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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.
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. 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. 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. 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. 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. 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 ...
Respiratory Distress in the Adult and Foal. Respiratory distress in the horse and foal is an emergency. Managing equine respiratory distress in the field starts with appropriate assessment of the patient to determine whether the breathing obstruction stems from the upper or lower respiratory tract or is nonrespiratory in origin. From a thorough, but efficient, physical examination to point-of-care ultrasound and endoscopy, the veterinarian has many tools in the field to help diagnose the patient.
Fracture Stabilization and Management in the Field. Management of fractures in the field starts with successful assessment and stabilization of the patient by the practitioner on the front lines. A careful examination is vital to succesful patient management. This includes identifying the fracture location and severity, evaluating skin integrity and potential contamination of the fracture, and treating any ongoing hemorrhage, hypovolemia or stress. Appropriate application of splints in the field will minimize ongoing tissue damage and improve patient comfort. This ultimately aids further assessment, facilitates referral, and improves opportunit...
Pelvic and acetabular trauma in amateur equestrian enthusiasts – A retrospective review. Horse riding related accidents can present with devastating pelvic and acetabular fractures. This study examines the nature, management and treatment outcomes of severe pelvic and acetabular trauma in amateur horse riders presenting to a national tertiary referral centre. We also aim to define certain at-risk groups. Methods: This was a retrospective descriptive cohort of all patients who were referred to the National Centre for Pelvic and Acetabular trauma resulting from horse riding accidents. All patients who were referred to the National Centre for Pelvic and Acetabular Trauma between Janu...
Response of UK Horse, Pony and Donkey Owners to the Early Stages of the COVID-19 Pandemic. In the UK, March 2020 was a time of great uncertainty as COVID-19 became increasingly widespread. The government responded by making suggestions about how people could reduce the risk of spread on 16 March, moved swiftly into closing schools on the 18 March before announcing a mandatory lockdown on the 23rd March. This was a challenging time for UK equestrians who had to balance maintaining their equine's routine and daily care alongside the increasing biosecurity measures. A cross-sectional survey was distributed to UK equestrians via social media over two days (28 and 29 March 2020) to bette...
[Rescue of injured horses, cattle and pigs from manure and cesspools by the large animal rescue service Switzerland and Liechtenstein (GTRD CH/FL)®]. One of the varied tasks of the Large Animal Rescue Service Switzerland and Liechtenstein (GTRD CH/FL)® is the recovery of animals from manure and cesspools. The aim of the present retrospective study was the evaluation of the rescue protocols of the GTRD CH/FL from such operations and the documentation of a rescue procedure. In the past 25 years, a total of 176 animals have been rescued from manure and cesspools. These included 113 cattle, 51 horses and 12 pigs. All animals could be safely rescued with the animal rescue and transport net (TBTN) or the large animal vertical rescue set (GTVBS)....
A national trauma data bank analysis of large animal-related injuries. Large animal-related injuries (LARI) are relatively uncommon, but, nevertheless, a public hazard. The objective of this study was to better understand LARI injury patterns and outcomes. Methods: We performed a retrospective review of the 2016 National Trauma Data Bank and used ICD-10 codes to identify patients injured by a large animal. The primary outcome was severe injury pattern, while secondary outcomes included mortality, hospital length of stay, ICU admission, and mechanical ventilation usage. Results: There were 6,662 LARI included in our analysis. Most LARI (66%) occurred while riding ...
Equine simplified acute physiology score: Personalised medicine for the equine emergency patient. Scoring models are useful tools that guide the attending clinician in gauging the severity of disease evolution and in evaluating the efficacy of treatment. There are few tools available with this purpose for the non-human patient, including horses. We aimed (i) to adapt the simplified acute physiology score 3 (SAPS-3) model for the equine species, reaching a margin of accuracy greater than 75% in the calculation of the probability of survival/death and (ii) to build a decision tree that helps the attending veterinarian in assessment of the clinical evolution of the equine patient. Methods: Fr...
Patterns of injury following equine trauma: a non-trauma centre experience. Horse riding carries risk of injury which can result in fatality. The majority of published literature describes major trauma centre experience. We aimed to characterise injury patterns following equine trauma at a Scottish district general hospital. Methods: A retrospective review of admissions following equine trauma was undertaken from 2014 to 2019. Mechanism and nature of injuries were noted. Patient management and outcomes were recorded and analysed to determine correlation. Results: Of the 162 patients identified, 121 (74.7 per cent) were female. The commonest mechanism and injury sustai...
