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The Down Horse Scenario


By Jennifer Dunlap, DVM

It is amazing to watch how easily a 1000+ pound horse can get down on the ground, roll around, and then leap back up running and bucking down the fence line. But what happens when your horse is down and can’t get up? Due to the large size and the sheer power of the horse, getting a truly down horse up can be a major undertaking and, if done incorrectly, permanent injury or death can result. Regardless of the reason your horse is down on the ground, it is very important that you not attempt to rush in and get your horse up without letting someone know what’s happening – for your own safety.

A down horse can be a panicking horse, and getting kicked or knocked down yourself can be a real possibility. So getting assistance, if at all possible, is important for your safety and your horse’s. The old adage “many hands make light work” is true in the down horse scenario.  Setting yourself and your horse up for success is paramount. This means to make sure your horse has plenty of head room, since a horse has to use his head and neck to swing himself up, and has plenty of room for leg extension to push himself up, and that you are in a safe position to help.

For a down horse, the areas which are most often injured are the eyes; the limbs, as a horse thrashes; and the muscles, due to the weight of a horse, which can lead to muscle damage and eventually prevent the horse from getting up at all. If the muscles are severely damaged, they will not be able to stand without the benefit of a lift and a sling.

I really don’t like for a horse to be down for more than two hours on one side. When a horse is down, the lungs on the down side collapse slightly and breathing is harder for the horse. It is for these reasons that we don’t see horses sleeping lying down for long periods of time. Horses have what’s called a “stay apparatus” in both hind limbs with which they can “lock” their legs so they can sleep standing up. 

The only easy thing about getting a down horse up is remembering that the five following rules are always correct:
1) Never try to pull a horse up by just pulling on the head. The connection of the head and the neck is surprisingly small and fragile and you can severely injure or kill a horse if you only pull on the horse’s head to get him up.

2) Never place a rope around the lower limb to try to pull a horse up or roll a horse over. The small size of a horse’s leg compared to the body size prevents you from getting any real leverage and, instead, you could break or dislocate the leg long before you move the body even an inch.

3) Never stand on the side the horse’s legs are pointing. If the horse starts thrashing or kicking, you could be seriously injured or knocked down. It is safest to stand on the side nearest the horse’s back.

4) Never pull a horse up by just the tail. The tail is the end of the spinal column and damage here can result in severe neurologic damage.

5) When in doubt, call for help from experienced horse rescuers and/or your veterinarian. My veterinary technician Katie and I handle a lot of emergency situations and we, along with your veterinarian and technical large animal rescue trained rescuers, are always here to help.

This all sounds rather scary, so let’s break it down to three common reasons why a horse gets down and what to do for each situation.

1.        One of the most common “down horse” situations is the horse that lays down in the stall too close to the stall wall and gets cast with his legs too close to the wall so he can’t get a good push up. This is typically a “first thing in the morning” call when an owner gets down to the barn to feed and hears a lot of struggling and banging going on, or the horse may be staying calm waiting for help. 

Here is how I handle a cast horse in my barn. I get a second person down to the barn to help and we quickly remove water buckets, feed buckets, and anything else that may catch my horse or me as we are maneuvering to get the horse up.  While the second person gently holds the horse’s head in a halter with a lead rope, with a large towel between the head and the halter to protect the down eye, and tilting the nose up slightly to keep the horse from making a violent effort to get up, I slip a tow strap under the horse’s neck gently see-sawing it to get beneath the down shoulder so I have one end in front of the withers and one end coming up just behind the front legs. I then pull both ends, pulling the horse away from the wall while the second person steadies the head. Once the horse gets enough clearance off the wall, he can make a good effort to get up. The person at the head gives the horse plenty of slack to use his head and neck to get up. We then check the horse for any abrasions, eye injuries, wounds, and lameness.

How to help prevent a horse from getting cast? Make sure the stall is big enough for that horse, although some horses get cast no matter the stall size. Bank the shavings in the stall, i.e., after bedding the stall, push some shavings up against the walls to create a bowl-like effect in the stall; this helps prevent a horse from getting up against the wall. There are other methods, but I have found these two the most beneficial.

