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.
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.
Webb AI, Coons TJ, Koterba AM, Kosch PC.New developments in therapy for foals in respiratory distress are discussed. Therapy is based on preservation of the foal's life by maintenance of a patent airway, resuscitation with fluids and warmth, provision of humidified oxygen to raise the fractional concentration of inspired oxygen sufficient to avoid hypoxia and provision of ventilatory support when hypercapnia becomes critical. Ventilatory support described includes assisted and controlled ventilation, positive end expiratory pressure, continuous positive airway pressure and intermittent mandatory ventilation. The aims of these techni...
Geiser DR, Walker RD.The pathophysiology and histopathology of thermal burns in large animals is very similar to that in humans. Burns are classified as first degree, superficial and deep second degree, third degree, and fourth degree, depending upon the depth of thermal injury. Most severe burns will produce a local and a systemic response--both of which must be properly treated to increase the patient's chances for survival. The systemic response is mainly characterized by hypovolemia, fluid and electrolyte loss, protein loss, pulmonary edema, increased caloric requirements, and depressed immune responses. The l...
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 ...
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...
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...
Haase L, Monett D, Sedlmayr M.Animal owners may increasingly rely on large language models for gathering animal health information alongside internet sources in the future. This study therefore aims to provide initial results on the accuracy of ChatGPT-4o in triage and tentative diagnostics, using horses as a case study. Ten test vignettes were used to prompt situation assessments from the tool, which were then compared to original assessments made by a veterinary specialist for horses. The most probable diagnosis suggested by ChatGPT-4o was found to be quite accurate in most cases, with the urgency to contact a veterinari...
Morales CJ, Costa LRR.The practice of medicine has always been associated with complications. In fact, in its early stages, these complications contributed to the understanding of certain diseases and advancement of the medical field. In equine practice, virtually every procedure carries an associated risk. In fact, even procedures that would have minimal risk in human medicine may pose significant risk in equine practice owing to the unique nature of the horse. For instance, a simple rectal palpation could result in a rectal tear following an unexpected movement of the patient. Thus, extrapolations of complication...
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...
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...
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...
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...
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...
