10 Things to Do in an Emer­gency

10 thing• to do in an emer­gency

Practical Horseman - - News - By Elaine Pas­coe with Mar­garet Mudge, VMD

Guide­lines to help you think clearly and act quickly dur­ing dif­fer­ent equine emer­gency sit­u­a­tions

Your horse is stand­ing in the pas­ture on three legs, un­able to walk. Or he’s at the gate, cov­ered in blood and fran­tic with dis­tress. Or you find him in his stall, hay un­touched, down and try­ing to roll. Let’s hope none of these things ever hap­pens—but if you have a horse, you need to be ready for emer­gen­cies. From foal­ing dif­fi­cul­ties to the el­derly horse that goes down and can’t get up, the pos­si­bil­i­ties for disas­ter are many. What should you do?

We turned to Mar­garet Mudge, VMD, an as­so­ciate pro­fes­sor and equine sur­geon who fo­cuses on emer­gency and crit­i­cal care at the Ohio State Univer­sity School of Ve­teri­nary Medicine. Here, with her help, we high­light 10 guide­lines that will en­cour­age you to think clearly and act fast in any equine health cri­sis. You’ll also find spe­cific tips for han­dling some of the most com­mon emer­gency sit­u­a­tions and, in the box on page 50, steps you can take to be ready be­fore mis­for­tune strikes.

Per­haps the most im­por­tant thing you can do to pre­pare for an emer­gency, Dr. Mudge

says, is es­tab­lish a re­la­tion­ship with a ve­teri­nar­ian. “Vet­eri­nar­i­ans have an obli­ga­tion to pro­vide emer­gency care and ad­vice to their clients, and they are more likely to re­spond to a mid­dle-ofthe-night call if it comes from a client,” she ex­plains. “Also, a vet can pro­vide phone ad­vice only if she has an es­tab­lished re­la­tion­ship and knows the horse. If she hasn’t seen your horse be­fore, legally she can’t do that.”

Emer­gency Top 10

Ev­ery emer­gency is unique, and it can be nearly im­pos­si­ble to know ex­actly what you may face. Use these guide­lines as a roadmap to help you get through any crit­i­cal sit­u­a­tion with your horse. Men­tally re­hearse them now, en­vi­sion­ing how you will smoothly han­dle dif­fer­ent sit­u­a­tions.

1. Stay calm. This is eas­ier said than done—but it is es­sen­tial. Horses tend to panic when they’re in pain and you will fuel that re­ac­tion if you panic as well. A pan­ick­ing horse can in­jure him­self and you, so take a deep breath. Speak sooth­ingly and move de­lib­er­ately when you han­dle the horse even if deep in­side you want to freak out.

2. Call right away. If you can’t leave the horse, call from your cell­phone or ask some­one to call for you. Your horse needs ve­teri­nary help ur­gently if he: can’t bear weight on a leg, has a wound that will not stop bleed­ing or an in­jury near a vi­tal struc­ture like a joint,

shows signs of se­vere or per­sis­tent colic or acute lamini­tis, in­jures an eye, strug­gles to breathe or shows se­vere neu­ro­log­i­cal symp­toms. Plenty of other sit­u­a­tions can qual­ify, too. If you’re not sure you’re look­ing at a true emer­gency, put in a call to your vet’s of­fice any­way to let her know what’s hap­pen­ing and get her in­put. Don’t worry that she’ll think you’re over­re­act­ing. While you’re wait­ing for the vet to call back,

3. Put the horse in a safe place. “Move him into a quiet stall or a round pen where you can mon­i­tor him. Pick a place where there will be plenty of room for the ve­teri­nar­ian to work around the horse,” Dr. Mudge says. “A dou­ble stall or a round pen is best for a horse that may go down, as there’s less chance that he’ll get cast or in­jured.” Ex­cep­tions: Don’t try to move the horse if you think he may have frac­tured a bone (if he is un­will­ing to put weight on a leg, for in­stance).

Put your safety first. “Stay back if he’s too pan­icky or un­steady on his feet to safely han­dle,” Dr. Mudge ad­vises.

4. Get help. An ex­tra pair of hands is in­valu­able in an emer­gency. Draft an

as­sis­tant to help hold the horse, open gates, get first-aid sup­plies, make phone calls and the like.

5. As­sess the prob­lem. Look the horse over care­fully for in­juries and trou­ble signs. Is he ag­i­tated or de­pressed? Off his feed? Lame or re­luc­tant to move? Stag­ger­ing or go­ing down? If he has a wound, where and how deep is it? Check his vi­tal signs— body tem­per­a­ture, heart rate and breath­ing rate—for clues to the se­ri­ous­ness of the sit­u­a­tion. Rapid res­pi­ra­tion or an el­e­vated heart rate (a rest­ing rate over 50 beats per sec­ond) may sig­nal dis­tress. A rec­tal tem­per­a­ture above 102 de­grees F may sug­gest in­fec­tion or in­flam­ma­tion.

