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.
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...
Barsan WG, Hedges JR, Syverud SA, Dalsey WC.The treatment of cardiovascular collapse and anaphylactic shock is largely empiric. A simple animal model was developed to evaluate the hemodynamic alterations in anaphylaxis. Eight adult New Zealand white rabbits of both sexes were studied. All animals weighed 3.8 kg to 5.3 kg. Sensitization was accomplished with a 2-mL subcutaneous dose of horse serum followed in two days with a 2-mL intravenous (IV) dose. At least 14 days elapsed after the IV dose before a 1-mL challenge dose of horse serum was given. On the day of the challenge dose, a femoral arterial catheter, arterial temperature probe,...
Muwanga LC, Dove AF.We report the frequency with which horse riders with a significant head injury present to a large accident and emergency department. We have also recorded details about the use of headwear and conclude that horse-riding is associated with a serious risk of head injury and 'protective' headwear may not always protect.
Koterba AM, Drummond WH, Kosch P.The basic concepts of diagnosis and treatment in the abnormal neonatal foal are presented. Methods of restraint, sedation, and general nursing care are discussed, as well as more specific techniques of respiratory and circulatory system support.
Beech J.Despite major advances in our knowledge and ability to treat respiratory diseases in neonatal foals, neonatal respiratory medicine is still in its infancy. It is hoped that this article may serve as a guideline for diagnosis and treatment. Specific antibiotic regimens and emergency procedures are covered in other articles in this symposium. Because management factors play a critical role in the pathogenesis of respiratory disease, education of clients as to their importance would help both prophylactically and therapeutically. The necessity of very careful monitoring of neonates, which is crit...
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.
Palmer JE.Cardiac arrest in foals is generally secondary to other serious systemic diseases. Although it can often be anticipated, a clear plan is vital to success. Establishing cardiac output through chest compressions is the most important first step. This step should be followed by ventilation, drug therapy, identifying the nonperfusing cardiac rhythm, and following a preplanned treatment algorithm. Birth resuscitation requires special treatment considerations. The clinician should be prepared to perform resuscitation any time a birth is attended.
Reed SM.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.
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. ...
Freeman DE, Bauck AG.Repeat celiotomy can be lifesaving in horses with a surgically treatable postoperative obstruction, although guidelines for its use are lacking, except for uncontrollable postoperative pain. Overdiagnosis of ileus as the cause of postoperative obstruction could delay a second surgery so the disease progresses beyond a manageable level of severity. Although many horses respond favorably to repeat celiotomy, complications can be severe and life threatening, such as incisional infection and adhesions. Repeat celiotomy does not seem to exacerbate postoperative ileus, despite additional surgical ma...
Shah W.Medical Usage Rate (MUR) of Galway Races: The Galway Races is the most popular horse-racing festival in Ireland. It takes place for a week starting from the last Monday in July. The races are held at Ballybrit race course in Galway. During the 7 days of racing, about 180,000 people attend. The average temperature in Galway around that time of the year is around 15-200C. The aim of this study is to calculate the MUR of Galway Races and to develop a model to predict the MUR for Galway Races in future. The MUR of Galway Races is calculated by looking retrospectively at the medical records of the ...
Foth PW, Gardner A, Pereira CR, Cooper E, Schroeder E, Mudge MC.To assess oral buccal microcirculation by hand-held videomicroscopy in horses during colic surgery, comparing microcirculation values with macrocirculatory parameters and with those of healthy elective surgical horses. Methods: Clinical prospective study. Methods: Client-owned horses (nine in the colic group; 11 in the elective group). Methods: In the colic group, buccal mucosal side stream dark-field microscopy (DFM) videos, cardiac output (CO), mean arterial pressure (MAP), and lactate were obtained at three timepoints under general anesthesia (30, 90, and 150 min after induction). Video a...
Mardassi A, Turki S, Mbarek H, Hachicha A, Chebbi G, Benzarti S, Abouda M.Combat-related facial injuries involve various lesions of the mouth, the eye sockets and the facial bones. The goal of this study is to precise the particularities of these affections and their therapeutic management. Methods: A retrospective study was performed about 56 cases of combat-related facial injuries over a period of 5 years (2010 - 2014). Results: Our study included 56 male patients with an average age of 29 years (20-37). The trauma occurred during a real security intervention in all the cases. It was isolated in 18 cases and associated to other lesions in 38 cases. Clinical examin...
McConnico RS.There is no way to prepare for every situation that arises in a disaster. By working closely with other producers and agricultural leaders, however, horse owners can lessen the impact of a disaster on their operation. Preparation and detailed planning are the most important aspects of flood-related injury prevention. Encouraging animal owners and caretakers to have an evacuation plan and dispersing knowledge about local and regional disaster authorities are critical for a successful disaster response. Educational programs on future disaster response empower communities to care for their people...