Evaluation of Antibody Response in Horses After Vaccination With an Inactivated Getah Virus Vaccine Using an Accelerated Immunization Schedule. Antibody response in horses after accelerated-schedule Getah virus vaccination was evaluated for its potential adoption during outbreaks. One-year-old Thoroughbred horses received two doses of priming vaccinations following an accelerated schedule (accelerated group: 14-day interval, n = 30) or the conventional schedule (control group: 28-day interval, n = 30). At Day 14, both groups showed similar seropositive rates (66.7% in control group and 73.3% in accelerated group) and geometric mean (GM) virus-neutralizing titers (5.2 [95% confidence interval (CI), 3.0-8.8] in control group and 5.3...
Clinical and biochemical factors associated with survival in equids attacked by dogs: 28 cases (2008-2016). Trauma from dog attacks has been associated with mortality rates as high as 23% in some species. However, the prognosis and clinical features of this type of injury have not been described in equids. Objective: To describe survival rate, signalment, clinical features, and biochemical results in equids presented for emergency care after presumed dog attacks. We hypothesized there would be differences between survivors and nonsurvivors. Methods: A total of 28 equids presented for presumed dog attacks from 3 referral centers. Methods: A retrospective study was performed using data from 3 hospital...
Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses. Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comp...
Management of Thermal Injuries in Donkeys: A Case Report. Burn injuries are uncommon in large animals and there are no reports of these injuries in donkeys. Burns cause local and systemic effects. Extensive thermal injuries can be challenging to manage and the extent of the burn surface affected will directly impact the severity of the illness and the prognosis. Burns are classified according to the depth of injury into four categories, from first-degree burns, and the least affect to fourth-degree burns, which are the more severely affected patients. This case report describes the medical management of four donkeys that sustained various degrees of ...
Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study. Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession. To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making. Participatory action research using mixed-methods approach. An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group a...
Compliance with the Code of Practice for the Care and Handling of Equines on 50 horse farms in Prince Edward Island. The objective of this study was to determine the proportion of horse farms on Prince Edward Island, Canada that comply with the requirements of the (Code). An investigator performed on-farm assessments while administering a questionnaire to owners of 50 horse farms. The percentage of farms in compliance with specific requirements in the Code ranged from 20% to 100% per requirement. The largest areas of non-compliance regarding facilities and housing were the lack of the ability to segregate sick or injured animals and the lack of an emergency action plan. It was determined that 72% of farms w...
Clinical and Therapeutic Aspects of Brazilian Native Bothrops Envenomation in Nine Horses. In this retrospective study, clinical records of nine horses with a diagnosis of Bothrops envenomation were investigated. The accidents were classified as severe (5/9), moderate (2/9), or mild (2/9) according to the adapted bothropic snakebite severity score (BSSS). All snakebites were on the head region. The main clinical signs were local edema, blood coagulation disorders, and respiratory distress. The whole-blood clotting time (WBCT) was prolonged in all horses, and five horses presented with uncoagulable blood. All horses received specific snake antivenom according to the BSSS (six vials f...
Retrospective case series to identify the most common conditions seen ‘out-of-hours’ by first-opinion equine veterinary practitioners. The study aim was to describe conditions seen 'out-of-hours' in equine practice. This was a retrospective case series of first opinion 'out-of-hours' cases seen at two equine practices between 2011 and 2013. Data were retrieved on case presentation, diagnostic testing, treatment administered and outcome, and diseases categorised using a systems-based coding system. A hierarchical logistic regression, formulated using a generalised linear model, was used to identify clinical variables associated with a binary outcome of 'critical' cases (required hospitalisation or euthanasia or died). Data fro...
Retrospective analysis of 15 years of horse-related maxillofacial fracture data at a major German trauma center. The purpose of this study was to estimate the effect of the mechanism of trauma (fall versus kick), rider demographics, equestrian experience, protective equipment, and whether or not a horse was shod on the anatomic site of a horse-related maxillofacial fracture, operating time, postoperative complication rate, and length of hospital stay. Methods: We retrospectively reviewed the medical records of patients treated for horse-related maxillofacial fractures at a single institution in Germany between January 2000 and March 2015. We used linear and logistic regression to test the above-mentioned...
