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.
Jokisalo JM, Corley KT.RECOVER was created to optimize survival of small animal patients from cardiopulmonary arrest. Several findings from this study are applicable to cardiopulmonary resuscitation in the neonatal foal. In particular, chest compressions should be a priority with no pauses and a "push hard, push fast" approach. The importance of ventilation is minimized with short, infrequent breaths at a rate of 10 to 20 per minute recommended.
Carr EA.The purpose of this article is to provide a quick reference for field triage of the sick neonatal foal. Therefore, information is focused toward diagnostics and treatments that can be performed in the field. When evaluating a weak, recumbent, or lethargic foal on a farm, it is often difficult to make a definitive diagnosis. Therefore, the approach should be to treat what is treatable and prevent what is preventable. In many cases, the goal will be to stabilize a foal before referral to a tertiary care facility where more intensive and continuous treatment can be performed.
Cook VL, Hassel DM.This article presents an overview of key factors that should alert the practitioner toward referral of a colic patient to a facility capable of surgical exploration or intensive medical management. Discussion includes a review of important aspects of colic history, signalment, physical examination findings, and diagnostic test results that indicate that a more serious medical or surgical condition exists, and advanced therapy is necessary.
Munsterman AS, Hanson RR.Bullet wounds in horses can cause a wide array of injuries, determined by the type of projectile, the energy of the bullet on entry, and the type of tissue the bullet encounters. Treatment includes identification of all structures involved, debridement of the permanent cavity, and establishing adequate drainage. Bullet wounds should be treated as contaminated, and broad-spectrum antibiotics, including those with an anaerobic spectrum, are indicated. Although musculoskeletal injuries resulting from gunshots are most common in horses, they carry a good prognosis for survival and return to functi...
Mudge MC.Treatment of acute hemorrhage in the horse involves targeted medical management and also may involve surgical stabilization. This article provides an approach to the initial stabilization and information on available topical hemostats. The practice of blood collection and transfusion is also described, with attention to new information on viability of transfused equine blood, potential negative effects of blood transfusion, and methods of cell salvage.
Bilaniuk JW, Adams JM, DiFazio LT, Siegel BK, Allegra JR, Luján JJ, Durling-Grover R, Pawar J, Rolandelli RH, Németh ZH.Patients with equestrian injuries were identified in the trauma registry from 2004 to 2007. We a priori divided patients into three groups: 0 to 18 years, 19 to 49 years, and 50 years old or older. There were 284 patients identified with equestrian-related trauma. Injury Severity Score for the three major age categories 0 to 18 years, 19 to 49 years, and 50 years or older, were 3.47, 5.09, and 6.27, respectively. The most common body region injured among all patients was the head (26.1%). The most common injuries by age group were: 0 to 18 years, upper extremity fractures; 19 to 49 year olds, ...
Papachristos A, Edwards E, Dowrick A, Gosling C.Despite a number of injury prevention campaigns and interventions, horse riding continues to be a dangerous activity, resulting in more accidents per hour than motorcycling, skiing and football. Injuries are often serious, with one in four patients requiring admission to hospital. This study aims to describe the severity of equestrian-related injuries (ERIs) using both clinical parameters and patient-reported outcomes. Methods: A retrospective study of all patients aged ≥18 years admitted to The Alfred Hospital between January 2003 and January 2008 with an ERI was performed. Specific clinica...
Srinivasan V, Pierre C, Plog B, Srinivasan K, Petraglia AL, Huang JH.Equestrian sports can result in a variety of injuries to the nervous system due to many factors. We describe our series of 80 patients with injuries sustained during participation in equestrian sports. Results: All patients seen at the regional trauma center with injuries associated with equestrian sports between 2003 and 2011 were reviewed; 80 patients were identified. Fifty-four per cent were female and the average age was 37 years (2·2-79·3). The mean injury severity score (ISS) was 9·9 ± 0·7. Only two patients had documented helmet use. Glasgow coma score (GCS) was 15 in 93% of patien...