Barton C, Hassel DM.A successful outcome to management of the critical colic patient is highly dependent on how the patient is monitored and treated, particularly, in the perioperative period. In this article, we will provide an update on monitoring techniques, advances in fluid therapy, nutrition management and pharmacotherapeutic agents, inclusive of pain monitoring and management, prokinetics, and management of systemic inflammatory response syndrome and the hypercoagulable state.
Mason DE, Ainsworth DM, Robertson JT.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...
Dechant JE.Equine toxicologic emergencies are relatively uncommon but can cause significant morbidity and mortality in a group of comanaged horses. The field veterinarian's role is to triage the situation, as well as the individual animal. Individual patient stabilization should focus on support of essential organ functions, providing time for treatments to have an effect or for elimination of the toxicant. Decontamination procedures can follow patient stabilization, if appropriate. Antidotes are often not available or feasible for equine intoxications. The field veterinarian should emphasize triage and ...
Brumbaugh GW.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.
Koljonen V, Söderlund T, Mäkisalo H, Gissler M.Contacts between humans and animals inevitably involve encounters possibly resulting in the human being injured. During the period of 2000 to 2014 almost 90 people died in this kind of conflict in Finland. Of these deaths, one third were associated with horses. In addition, over the same period 85 people died in traffic accidents in which an animal was hit by a car. Accidents requiring hospitalization occurred for approx. 8 000 people.
Rebhun WC.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.
Boyle AG.Respiratory distress in the horse and foal is an emergency. Managing equine respiratory distress in the field starts with appropriate assessment of the patient to determine whether the breathing obstruction stems from the upper or lower respiratory tract or is nonrespiratory in origin. From a thorough, but efficient, physical examination to point-of-care ultrasound and endoscopy, the veterinarian has many tools in the field to help diagnose the patient.
Donawick WJ.The horse with an abdominal crisis caused by acute gastro-intestinal tract obstruction develops hypovolaemia, haemoconcentration, electrolyte depletion, metabolic acidosis and shock. During preparation for operation, treatment with fluids, antibiotics and bicarbonate will impede metabolic imbalance. Stomach decompression may slow the passage of sodium, water and potassium to the gut lumen, reduce pain and minimize the risk of stomach rupture. Selected laboratory determinations and the monitoring of arterial and venous pressures will provide a measure of security, and serve as a guide to replac...
Perkins NR, Frazer GS.Topics addressed in this article include complications of castration, scrotal and inguinal hernias, torsion of the spermatic cord, traumatic injuries to the external genitalia, and posthumous collection of spermatozoa. A concise overview of the clinical management of emergency cases is provided.
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.
Hofstee W.Vet and owner of Unicorn Trails Wendy Hofstee explains how she developed a horse-riding holiday business alongside a successful career in emergency veterinary work.
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.
Morgan JM, Galuppo LD.Management of fractures in the field starts with successful assessment and stabilization of the patient by the practitioner on the front lines. A careful examination is vital to succesful patient management. This includes identifying the fracture location and severity, evaluating skin integrity and potential contamination of the fracture, and treating any ongoing hemorrhage, hypovolemia or stress. Appropriate application of splints in the field will minimize ongoing tissue damage and improve patient comfort. This ultimately aids further assessment, facilitates referral, and improves opportunit...
Saulez MN, Slovis NM, Louden AT.Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by...
Schröter C, Bielefeld M, Bielefeld D, Macke C, Winkelmann C, Mommsen P, Krettek C, Zeckey C.The upper limb is one of the most frequently injured body regions in equestrian sports, but it is unclear which injuries are involved, and there are no data on the associated accident mechanism. The present study is aimed at evaluating the accident mechanisms, injuries of the upper limbs, and the circumstances of the accident in equestrian sports. We included 218 patients who were all treated between 2006 and 2014 at the level I trauma center at the Medical University in Hannover because of equestrian-related accidents. The most frequent injuries were fractures and bruising in the shoulder ...
French DA.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 ...
Dujardin CL, Gootjes P, Moens Y.To quantify the isoflurane measurement error arising from the use of short wavelength infrared (IR) anaesthetic gas analysis during low flow anaesthesia in horses. Methods: Prospective clinical study. Methods: Sixty-four client-owned horses referred for elective or emergency surgery (age 1-16 years, body mass 400-650 kg). Methods: Horses were divided into four groups based on duration of pre-anaesthetic food deprivation period (FDP) and fresh gas flow during anaesthesia: a high flow group with normal FDP (n = 16) and three groups with low flow and normal (n = 29), long (n = 5) or no (n = 14) F...
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 ...
Hubbell JA, Muir WW.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...
Grulke S, Salciccia A, Arévalo Rodríguez JM, Sandersen C, Caudron I, Serteyn D, de la Rebière de Pouyade G.Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed. This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up. In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases a...
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...
