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.
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 ...
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.
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...
Davidson SB, Blostein PA, Schrotenboer A, Sloffer CA, VandenBerg SL.The size, speed, and unpredictable nature of horses present a significant risk for injury in all equine-related activities. Objective: We sought to examine the mechanism, severity, frequency, body regions affected, surgical requirements, rehabilitation needs, safety equipment utilization, and outcomes of equine-related injured patients. Methods: Records of inpatients who sustained an equine-related injury from 2002-2011 with International Classification of Diseases, Ninth Revision codes E828 and E906 were retrospectively reviewed for pertinent data. Results: Ninety patients, 70% female, age (m...
Palmer JE.Many sick neonatal foals have respiratory failure secondary to perinatal hypoxia, sepsis, or pneumonia. These foals require ventilatory support to prevent respiratory embarrassment and other complications associated with chronic hypoxia and hypercapnia. This article discusses practical aspects of ventilatory therapy, such as choosing a candidate for mechanical ventilation, choosing the proper ventilatory mode, placing a foal on a ventilator, maintaining a foal on mechanical ventilation, and weaning from mechanical ventilation. This article details some of the techniques that have been develope...
To determine the causes of horse-related injuries in a rural western community. Methods: Prospective identification of persons with horse-related injuries and retrospective interviews with patients or witnesses to determine causes. Methods: A small rural community in Alberta where the western style of riding predominates. Methods: All patients presenting to two family medicine clinics or to the Sundre General Hospital emergency department. Methods: Factors contributing to the injury as recalled by patients or witnesses, and characteristics of the persons, horses, and injuries. Results: Two thi...
van Loon JP, Jonckheer-Sheehy VS, Back W, van Weeren PR, Hellebrekers LJ.Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another...
Boles C.Emergency equine abdominal surgery is easiest and most efficiently carried out with a team of surgeons. The surgical site should be as protected as possible by the use of sterile drapes and wound protectors. A ventral midline laparotomy incision has been found to be the most convenient approach to most equine intestinal obstructions. A standing laparotomy through the left paralumbar fossa gives adequate exposure for exploration of the abdomen and is, therefore, useful as a diagnostic tool. Horses tolerate having both ventral midline and left paralumbar laparotomy incisions well. If the cause o...
Corley KT, Axon JE.Early intervention can dramatically alter outcome in foals. Cardio-pulmonary cerebral resuscitation can be successful and clinically worthwhile when applied to foals that arrest as part of the birthing process. Readily available equipment and an ordered plan starting with addressing the respiratory system (airway and breathing) followed by the circulatory system (circulation and drugs) are the keys to success. Hypoglycemia is common in foals that are not nursing and in septic foals. Support of serum glucose can be an important emergency treatment. Respiratory support with oxygen therapy should...
Burba DJ.Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.
Hunt RJ, Allen D, Baxter GM, Jackman BR, Parks AH.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...
Bucak IH, Turgut K, Almis H, Turgut M.The aim of this study was to examine the characteristics of patients presenting to a pediatric emergency department in a rural province of Turkey due to horse and donkey bites and to analyze whether these features differ from those of more common animal bites in rural areas. Methods: The records of patients presenting to the pediatric emergency department of a tertiary hospital due to horse and donkey bites over a 3-year period were examined retrospectively. Demographic data, month of presentation, animal species involved (horse or donkey), the body area bitten, treatment applied to the wound ...
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 ...
Fessler JF.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...
BMC public healthFebruary 20, 2014
Volume 14 182 doi: 10.1186/1471-2458-14-182
Sawford K, Dhand NK, Toribio JA, Taylor MR.After the 2011 cluster of Hendra virus cases in horses in Australia, public health targeted education initiatives at people in the equine industry to reduce human exposure to potentially infected horses. 'Horse owners and Hendra Virus: A Longitudinal cohort study To Evaluate Risk' aims to enhance public health measures through improved understanding of Hendra virus risk perception and risk mitigation strategies among horse owners and horse care providers. This paper describes the stakeholder consultation that was undertaken to ensure the cohort study outcomes were relevant to diverse groups wh...
Bertone AL.Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, a...
Francis AO, McCabe F, McCabe P, O'Daly BJ, Leonard M.Horse riding related accidents can present with devastating pelvic and acetabular fractures. This study examines the nature, management and treatment outcomes of severe pelvic and acetabular trauma in amateur horse riders presenting to a national tertiary referral centre. We also aim to define certain at-risk groups. Methods: This was a retrospective descriptive cohort of all patients who were referred to the National Centre for Pelvic and Acetabular trauma resulting from horse riding accidents. All patients who were referred to the National Centre for Pelvic and Acetabular Trauma between Janu...
