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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.
The prognostic importance of physiological and biochemical parameters in horses afflicted with colic. Colic, a primary cause of illness and death in horses, necessitates the development of improved prognostic tools. Unassigned: The aim of this study was to investigate the prognostic significance of physiological and biochemical parameters in horses suffering from colic. Unassigned: A comprehensive clinical evaluation of 117 horses included assessment of heart rate, mucous membranes, capillary refill time, rectal temperature, respiratory rate, gut motility, reflux, and limb pulse strength. Unassigned: Stomach reflux, absence of gut noises, and increased heart rate (mean increase of 12 bpm) stro...
Trends in the management of horses referred for colic evaluation preceding and during the COVID-19 pandemic (2013-2023). The COVID-19 pandemic represented a significant source of anxiety and stress for equine veterinarians and clients, with the potential for measurable effects on caseload and owner economics. Unassigned: To compare the number of horses presenting for emergency colic evaluation and treatment, as well as costs at two equine referral hospitals. Unassigned: Retrospective cohort. Unassigned: Medical records of horses admitted to North Carolina State University (NCSU) and Bell Equine Veterinary Clinic (BEVC) were compared. Total equine accessions, number of horses referred for colic, and patient age w...
Use of extracorporeal hemoperfusion therapy in an adult horse with Clostridioides difficile colitis and severe systemic inflammatory response syndrome. An 8-year-old American Quarter Horse gelding was treated with extracorporeal hemoperfusion (HP) therapy for treatment of Clostridioides difficile (C. difficile) colitis-induced systemic inflammatory response syndrome (SIRS). The gelding developed C. difficile associated peracute colitis and severe SIRS as evidenced by a positive fecal C. difficile PCR and tachypnea, tachycardia, fever, neutropenia, altered mucous membrane color, and hyperlactatemia. Concurrent acute kidney injury in the horse limited the use of routine anti-inflammatory and anti-lipopolysaccharide treatments, including flunixi...
Emergency Standing Laparoscopic Treatment of Uncontrolled Post-Castration Hemorrhage in Two Geldings. Persistent hemorrhage of testicular vessels is a potentially life-threatening complication of equine castration. Frequently, general anesthesia is required to retrieve and ligate the bleeding vasculature when standing wound packing and retrieval of the spermatic cord are unsuccessful. We propose standing laparoscopic ligation of the testicular arteries via the paralumbar fossa as a rapid, effective means of halting hemorrhage while avoiding castration site trauma as well as the cardiovascular and recovery risks of general anesthesia. Methods: Two geldings, 6 and 9 months old, presented for eme...
Prices for veterinary care of dogs, cats and horses in selected countries in Europe. In recent years, prices for veterinary care have received considerable attention in mainstream media, yet scientific literature has not delved into actual figures. This study aims to elucidate veterinary care costs for dogs, cats, and horses across five countries [Sweden (SE), Norway (NO), Denmark (DK), United Kingdom (UK), and Ireland (IR, with limited data)] through web searches. Unassigned: Utilising online business directories, we located URLs featuring veterinary care prices in autumn 2022, and repeated tri-monthly five times. Vetpris.se (VP), a price comparison site for SE, NO, and DK, e...
Ultrasound findings in 34 newborn foals with uroperitoneum. Uroperitoneum is a typical disease of the newborn foal, which occurs rarely but regularly. Ultrasonography is considered the most important imaging method for diagnosing this disease. Thus far, only one older case series comprising 31 foals suffering from uroperitoneum has systematically listed results of ultrasound examinations. Objective: This paper presents the findings of an ultrasonographic examination of 34 foals with uroperitoneum in order to inform future interpretation of ultrasonographic data in suspected uroperitoneum cases. Methods: Ultrasonographic data of 34 neonatal foals up to ...
Suspected envenomation by the common European adder (Vipera berus berus) in 28 horses in Finland. Vipera berus berus is the only venomous snake present in the Nordic countries and cases of envenomation in horses are reported during the warmer months. Little is known about the presentation, treatment and survival of horses with common European adder envenomation. Clinical and laboratory findings, treatment and outcome are reported for 28 horses admitted to Helsinki University Equine Hospital in 2008-2023 due to suspicion of snake bite. Eleven of these horses received antivenom treatment. Other common treatments included non-steroidal anti-inflammatories (22/28), antimicrobials (19/28), intr...
[Behavior of the mare during parturition – a literature review]. In horses, parturition is characterized by the fact that any delays may rapidly result in the death of the foal. Therefore, birth monitoring and the rapid detection of dystocia are of great importance. For this purpose, the differentiation between behavior associated with physiological parturition and activities related to difficult parturition is important. The aim of this publication is to present the physiological behavior of mares during parturition on the basis of a literature review. The behavior of mares in the opening phase of parturition is highly individual. In general, it is charact...