Carmichael SP, Davenport DL, Kearney PA, Bernard AC.The purpose of this study is to determine whether discrepant patterns of horse-related trauma exist in mounted vs. unmounted equestrians from a single Level I trauma center to guide awareness of injury prevention. Methods: Retrospective data were collected from the University of Kentucky Trauma Registry for patients admitted with horse-related injuries between January 2003 and December 2007 (n=284). Injuries incurred while mounted were compared with those incurred while unmounted. Results: Of 284 patients, 145 (51%) subjects were male with an average age of 37.2 years (S.D. 17.2). Most injurie...
Wiese AJ, Brosnan RJ, Barter LS.To compare effects of 2 acetylcholinesterase inhibitors on recovery quality of horses anesthetized with isoflurane. Methods: 6 horses in phase 1, 7 horses in phase 2A, and 14 horses in phase 2B. Methods: The study comprised 3 phases (2 randomized, blinded crossover phases in horses undergoing orthopedic procedures and 1 prospective dose-determining phase). In phase 1, horses were anesthetized with isoflurane and received neostigmine or saline (0.9% NaCl) solution prior to anesthetic recovery. Phase 2A was a physostigmine dose-determining phase. In phase 2B, horses were anesthetized with isoflu...
BMC public healthFebruary 20, 2014
Volume 14 182 doi: 10.1186/1471-2458-14-182
Sawford K, Dhand NK, Toribio JA, Taylor MR.After the 2011 cluster of Hendra virus cases in horses in Australia, public health targeted education initiatives at people in the equine industry to reduce human exposure to potentially infected horses. 'Horse owners and Hendra Virus: A Longitudinal cohort study To Evaluate Risk' aims to enhance public health measures through improved understanding of Hendra virus risk perception and risk mitigation strategies among horse owners and horse care providers. This paper describes the stakeholder consultation that was undertaken to ensure the cohort study outcomes were relevant to diverse groups wh...
Costa-Farré C, Prades M, Ribera T, Valero O, Taurà P.Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia w...
van Loon JP, Jonckheer-Sheehy VS, Back W, van Weeren PR, Hellebrekers LJ.Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another...
Lyon RM, Macauley B, Richardson S, de Coverly R, Russell M.Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Methods: Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 20...
Lang J, Sathivelu M, Tetsworth K, Pollard C, Harvey K, Bellamy N.The dangers associated with horse riding, a popular activity throughout Australia, are well documented; yet, few studies have comprehensively described injuries caused by horses to nonriders. This study aimed to facilitate targeted injury prevention strategies and appropriate trauma management by describing all horse-related injuries, for both riders and nonriders, in Queensland, and identifying those at greatest risk. Methods: Horse-related injury data from 2005 to 2009 were extracted from the Queensland Trauma Registry. Descriptive comparisons were undertaken for demographic, injury, and acu...
Islam S, Gupta B, Taylor CJ, Chow J, Hoffman GR.We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated inju...
Tirosh-Levy S, Tatz A, Kelmer G.A 6-month-old Arabian filly escaped its handler while being led and slipped on pavement. The referring veterinarian recognized severe, soft tissue damage to the filly's lower jaw and referred the filly to the Veterinary Teaching Hospital for surgical management. Blessure de dégantage mandibulaire chez une pouliche arabe. Une pouliche arabe âgée de 6 ans s’est échappée de son préposé pendant qu’il la menait et a glissé sur la chaussée. Le vétérinaire traitant a reconnu des dommages graves aux tissus mous de la mâchoire inférieure de la pouliche et a recommandé la pouliche à l...
Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN.Objectives of this study were to compare the ability of serial thromboelastography, Sonoclot, and traditional coagulation panels to detect coagulopathies associated with disease category, systemic inflammatory response syndrome (SIRS), complications, and nonsurvival in horses with gastrointestinal disease. Methods: Prospective clinical evaluation. Methods: University referral hospital. Methods: One hundred twenty-one horses admitted as emergencies for gastrointestinal disease and 28 healthy adult horses. Methods: Blood samples were collected ≤4 times from emergency horses (admission and if s...