Maekawa Y, Sakamoto T, Umezu K, Ohashi N, Harada Y, Yasukochi S, Takigiku K, Takei K, Nakano Y, Inoue N, Otagiri T, Hashida Y.We report a female infant with acute coronary syndrome after Aubert-Imai modification for transposition of the great arteries. Two months postoperatively, she visited the emergency room because of perspiration and tachypnea. She was diagnosed with acute coronary syndrome by blood chemistry examination. Cardiac catheterization revealed Aubert route stenosis, and emergency operation was performed. The lumen around the aortopulmonary window was almost totally occluded by fibrous tissue extending from the equine pericardial patch. This fibrous tissue was completely resected and the aortopulmonary ...
Newton TA, Rose SR.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...
Lin HC, Wallace SS, Robbins RL, Harrison IW, Thurmon JC.In 4 mares suffering from dystocia, general anesthesia was induced with xylazine (1.1 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with continuous intravenous infusion of ketamine (2 mg/ml), xylazine (0.5 mg/ml) and guaifenesin (50 mg/ml) in 1 L of 5% dextrose. The duration of the procedure of these mares were 40, 45, 180, and 35 minutes, respectively. For procedures required more than 1 hour (Mare 3), the dose of ketamine and xylazine in the mixture was reduced to 1 mg/ml and 0.25 mg/ml, respectively. Average infusion rate of the mixture used to maintain anesthesia for each mare was...
Bixby-Hammett D, Brooks WH.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 ...
Croft MG, Fraser GC, Gaul WN.A Laboratory Information Management System (LIMS) was used to manage the laboratory data and support planning and field activities as part of the response to the equine influenza outbreak in Australia in 2007. The database structure of the LIMS and the system configurations that were made to best handle the laboratory implications of the disease response are discussed. The operational aspects of the LIMS and the related procedures used at the laboratory to process the increased sample throughput are reviewed, as is the interaction of the LIMS with other corporate systems used in the management...
Lovett A, Vokes J, Loghides N, Johnstone L, Sykes B.Formalin intoxication via the gastrointestinal route has not been previously reported in the horse. Whereas ingestion of formalin in humans, although rare, is well documented. Majority of human cases are either accidental, suicidal or homicidal and often lead to fatality, with a reported lethal formaldehyde dose equating to 0.12 - 0.16 g/kg bwt. Objective: To describe a single case report of the clinical management of an adult horse referred to a veterinary teaching hospital following accidental administration of 10% formalin via nasogastric tube. Methods: A 13-year-old Thoroughbred gelding or...
The Journal of traumaAugust 13, 2008
Volume 65, Issue 2 447-460 doi: 10.1097/TA.0b013e31817dac43
Loder RT.It was the purpose of this study to review equestrian-related injuries using a large nation wide database and analyze predictors of significant injury. Methods: The National Electronic Surveillance System database was queried for equestrian injuries from 2002 to 2004. The presence of a fracture, dislocation, traumatic brain injury, musculoskeletal injury, orthopedic injury, and spinal injury, as well as injury mechanism, geographical location, and emergency room disposition were noted. Bivariate, cosinor seasonal, and multiple logistic regression analyses were performed. p < 0.01 was considere...
Calvo-Pinilla E, de la Poza F, Gubbins S, Mertens PP, Ortego J, Castillo-Olivares J.Previous studies show that a recombinant modified vaccinia Ankara (MVA) virus expressing VP2 of AHSV serotype 4 (MVA-VP2) induced virus neutralising antibodies in horses and protected interferon alpha receptor gene knock-out mice (IFNAR -/-) against challenge. Follow up experiments indicated that passive transfer of antiserum, from MVA-VP2 immune donors to recipient mice 1h before challenge, conferred complete clinical protection and significantly reduced viraemia. These studies have been extended to determine the protective effect of MVA-VP2 vaccine-induced antiserum, when administered 48h be...
Chitnavis JP, Gibbons CL, Hirigoyen M, Lloyd Parry J, Simpson AH.Horse riding is a dangerous pastime with more accidents occurring per hour than during motor-cycling. Since a prospective survey of horse-related injuries conducted at a major centre in 1971-1972, equestrian groups and the medical profession have encouraged improvements in training and protective riding wear. By conducting a similar study at the same centre 20 years later we hoped to assess the effects of these measures on the pattern of injuries resulting from contact with horses. Patient and injury details were recorded prospectively for all those presenting to the Accident Service at Oxford...