UK horse owners and veterinary practitioners’ experiences of decision-making for critical cases of colic. The survival of horses diagnosed with critical colic (requiring referral or euthanasia) relies on rapid and effective decision-making by the owner and veterinary practitioner. Objective: To explore UK horse owners' and veterinary practitioners' experiences of decision-making for critical cases of equine colic. Methods: Qualitative study using a phenomenological approach. Methods: Individual, semi-structured telephone interviews were conducted with 14 horse owners and 13 veterinary practitioners (vets) who had experienced a critical decision (referral or euthanasia) for a horse with colic. A pu...
Craniofacial Trauma of Equestrian Origin. Horse riding is a popular yet dangerous sport, often resulting in facial traumas due to unpredictable horse reactions or falls. This retrospective study examines 20 patients. The aim of the study is to analyze maxillofacial traumas of equine origin and discuss prevention strategies. Conducted from 2004 to 2021 at our university hospital's emergency department in France, inclusion criteria encompassed patients with maxillofacial trauma admitted to the emergency department and referred to ENT and/or dentistry post-horse-related accidents. Patients were identified from the Health Data warehouse. ...
Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT. An accurate risk score that can predict peri-anesthetic morbidity and mortality in equine patients could improve peri-operative management, outcome and client communication. Unassigned: Three hunded horses underwent pre-anesthetic risk assessment using the American Society of Anesthesiologists-Physical Status augmented with equine-specific diseases (ASA-PS-Equine), a multifactorial 10-part rubric risk scale (10-RS), and a combination of both, the Combined horse anesthetic risk identification and optimization tool (CHARIOT). Intra-and post-anesthetic complications, the recovery phase and mortal...
Neurosurgical Injuries Associated with Recreational Horseback Riding: A 6-year Retrospective Analysis. Horseback riding can cause severe brain and spinal injuries. This study aimed to identify the spectrum of neurosurgical injuries related to recreational horseback riding. A retrospective study was performed utilizing the University of Puerto Rico neurosurgery database to identify patients who were consulted to the neurosurgery service between 2018 and 2023 after a horse fall during recreational activities. The outcome upon discharge using the modified Rankin scale (mRS) was documented. Descriptive statistics were used to report frequency and median values. The neurosurgery service evaluated an...
Comparison of Xylazine and Lidocaine Infusion versus Medetomidine Continuous Rate Infusion during General Anesthesia with Isoflurane in Horses Undergoing Emergency Laparotomy. (1) The main goals of general anesthesia include pain management and a safe anesthetic protocol for smooth recovery. In this retrospective study, we compared two anesthetic protocols for general anesthesia with isoflurane during emergency laparotomy: sedation with xylazine and the intraoperative infusion of lidocaine (X group) versus medetomidine as a preoperative sedation and intraoperative infusion (M group). (2) The medical records of horses who underwent emergency laparotomies between 2016 and 2023 were reviewed. According to the anesthetic protocol, patients were allocated to the X or M g...
The Management of Xylazine Overdose With Naloxone. This article discusses a rare case of isolated xylazine overdose in a human, treated successfully with naloxone. Xylazine, typically used as a veterinary tranquilizer, acts as a potent α2 adrenergic agonist, leading to sedation, muscle relaxation, and potential respiratory depression. In this case, a female mistakenly injected herself with xylazine mistaking it for a different medication. The report discusses naloxone's role beyond opioid overdose, especially regarding substances causing central nervous system (CNS) depression via mechanisms similar to those of opioids. While naloxone is trad...
Evaluation of remote assistance for point-of-care ultrasonography in a large animal hospital: a controlled randomized trial. To assess whether remote assistance is beneficial to the accuracy of point-of-care ultrasound (POCUS) examinations during equine emergency evaluations. Methods: Adult horses presenting to a tertiary care large animal emergency service for respiratory or gastrointestinal clinical signs. Methods: Prospective, randomized, controlled, clinical study. Cases were assigned to receive POCUS with remote assistance ("POCUS-R" group) or POCUS with no assistance ("POCUS" group). Accuracy of diagnosis, duration of sonograms and survival to discharge were the objective outcomes compared between groups. Perc...