Hug SA, Riond B, Schwarzwald CC.To evaluate the applicability and accuracy of a continuous glucose monitoring system (CGMS) in critically ill foals by comparing the performance of the CGMS, a point-of-care (POC) glucometer, and an in-house standard laboratory assay (SLA). Methods: Prospective study. Methods: University teaching hospital. Methods: Seven critically ill neonatal foals requiring intensive care. Methods: Foals were instrumented with a CGMS that measured interstitial glucose concentration every 5 minutes for the duration of 15-79 hours. Capillary and venous blood samples were taken every 4-6 hours for POC and SLA...
Abu-Kishk I, Klin B, Gilady-Doron N, Jeroukhimov I, Eshel G.Horse riding and horse handling are dangerous. There is a lack of knowledge concerning the incidence of hospitalization due to horse-related injuries and types of injuries in Israel. During the last two decades we have observed an increasing incidence of hospitalizations due to horse-related injuries at our medical center as well as the frequent involvement of pediatric patients. Objective: To investigate these injuries with respect to type, incidence and modes of prevention. Methods: We conducted a retrospective study of medical records for all patients admitted to Assaf Harofeh Medical Cente...
Sandiford N, Buckle C, Alao U, Davidson J, Ritchie J.To assess the incidence and distribution of recreational equestrian injuries seen in the Kent and Sussex region and review the available literature on this subject. Methods: This is a retrospective case series with historical controls. Methods: Kent and Sussex region, England. Methods: Injuries related to horses in the recreational setting. Methods: Subjects were selected from our acute injury database. Notes of all patients presenting with horse riding-related injuries between January and December 2010 were reviewed. Skeletal injuries were confirmed using our Picture Archiving and Communicati...
Burba DJ.Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.
Kamali MF, Wilson AC, Acquisto NM, Spillane L, Schneider SM.Flunexin is a nonsteroidal anti-inflammatory drug approved for veterinary use in horses and cattle. Acepromazine is a phenothiazine derivative used in horses, dogs, and cats. Human exposure to these substances is rare. Methods: We report a case of a human injection of two equine medications, flunixin and acepromazine, which resulted in altered mental status, respiratory alkalosis, gastrointestinal bleeding, and elevation of liver transaminases in a 43-year-old woman who worked as a horse trainer. The patient intentionally self-injected these medications and subsequently presented to the Emerge...
Boesch JM.This article discusses anesthesia for horses with colic from acute gastrointestinal disease. Emphasis is placed on new developments in pre-, intra-, and immediate postoperative management over the last decade, including early goal-directed therapy (EGDT) in the resuscitation of septic patients, the controversy over the optimal fluid type to administer, and the management of complications, such as cardiovascular depression, hypoventilation and hypoxemia, and decreased colloid oncotic pressure (COP). An update on analgesia is also provided; older drugs such as ketamine and lidocaine are increasi...
Guyton K, Houchen-Wise E, Peck E, Mayberry J.Horse-related injury can be severe and disabling. We investigated the causes, severity, and costs of equestrian injury with the goal of injury prevention. A retrospective review of horse-related injuries from 2001 to 2008 identified 231 patients with a mean age of 38 years and a mean Injury Severity Score of 11 (range, 1 to 45). Mean length of stay was 5.5 days. Fifty-nine patients (25%) required 84 surgeries. Helmet use was 20 per cent and of the 172 patients not wearing a helmet while mounted, 38 per cent received potentially preventable head injuries. There were three deaths of which two we...
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...
