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Topic:Emergency Care
Emergency care in horses involves the immediate assessment and treatment of acute medical conditions or injuries to stabilize the animal and prevent further harm. This area of veterinary practice encompasses a range of situations, including colic, traumatic injuries, respiratory distress, and sudden lameness. Emergency care procedures may involve physical examinations, diagnostic imaging, fluid therapy, pain management, and, in some cases, surgical intervention. This topic includes peer-reviewed research studies and scholarly articles that explore the methods, protocols, and outcomes associated with emergency interventions in equine medicine.
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...
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.
Surgical treatment of sand colic in equids: 48 cases (1978-1985). 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...
Trauma and the veterinarian. 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 ...
Anesthetic considerations for emergency equine abdominal surgery. 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.
Prevention and management of peritonitis in horses. 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.
Intensive care of the patient after abdominal surgery. 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.
Decision for surgery. 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...
Near drowning of a gelding. 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.
Riding and other equestrian injuries: considerable severity. 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.
Isoflurane anesthesia for equine colic surgery. Comparison with halothane anesthesia. 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...
Equestrian injuries: a comparison of professional and amateur injuries in Berkshire. 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,...
