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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.
Early Identification of Intestinal Strangulation: Why It Is Important and How to Make an Early Diagnosis.
The Veterinary clinics of North America. Equine practice    April 25, 2023   Volume 39, Issue 2 211-227 doi: 10.1016/j.cveq.2023.03.007
Southwood LL.Horses with colic caused by intestinal strangulation can have an excellent outcome with early surgical correction of the obstruction. The expense associated with surgery is typically less with early lesion correction. The challenge is making an early diagnosis of intestinal strangulation. Although for some horses with a strangulating obstruction, the need for surgery is made based on severe colic signs or lack of response to analgesia, in other horses, it is less obvious. Signalment, history, and meticulous physical examination, combined with some targeted diagnostic procedures can help with e...
On the trail of the Unicorn: a mythical combination of two enviable careers.
The Veterinary record    April 1, 2023   Volume 192, Issue 7 i-ii doi: 10.1002/vetr.2944
Hofstee W.Vet and owner of Unicorn Trails Wendy Hofstee explains how she developed a horse-riding holiday business alongside a successful career in emergency veterinary work.
Horse-riding hazards: an observational cohort study mapping equestrian related injuries at a Scandinavian trauma centre.
BMC sports science, medicine & rehabilitation    March 28, 2023   Volume 15, Issue 1 46 doi: 10.1186/s13102-023-00646-y
Franzén Lindgren E, Hammarqvist F, Ahl Hulme R.Horse-riding is practiced on a regular basis by 500,000 people in Sweden. It is reputed to be one of the most dangerous sports. On average, there were 1756 acute injuries and three fatalities each year between 1997 and 2014 in Sweden related to horses. The primary aim of this study was to outline the injury spectrum related to equestrian activities cared for at a large Swedish trauma centre. The secondary aim was to identify trends in clinical outcomes and to investigate the association between age and such outcomes. Methods: The electronic medical records system at Karolinska University Hosp...
[Definition, incidence and causes of dystocia in horses – a review of the literature].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    March 13, 2023   Volume 51, Issue 1 22-34 doi: 10.1055/a-2006-9248
Ellerbrock M, Wehrend A.In horses, birth is classified as dystocia when the process of parturition threatens to inflict damage onto the mare or the foal, when assistance is required to complete the process of parturition, or when there are temporal deviations in the physiological duration of the first and/or second parturition stages. In this, the duration of the second stage is an important indicator in identifying dystocia, as this phase is easily discernible by the mare's behavior. Equine dystocia is classified as an emergency with life-threatening consequences for mare and foal. A large degree of variation has be...
Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy.
The Veterinary record    March 12, 2023   Volume 192, Issue 11 e2782 doi: 10.1002/vetr.2782
Gandini M, Giusto G.Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. Methods: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from an...
Horse and Cattle-Related Trauma: A Retrospective Review of Injuries and Management in a Regional Queensland Hospital.
Cureus    March 3, 2023   Volume 15, Issue 3 e35746 doi: 10.7759/cureus.35746
Savage G, Liesegang A, Campbell J, Lyon M, Fry D.Horse and cattle-related trauma is a common presentation to regional hospitals in Australia. We review local incidence and patterns of injuries relating to horse and cattle trauma over a three-year period at the Toowoomba Base Hospital within the Darling Downs region in Queensland, an area rich in cattle farming and equestrian recreation. Methods: We conducted a single-centre retrospective cohort study. The inclusion criteria were all patients presenting with injuries following cattle or horse-related incidents between January 2018 and April 2021. Primary outcomes were the mechanism of trauma,...
Serum amyloid A does not predict non-survival in hospitalised adult horses with acute colitis.
The Veterinary record    February 13, 2023   Volume 192, Issue 7 e2644 doi: 10.1002/vetr.2644
Runge KE, Bak M, Vestergaard A, Staerk-Østergaard J, Jacobsen S, Pihl TH.Predicting non-survival in horses with acute colitis improves early decision making. Therefore, this study aimed to determine the prognostic value of serum amyloid A (SAA) and other clinicopathological and clinical variables in adult horses with acute colitis. Clinical variables, SAA and other blood biomarkers, including plasma L-lactate (lactate), were assessed in 176 horses with acute colitis. A multivariate model for the prediction of non-survival was constructed. Icelandic horses were analysed separately. Admission SAA was similar in survivors (median 548 mg/L; range 0-5453 mg/L) and...
