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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.
Umbilical Cord Herniation With Small Intestinal Evisceration in Two Thoroughbred Neonates.
Journal of equine veterinary science    April 14, 2022   Volume 114 103959 doi: 10.1016/j.jevs.2022.103959
Gough R, McGovern K, Bladon B, De Oliveira F.This report describes two cases of spontaneous small intestinal evisceration via normally inserted umbilical stumps, without abdominal wall trauma. Both cases occurred immediately following uneventful parturition. The authors believe that these represent cases of umbilical cord herniation. This is a well-recognised condition in humans, but has not been previously described in equines. One foal died before veterinary intervention. The second foal underwent a jejunal resection with end-to-end anastomosis and survived to successfully race. This report describes a previously unrecognised condition...
Full-thickness endotracheal tube defect resulting in an anaesthetic circuit leak.
Equine veterinary journal    March 10, 2022   Volume 55, Issue 1 66-68 doi: 10.1111/evj.13569
Miller L, Lord S.Loss of endotracheal tube (ETT) integrity secondary to dental damage is reported in the human literature. Objective: To describe this problem in equine anaesthesia. Methods: Case report. Conclusions: An 18-year-old Standardbred gelding presented out of hours with colic signs. Findings on clinical examination and pain refractory to analgesia meant that exploratory laparotomy was elected for. Prior to general anaesthesia (GA) leak testing of the anaesthetic machine was performed and the pilot balloon of the endotracheal tube (ETT) was inflated to confirm cuff integrity. Intermittent-positive pre...
Investigation of plasma cell-free DNA as a potential biomarker in horses. Bayless RL, Cooper BL, Sheats MK.Plasma cell-free DNA (cfDNA) is a biomarker of ischemia, systemic inflammation, and mortality in humans with gastrointestinal disease. Cell-free DNA has not been investigated as a biomarker for equine colic, to our knowledge. We hypothesized that cfDNA could be measured accurately in neat equine plasma using a benchtop fluorometer and that plasma cfDNA would be elevated in emergency patients compared to healthy horses. Plasma was obtained from blood collected in Roche DNA stabilizing tubes. We used the Qubit 4 fluorometer and 1× dsDNA HS assay kit to measure cfDNA concentration in neat patien...
How to perform a percutaneous cecal or colonic trocarization in horses with severe abdominal tympany.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    January 20, 2022   Volume 32, Issue S1 57-62 doi: 10.1111/vec.13123
Schroeder EL, Gardner AK, Mudge MC.Cecal or colonic gas tympany of any cause may result in increased intraabdominal pressure, causing a significant decrease in venous return and cardiac output. Trocarization of the large colon or cecum in the event of large intestinal tympany may resolve gas distension and accompanying increased intraabdominal pressures sufficiently enough to promote resolution of a displaced large colon. Furthermore, trocarization of the medical colic may decrease morbidity and mortality associated with severe intraabdominal hypertension. Methods: This how-to description details the technique of transcutaneous...
The pathophysiology of uncontrolled hemorrhage in horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    January 20, 2022   Volume 32, Issue S1 63-71 doi: 10.1111/vec.13122
Hurcombe SDA, Radcliffe RM, Cook VL, Divers TJ.Hemorrhagic shock in horses may be classified in several ways. Hemorrhage may be considered internal versus external, controlled or uncontrolled, or described based on the severity of hypovolemic shock the patient is experiencing. Regardless of the cause, as the severity of hemorrhage worsens, homeostatic responses are stimulated to ameliorate the systemic and local effects of an oxygen debt. In mild to moderate cases of hemorrhage (<15% blood volume loss), physiological adaptations in the patient may not be clinically apparent. As hemorrhage worsens, often in the uncontrolled situation suc...
Calculating and selecting fluid therapy and blood product replacements for horses with acute hemorrhage.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    January 20, 2022   Volume 32, Issue S1 97-107 doi: 10.1111/vec.13127
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...
Epidemiological Study of Equestrian Trauma in Geneva.
Journal of pediatric orthopedics    December 4, 2021   Volume 42, Issue 2 e126-e131 doi: 10.1097/BPO.0000000000002025
Naef S, Steiger CN, Tabard-Fougère A, Dayer R, Ceroni D.Horse-related activities are increasingly popular among young people but are frequently associated with severe injuries requiring hospital treatment. There are few data on the incidence of equestrian injuries, especially in child populations, or on means of prevention. Thus, this study's purpose was to highlight the epidemiological data on specific injuries due to equestrianism and serve as the groundwork for future studies on the prevention of equestrian accidents. Methods: A retrospective study collected data on all children younger than 16 years old who attended our regional emergency depar...
