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.
Neurosurgical management of head injuries incurred during sports: a single centre experience. Accidents during sporting activities are a common cause of head injury, particularly in children and young adults. Whilst most sporting head injuries are minor, there remains a proportion which is associated with high morbidity and mortality. The epidemiology of sports associated head injuries is variable based on geographical region so the aim of this study was to review the management and outcomes of sporting head injuries managed by a single neurosurgical unit in the South of England. A retrospective review of the Trauma Audit and Research Network database was conducted for all patients ad...
Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies. Despite inherit dangers of horseback riding (HBR), research on HBR-related injuries is sparse. This study used both quantitative and qualitative methods to (1) examine HBR-related injuries treated in emergency departments (EDs) and associated risk factors and (2) explore HBR-related injury experiences and recommendations for prevention strategies from the perspective of riders. We retrospectively analyzed data from the Nationwide Emergency Department Sample (NEDS), identifying HBR-related ED visits between 2010 and 2014. Additionally, we conducted 10 phone interviews with active horseback ride...
Operative management of equine-related maxillofacial trauma presenting to a Melbourne level-one trauma centre over a six-year period. The aim of this study was to examine the pattern of equine-related maxillofacial trauma that required operative treatment in patients who presented to a level-one trauma centre in Melbourne between 2011 and 2016. A total of 28 patients (16 female and 12 male, median (range) age 31 (16-76) years) were identified from a database of all operatively managed maxillofacial trauma cases, and data were collected on demographics, mechanisms and patterns of injury, and management. The most common mechanism was kicking (n=16), which was also the most likely to result in multiple injuries. Half the patien...
Horse owners’ knowledge, and opinions on recognising colic in the horse. Colic is the most common emergency problem in the horse. An owner's ability to recognise colic and seek assistance is a critical first step in determining case outcome. Objective: The aim of this study was to assess horse owners' knowledge and opinions on recognising colic. Methods: Cross-sectional study. Methods: An online questionnaire was distributed to horse owners with open and closed questions on their knowledge of normal clinical parameters in the horse, confidence and approach to recognising colic (including assessment through case scenarios), and their demographics. Descriptive and ch...
Assessment of costs and insurance policies for referral treatment of equine colic. Colic is the most common emergency problem in horses. The aims of this study were to survey costs of different referral treatments and to review insurance policies relevant to horses with colic. Data were collected retrospectively from nine equine hospitals for case costs, categorised into four different outcomes: admitted and euthanased; euthanased during or immediately after surgery; medical treatment and survived more than 24 hours; and surgical treatment and survived more than 24 hours. Data from five UK equine insurance companies were extracted and analysed using a standardised case e...
Description of Placement Procedures for Common Methods Used in Equine Emergency Rescue Using a Simplified Loops System. Entrapped, stranded and recumbent equids often require emergency rescue. The success of the rescue is often affected by secondary injuries from struggling of the horse to rise and from injury secondary to attempted rescue by pulling on the head or limbs of the equid. Therefore, having ready access to simplified rescue equipment which can be easily applied would be desirable. The devices currently available for these manipulations are not always readily available at the site of an incident. Here, we describe and illustrate the step-by-step use of a Loops System consisting of 183 cm round slings...
Evaluation of a Simplified Loops System for Emergency Rescue Lifting of the Stranded or Recumbent Horse. Stranded and recumbent equids often require emergency rescue, and a successful rescue often requires vertical lifting of the animal. Currently, the devices used for vertical lifting of equids are not readily available at an incident or urgent situation. The current study describes and evaluates the use of a simple lift device utilizing commercially available, and reasonably priced, equipment. The system, referred to as the Loop Vertical Lift System or Loops System, is basically composed of four round slings placed in such a way that utilizes the skeletal system for support. The study demonstra...
Nonfatal horse-related injuries treated in emergency departments in the United States, 1990-2017. Horse-related injuries can cause severe morbidity and mortality. The objective of this study is to investigate the epidemiological features of horse-related injuries treated in emergency departments (EDs) in the United States. A retrospective analysis of horse-related injuries from 1990 through 2017 was conducted utilizing the National Electronic Injury Surveillance System (NEISS). Cases were identified using the NEISS code 1239 (Horseback Riding: Activity, Apparel, or Equipment). Analyses performed included calculation of national injury estimates, relative risks (RRs) with 95% confidence int...
Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes. Acute abdominal pain (colic) is the most common reason for emergency veterinary treatment in the horse. Consolidation of data through a systematic review is important to inform evidence-based medicine and clinical guidelines, but there are currently no published systematic reviews on colic in the horse. The aim of this study was to identify, categorize and appraise the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal disease in the adult horse. A scoping review was performed to identify and categorize evidence on all risk factors f...