Horse-related injury patterns: a single center report.
Journal of orthopaedic surgery and research    February 2, 2023   Volume 18, Issue 1 83 doi: 10.1186/s13018-023-03549-3
Hoffmann MF, Bernstorff M, Kreitz N, Roetman B, Schildhauer TA, Wenning KE.For ages, humankind and horses have been closely related to occupational and recreational activities. The dangers of engaging with horses have been previously reported. Among sporting activities, horse riding is well-known for its risks. Despite multiple recommendations to wear protective gear, horse-related activities still comprise the risk of severe injuries. This study aimed to examine: (1) if specific mechanisms are correlated to particular injury patterns and (2) if injury types are related to patient demographics. Methods: From one level I trauma center, between July 2019 and July 2022 ...
Blood types and antibody profiles of Straight Egyptian Arabian horses in Qatar: Preliminary results.
Journal of equine veterinary science    January 3, 2023   Volume 122 104209 doi: 10.1016/j.jevs.2022.104209
Mattei D, Fenn MS, Caraguel C, Vinardell T.The characterization of the blood groups, antibody profiles, and its distribution pattern among different horse breeds and geographic locations, can be very useful in life-threatening situations where a blood transfusion is needed, and compatibility tests are not readily available. This study estimated the distribution of blood types and antibody profiles in Straight Egyptian Arabian horses from Qatar. A total of 20 Straight Egyptian Arabian horses, from multiple origins and genetic background were included. Venous blood from each horse was typed and screened for anti-red blood cell (RBC) hemo...
Evaluation of Eosinopenia as a SIRS Biomarker in Critically Ill Horses.
Animals : an open access journal from MDPI    December 15, 2022   Volume 12, Issue 24 3547 doi: 10.3390/ani12243547
Martín-Cuervo M, Gracia-Calvo LA, Macías-García B, Ezquerra LJ, Barrera R.Systemic inflammatory response syndrome (SIRS) is a very common finding in critically ill patients. To accurately identify patients with SIRS and those who need intensive care, several markers have been evaluated, including cortisol, WBC or lactate. It is widely known that a stress leukogram includes eosinopenia as one of its main markers (neutrophilia, eosinopenia, lymphopenia and mild monocytes). It is known that cortisol concentration in plasma is the main stress biomarker and is strongly correlated with the severity of disease in horses. However, it is not possible to measure this paramete...
Risk of anesthesia-related complications in draft horses: a retrospective, single-center analysis.
Veterinary anaesthesia and analgesia    December 11, 2022   Volume 50, Issue 2 157-162 doi: 10.1016/j.vaa.2022.12.002
O'Donovan KA, Aarnes TK, Hubbell JA, Parker EM, Mollenkopf D, Lerche P, Ricco Pereira CH, Bini G, Bednarski RM.To report anesthetic-related complications and determine risks associated with anesthesia in draft horses. Methods: Retrospective study. Methods: A total of 401 anesthetic records for draft horse breeds that underwent general anesthesia from January 2010 through December 2020 were reviewed; horses euthanized during general anesthesia were excluded. Methods: Demographics, perioperative drugs used, procedure type and duration, time to extubation, number of attempts to stand, use of sling in recovery and perioperative morbidity and mortality were investigated. Morbidity and mortality statistical ...
A retrospective study of helmet use and head injury in severe equestrian trauma.
Journal of neurosciences in rural practice    December 2, 2022   Volume 14, Issue 1 161-164 doi: 10.25259/JNRP-2022-3-14
Carter BT, Richardson MD.The aim of the study was to examine helmet use, incidence of injury, and patient outcomes in a rural cohort of equestrian accidents. Unassigned: EHR records of patients admitted to a Level II ACS trauma center in the North-west United States were reviewed for helmet use. Injuries were categorized according to International Classification of Diseases-9/10 code. Unassigned: Of 53 identified cases, helmets only reduced superficial injury (χ (1) = 4.837, = 0.028). Intracranial injury rates were not different between those with and without helmets ( > 0.05). Unassigned: In equine related injur...
Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report.