“Gum color can help show the horse’s pain level and sever­ity of ill­ness,” Dr. Mudge says. Gums and other mu­cous mem­branes should be moist and healthy pink; dry, dark, bright red or pur­ple gums could in­di­cate a po­ten­tially se­ri­ous con­di­tion.

6. Re­port what you see. Write down your ob­ser­va­tions and re­port them to the vet. The in­for­ma­tion you pro­vide will help her judge the sever­ity of the case and de­cide on the next steps. “If you have a smart­phone, send pic­tures of in­juries or a video show­ing the horse’s be­hav­ior or move­ment,” Dr. Mudge sug­gests.

7. Give first aid when you can. Ba­sic first aid can make a big dif­fer­ence for wounds and cer­tain other con­di­tions. You’ll find de­tails of some ac­tions you can take—and some you should not take—be­low.

8. Hold off on med­i­cat­ing. Get a green light from the vet be­fore giv­ing your horse drugs. “There is rarely a need to ad­min­is­ter med­i­ca­tion be­fore the vet gets there,” Dr. Mudge says, and there are risks. Cer­tain drugs could be harm­ful if the horse has suf­fered se­vere blood loss or shock from an in­jury and some may mask signs and make it more dif­fi­cult for the vet to as­sess his con­di­tion. “If you have given med­i­ca­tion, be sure to tell the vet when she ar­rives so she can fac­tor that into her treat­ment," she adds.

9. Let him chill. Once you’ve checked the horse and ap­plied any ap­pro­pri­ate first aid, let him rest qui­etly while you wait for the vet. “Un­less the prob­lem is colic or choke, you can of­fer hay—for­age can dis­tract and calm him,” Dr. Mudge sug­gests. Keep noise and ac­tiv­ity to a min­i­mum around the horse’s stall. If you’re at a busy barn and cu­ri­ous on­look­ers clus­ter around, ask them to stay away.

10. Stay watch­ful. Keep an eye on the horse and note if his signs change for bet­ter or worse. As long as he seems sta­ble, you don’t need to do more, but be ready to act quickly if the pic­ture changes. You may need to calm him if he be­gins to get ag­i­tated, for ex­am­ple, or bring him out for a walk.

Ac­tion Plan: Colic

Colic tops the list of horse health crises that worry peo­ple most. A col­ick­ing horse may go off his feed, paw the ground, stand stretched out, turn to look or nip at his belly, re­peat­edly lie down and get up or try to roll. He may stop pass­ing ma­nure or his ma­nure may be ab­nor­mally hard and dry or soft and runny. The signs don’t tell you what’s go­ing on in­side—the prob­lem could be as sim­ple as a bit of gas or as se­vere as a blocked or twisted in­tes­tine. Here’s what

Walk him when nec­es­sary. If he’s ly­ing qui­etly in his stall, you don’t need to get him up—but if he starts to roll and thrash around, that’s a dif­fer­ent sit­u­a­tion.

you should do.

“Re­move hay and any other feed from the horse’s stall. If he has an im­paction, you don’t want any­thing to add to it,” says Dr. Mudge. Wa­ter should al­ways be avail­able, though.

Watch him closely. Mild gas colic may dis­ap­pear on its own. Un­less the horse is try­ing to roll or show­ing other signs of se­vere pain, it may be safe to watch him for a while. But if he is still un­com­fort­able af­ter a cou­ple of hours or if his signs clear up and then re­turn, call the

vet right away.

Walk him when nec­es­sary. If he’s ly­ing qui­etly in his stall, you don’t need to get him up—but if he starts to roll and thrash around, that’s a dif­fer­ent sit­u­a­tion. “The idea that rolling can cause a twisted gut is de­bat­able, but the horse may in­jure him­self or get cast in the stall,” Dr. Mudge says. “Bring him out and walk for five min­utes or so un­til the spasm passes.” Walk­ing may help the horse pass gas, but it should not con­tinue for hours, she adds. If the pain doesn’t seem to re­lent with mod­er­ate walk­ing, he needs ve­teri­nary at­ten­tion, not more of the same treat­ment.

