Recumbent Horses: Factors Associated With Survival

Finding a horse recumbent (unable to rise after lying down) is a nightmare no horse owner wants to experience. Once a horse is recumbent, veterinarians often offer a poor prognosis. But according to Laramie Winfield, DVM, of the University of California (UC), Davis, College of Veterinary Medicine, owners and their veterinarians should evaluate several factors before giving up hope on a recumbent horse.

At the 2011 American College of Veterinary Internal Medicine Forum, held June 15-18 in Denver, Colo., Winfield discussed a retrospective study that reviewed medical records of 101 horses with a history of recumbency admitted to the UC Davis Veterinary Teaching Hospital from 1995-2010 to determine which factors were associated with their survival. Many different diseases and ailments can spur recumbency, including equine protozoal myeloencephalitis, central nervous system disorders that cause brain diseases, spinal cord problems (such as wobbler syndrome), botulism (a neurologic disease caused by a neurotoxin produced by the bacterium Clostridium botulinum), adverse reactions following general anesthesia, musculoskeletal disease, parasite infestations, tetanus, and pneumonia.

The average age of case horses was 10 years. Three-quarters of hospitalized horses received veterinary treatment in the field prior to transfer to the referral clinic, and the overall survival rate for the recumbent horses was 30% with an average hospitalization cost of $3,200.

Winfield discussed several factors consistent with a poor outcome including spinal cord disease, botulism, and ataxia (incoordination) in horses that were not yet recumbent, or increased BUN (kidney enzyme) on laboratory blood tests. An elevated BUN could be indicative of kidney disease, which is a problem in recumbent horses due to a risk of dehydration, muscle damage, and poor bladder function.

Winfield said early treatment and stabilization can improve a horse's chances of survival. Providing horses with long-term supportive care was also important, as she noted that horses that remained hospitalized for longer periods of time were more likely to have favorable outcomes than those not hospitalized or discharged after a short time frame.

Horses that tolerated being supported by a sling in recovery had a better prognosis since they were less likely to develop secondary problems related to recumbency, such as myopathy (muscle inflammation). More than half of horses with musculoskeletal disease successfully used a sling, which allowed their primary injury to heal.

Botulism was associated with only 10% survival rate, best achieved by early treatment with a botulism antitoxin. Horses with spinal cord disease recovered only 15% of the time, while all horses with post-anesthetic problems recovered fully.

Winfield concluded, "As time and cost of hospitalization increased for horses, chances of survival improved, indicating that the recumbent horse responds positively to good quality nursing and supportive care."

About the Author

Nancy S. Loving, DVM

Nancy S. Loving, DVM, owns Loving Equine Clinic in Boulder, Colorado, and has a special interest in managing the care of sport horses. Her book, All Horse Systems Go, is a comprehensive veterinary care and conditioning resource in full color that covers all facets of horse care. She has also authored the books Go the Distance as a resource for endurance horse owners, Conformation and Performance, and First Aid for Horse and Rider in addition to many veterinary articles for both horse owner and professional audiences.

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