Complete Traumatic Rupture of the Pancreas by a Horse Saddle: A Case Report. Pancreatic trauma is one of the least observed diagnoses in the emergency room, much less in pediatric emergencies. Any cause of direct abdominal blunt trauma can cause it. With only a few cases presented in the literature, horse accidents have been associated with this complication, but it has been never seen in literature as a case where the horse-riding saddle is the one causing the pancreatic trauma, until now. Emphasizing the importance of an early diagnosis is the key point, but more importantly, to highlight that the correct diagnostic approach will grant the opportunity for a lesion in...
Horse to human: Streptococcus equi septicemia presenting as endogenous endophthalmitis. To present a rarely reported systemic infection with (), transmitted from a horse, and to describe successful treatment when complicated by endogenous endophthalmitis. Unassigned: We diagnosed suspected septicemia presenting as loss of vision in the right eye of an otherwise healthy polo player/horse trainer. He received immediate intravenous antibiotics and three vitrectomies with two intravitreal antibiotic injections during the first week, to cure infection and subsequent retinal detachment. Blood and initial vitreous cultures rapidly grew The septicemia was quickly controlled by systemi...
Snake Envenomation. Snakebite envenomation (SBE) in horses can have devastating outcomes. Tissue damage, cardiotoxicity, coagulopathy, and neurotoxicity can be concerns with SBE. Understanding the actions of venom components is important in developing a successful treatment plan. Antivenom is the mainstay of treatment. Long-term deleterious effects can occur including cardiac dysfunction and lameness.
Flemish equine veterinarians’ perceptions on the use of and client communication about complementary and alternative veterinary medicine. 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...
Clinical findings, surgical techniques, prognostic factors for short-term survival and long-term outcome in horses with acquired inguinal hernias: Ninety-eight cases (2005-2020). To report findings, outcome and determine variables associated with survival in horses with acquired inguinal hernia (AIH). Methods: Retrospective study. Methods: A total of 98 cases in 97 horses. Methods: The medical records (2005-2020) of horses diagnosed with AIH were reviewed. Retrieved data included signalment, history, clinical variables, surgical aspects, postoperative complications, and short- and long-term outcomes. Logistic regression analyses were used to determine factors associated with short-term survival (p < .05). Results: Manual reduction was attempted in a third of the...
Survival of formalin intoxication in a 13-year-old Thoroughbred gelding. 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...
Equine Gunshot Euthanasia: Creation of a 3D-Printed Model with Integrated Sensors for Training. Challenges and issues related to the use of pentobarbital euthanasia and disposal of animal remains within the US have recently been reviewed. Environmental and public health challenges increasingly necessitate consideration of alternative methods such as gunshots, an American Veterinary Medical Association (AVMA) "acceptable with conditions" method, for the humane euthanasia of horses. A recent study reported a correctly aimed gunshot provides a humane option for euthanizing horses. However, although aiming guidelines exist, studies examining bullet trajectories in animals euthanized by gunsh...
The effects of orally administered trazodone on ambulation and recumbency in healthy horses. Trazodone, a serotonin receptor antagonist and reuptake inhibitor, might be a useful adjunctive treatment in the initial management of horses with acute laminitis if it minimizes ambulation or encourages recumbency. Objective: (1) Evaluate the effects of PO trazodone on ambulatory activity and recumbency in healthy horses; and (2) assess the pharmacokinetics of multiple PO doses of trazodone. Methods: In a randomized cross-over design, 8 healthy horses received placebo or trazodone at 2 doses (2.5 and 7.5 mg/kg) PO q12h for 48 hours with a 14-day washout period between treatments. Forelimb...
Assessment and comparison of microcirculation and macrocirculation in horses undergoing emergency exploratory celiotomy versus elective surgical procedures. 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...
Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations. 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...
Abdominal Sonographic Evaluation: In the Field, at the Hospital, and After Surgery. Abdominal sonography is currently a routine procedure in the evaluation of colic in the horse. This imaging technique is used in both the assessment of the horse presented in the emergency setting with acute colic and the assessment of the horse presented for chronic or recurrent colic in the nonemergency setting. Sonography for colic evaluation is used by specialists in different disciplines and by general practitioners in the ambulatory and hospital settings. In this review, we will focus on indications and clinical interpretation of findings as well as recent developments in abdominal sonog...
Critical Care of the Colic Patient: Monitoring, Fluid Therapy, and More. 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.
Updates on Diagnosis and Management of Colic in the Field and Criteria for Referral. Gastrointestinal colic is the most common primary care equine emergency and affects nearly one of four horses per year. Colic is a significant welfare concern for equine patients and a financial and emotional burden for owners. The primary care practitioner is instrumental in identifying critical cases quickly and making appropriate management recommendations to improve patient outcomes.
Repeat Celiotomy-Current Status. 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...