Development of an Equine Antitoxin by Immunizing the Halla Horse with the Receptor-Binding Domain of Botulinum Neurotoxin Type A1. Botulinum neurotoxins (BoNTs), produced by , are the most toxic substances known. However, the number of currently approved medical countermeasures for these toxins is very limited. Therefore, studies on therapeutic antitoxins are essential to prepare for toxin-related emergencies. Currently, more than 10,000 Halla horses, a crossbreed between the native Jeju and Thoroughbred horses, are being raised in Jeju Island of Korea. They can be used for equine antitoxin experiments and production of hyperimmune serum against BoNT/A1. Instead of the inactivated BoNT/A1 toxoid, Halla horse was immunized...
Safety and Clinical Outcomes of an Equine-derived Heptavalent Botulinum Antitoxin Treatment for Confirmed or Suspected Botulism in the United States.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Botulism is a rare, life-threatening paralytic illness. Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine) (BAT) manufactured by Emergent BioSolutions Canada Inc is an equine-derived heptavalent botulinum antitoxin product indicated for the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A-G in adults and pediatric patients. BAT product was US-licensed in 2013. In the United States, from October 2014 through July 2017, safety and clinical outcomes data were collected under a registry for patients treated with BAT product. Regi... Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery. Administration of pulsed inhaled nitric oxide (PiNO) improves arterial oxygenation in spontaneously breathing anaesthetised healthy horses and in horses undergoing colic surgery. However, because hypoventilation commonly occurs, horses are often mechanically ventilated to prevent hypercarbia. Objective: To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Methods: Prospective nonblinded clinical trial. Methods: Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing coli...
Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy. Acute-phase proteins may help assess the nature and severity of lesions and outcome in horses undergoing colic surgery. Objective: To compare serum amyloid A and plasma fibrinogen concentrations ([SAA] and [fibrinogen]) in the immediate post-operative period after exploratory celiotomy and determine their value in assessment of post-operative complications and survival to discharge. Methods: Observational study. Methods: This study included horses over 1 year of age undergoing exploratory celiotomy. Surgical procedures, lesions, post-operative care, complications and survival to discharge wer...
The Epidemiology, Injury Patterns and Outcomes of Horse-Related Injuries in Israeli Children. Horse riding has become increasingly popular in recent years and is a common activity among children. As a result, pediatric horse-related injuries are frequently encountered in emergency departments. Objective: To examine the characteristics of horse-related injuries in the pediatric population. Methods: We collected and analyzed the data on all pediatric horse-related injuries presented to a tertiary hospital, level one trauma center, during the years 2006-2016. Results: A total of 53 children with horse-related injuries were documented. Forty-two patients were male (79%) and their mean age ...
Jockey injuries during the Siena “Palio”. A 72-year analysis of the oldest horse race in Italy. Horse racing is a hazardous sport. We analyzed the incidence and characteristics of jockey injuries in a typical horse race. Methods: We analyzed all injuries sustained by 224 jockeys in the last 72 years. Results: It was found that in 96.1% of the races there was at least one fall and in 28.6% of the races 50% or more of the jockeys fell. In 43.4% of the falls, the jockey was taken to the emergency room. Comparing the Palio with traditional races in other countries, a higher injury incidence rate was observed for every 100 falls (109.884 vs 27-59) and a lower concussion rate/100 falls (0.97 v...
The dangers of pets and horses, animal related injuries in the Emergency department. Every year patients present to the emergency department due to bites, scratches and falls caused by animals. Although bite and scratch injuries have been described in literature, the exact number of patients that visit the emergency department due to all animal related injuries has never been described before. Methods: A retrospective analysis of all emergency department visits throughout a 1-year period was performed from April 2015 until March 2016. Results: 516 Patients were treated at the emergency department because of animal related injuries. Most were female and the median age was 38 ...
Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger-How to Manage? Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle s...
Equestrian-related injuries, predictors of fatalities, and the impact on the public health system in Sweden. Horse riding is a popular activity but has also been found to lead to many injuries and even fatalities. No reduction in the numbers of those being admitted to hospital for equestrian-related injuries have been seen in Sweden in recent years. The aim of this work was to examine injuries, fatalities, and predictors of fatalities in equestrian-related activities and to investigate the cost of these injuries to the public health system. Methods: The study is a retrospective analysis of hospital data. Methods: National Swedish hospital and mortality registers were retrospectively examined, inclusi...
Analysis of agriculture-related life-threatening injuries presenting to emergency departments of rural generalist hospitals in Southern Queensland. Agricultural industries are among the most dangerous in Australia posing significant public health risks. This study analyses the nature and management of agriculture-related injuries presenting to EDs in selected hospitals in Southern Queensland. Data on agricultural injury presentations over a 6 month period was collected at four rural hospitals by a dedicated onsite hospital data coordinator. Additionally, in two of the participating hospitals all injury presentations over the same 6 month period were recorded. A pre-tested survey instrument, modified for rural settings and designed and dev...