Large Animal Emergency Relief Services-A Model for University Engagement With Private Practitioners and Development of Practice Readiness for Veterinary Students. Large animal teaching hospitals often struggle to maintain consistent teaching caseloads, which are affected by seasonal variations, economic pressures, increased abilities of local large animal practices to hospitalize large animals, and client intolerance for the operational needs of an academic mission. Non-academic large animal practices enjoy a more consistent caseload but suffer from a lack of emergency relief and a limited ability to share emergency duties, which may have adverse effects on work-life balance. An academic, on-farm, large animal emergency relief service can combine multip...
Accidental Overdose of Pergolide (Prascend) Followed by Loss of Appetite, Tachycardia, and Behavioral Abnormalities in a Pony Mare. A 26-year-old pony mare (ca. 180 kg bodyweight) was presented as an emergency because it had erroneously received 110 times its standard dose of pergolide (Prascend) per os approximately 4 hours earlier. Clinical examination initially was normal except tachycardia of 52 beats/min. The pony was treated symptomatically with paraffin oil and activated charcoal per nasogastric tube to prevent further systemic absorption and accelerate intestinal excretion of the pergolide. Furthermore, the pony received 400 mg of dopamine antagonist azaperone (Stresnil) intramuscularly (i.m.) followed by 80 mg...
Hippotherapy Practice and Safety Patterns in the United States: A Descriptive Survey Study. Objective: The use of equine movement as a therapy tool in a plan of care, or hippotherapy, has grown considerably over the past three decades. However, there is little evidence of safety rates and related practice patterns to guide key stakeholders such as clients, therapists, the health care team, and third-party payers. The purpose of this article is to describe the safety and practice patterns of contemporary use of hippotherapy. Design: A survey was distributed to occupational therapy (OT), physical therapy (PT), and speech-language pathology clinicians who incorporate hippotherapy into t...
Bacterial translocation in horses with colic and the potential association with surgical site infection: a pilot study. Surgical site infection (SSI) is a leading cause of morbidity in horses undergoing emergency exploratory laparotomy for the treatment of acute colic. The exact mechanism by which SSI develops in these cases is unclear. This prospective observational study investigated whether bacterial translocation occurs in horses with acute colic and if there is an association between bacterial translocation and development of SSI. Peripheral venous blood (PVB) and peritoneal fluid (PF) samples were collected on admission and PF samples were collected at the end of surgery from horses presenting for investi...
Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment. Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed. This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up. In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases a...
Assessment of Rabies Prophylaxis Cases in an Emergency Service. The aim of the present study was to evaluate the demographic characteristics, exposure features, and prophylactic care aspects of cases that presented to the emergency department of 1 state hospital in Turkey between 2013 and 2017 because of the risk of rabies contact. Methods: Data from the retrospective cohort study were obtained from ED records of Erzurum Palandöken State Hospital between August 2013 and June 2017 regarding patients presenting to emergency service after the risk of rabies contact. Evaluation forms included demographic characteristics of the patients, contact type, contacte...
Disaster Medicine: Implementation of an animal health database in response to the 2018 California Camp Fire. To describe an animal health database used to facilitate effective disaster response and retrospective analysis of data concerning animals other than cats and dogs affected by the 2018 California Camp Fire. Methods: Veterinary medical entries (n = 206) for evacuated or rescued animals (151) of various species, including avian, bovine, camelid, caprine, equine, ovine, and porcine species, temporarily housed at the Butte County fairgrounds in Gridley, Calif. Methods: Case data were collected via a standardized form by volunteers with the University of California-Davis Veterinary Emergency Respon...
Higher body mass index may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy. Obesity is common in the equine population and it has been associated with increased surgical morbidity and mortality in humans. The effect of increased body mass index (BMI) on the incidence of surgical site infections has not been investigated in horses. Objective: To determine whether horses with increased body fat, as estimated by BMI, are more likely to develop post-operative complications, particularly incisional complications, following emergency ventral midline celiotomy. Methods: Retrospective, multi-institutional clinical study. Methods: Medical records of horses >2 years old presen...