2.        The second reason is the elderly horse that just doesn’t have the strength to get back up – if they are on a hill; if it is freezing cold so their body heat has dropped and their muscles are reluctant to move; or if they have arthritis. This is a common scenario that we see in the winter. For these situations I quickly make sure a leg isn’t stuck in something like an armadillo hole. I get a halter on the horse and gently cradle the head, padding the halter with towels as needed. I shake some grain or some treats to get the horse up in sternal position (sitting on his belly, instead of on his side) and prop hay bales against the side he is leaning on to help him sit up for a minute and orient himself.  At that point we “head and tail” him up. One person holds the lead rope and gently tugs, giving plenty of play in the rope when the horse makes an effort, while I gently tug on the tail assisting with standing and steadying the horse as he makes an effort. If the horse if very weak, we can give warmed IV fluids with electrolytes added to give him a boost or get him up with straps and assist with slinging if needed.

How can we help prevent our elderly horses from getting into these situations? Make sure their paddocks and pastures are safe, free from stobs, large ditches, and other things they can get caught in. Because an elderly horse’s joints might not have the flexibility they once had, an elderly horse can’t always catch himself if he stumbles. Plan on providing a well-fitting waterproof blanket for your elderly horse when it’s cold. This can help an elderly horse conserve body heat and keep their muscles moving better since they no longer have the plush hair coat and body fat layers that they had when they were younger.  If your elderly horse has arthritis, an anti-inflammatory drug can be a lifesaver. I have had tremendous success with Previcox or the equine version Equioxx.  This medication can keep the arthritic horse much more comfortable, allowing them to get up and down much more easily and safely.

3.        The medical emergency down horse. These can include colic, founder, weakness from blood loss from a severe laceration, and hoof abscesses.  These are all obviously veterinary emergencies. Colicky horses may get up and down, but some will lie down and not want to get up.  Once an assessment has been made, then appropriate treatment can begin whether it is oral or IV fluids or surgery.

Founder can cause such pain to some horses that they will not stand. In these cases we can use some potent pain medications, both IV and by blocking out the feet. Then we get some quick x-rays to assess the situation and devise with a treatment plan, being sure to involve a skilled farrier to provide hoof support. We need to determine the cause of the founder. In our area, the most common reason for founder is insulin resistance. The classic case is the easy keeper out on spring grass.

Due to the fact that the major blood vessels of the leg are just beneath the surface of the skin, it is not uncommon for even small lacerations over these areas to result in heavy blood loss. We see these cases fairly commonly and we have to give IV fluids in the field as we secure the bleeding limb. It still amazes me after over 19 years of being a veterinarian how quickly a horse bounces back from blood loss with IV replacement fluids. I want to put a plug in for our crew of blood donor horses. They have saved our patients’ lives more than once with their life giving donations. A 1,000 pound horse with no health problems has about 45 liters of blood and they can lose up to 10 liters before we have to consider a blood transfusion. If they lose between 4-9 liters we have to give regular IV fluids. The average 1,000 pound horse who loses less than three liters generally requires no IV fluid supplementation.  

A hoof abscess can cause a horse to be “broken leg” lame and this can be a cause for a horse to be down. The pressure from a hoof abscess is incredibly painful and can cause a horse to not want to put any weight on the hoof and sometimes not even stand up.

I will never forget getting a down horse call in the dead of winter when it was heavily snowing. When I arrived, the horse was down on her side with labored breathing with her left forelimb shaking. I started gently palpating her limb and found no areas of swelling or soreness, but when I put my hoof testers on her hoof and gave a little squeeze, a huge hoof abscess popped like a geyser. After that, the horse jumped up and ran to the barn bucking and farting.  She healed uneventfully from the hoof abscess.

We field calls all the time regarding down horses. There are entire training courses taught about getting a down horse up. I like to keep a down horse emergency kit in my barn, horse trailers, and vet truck. It consists of two tow straps rated for at least 5,000 pounds (available at your local hardware, auto parts store, or farm supply store) and some old towels for padding a horse’s head.  While no horse weighs 5,000 pounds, we have to keep in mind the force and torque that a “live load,” i.e., the horse, can put on the strap, which can be more than just his body weight of 400-2,000 pounds.

We want to do everything we can for our equine family members. When faced with a down horse situation, remember to be safe and get experienced help if you are unsure about how to go about getting a horse up. Please note: there is no shame in calling for expert assistance! If you are interested in learning more about dealing with equine emergencies, including the down horse scenario, I will be teaching a horse owner seminar on this topic this fall. Check the Dunlap Equine Services facebook page for more information.

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