Emergency Care

There’s an old saying: If your horse can find a way to get in trouble, he will. So, if you own a horse long enough, chances are that some time you will face an emergency accident or injury. But will you know how to deal with the different types of injury situations you might encounter? Will you know how and when to perform immediate first aid procedures and, just as importantly, when not to? After all, making the wrong decision during this kind of crisis could result in unnecessary scarring, delayed healing, and even the death of your horse

Is It An Emergency?

It's hard to tell if you are dealing with a life-threatening situation that requires immediate emergency treatment. Notes Earl M. Gaughan, DVM, associate professor and section head of Equine Medicine and Surgery, Kansas State University, "A lot of people really worry about bleeding. A horse has a tremendous volume of blood. The classic one is when its snowy outside and you get blood on white snow; it often looks worse than it is.

There are certain types of injuries that merit deep concern. Says Venaye Reece, DVM, veterinary medical officer for the State Veterinary Office at Clemson University, Animal Emergency Response Coordinator for South Carolina, and North American Trail Ride Conference veterinarian/judge, "Punctures are generally considered fairly important, particularly if the puncture is in the area of a joint or in the foot. Cuts that involve tendons, joints, or large blood vessels may be emergencies. Eye lesions that involve the actual globe of the eye are almost always emergency situations. Severe lameness, severe reluctance to move, and any known fracture warrant emergency treatment

On the other hand, bee stings, mild choke, or moderate cuts in a muscle or skin that don't involve a joint, tendon, blood vessel, or eye might be scary, but probably wont necessitate immediate treatment. "Within a couple of minutes, horses are over the fright and pain of bee stings," says Reece. "With choke, you have plenty of time to get a vet. Sometimes, just walking the horse or trying to get him relaxed, or, under a veterinarians direction, giving a mild sedative or tranquilizer will clear a choke. Moderate skin or muscle cuts may need moderately immediate attention in that the quicker you can clean up and suture, the better healing you're going to get, but those are not usually life-threatening." When you report the injury to the veterinarian, he or she will decide whether the horse requires immediate veterinary attention or immediate veterinary advice. "Most veterinarians who deal with horses appreciate the phone call and the conversation and making the decision about whether the horse needs to be treated immediately or as soon as possible," Gaughan says.

When Accidents Happen

Because your veterinarians response relies in part on your description, it's important that you assess and describe the situation as accurately as possible. Determine where the injury is, how severe it might be, the amount of the pain the horse is in, the degree of bleeding, and the risk of moving the horse, advises Reece. If you're in the midst of an activity when the injury occurs, and the horse can be moved, walk him to an area that's quiet. Naturally, if you're mounted, you should dismount immediately, except if you've just ridden through an area where bees are. In that case, says Reece, keeping riding for at least another minute to move out of the area. "If you stop, you usually end up with a horse that's bucking and pulling away as you try to get off," she warns.

Next, check the horse's vital signs. Explains Gaughan, "It's a huge benefit when a rider or owner can call and tell the veterinarian what the horse's heart rate, respiratory rate, and temperature are. The respiratory rate isn't always so important as injured horses frequently pant or breathe in an odd pattern."

If possible, quiet the horse and, if you have a stethoscope, check the heart rate behind the left elbow. Hopefully, you will have practiced checking the heart rate before so you will know what your horse's normal heart rate is and will be able quickly to locate where you should listen. "Normal rates for most horses at rest are in the low 40s per minute," says Reece. "A heart rate more than 100 is not unusual immediately after exertion or a distressful injury. A continued heart rate above 60, after the horse has been quieted and had time to recover from exertion, signifies some continued stress, and above 80 signifies distress and/or stress to the vital systems of the horse." Next, check respiration. "You're looking for a slow, steady, relaxed, deep respiration," says Reece. "Rapid, shallow respiration could indicate the horse is shocky, while ragged, distressed respiration tells you the horse is still in pain." But don't expect breathing to be normal as long as the horse remains agitated or upset. Inspect mucous membrane color by examining the gums, inside the lips, and inside the eyelids. "Normally, the horse would have a nice, bright pink color," Reece says. "If the color is real pale, that could be due to pain, blood loss, or anemia. If red and congested, the horse may have a high fever or a lot of inflammation. If the color is a darker the horse may be very dehydrated. If the color is a muddy brown and congested, the horse may be in shock or circulatory collapse that horse is extremely fatigued or in a lot of distress, and is in trouble. A very blue color means you have a very hypoxic horse that's not receiving enough oxygen or is going into circulatory/respiratory collapses very much an emergency situation."

