Emergency Care for Horses

Preventing and treating dehydration is a primary concern. Dehydration often develops along with other injuries and illnesses. Diarrhea is a major cause of dehydration, particularly in foals. If the horse is losing fluids, such as with diarrhea, very large quantities of fluids may be needed to correct the fluid loss. For example, a 1,000‑pound horse that has become 5% dehydrated will need 25 liters (about 6¼ gallons) of fluids to correct that loss.

If a lot of blood has been lost, or the horse is exhausted or overheated, emergency fluid replacement is needed.

Nasogastric intubation is an essential and possibly life-saving procedure commonly used in cases of equine colic. A tube is placed through a nostril down into the stomach to remove any fluid that has accumulated in the stomach due to a blockage in the small intestine. Removing the fluid not only relieves the pain of the distended stomach, it may also prevent rupture of the stomach. If a blockage is not present, the nasogastric tube can be used to provide fluids or medications.

In abdominocentesis, a needle or syringe is inserted through the abdominal wall to obtain a fluid sample from the abdomen. The fluid is used in the evaluation of abdominal diseases such as colic and weight loss. If the horse has suffered an intestinal rupture, this test will generally detect the problem. For the first 2 to 4 hours after a rupture of the intestine, the horse may not show any signs. Internal bleeding, infections, and inflammatory conditions can also be detected by abdominocentesis.

Trocarization is a technique used to relieve the pressure in the abdomen when it becomes distended with gas due to an intestinal blockage. Such blockage can result in severe bloating (distention), pain, and rapid or uneven breathing. The veterinarian will identify the segment of intestine that is involved by rectal examination in adult horses. In foals or small horses, imaging with x-rays or ultrasound can be used. If the problem is in the large intestine, trocarization may be used. After the pressure is relieved, the trocar is removed, and an antibiotic is infused. Because infection and other problems are possible after trocarization, the horse is usually monitored carefully for 24 hours for signs of any complications. Trocarization is not intended to solve a blockage problem, and the horse is likely to still need additional treatment or even abdominal surgery.

If the upper airway (nasal passages and throat) is blocked due to swelling, a foreign object, or excessive bleeding, the airway needs to be opened. The emergency procedure of inserting a tube through the neck and into the trachea to allow breathing is called a tracheostomy. A local anesthetic may be given. The incision is made in the neck, and a tube is inserted into the trachea to help the horse breathe.

Once the horse can breathe without using the tube, it is removed. The incision site generally closes in 10 to 14 days and heals in 3 weeks. During that time, antibiotics may be used, and the site is cleaned and monitored.

Eye injuries are usually caused by trauma. They include cuts, scratches, and penetrating injuries from foreign bodies. Direct blows to the eye can cause retinal detachment.

Bone fractures, particularly in the legs, are one of the more common musculoskeletal injuries in horses. Luxations, or dislocations, are also common. Initially, the goals are to relieve anxiety, prevent further injury, and allow safe transportation to the veterinary facility. Emergency splinting or other stabilization of injured legs should be performed.

Horses usually cannot bear weight on a leg with a traumatic fracture. Certain stress fractures and other skeletal and tendon injuries may take some weight. Generally, the first indication of a fracture is the sound of a loud crack (if you are present at the time of the injury) or sudden, non-weight-bearing lameness. Other indications of a break are a misaligned or visibly unstable leg. A horse may lie down, or be unable to get up after a fall, if the injury is severe. If the horse is lying down, it should be examined before attempts are made to get it to stand. If the horse is standing, it should be examined before attempts are made to move it.

For examination, the horse should be restrained and sedated, if necessary, to relieve pain and anxiety. Fractures are often accompanied by significant skin and other tissue injuries. The veterinarian will begin by locating and assessing the injury. Bleeding must be controlled. Wounds are cleaned and debrided (foreign matter and dead tissue are removed), then bandaged. The fracture is then stabilized. A splint is usually used to stabilize the leg to prevent further injury during transport. Many splints are commercially available and are part of equine first aid kits. The splints should be well padded to avoid the development of sores.

Head injuries can result in severe damage to the central nervous system. In many head injuries, swelling and bleeding continue after the initial injury, and quick veterinary care is needed to minimize the damage. Causes of head injury in horses include direct trauma from a fall, blows to the head, and falling over backward.

Horses with head injuries should be handled and moved with extreme caution. If the horse is down, it may need short-term general anesthesia.

Heat stroke is an emergency. A rectal temperature of more than 104.9°F (40.5°C) in a horse indicates overheating. Foals are especially susceptible to heat stroke. The first sign of heat stroke is that a horse stops sweating. Horses may also breathe heavily and begin to breathe through the mouth instead of the nose. Horses with heat stroke should be continuously hosed with cool water, stood in the shade and, if possible, placed in a cooling breeze. Seek veterinary attention immediately.

Wounds and lacerations are common in horses. The steps involved in the management of these injuries are similar to those for small animals ( see Wound Management). Control of bleeding is an immediate concern. In addition to wound management, a tetanus shot may be required.

Esophageal obstruction, or choke, is common in horses. It is generally caused by feed blocking the esophagus. A horse is more likely to develop choke if it bolts its food or does not chew it completely, has problems with its teeth, has been recently sedated, is dehydrated, or is fed poor-quality feed.

Coughing, drooling, and frequent attempts to swallow are obvious signs of choke. There may also be a discharge from the nose containing saliva and feed material. A veterinarian should be called immediately if choke is suspected, and access to feed should be restricted until the horse is examined.

If esophageal obstruction is confirmed, the horse is muzzled to prevent any further feed intake. The horse is then sedated to relax the muscles of the esophagus. This often clears the obstruction without surgery. However, if the obstruction has not cleared after about 1 hour, a tube is usually inserted through the nose and into the esophagus. Water or saline solution is passed through the tube to flush the esophagus. Mineral oil should never be used because of the risk of aspiration into the lungs. If repeated attempts to clear the obstruction are unsuccessful, further tests may be required to determine the cause of blockage (such as a foreign object).

Horses that have choked are at risk of recurrence for the next 2 to 4 weeks. In addition, the damaged esophagus may take 4 weeks or longer to heal. Feeding a slurry made from pelleted feed or fresh grass can help prevent recurrence. Permanent damage, resulting in a narrowed esophagus, sometimes develops as a result of choke.

Evisceration, or internal tissue such as intestine protruding through the incision, is a risk after open castrations. The risk is increased after castration of an adult stallion.

Evisceration is first identified by a structure hanging out of the surgical incision. It is important to keep the horse quiet and to support the structure with a clean, moistened towel to avoid further stretching or damage. The horse is generally anesthetized for treatment, which often requires surgery.