Ask the Veterinarian: Handling Emergencies

By Dr. Alli Forbes

Question: I feel like my gelding is always accident prone! He is constantly injuring himself, regardless of whether he is in a stall or out in the pasture, and I think I’m seeing my veterinarian more than my husband! What tips do you have for handling emergency injuries? Do I always need to call my veterinarian? Thank you!

Answer: The first step to being prepared is to stay calm. It’s scary and frightening to have a sick or injured horse, so take a few deep breaths. Then, locate your handy first aid kit. Make sure it’s well marked and in a good, easy to find location. It’s good practice to also have a second one in your trailer. The first aid kit should consist of the following items:

• Veterinarian’s phone number, and a back up

• Vitals card with normal parameters

• Thermometer

• Stethoscope

• Bandage scissors

• Gloves

• Flash light

• Vet wrap

• Telfa or gauze pad

• Standing wrap

• Duct tape or adhesive tape

• Clean towels

• Betadine

It is important for you to know normal vital signs for your horse. The more you practice, the easier it will become for you to recognize when something is wrong, and you can describe your horse’s abnormalities over the phone to your veterinarian. Below are normal vital signs:

To get a heart rate, listen with a stethoscope on the left side, just behind the elbow. You can count how many beats you hear in 15 seconds (i.e., 6), then multiple by four to get beats per minute (i.e., 24). For a respiratory rate, you can watch the horse’s chest rise or the nostrils flare for 15 seconds, and then multiple by four to get breaths per minute. To assess mucous membrane color and hydration, flip up the upper lip and look at your horse’s gums. Normal color is pink to light pink, and the gums should be wet and slimy. Press a finger to the gums above the front teeth. The pink color will become white, and the period of time it takes for the gums to become pink again is “capillary refill time.”

The next step is to call your veterinarian. It’s essential for your veterinarian to be included! Depending on the severity of the injury or illness, the relationship you have with your veterinarian, communication, and how well you describe the injury or concern, it may be possible to avoid a visit from your veterinarian. Sometimes, however, an emergency visit from the veterinarian is unavoidable. Typically, these cases are colics, lacerations, any wound or puncture over or near a joint or tendon structure, acute severe lameness, allergic reactions, esophageal obstruction (i.e., choke), and eye injuries. We like to get videos and pictures, which can aid in our recommendations and prepare us for what we will be seeing.

COLIC – mild or severe, an episode of colic (abdominal pain) should always be seen by your veterinarian. Mild colics can progress to severe ones, and horses that are consistently mildly painful may have a more severe lesion. When your veterinarian assesses your horse for colic, there are key physical exam and diagnostic findings we look for that help aid us in diagnosis, prognosis, and recommended treatment and therapy.

ESOPHAGEAL OBSTRUCTION – more commonly known as choke, secondary complications can include aspiration, pneumonia or esophageal stricture. Common clinical signs are drooling, difficulty swallowing, coughing, feed material coming from nostrils, and regurgitation of feed and water. When your veterinarian is en route, make sure to pull feed and water away from the horse, and put the horse in a stall or in a situation that will keep them relaxed and quiet.

LACERATIONS AND PUNCTURES – typically, we are concerned with lacerations that are at or below the level of the knee and the stifle. These areas have several synovial structures that can be involved (joints, tendon sheaths). Penetrating wounds into the chest or abdomen are also a cause for concern. Facial lacerations bleed a lot, but typically they will heal well. If your horse does have a facial cut or wound, always check the eyes and make sure they appear normal. If your horse has a wound, clean it! Betadine and a water hose will work just fine. This will let you determine how much it is bleeding, how deep the wound goes, and if there are multiple wounds present. If a foreign body penetrating wound is present, DO NOT pull the impaling object out. Sometimes moving or removing the object can cause more trauma or damage. If the wound or laceration is on the leg, you can apply a light bandage consisting of a telfa pad or gauze pad and vet wrap. If it is appears to be bleeding more than you think is normal, you can place a telfa pad and vet wrap to hold it over the wound, then place a standing wrap or clean towel supported with a polo wrap to support and provide compression, either during transport to the clinic or until your veterinarian can make it out for assessment.

LAMENESS – acute, severe lameness is often caused by an abscess or sole bruise. However, because it can also be a fracture, being seen by your veterinarian immediately is a necessity. Quick onsets of lameness can also be caused by dislocation, septic (infected) joints or tendon sheaths, laminitis (founder), tendon rupture or tears, or underlying neurologic disease. Being seen promptly by your veterinarian will allow everyone to come to a quick but thoughtful diagnostic and treatment plan.

EYES – simple eye injuries can quickly progress, so it’s best to be seen immediately by your veterinarian. Not only do we look in the eye, but we also numb the eye, lids, and surrounding tissues, as well as stain the eye to look for scratches and ulcers. The quicker and more aggressive we are with initial treatment, the increased likelihood of a successful outcome.

ALLERGIC REACTIONS – allergic reactions are a concern due to the possibility of involving the airway. Aggressive treatment is needed to get the inflammation and body’s reaction under control. Things that you can do while the veterinarian is on the way are: hosing your horse down, if having a generalized reaction, or cold hosing a specific area for 15-20 minutes.

Again, remember to STAY CALM and SAFE! Together with your veterinarian, your horse will receive the prompt care and attention they need to bounce back and be happy and healthy!