TEH Annual Holiday Barn Parties

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November was Holiday Barn Party month for Tennessee Equine Hospital (TEH), which hosted customer appreciation and educational events at each of their four locations.

The first was in Eads, Tenn. at Tennessee Equine Hospital West on Thursday November 7, 2019. The next TEH Barn Party was at Gallatin, Tenn. on November 12, and the third at their Thompson’s Station main facility on November 14, celebrating their Tenth Anniversary! After dinner, Dr. Lauren Mundy spoke about equine colic, with live entertainment following featuring guest performer Rory Feek of Joey+Rory and People on the Porch. TEH hosted an Open House at their new Harvest, Alabama satellite on November 21 to meet veterinarians Dr. David Dunlap and Dr. Zach Hulbert. After dinner, Dr. Monty McInturff spoke on the importance of vaccines and an update on equine disease.

November 7 was a west Tennessee wintry day with rain falling most of the day as temperatures steadily dropped. By dinner time, the rain had stopped, but a stiff, cold, northwest wind precluded having dinner out in the covered arena.  Folks gathered in the barn area for Dr. Reese’s presentation:

What constitutes an equine emergency?

Dr. Reese’s first concern about equine emergencies is the person’s safety. Use caution when approaching sick or injured horses because even calm horses can hurt you unintentionally in times of distress.

Before deciding what is or is not an emergency, the first step is knowing what is normal in your horse; if you know what’s normal, then you know what’s abnormal. Know the horse’s normal vital signs: heart rate 28-48 beats per minute; respiratory rate less than 20 breaths per minute; temperature less than 101.5°F.

Colic is simply abdominal pain. Everything from the esophagus back is included in the abdomen: stomach, small intestine, cecum, large intestine, and small colon. Any of these organs can be the source of belly pain. The most common signs of colic are: not interested in feed; pawing; looking and/or kicking at abdomen; stretching out; laying down; even curling the upper lip. They generally show signs of discomfort.

What should you do if you think your horse is colicking? First, remove all food (grain, hay, grass). Then call your veterinarian. In the meantime, assess what may have triggered the colic, e.g., what may have changed during the horse’s day; did the weather change; did you put out a new round roll of hay; did he get dehydrated; and consider the horse’s age. You can walk the horse, which is trying to get their gut to move a little bit. But don’t walk the horse to exhaustion.  The horse may want to lie down, and if he does so quietly, you can let him lie. Don’t give the horse any medications, such as Banamine®, until you talk to your veterinarian.

Dr. Reese said that approximately 80% of colics can be treated on the farm. Usual veterinary treatment includes Banamine®, tubing the horse to give fluids, water, oral laxatives or some electrolytes, sometimes mineral oil. About 10 to 20% don’t respond to this treatment. If the horse doesn’t respond to on-the-farm treatment, then it is best to trailer the horse to the veterinary clinic where the horse can be given IV fluids and the vet can continue tubing them, giving them oral fluids if possible. About 10% are surgical cases, when the horse is not responding to medical treatment and the veterinary surgeon may need to correct the twist or perform some other surgical procedure. Timing is very important to correct the problem as soon as possible!

Choke happens in the first part of the digestive tract – the esophagus. Signs of choke include feed material and saliva dripping from the nostrils, along with coughing, retching, extending the neck, and some horses may even start rolling.  Remember: horses can still breathe when they choke because it’s happening in the esophagus; the horse can’t swallow food.

What to do? Take all food away so they don’t try to keep eating. Set their water bucket on the ground and try to keep their head down. Try to keep the horse calm and call the veterinarian. Some cases can resolve on their own within 15 – 20 minutes, if they took a bit of food that got stuck. Some may need lavaging (washing out a body cavity with water or a medicated solution) through a nasogastric tube. The veterinarian will try to flush it out and push fluid in and out until the food gets into the stomach. They always do this with the horse sedated. The horse needs to have its head down because aspirating food and saliva is definitely a risk.

The most important thing is to help prevent choke. Most cases are caused by the horse eating too fast, so use of slow feeders (that look like a muffin tin on the bottom) can slow a horse’s eating down. The horse has to pick out the feed from the little holes. Wet the grain is another option. Some horses may eat too fast because they feel threatened by other horses in the herd stealing their food. So remove them from the herd to eat. Then the veterinarian will want to look at the horse’s teeth to see if they can chew their food properly or if there is some kind of dental problem. “A good oral exam and possibly a teeth float is always indicated,” Dr. Reese said.

Severe Lameness
Lameness that is non weight bearing or toe touching; the horse is reluctant to move; or severe limb swelling are all emergency situations. The horse is in distress and may look panicked. The horse may have a history of trauma, such as being kicked or falling in the pasture.

What to do? Keep the horse confined to limit movement. Inspect the limb for any swelling, heat, or foreign bodies, such as wire or nails. Look for puncture wounds. If there is an open wound or huge swelling, you can bandage the limb. Call the veterinarian. Again, do not give any medications until you speak with your veterinarian.

 A fairly common cause of severe lameness is a foot abscess. More severe situations include fractures.