Craniofacial Fractures in Equine-Related Injuries: What Should a Maxillofacial Surgeon Expect?
The Journal of craniofacial surgery    November 30, 2021   Volume 32, Issue 4 1409-1412 doi: 10.1097/SCS.0000000000007545
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...
Mechanical Principles of the Equine Foot.
The Veterinary clinics of North America. Equine practice    November 17, 2021   Volume 37, Issue 3 581-618 doi: 10.1016/j.cveq.2021.09.001
Bras R, Morrison S.A healthy foot requires a well-balanced foot capable of shock absorption, traction, and normal proprioception. Radiographs and venograms are helpful in assessing health of the external and internal structures of the foot and in early diagnosis. Other techniques to assess foot mechanics include force plate and inertial sensors. When foot pathology ensues, early recognition and emergency mechanical treatment can improve prognosis and overall outcome. Sheared heels, under-run heels, and clubfeet are common problems that need to be corrected early. Successful management and results require he vete...
Occupational vs. non-occupational equestrians: Differences in demographics and injury patterns.
Injury    November 1, 2021   Volume 53, Issue 1 171-175 doi: 10.1016/j.injury.2021.10.033
Samuels K, Bettis A, Davenport DL, Bernard AC.Nineteen million people participate in horseback riding activities in the US, and the horse industry employs more than 460,000 full-time workers. Emergency department data suggest young female amateurs and male professionals are most at risk of death from horse-related injuries. However, there has been no investigation into factors that may increase severe injury and mortality risk in these populations. This study investigates demographics and injury pattern differences between occupational and non-occupational horse-related injuries in the US. Methods: The 2017 American College of Surgeons Na...
Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses.
Journal of the American Veterinary Medical Association    November 1, 2021   Volume 259, Issue 11 1337-1343 doi: 10.2460/javma.20.10.0577
Gandini M, Giusto G.7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypa...
Head and tail rope-assisted recovery improves quality of recovery from general anaesthesia in horses undergoing emergency exploratory laparotomy.
Equine veterinary journal    October 19, 2021   Volume 54, Issue 5 875-884 doi: 10.1111/evj.13516
Louro LF, Robson K, Hughes J, Loomes K, Senior M.In equine anaesthesia, the recovery period is critical, accounting for most anaesthesia-related fatalities reported. Horses may recover unassisted or may be assisted, for example, using a head and tail rope recovery method. Objective: To compare the impact of head and tail rope and unassisted recovery method on quality of recovery in horses undergoing colic surgery under general anaesthesia (GA). Methods: Single centre retrospective cross-sectional study, with prospective model performance analysis. Methods: Clinical data were obtained from horses undergoing emergency exploratory laparotomy ov...
Fall, Crush, Kick: Mechanisms and Outcomes in a Cohort of Equine-Related Injuries.
The American surgeon    October 13, 2021   Volume 89, Issue 4 875-880 doi: 10.1177/00031348211048836
Bhade P, Parsons A, Smiley A, Shreffler J, Nash N, Baker J, Harbrecht B, Huecker M.The potential for significant traumatic injury to individuals who interact with horses remains high due to animal size, forces applied, and unpredictability. Despite an estimated 30 million riders in the United States annually, few recent publications have addressed this patient population. Objective: This study describes characteristics of patients injured in interactions with horses, focusing on mechanism of injury and use of protective equipment. Methods: We queried our institution's trauma registry for all patients admitted for equine-related injuries (ERI) between January 1, 2013 and Dece...
Development of a Colic Scoring System to Predict Outcome in Horses.
Frontiers in veterinary science    October 8, 2021   Volume 8 697589 doi: 10.3389/fvets.2021.697589
Farrell A, Kersh K, Liepman R, Dembek KA.Acute abdominal pain in the horse is a common emergency presenting to equine practices. The wide variety of etiologies makes prognosticating survival a challenge. A retrospective, multi-institutional clinical study was performed to determine clinical parameters associated with survival of horses with colic, and to use them to develop a colic survival scoring system. The scoring system was then validated using clinical data in the prospective portion of the study. Medical records from 67 horses presenting for acute abdominal pain were evaluated to develop the colic assessment score. Twenty eigh...
Systemic serum amyloid A in early (<24 h) diagnosis of acute synovial structure involvement in horses with penetrating limb injuries.