Veterinary sciences    October 4, 2022   Volume 9, Issue 10 546 doi: 10.3390/vetsci9100546
Gandini M, Cerullo A, Franci P, Giusto G.Reducing postoperative incisional infection is the main reason to administer postoperative antimicrobials (AMD) after emergency laparotomy in horses, while reducing inflammation and providing analgesia are the reasons to administer anti-inflammatory drugs (AID). The basis for postoperative AMD and AID administration is empirical and only recently has been questioned. Empirical approaches can be changed, and these changes, along with the description of their outcomes, can help produce appropriate stewardship. The aim of this study is to report the changes in AMD and AID regimens in horses under...
Blood Transfusion in Equids-A Practical Approach and Review.
Animals : an open access journal from MDPI    August 23, 2022   Volume 12, Issue 17 2162 doi: 10.3390/ani12172162
Jamieson CA, Baillie SL, Johnson JP.Transfusion medicine is a crucial part of equine intensive and critical care. Blood transfusions can save lives in both acute and chronic cases of anemia, hemorrhage, and hemolysis. It is vital to have a comprehensive theoretical and practical understanding of the techniques, implications, risks, and complications. This review covers the physiology and pathophysiology of conditions requiring transfusion, as well as step by step guidance for practitioners of all experience levels. This review is designed to serve as a practical reference for those who are treating horses in either the field or ...
Outcome following emergency laparotomy in 33 UK donkeys: A retrospective multicentre study.
Equine veterinary journal    June 21, 2022   Volume 55, Issue 2 222-229 doi: 10.1111/evj.13578
Merridale-Punter MS, Prutton JSW, Stefanovski D, Worsman FCF, Payne RJ, Wylie CE, Archer DC, Menzies-Gow NJ, Coles L, McGovern KF, Parker RA.Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject. Objective: To determine findings and associated outcomes of exploratory laparotomies in donkeys. Methods: Descriptive retrospective study. Methods: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps. Results: Thirty-thr...
Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic.
Veterinary surgery : VS    June 8, 2022   Volume 51, Issue 6 891-902 doi: 10.1111/vsu.13839
Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM.To evaluate previously published predictive survival models in a population of horses undergoing colic surgery in the midwestern United States. Methods: Retrospective cohort study; single referral hospital. Methods: A total of 260 horses met the inclusion criteria. Methods: Medical records of horses undergoing surgical treatment for colic were reviewed. Previously published models were applied to cohort data to predict outcome. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for prediction of short-term survival were calculated. Results:...
Incidence of Severe Hypoxemia in Anesthetized Horses Undergoing Emergency Exploratory Laparotomy.
Journal of equine veterinary science    May 31, 2022   Volume 116 104026 doi: 10.1016/j.jevs.2022.104026
Marchese GA, Crystal J, Louro LF.Prevalence and risk factors of severe hypoxemia in anesthetized horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxemia ( PaO2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single center retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariab...
Predictive Models for Equine Emergency Exploratory Laparotomy in Spain: Pre-, Intra-, and Post-Operative-Mortality-Associated Factors.
Animals : an open access journal from MDPI    May 27, 2022   Volume 12, Issue 11 1375 doi: 10.3390/ani12111375
Iglesias-García M, Rodríguez Hurtado I, Ortiz-Díez G, De la Calle Del Barrio J, Fernández Pérez C, Gómez Lucas R.The extrinsic and intrinsic characteristics of an equine population may influence the onset of gastrointestinal lesions and affect the survival rate of patients. The equine population in Spain has been the focus of a small number of studies, none of which have involved more than one surgical center. In this retrospective cohort study, we aimed to analyze the survival rate, identify the variables that influenced death, and generate multivariate models using clinical variables. Data were collected from the clinical records of two surgical referral centers in the same region, and a total of 566 h...
Injury patterns of equine-related trauma: A fifteen-year review of hospital admissions to a level 1 trauma center.
The Physician and sportsmedicine    April 26, 2022   Volume 51, Issue 4 306-312 doi: 10.1080/00913847.2022.2070046
Cunningham L, Agel J.Little information exists about horse-related injury admissions to Level 1 trauma centers in the Western United States. This study describes injury patterns in this population, to reveal potential areas for injury prevention initiatives. A retrospective database review of 512 non-fatal equine-related injuries over a 15-year period was conducted, using a Level 1 hospital trauma registry. To determine patterns of injury, patients injured by riding or being near a horse were classified according to age, sex, helmet use, abbreviated injury score, anatomical region injured, and length of stay. Equi...
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...