient with left dorsal displacement under general anesthesia. For that purpose a total of 49 horses with a complete nephrosplenic entrapment out of 542 colic patients presented at the Tierklinik Kerken in 1996 were retrospectively evaluated. Having performed a preliminary colic examination and initial treatment if needed, horses which did not undergo surgery immediately where left loose in a small sized arena to move and roll themselves under observation. According to the results of further exams, horses were left in...
Ueeck BA, Dierks EJ, Homer LD, Potter B.Studies of trauma patients have described patterns of injuries sustained from unfortunate encounters with large animals. However, the patterns of maxillofacial injuries have yet to be reported. The goal of this investigation was to describe and report on maxillofacial injuries that are associated with interaction with horses. Methods: Charts were selected from the trauma registry by E-code at a level 1 trauma center in Portland, OR. A retrospective review was performed on charts collected from the previous 5 years (1998-2002). Data were collected according to patient, pattern of injuries, and ...
Miller RL, Webster JK, Mariger SC.The purposes of this study were to identify the source and frequency of agricultural injuries in Utah, and determine an injury rate for common agricultural activities. Previous studies conducted in Utah examined injury rates by utilizing emergency room logs. This study collected data directly from the source, farmers and ranchers in Utah, and included all modes of treatment. A random sample of Utah Farm Bureau members were mailed questionnaires to assess the number of injuries occurring during the past three years, the mode of treatment for the most recent injury, and the percentage of time sp...