Dahl E.During a 2-year period all Casualty Department data charts with the diagnosis "animal bite" were reviewed as part of internal quality control. Of 1,051 recorded episodes, 503 (48%) were women and 147 (14%) children under 16 years of age. 951 (90%) wounds were treated without closure. Half of the patients were not given antibiotics on the first visit, whereas one third were given penicillin. Tetanus status had been evaluated on 1,015 (97%) charts. Most bites were caused by dogs (76%), cats (17%), and horses (2%). Children were the victims of 118 (15%) dog bites, eight (4%) cat bites, and ten (5...
Dugdale AH, Barron KE, Miller AJ, Proudman CJ.To compare the effects of preoperatively administered pentastarch (10% concentration in isotonic saline [0.9% NaCl] solution) and hypertonic saline (7.2% NaCl) solutions on PCV and circulating total protein (TP) concentration in horses with colic undergoing emergency exploratory laparotomy and to assess survival rates of horses that received each treatment. Methods: Prospective, randomized study. Methods: 100 horses with signs of abdominal pain and PCV ≥ 0.46 L/L. Procedures-Horses received a 4 mL/kg (1.8 mL/lb) dose of pentastarch solution (n = 50) or hypertonic saline solution (50) over a ...
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...
Bernard WV, Reimer JM.Recent advances in veterinary diagnostics have improved our ability to diagnose and treat foal diseases. However, these advances do not replace the physical examination as the most valuable diagnostic aid available to the equine practitioner. The basic physical examination provides the majority of information needed to make a presumptive diagnosis, provide a direction for ancillary tests, and formulate a plan for emergency therapy if needed.
Pantaleon LG.Fluid therapy is an important component of resuscitation and treatment of critically ill equine patients. However, the decision of which fluid type to use in certain critical situations is somewhat controversial. This article focuses on the potential benefits of performing small-volume resuscitation in critically ill horses by combining hypertonic saline with a colloid (e.g., hetastarch).
Dolente BA.The variety of diseases that occur in the peripartum mare require the examining veterinarian to evaluate the patient and the historical information carefullly so as to make an accurate diagnosis and begin appropriate therapy. An understanding of equine behavior, reproduction. mechanisms of shock,and gastrointestinal and reproductive physiology is requisite for accurate interpretation of the myriad of clinical signs of diseases present in this population. Attention to the unique metabolic and physiologic needs of the pregnant and lactating mare can aid the critical care clinician in providing o...
Trim CM, Eaton SA, Parks AH.An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indi...
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...
Beech J.Despite major advances in our knowledge and ability to treat respiratory diseases in neonatal foals, neonatal respiratory medicine is still in its infancy. It is hoped that this article may serve as a guideline for diagnosis and treatment. Specific antibiotic regimens and emergency procedures are covered in other articles in this symposium. Because management factors play a critical role in the pathogenesis of respiratory disease, education of clients as to their importance would help both prophylactically and therapeutically. The necessity of very careful monitoring of neonates, which is crit...
Fielding CL, Magdesian KG, Meier CA, Rhodes DM.To describe the clinical and laboratory changes associated with the use of IV0.9% sodium chloride and a commercially available acetated fluid (CAF) to treat endurance horses requiring emergency medical treatment. Methods: Randomized, controlled clinical trial from 2007 to 2010. Methods: Emergency treatment centers of the Western States 100-mile (220 km) endurance ride. Methods: Twelve horses requiring emergency medical treatment in the form of IVfluids completed the study. Methods: Horses were assigned to either the 0.9% sodium chloride group (6 horses) or CAF group (6 horses) and received a t...
Trumble TN, Ingle-Fehr J, Hendrickson DA.A 364-kg (800-lb) 1-year-old mixed-breed horse was admitted for treatment of uncontrolled bleeding after castration. Multiple attempts to ligate the testicular artery through the scrotal incisions prior to referral had been unsuccessful. Because of the owner's concerns about cost, an attempt was made to control the bleeding by applying pressure to the inguinal region and administering formalin IV. However, hemorrhage continued. A decision was made to use laparoscopy to ligate the testicular artery. The horse was anesthetized and positioned in dorsal recumbency, and a routine ventral laparoscop...