Veterinary journal (London, England : 1997)    September 30, 2021   Volume 277 105759 doi: 10.1016/j.tvjl.2021.105759
Müller AC, Büttner K, Röcken M.Synovial structure involvement secondary to limb injury is a common emergency in equine practice, requiring an accurate initial diagnosis for immediate treatment. This study aimed to investigate the clinical usefulness of Serum amyloid A (SAA) in the initial diagnosis of synovial structure involvement caused by acute (<24 h) penetrating limb injuries in horses and to correlate SAA with standard diagnostic parameters. Fifty-five horses with acute limb injuries were divided into two groups: Group 1 (G1, n = 26) with a diagnosis of penetrating synovial trauma and Group 2 (G2, n = 29) without s...
Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA.
Trauma surgery & acute care open    September 14, 2021   Volume 6, Issue 1 e000728 doi: 10.1136/tsaco-2021-000728
Mutore K, Lim J, Fofana D, Torres-Reveron A, Skubic JJ.There is a paucity of evidence about traumatic injuries and their sequelae sustained due to equestrian injuries nationally. Methods: Retrospective study analyzing National Trauma Data Bank data from 2007 to 2016. Variables collected included age, sex, race, payer status, Injury Severity Score (ISS), hospital length of stay, Glasgow Coma Scale, systolic blood pressure (SBP) at presentation, discharge disposition, and mortality. Patient data were analyzed by anatomic region. Results: The most frequent type of injury was in the thorax, but head and neck injuries produced the highest mortality. In...
Practical Review of the Management of Animal Bites.
Plastic and reconstructive surgery. Global open    September 9, 2021   Volume 9, Issue 9 e3778 doi: 10.1097/GOX.0000000000003778
Savu AN, Schoenbrunner AR, Politi R, Janis JE.Animal bites are common worldwide. Due to the plethora of animals, there are diverse pathogens with specific associated risks and treatment algorithms. It is crucial to understand these to develop and execute appropriate management plans. This practical review was designed to amalgamate the most common bites worldwide and synthesize data to help guide treatment plans. Methods: A PubMed literature search was performed focusing on the major animal bites. High-level studies were preferred and analyzed but lower-level studies were also used if high-level studies did not exist. Results: The tables ...
Demographic, preoperative and anaesthesia-related risk factors for unsatisfactory recovery quality in horses undergoing emergency abdominal surgery.
Veterinary anaesthesia and analgesia    September 4, 2021   Volume 48, Issue 6 882-890 doi: 10.1016/j.vaa.2021.04.013
Santiago-Llorente I, López-San Román FJ, Villalba-Orero M.To determine demographic, preoperative and anaesthesia-related variables that may be associated with unsatisfactory recovery quality in horses undergoing emergency abdominal surgery (colic) in an equine teaching hospital. Methods: Retrospective case series. Methods: A total of 313 horses. Methods: The anaesthetic records of horses admitted for surgical treatment of colic between 2005 and 2018 were examined. Overall quality of recovery was assessed as dangerous, poor, fair, good or excellent. The following categories were constructed as a dichotomic variable: unsatisfactory recovery (poor and d...
Exploring the Severity of Craniomaxillofacial Injuries From Horseback Riding.
The Journal of craniofacial surgery    August 3, 2021   Volume 33, Issue 1 62-65 doi: 10.1097/SCS.0000000000008004
Stanbouly D, Besmer AV, Chuang SK.The purpose of our study is to assess the severity of craniomaxillofacial injuries from horseback-riding accidents. Methods: This is a 20-year retrospective cross-sectional study of the National Electronic Injury Surveillance System. Injuries from the activity of horseback-riding were included if they occurred in the craniomaxillofacial complex. Study predictors were derived from both patient and injury characteristics. The study outcome was the presence or absence (probability) of hospital admission from the emergency department. A multiple logistic regression model was created to model the o...
The Human Aspect of Horse Care: How the COVID-19 Pandemic Impacted the Wellbeing of Equestrian Industry Stakeholders.
Animals : an open access journal from MDPI    July 22, 2021   Volume 11, Issue 8 2163 doi: 10.3390/ani11082163
Ward A, Stephen K, Argo C, Watson C, Harris P, Neacsu M, Russell W, Grove-White D, Morrison P.During the lockdown phase of the COVID-19 pandemic, equestrian stakeholders faced a dilemma whereby they were required to balance caring for the welfare of horses with adapting to the restrictions imposed to protect public health. The present study investigated the impact of the pandemic on the wellbeing of a sample of industry stakeholders, including horse owners, equine veterinarians, farriers and welfare centre managers ( = 26) using a qualitative methodology. Findings from the interviews indicated that the mental health and wellbeing of veterinarians and horse owners was negatively affecte...