Check the capillary refill time by pressing your thumb against the gum above the teeth. This indicates how the horse's circulatory system is doing. When you release the pressure, the blanched area you created should return to normal color within one or two seconds. "If it stays blanched for three seconds, that's a problem," Reece states. "Four seconds or more, your horse is in serious trouble." Take the horse's temperature. Says Reece, "Normal temperature is generally between 99 and 101 degrees Fahrenheit. An elevated temperature (above 103 degrees) could signify heat exhaustion or impending heat distress, or it could signify an underlying disease problem that is contributing to the emergency situation. A decreased temperature (less than 99 degrees) could signify a horse's going into shock due to pain, blood loss, or internal organ damage (for instance, after a fall or accident involving an automobile or trailer)." If you're concerned about blindness, examine the eye for obvious cloudiness or signs of injury such as swelling, blood, cut, puncture, or tear. Check the horse's eye by making a fist and dealing a false blow toward your horse's eye; the horse should blink and pull back. Don't use an open hand, which creates enough air movement that even a blind horse might pull back. Observe the horse for alertness or awareness. Is he responsive, or aware of his surroundings?

Assess the horse's ability to move. "Do that at a walk," says Reece. "See if he can turn and back. Compare this to his normal walk. But don't force it. Trot only to assess mild to moderate lameness."

You can check for dehydration by pinching the skin to make a tent on the side of the neck or on the shoulder, then timing how quickly the skin returns to normal. This often is unreliable, as it varies from horse to horse. Also, there is a longer return to normal time on wet or sweaty horses. "If you're used to your horse and know what his normal time is, you can try this," says Reece. "If your horse's skin is loose and you pull it up and drop it, it should go back within a second to 1 to 2 seconds. If the horse is very dehydrated, it will go up to three or four seconds. But this is very variable and needs to be done with other things in mind, such as mucous membrane color and capillary refill time, not just taken alone."

Waiting for the Veterinarian

After reporting your findings to the veterinarian, there might be a few things you can do to help your horse while awaiting the veterinarian's arrival and a few things that you shouldn't do

Calm the horse. Remove the tack, put on a halter and lead, and, if possible, move the horse to a quiet, secure area such as a stall, wash room, or just away from other activities. "If the horse will stand quietly, let it stand quietly," advises Reece. "If it's upset, you may need to hand walk it or move it to keep it from throwing itself around. One of the safest ways to handle an unmanageable horse is to put on two lead shanks and cross-lead him by having a person on each side. But don't put yourself in a position where you're risking your own injury." A blindfold, or cotton in the ears also can help calm a frightened horse. Offering hay might calm a horse. Says Gaughan, "If first aid is going to be rendered and there's a lag phase of more than a couple of hours before any kind of surgery is going to be needed, then offering feed may be a good thing to do. But if surgery is needed in short order, then don't feed because it can complicate the anesthesia. If you're in doubt, don't feed

Try to stanch bleeding by putting pressure on or by bandaging the wound. Says Reece, "In general, as long as you use large, padded pressure wraps, you're going to be safe. But you have to be careful not to bind the tendons. This is why we use large padded materials such as a folded towel or baby diaper, then put a pressure wrap over that.

Flush the wound with an antiseptic or sterile solution. "Use Betadine solution in water to rinse dirt, grass, or debris out of the wound," says Gaughan. If possible, he suggests diluting the Betadine in sterile saline or lactated ringer solution, about 10-50 cc of betadine to 1,000 cc of solution (the color is that of iced tea). Use a syringe to inject the Betadine solution into the plastic top or bag or bottle of the fluid; even clean water would be okay. Be very careful not to flush debris deeper into the wound. If you're uncertain about that, then it's better to do nothing.

Don't apply topical wound dressings or colored disinfectants before the veterinarian examines the wound. "Often, these things inhibit a veterinarian's ability to look further into the wound and fully diagnose what's been injured, especially the colored wound treatments," Gaughan says.

Don't administer pain relievers or drugs, as these can mask symptoms and hinder an accurate diagnosis. In the case of a severely dehydrated or shocky horse, inappropriate use of sedatives or tranquilizers such as Rompun or acepromazine can precipitate a further drop in blood pressure and possible collapse.

Don't pull out a nail from a horse's foot until you can mark the point of the injury. Explains Reece "These things (wound holes) disappear, and a lot of times the horse is not lame once you pull the nail out. The owner can't remember which foot it was in or where it was. Either mark the puncture with a magic marker, fingernail polish, crayon, lipstick, etc., or leave the nail there until the veterinarian arrives.

Be very cautious about removing penetrating foreign bodies. "If the horse has a stick stuck through its leg or in the chest or side, it may be better not to remove it," Reece warns. "It may be into a body cavity or joint, or may start bleeding profusely when removed. If the stick is in the chest, it could be in the lung cavity and if you remove that, you could collapse the lung. Just leave it alone until the professionals can get there and be ready for the consequences.

Do nothing for eye wounds. "Most of the time when you approach an injured eye, you create more panic for the horse," explains Gaughan. "This usually requires profound sedation and local anesthesia from the vet to access completely.

Avoid worsening a fracture. Try to reduce the horse's panic and keep it quiet until the veterinarian arrives.

About the Author

Marcia King

Marcia King is an award-winning freelance writer based in Ohio who specializes in equine, canine, and feline veterinary topics. She's schooled in hunt seat, dressage, and Western pleasure.

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