Should you give Banamine ? Many barns keep this drug (flu­nixin meg­lu­mine, a non­s­teroidal anti-in­flam­ma­tory) on hand in case of colic be­cause it’s par­tic­u­larly ef­fec­tive for eas­ing gut pain. But, Dr. Mudge notes, “It’s im­por­tant to know that Banamine is not a colic cure—it does not change the con­di­tion that causes the colic.” If a col­icky horse is given Banamine and seems to re­cover on the spot, odds are the signs were caused by gas that was passed be­fore the drug wore off, she says. “Un­less the horse is very de­hy­drated, there’s prob­a­bly no harm in giv­ing one dose [1 mil­ligram per kilo­gram of body weight, or 500 mil­ligrams for a typ­i­cal adult horse] to see if that re­solves the colic. If it doesn’t, don’t just re­peat the dose. The horse will need other treat­ment, in- clud­ing flu­ids and a seda­tive that the vet can pro­vide.”

Ac­tion Plan: Wounds

Ev­ery scrape or cut isn’t an emer­gency. Those that are in­clude wounds that won’t stop bleed­ing or are deep enough to re­quire stitches—that is, the cut goes all the way through the skin so it gaps if you gen­tly pull the edges. These wounds heal best if they’re su­tured within the first eight hours. Punc­tures (es­pe­cially in the foot) and wounds that in­volve a joint or ten­don need quick ve­teri­nary at­ten­tion, too—the risk of in­fec­tion is high.

Use your smart­phone to send a pic­ture of the wound to your vet, Dr. Mudge sug­gests: “A photo will help her make a pre­lim­i­nary as­sess­ment of the dam­age and give you ap­pro­pri­ate ad­vice on what to do next.”

Clean the wound with ster­ile saline so­lu­tion or a gen­tle stream of wa­ter from a hose to flush out dirt and de­bris. But don’t at­tempt to re­move large or deeply em­bed­ded pieces of de­bris—splin­ters, a nail in the hoof—with­out con­sult­ing with the vet.

Ban­dage the wound if the lo­ca­tion per­mits. For a leg wound ap­ply a clean gauze pad cov­ered with a clean leg quilt and a knit or flan­nel wrap. The wrap should be snug enough to keep the gauze against the wound with­out harm­ing ten­dons or other tis­sues.

Stop bleed­ing. Bandag­ing usu­ally helps stop bleed­ing. “If a leg wound keeps bleed­ing through the ban­dage, you may need to ap­ply a snug layer of bandag­ing above the wound to slow the flow,” Dr. Mudge says. For a body wound, hold ster­ile gauze pads or a clean folded cloth over the site and press firmly un­til the flow stops.

Don’t ap­ply top­i­cal oint­ments or sprays with­out the vet’s ap­proval. They may in­ter­fere with su­tur­ing and make it more dif­fi­cult for the vet to as­sess and treat the wound.

Ac­tion Plan: Eye In­jury

“An in­jury in or around an eye is al­ways an emer­gency. It may seem mi­nor, but it’s dif­fi­cult to tell with­out ex­per­tise and spe­cial equip­ment,” Dr. Mudge says. Swelling, squint­ing, red­ness, cloudi­ness, ex­ces­sive tear­ing or other dis­charge should prompt a call to the vet. “Even a small lac­er­a­tion

Don’t ap­ply top­i­cal oint­ments or sprays with­out the vet’s OK. They may in­ter­fere with su­tur­ing and make it more dif­fi­cult for the vet to as­sess and treat the wound.

on the lid must be su­tured to make sure that the lid heals with smooth mar­gins and closes prop­erly.” Send a pic­ture to the vet if you can. Man­age dis­com­fort. Eye in­juries can be very painful, so the vet may OK a dose of Banamine or an­other non­s­teroidal an­ti­in­flam­ma­tory. If the horse is squint­ing and seems sen­si­tive to light, move him to a dark stall or put on a fly mask to shade the eye.

Pre­vent rub­bing. It’s com­mon for a horse to rub a sore or itch­ing eye against his leg, but that will only make the prob­lem worse. Walk him or of­fer food to dis­tract him.

Don’t try to treat the prob­lem on your own, Dr. Mudge ad­vises: “It may be safe to gen­tly flush away dirt and dis­charge with ster­ile eye­wash—if the horse will let you. Oth­er­wise, wait for the vet, who can give the horse a tran­quil­lizer and carry out a thor­ough ex­am­i­na­tion.” And don’t med­i­cate the eye with oint­ments or drops you may have on hand, she adds: “They may be con­tam­i­nated with bac­te­ria, and us­ing the wrong med­i­ca­tion may do more harm than good.”