Effect of anesthesia duration on the quality of recovery in horses undergoing elective and emergency surgeries using the same anesthetic protocol. Vermedal H, Valverde A, Sears W.The objective of this study was to investigate the effect of anesthesia duration on the quality of recovery in horses. The medical records of horses that were anesthetized and underwent surgery for elective and emergency soft tissue and orthopedic conditions from 2013 to 2019 were reviewed. Horses included in the study (N = 305) fulfilled the following requirements: all had the same premedication/induction protocol and the same balanced anesthesia for maintenance and were anesthetized by the same, experienced Board-certified anesthesiologist. A standardized anesthetic recovery score was comple...
Emergency Management of Equid Foals in the Field.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 407-420 doi: 10.1016/j.cveq.2021.04.009
Swain O'Fallon EA.Foal emergencies can be intimidating to manage in the field, yet many conditions will respond well to the supportive care possible on the farm. Triage of the foal targets focused supportive care to stabilize the foal before referral to a hospital or to facilitate the management in the field. There are many diagnostic and therapeutic options available in the field setting to support a successful outcome on the farm.
Orthopedic Infections-Clinical Applications of Intravenous Regional Limb Perfusion in the Field.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 275-291 doi: 10.1016/j.cveq.2021.04.003
Kilcoyne I, Nieto JE.For the equine veterinarian, orthopedic emergencies are a common occurrence in clinical practice, with traumatic wounds of the distal limb and penetrating injuries of the hoof being some of the most common medical conditions to affect horses. Intravenous regional limb perfusion is a technique widely used for the treatment of orthopedic infections in horses. The objectives of this review are to discuss some of the clinical applications for this treatment modality in the field and to review the technique for the practitioner.
Management of Colic in the Field.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 421-439 doi: 10.1016/j.cveq.2021.04.010
Rhodes DM, Madrigal R.Colic is one of the most frequent emergencies necessitating veterinary attention. Referral is not an option in many cases; therefore, the ability to diagnose and treat colic in an ambulatory setting is paramount. Portable imaging and point-of-care testing has improved the ability to identify lesions and assess the patient's status. In cases when field management is the only option, practitioners should be aware of the various treatment options available.
Managing Reproduction Emergencies in the Field: Part 2: Parturient and Periparturient Conditions.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 367-405 doi: 10.1016/j.cveq.2021.04.008
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...
Managing Reproduction Emergencies in the Field: Part 1: Injuries in Stallions; Injury of the External Portion of the Reproductive Tract and Gestational Conditions in the Mare.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 339-366 doi: 10.1016/j.cveq.2021.04.007
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...
Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases.
Chinese journal of traumatology = Zhonghua chuang shang za zhi    July 6, 2021   Volume 24, Issue 6 397-400 doi: 10.1016/j.cjtee.2021.07.003
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...
Antimicrobial prescribing patterns in equine ambulatory practice.
Preventive veterinary medicine    June 11, 2021   Volume 193 105411 doi: 10.1016/j.prevetmed.2021.105411
Rule EK, Boyle AG, Redding LE.Antimicrobial resistance is one of the most important public health risks facing our world today. Antimicrobials are commonly prescribed in equine veterinary medicine, but limited information exists documenting their use in practice. The goal of this study was to investigate antimicrobial prescription patterns in regards to prescription frequency, duration, drug class, clinician and affected body system in an equine ambulatory setting via retrospective analysis of billing and electronic medical records. Risk factors associated with antimicrobial prescription including the nature of the visit, ...
Acute Central Nervous System Trauma in the Field.
The Veterinary clinics of North America. Equine practice    June 10, 2021   Volume 37, Issue 2 245-258 doi: 10.1016/j.cveq.2021.04.001
Estell K.Acute central nervous system (CNS) trauma in the field is best approached by a systematic and thorough physical and neurologic examination that allows the practitioner to localize the brain or spinal cord injury. The skull and vertebral canal are complex 3-dimensional structures, and orthogonal radiographic views are necessary for an accurate diagnosis. Therapeutics aimed at decreasing pain, inflammation, and edema or increased intracranial pressure in the case of traumatic brain injury should be administered. Survival and return to athleticism can be achieved even in moderate-to-severe trauma...
Approach to Toxicologic Emergencies.
The Veterinary clinics of North America. Equine practice    June 9, 2021   Volume 37, Issue 2 327-337 doi: 10.1016/j.cveq.2021.04.006
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 ...