By Kerry Comb BVMS CertEP MRCVS
www.ashbrookequinehospital.co.uk 01565 723030.
First Aid and Equine Emergencies.
Dealing with first aid and equine emergencies relies on being able to recognise a problem. Taking note of your horse’s normal demeanour and monitoring drinking, eating and the passage of urine and faeces will allow you to detect problems early. The vital signs – pulse, respiration and temperature – should be monitored when the horse is relaxed and in its normal environment. These vary slightly between each individual so it is good to know what is normal for your horse.
NORMAL VITAL SIGNS
Temp 37.0-38.5°C
Pulse 30-45 per min
Resp 8-16 per min
It is helpful to have a list of telephone numbers ready in case of an emergency and leave instructions whenever you are away on holiday of what is to be done in the event of an emergency.
The remainder of this article discusses the common emergencies seen in horses and how to deal with them.
Colic
Colic is the name given to abdominal pain in horses and although usually related to the intestines, it can be caused by other organs such as the bladder. Colic is a relatively common condition which is usually mild and easily resolved. Signs vary from mild to severe. Mild signs include appearing unsettled, pawing of the ground, stretching as if to urinate and flank watching. Severe signs are kicking out, sweating and rolling.
If signs are mild, removing the food and walking the horse may settle it. If symptoms continue after 20 minutes or are severe then call your vet immediately. It is best not to administer medication to your horse as this can confuse the vet’s examination. It is NOT necessary to prevent rolling whilst waiting for the vet but walking may be beneficial if it is not dangerous for the horse or owner. It is helpful if you can inform the vet when the horse was last seen to be normal, passing faeces, eating and was wormed. This can help identify the cause of the problem.
On arrival, the vet will perform a full examination including listening to the intestines. They may need to pass a stomach tube and rectal the horse to determine the extent of the problem.
Most colics are treated successfully with medication injected by the vet. Some horses require further treatment with oral fluids (via a stomach tube) or intravenous fluids. On rare occasions surgery may be necessary. The success rates for colic surgery are constantly improving and many horses make a full recovery.
Minimising the risk of colic in your horse involves regular worm control (this is often achieved by monitoring worm egg counts), routine dental care, minimising bedding ingestion and avoiding sudden changes in diet.
Azoturia / tying up / Monday morning disease / Rhabdomyolosis
These many names are all used for one condition. Azoturia usually occurs during exercise and the horse’s gait becomes stilted, the muscles of the hindend commonly become tense and this can progress to a horse that cannot move. The horse will often start to sweat and become distressed, similar signs to colic. The problem occurs due to a build up of lactic acid in the muscles. The cause is often a sudden increase in exercise level, but can be associated with viral respiratory diseases. Severe cases can result in kidney damage if not treated promptly.
If this occurs in your horse then stop all exercise immediately and do NOT force your horse to walk to the stable. Keep the horse warm with a rug if necessary and call the vet. The vet will administer pain relief and possibly sedation. A blood sample is often taken to determine the degree of severity.
Treatment involves anti-inflammatories and box rest, usually for a minimum of two weeks. To prevent this disease occurring, exercise levels should be gradually increased, sick or coughing horses should not be worked and food should be decreased if the horse has an enforced rest. Susceptible horses can be fed specific diets to help prevent this condition recurring.
Severe (non-weight bearing) lameness
There are three main causes – pus in the foot, fracture or joint infection. In adults, pus in the foot is the most common whereas in foals a joint infection is more likely.
If you find your horse in this situation remain calm and keep the horse still whilst waiting for the vet.
Pus in the foot is usually identified by heat in the foot and a bounding digital pulse. Hoof testers and a hoof knife are used to identify the area involved and release the built up infection. A poultice is then usually applied to draw out the remaining infection. Your horse should rapidly improve and return to full work. Prevention involves good routine hoof care and regular attention from your farrier.
Fractures are not always obvious and may require x-rays for diagnosis. Not all fractures are fatal but they do require a prolonged recovery. Your vet may require the horse to be transported to a hospital for diagnosis. The affected leg is often heavily bandaged and splinted for this journey.
Joint infections are not always the result of large wounds, they can be the result of a small thorn penetrating through the skin into the joint. The site of entry may not even be visible by the time the horse goes lame. The joint will often be swollen and very sore on palpation. Most septic joints require flushing out and antibiotic medication. To help prevent this happening to your horse we suggest good upkeep of fields, fencing and yards.
Laminitis
Laminitis is a painful condition of the feet of horses. It is most commonly associated with the metabolic diseases Equine Metabolic Syndrome and Cushing’s disease.