Ac­tion Plan: Choke

“The term ‘choke’ is re­ally a mis­nomer as it’s ap­plied to horses,” Dr. Mudge says. A per­son chokes when food takes a wrong turn into the tra­chea (wind­pipe), cut­ting off air in­take, in­stead of head­ing down the esoph­a­gus, the long tube that leads to the stom­ach. In horses, she ex­plains, “Choke is an ob­struc­tion of the esoph­a­gus, not the tra­chea, so the horse can still breathe. But it’s an emer­gency all the same.” As chewed food and saliva back up in the esoph­a­gus, “The backup may foam out through the horse’s mouth or nos­trils, or—and this is the big risk—it may be as­pi­rated, in­haled into the lungs as the horse breathes.” That could po­ten­tially lead to pneu­mo­nia.

Put the horse in an empty stall with no food or wa­ter. Any­thing he con­sumes could be in­haled into his lungs and make the con­di­tion worse.

Call the vet. Many cases of choke clear on their own, but wait­ing for that to hap­pen in­creases the risk of side ef-

fects. Be­sides as­pi­ra­tion and pneu­mo­nia, those can in­clude dam­age and scar­ring of the esoph­a­gus.

Stay with the horse and try to keep his head down. A horse with choke will of­ten lower his head as he tries to clear the block­age. En­cour­age that be­hav­ior— with his head down, what­ever comes up his esoph­a­gus will tend to exit through his mouth and nos­trils rather than down his tra­chea.

Con­cen­trate on calm­ing the horse. Don’t up­set him with heroic at­tempts to clear the block­age. You can’t per­form the Heim­lich ma­neu­ver on a horse and if you could it wouldn’t help—that move clears the tra­chea, not the esoph­a­gus. You won’t be able to clear the block­age by reach­ing into the back of his mouth, ei­ther, be­cause it could be any­where in the esoph­a­gus, even all the way down by the stom­ach.

When the vet ar­rives, she can give the horse a strong seda­tive that will help keep his head down and re­lax his esoph­a­gus. If that’s not enough to clear the choke, she can also per­form lavage— insert­ing a na­so­gas­tric (stom­ach) tube down the esoph­a­gus and gen­tly pump­ing in warm wa­ter. This process can of­ten help to soften the block­age and move it along.

Ac­tion Plan: Neu­ro­logic Signs

Neu­ro­logic signs range from sub­tle to scary—any­thing from a slight ab­nor­mal­ity in gait to seizures, stag­ger­ing, head­bob­bing and other strange be­hav­ior. The cause may be a toxic plant that the horse con­sumed, an in­jury or con­gen­i­tal de­fect that af­fects the cen­tral ner­vous sys­tem or a dis­ease like equine pro­to­zoal myeli­tis (EPM) or equine her­pesvirus myeloen­cephalopa­thy (EHM). The more se­vere the signs, the more ur­gent the need for ve­teri­nary care—the horse could in­jure him­self or the peo­ple around him.

Rec­og­nize when it may not be safe to han­dle the horse alone. “A horse with a neu­ro­log­i­cal prob­lem may be men­tally off or so un­steady on his feet that he falls with­out warn­ing,” Dr. Mudge says. You don’t want to be in the wrong place if that hap­pens.

If the horse is safe to han­dle and you have a round pen, put him in it. Be­cause a round pen doesn’t have cor­ners, he will have less of a chance of in­jur­ing him­self there. A dou­ble stall is the nextbest op­tion.

Take a video. “Neu­ro­log­i­cal signs of­ten shift or come and go, so the be­hav­ior that prompted you to call the vet may dis­ap­pear by the time she ar­rives,” Dr. Mudge ex­plains “A video will serve as a record and help her fig­ure out what’s go­ing on.”

For a bleed­ing wound, hold ster­ile gauze pads or a clean folded cloth over the site and press firmly un­til the flow stops. Bandag­ing the wound will also help.

Dis­cov­er­ing your horse in his pas­ture with a se­verely in­jured leg can be a night­mare sit­u­a­tion for any owner. Talk to your horse in a sooth­ing voice and try to keep him still un­til your vet ar­rives.

A col­ick­ing horse may try to lie down and roll re­peat­edly. Re­move his hay in case he has an im­paction and if he has gas colic it may dis­ap­pear on its own. Keep an eye on him and let your vet know if his con­di­tion doesn’t im­prove in a few hours.

LEFT: Not all wounds re­quire an emer­gency call to your vet. Try to take a photo with your smart­phone and send it to your vet to get her ad­vice on a plan of ac­tion for treat­ment.

ABOVE: Care­fully clean your horse’s wound with ster­ile saline so­lu­tion or a gen­tle stream of wa­ter in or­der to flush out de­bris or dirt. Cold-hos­ing an in­jury can also help re­duce swelling.

Eye in­juries can be es­pe­cially painful and a se­ri­ous con­cern, no mat­ter how seem­ingly small the is­sue, and al­most al­ways war­rant a call to your vet for im­me­di­ate help.

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