Veterinary Public Health Activities and Management of the Livestock Sector during Earthquakes and Snowstorms in the Abruzzo Region-Italy, January 2017. In 2017 the Abruzzo region, located in central Italy, was struck by a sequence of four moderately powerful seismic events (5.0 magnitude on Richter scale), in addition to heavy snowfall that caused a state of emergency affecting the resident population and farm animals. A total of 282 stables were reported to have collapsed or been damaged and several animals (224 cows, 4025 ewes, 40,725 chickens, 22 horses and 3092 pigs) were killed. The Istituto Zooprofilattico of Abruzzo and Molise "G. Caporale" (IZSAM)-National Reference Center for Veterinary Urban Hygiene and Non-Epidemic Emergencies (IUV...
Wound Management: Wounds with Special Challenges. Distal limb wounds in horses heal substantially different than trunk wounds, commonly resulting in exuberant granulation tissue and exposed and sequestered bone. Surgical intervention of severe rectovaginal lacerations in the mare should be delayed until the tissues have heeled and scar tissue has remodeled. Wounds resulting in severe hemorrhage require appropriate emergent fluid therapy and potentially transfusion therapy.
Assessing the risk for major injuries in equestrian sports. Horse riding is a popular sport, which bears the risk of serious injuries. This study aims to assess whether individual factors influence the risk to sustain major injuries. Methods: Retrospective data were collected from all equine-related accidents at a German Level I Trauma Centre between 2004 and 2014. Logistic regression was used to identify the risk factors for major injures. Results: 770 patients were included (87.9% females). Falling off the horse (67.7%) and being kicked by the horse (16.5%) were the two main injury mechanisms. Men and individuals of higher age showed higher odds for ...
Hypernatraemia in 39 hospitalised foals: clinical findings, primary diagnosis and outcome. To evaluate hypernatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) to determine the prevalence, clinical findings, primary diagnosis and outcome. Methods: Retrospective case study of records from Thoroughbred foals aged less than 3 months that presented to an ICU as medical emergencies in 2002-12. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis and outcome. Foals with hypernatraemia (serum sodium > 145 mmol/L) on admission laboratory data were identified and further evaluated. Results: A total of 39 of 171...
Equine pericardium-covered stenting in post-traumatic pseudoaneurysm of cavernous internal carotid artery. We report a case of traumatic intracranial carotid artery pseudoaneurysm treated with an equine pericardium-covered stent. The patient was admitted to the Emergency Department after sustaining severe polytrauma in a motor vehicle accident. A cavernous carotid pseudoaneurysm was detected after an episode of massive epistaxis that required emergent nasal packing. Treatment with parent vessel sacrifice was ruled out after an unfavourable balloon test occlusion. We opted for an equine pericardium-covered stent as a means to immediately seal the wall defect in the setting of massive bleeding second...
Advanced Atrio-Ventricular Blocks in a Foal Undergoing Surgical Bladder Repair: First Step to Cardiac Arrest? A 3-day-old Swiss Warmblood colt was diagnosed with uroabdomen after urinary bladder rupture. The foal had classical electrolyte abnormalities (hyponatremia, hypochloremia and hyperkalemia) on presentation. The foal was supported prior to surgery with intravenous fluids and the electrolyte abnormalities were treated with physiologic saline, glucose and insulin. Urine could not be drained from the abdomen prior to surgery because the omentum was continuously occluding the drainage cannula and due to progressive abdominal distension, it was decided to pursue surgery without further correction of...
Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems. With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease. This article addresses the practical use of these 3 treatment cate...
Fifty years of colic surgery. Colic surgery is one of few treatments in which a veterinarian can use a skill to save an animal's life from a deadly disease within a short timeframe. Unfortunately, such success is not achieved without considerable risk for surgical failure, which is responsible for most complications in the immediate post-operative period. The last 50 years have witnessed considerable improvements in colic surgery, although a ranking of the most important ones might not meet with universal agreement. Teamwork plays a critical role in the final outcome, starting and finishing with the referring veterinarian...
Treatment of Hydropsical Conditions Using Transcervical Gradual Fetal Fluid Drainage in Mares With or Without Concurrent Abdominal Wall Disease. Hydropsical conditions are exceedingly rare in the horse. However, when they occur, they are true emergencies due to the severe enlargement of the pregnant uterus, which can result in clinical signs, such as an enlarged round abdomen, dyspnea, reluctance to walk, and colic, and may lead to the development of abdominal wall disease. The pathogenesis of hydropsical conditions is not fully elucidated, but they have been associated with placentitis and fetal abnormalities. This report describes six cases of hydropsical conditions in mares with or without concurrent abdominal wall disease. Five out...