Lascola KM, Vander Werf K, Freese S, Morgera A, Schaeffer DJ, Wilkins P.To compare blood gas, electrolyte, and metabolic analysis results between blood obtained by jugular and transverse facial venous sinus (TFVS) venipuncture in healthy adult horses and sick adult horses presented for emergency evaluation. Methods: Prospective, experimental study, from June 2012 to October 2013. Methods: Large animal university teaching hospital. Methods: Ten healthy adult University-owned horses and 48 client-owned adult horses (≥2 years old) presenting to the large animal hospital emergency service for medical or surgical evaluation of systemic illness. Methods: Venipunctures...
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...
Diel de Amorim M, Chenier TS, Card C, Back B, McClure JT, Hanna P.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...
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...
The American surgeonOctober 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...
Schröter C, Schulte-Sutum A, Busch M, Winkelmann M, Macke C, Zeckey C, Krettek C, Mommsen P.The cervical spine is considered fragile and vulnerable to injuries in equestrian sport. This retrospective study investigates the injury pattern and severity. Patients of the medical university in Hannover from the years 2006-2011, who had an equestrian accident, were identified. Patients who had been injured in the course of their work were excluded. Results counted with a p-value < 0.05 were considered significant. In 13.1% of patients, there were 71 cervical spine injuries (92.4% female; 7.6% male). The mean age was 27.1 ± 13.2 years. Of these, 86.4% associated the injury to the r...
Fielding CL.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...
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...
Collins NM, Axon JE, Carrick JB, Russell CM, Palmer JE.To evaluate severe hyponatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) in order to determine the prevalence, clinical findings, primary diagnosis and outcome. Methods: Retrospective case study of records from Thoroughbred foals aged less than 3 months presenting to an ICU as medical emergencies in 2002-12; foals with severe hyponatraemia (serum sodium <122 mmol/L) on admission laboratory data were identified. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis, treatment and outcome. Results: Severe hyponatraemia w...
Schaer BD.The emergency clinician is frequently in the position of receiving, evaluating, and initiating treatment on horses with ophthalmic emergencies or orbital trauma. In the best of circumstances, an ophthalmologist is available to guide initial therapy and ultimately assume responsibility for the management of the patient during the remainder of its hospitalization, but this is not always the case. The information presented here is meant to provide the emergency clinician with basic guidelines for the initial assessment and management of horses sustaining ocular injuries or presented with an ophth...
de Barros AMC, Silva AFR, Zibordi M, Spagnolo JD, Corrêa RR, Belli CB, de Camargo MM.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...
Bleetman D.The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport...
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...
Marolf V, Mirra A, Fouché N, Navas de Solis C.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...
Hance SR, Robertson JT.A 5-year-old Thoroughbred gelding was examined because of a small axillary wound sustained 5 days earlier and had resulted in extensive subcutaneous emphysema. Three days after admission, the horse's respiratory rate had increased to 72 breaths/min, and the horse appeared anxious and distressed. Thoracic radiography revealed pneumomediastinum and severe bilateral pneumothorax. Tube thoracostomy was performed on both hemithoraxes. The drains were connected to one-way suction valves and suction devices to decompress the thorax. A nasopharyngeal catheter was inserted, and oxygen insufflation was ...
Vitale V, Viu J, Armengou L, Ríos J, Jose-Cunilleras E.To evaluate the prognostic value of measuring heart rate variability (HRV) in horses with colic at the time of admission to a referral hospital. Methods: 51 horses > 1 year of age with colic (41 that survived [survivors] and 10 that died or were euthanized [nonsurvivors]). Methods: HRV was recorded within 1 hour after admission by use of heart rate sensors with horses restrained in stocks. A 5-minute recording period was analyzed to obtain HRV measurements (eg, SD of R-R intervals [SDRR], root mean square of successive differences between R-R intervals [RMSSD], and geometric SDs determined ...
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...