When laminitis presents as an acute (immediate) problem the horse can be in severe pain. Laminitis does also exist as a chronic (ongoing) problem with mild to moderate pain in the feet.
Laminitis is most commonly seen in the spring triggered by lush grass ingestion but can be seen throughout the year.
Laminitis is often diagnosed from a characteristic stance and gait, with increased loading of the heels of the feet. The horse often shifts weight from one foot to the other and in severe cases they may lie down and be unwilling to stand. There is usually heat in the feet, bounding digital pulses and pain on application of hoof testers. Sometime it is not possible to lift the feet during the examination.
If you find your animal in this situation then you will need a vet. While you are waiting you can place them in a deep shavings bed to support the feet.
Treatment involves anti-inflammatories, strict rest and frog supports. Any underlying metabolic diseases also need to be addressed. In the longer term, specialist farriery with metal or plastic heart bar shoes may be required.
Prevention involves exercise and dietary restriction. Regular blood tests can allow early detection of Cushing’s disease or laminitis risk factors which gives you more chance of avoiding laminitis in the future.
Allergic airway disease
Also known as EAS (equine asthma syndrome), COPD (chronic obstructive pulmonary disease) and RAO (recurrent airway obstruction), is very similar to asthma. It is very commonly seen in a mild to moderate form. However on rare occasions this disease can have a very quick and severe onset which can be life threatening. It is more common in horses 8 years and older as the allergic response builds up with time.
Signs are those of breathing difficulty with flared nostrils, abdominal effort to breathe and the horse can become anxious and start sweating. If these signs occur call the vet immediately to discuss the severity of the signs. It is helpful to remove the horse from the likely allergen, increase the fresh air available to the horse and keep the horse calm. Treatment involves various medications and long term control can involve the use of human inhalers via devices such as the Aeromask.
Management plays a huge part in controlling this disease and in preventing it, keeping the horse in as dust free an environment as possible. Prompt treatment of early signs prevents severe flare ups from occurring.
Choke
Choke is oesophageal obstruction. The blockage in the oesophagus results in saliva overflow through the nostrils with food material contaminating it. The mass is sometimes visible in the neck but lots of obstructions are at the chest level and therefore not palpable. The horse is usually dull and depressed and unwilling to eat. Common causes are feeding un-soaked sugar beet pulp, rivalry at feed times and dehydration.
Whilst waiting for the vet all food should be removed from the horse. On arrival the vet will usually administer medication and may need to pass a stomach tube and flush the oesophagus until it is cleared. Often the horse clears the obstruction itself before the vet has time to arrive!
To help prevent this condition ensure feeds are soaked adequately, settle horses before feeding and do not feed in groups.
Urticaria
This is allergic skin disease also known as ‘nettle rash’. The horse develops elevated skin patches with intense itching and the lumps can exude serum. If the cause (irritant) is obvious then remove it or wash it off. In some horses the cause is not obvious and can range from feed given to pollen in the air. These horses cause great concern but are not really a medical emergency. Anti-inflammatories are used to treat the condition while the cause is removed.
Wounds
Wounds vary greatly in severity and some of the smallest wounds can be the most dangerous. If you are in any doubt then you should contact your vet. Wounds on the body heal much faster then those on the limbs where there is minimal soft tissue. Small and superficial wounds can often be managed at home with thorough cleaning with warm water with dilute hibiscrub or bags of saline if they are available. Application of a wound cream or gel will then keep the wound moist which will hasten healing. Wounds should NOT be poulticed as this causes maceration and increases infection risk. The horse’s tetanus vaccination status should be checked; tetanus can gain entry through the smallest of wounds and is usually fatal.
It is important to check that no joint or tendon sheath has been penetrated with the wound. The fluid can be mistaken for serum leaking from the damaged tissues and with leakage of fluid the horse is not always severely lame. Joint penetrations require prompt treatment so if you are in any doubt seek a veterinary opinion.
Wounds that are bleeding heavily require veterinary attention. Whilst waiting for the vet application of pressure will decrease the bleeding and keep the horse warm and comfortable.
Wounds heal fastest when sutured but this is not always possible due to the nature of the wound or the degree of contamination. Suturing of a fresh wound should be done within 6 hours of the wound occurring as this is the golden period. Some wounds are sutured after a few days. This is known as secondary closure and is performed once the contamination has been dealt with. Bandages are often used on wounds especially if they cannot be sutured. The bandage decreases movement and keeps a nice moist environment for epithelial migration and healing.
In order to allow you to perform the best possible first aid for your horse it is important to keep a well stocked first aid kit at your yard and in your horse box.