Dr. Reese gave several examples of cases she had recently seen: one, a nail with a piece of wood attached in the bottom of a foot; another, a screw in the bottom of the foot. Do you yank it out or leave it in? Her recommendation is to leave it in so an x-ray can reveal where the nail went. You don’t want the nail to go in any further, but the vet really needs to know where it is inside the foot, which guides veterinary treatment. In the latter case, the screw went into the digital cushion. In the former, the nail went through the deep digital flexor and hit the bone, so the horse has an infected navicular bursa.

Location of the laceration is the most important factor. Is it on the body or on a limb? Body wounds heal really well. Is the horse bleeding? If so, a little or a lot?

What to do? First is to keep the wound clean. You may need to use water to clean it. If it’s on a leg, put a bandage on it especially if it’s bleeding. Confine the horse to reduce movement. And call the veterinarian. The sooner the wound can be sewn, the better it will heal. “If the wound is over 12 hours old sometimes it’s hard to sew up because the skin contracts and pulls away,” Reese said. Look up the horse’s vaccination history. When was the last time the horse had a tetanus shot? Reese likes to get photos of the wounds, which helps her plan the appropriate treatment. She stresses: “Don’t put anything on it besides water until we see it! Blood Stop Powder is the devil. You can’t get it off; I can’t sew it up; I can’t even get it clean.” So don’t put any powders or ointments on the wound since that can impair the veterinarian’s ability to close the wound with sutures. Most lacerations can be closed if they are fairly fresh. Reese says that even if the sutures only last 5 to 7 days and the wound doesn’t stay together completely, it can provide a good base to get the healing process started.

Lacerations over tendons and joints can be a lot more trouble, because if there is any type of bacterial infestation into the joint or tendon, those horses need to come to the clinic for more aggressive treatment, or even go to the surgical facility to be flushed and lavaged.

Eye Injuries
Eye injuries in horses are a big emergency! Signs: squinting, tearing, lid swelling, surface of the eye appears blue; lacerations of lids; foreign body in the eye. ”Generally, horses only injure one eye at a time so you have a normal eye to compare it to,” she explained.

What to do? Take the horse out of the bright light and bring into the barn, a stall. Examine the eye and call your veterinarian. If there is an injury to the eyelid, it definitely needs repair because the eyelid is what cleans the eye every time the horse blinks. “Eyelid lacerations really need to be sewn together quickly!” she said.

“When I come to look at your horse’s eye, I’ll stain it,” Reese explained. The green stain will stick to the surface of the eye where it’s rough. She gave examples of horses with eye ulcers, one that had just started and one that was healing.  “Ulcers are a big deal in horses,” she said. They are usually caused by bacteria on the eye or a fungal infection.

Fever is indicated by a rectal temperature greater than 101.5°F; lethargy; poor appetite; breathing heavily, i.e., elevated respiratory rate, nostril flare, sweating. Get your thermometer and take the horse’s temperature.

She recommends checking everybody else on the farm because if you have one sick horse, often there are other sick horses around as well. Call the veterinarian, and examine the horse. Does it have a snotty nose? A cough? Are any of its legs swollen? Sometimes they can have a wound that sets up an infection which can give them a fever. Again, know when your horse was last vaccinated; and if your horse has been traveling, inform the veterinarian.

Other emergencies
(1) Down horse – any horse that’s down and can’t get up without a little bit of coaxing. Could be a horse colicking, or an older horse that may be stiff and arthritic that’s down in the winter.
(2) Allergic reaction – such as hives, where you see little bumps all over their skin. A horse with a small bug bite is not an emergency, but a horse that’s covered with large hives is definitely an emergency. A common cause is rolling in a fire ant mound.
(3) A horse that flips over backwards can be a cause of concern for seizures.
(4) Not being able to chew correctly. “I’ve found sticks in horses’ mouths, fractured teeth. If your horse isn’t eating properly there’s probably something going on because horses live to eat,” she explained.
(5) Profuse watery diarrhea is definitely an emergency because they can lose a lot of water really quickly.
(6) Nosebleeds that don’t stop.
(7) Mare and foal emergencies. A mare that is foaling that hasn’t had the foal in ten minutes after the water breaks. Any foal that isn’t quite right, such as sick foal, swollen joints, not getting up or nursing, coughing, nasal discharge.

Tennessee Equine Hospital has put together an equine first aid kit that sells for $175. It includes lots of emergency first aid equipment and a card with many of the signs and symptoms that Dr. Reese described in her presentation. Dr. Monty McInturff said, “They make great Christmas gifts!” Through their satellite clinics, Dr. McInturff said their goal is to provide emergency care for horses, “so that when you call, we’re going to respond – 24/7,” he added. “These facilities can give emergency care to horses when they need it – now!”

About Dr. Reese: Dr. Reese graduated from the University of Tennessee with a Master of Science, studying gastric ulcers in horses, and the University of Tennessee College of Veterinary Medicine, graduating in 2013. Working at Tennessee Equine Hospitals she has also continued her education in acupuncture and chiropractic medicine. “I wholeheartedly believe in both, and great western veterinary medicine,” she said because they work well in conjunction with appropriate veterinary care. Dr. Reese has a five-month-old daughter, Mary Reese Hanks. “This was her first Halloween and she was a carrot, not a pumpkin,” Dr. Reese said. She is married to Drew Hanks, DVM.

Additional resource:
AAEP Guidelines for Equine Emergencies. https://aaep.org/issue/guidelines-equine-emergencies

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