Emergency First Aid

Normal Values in the Horse

Temperature: 37-38°C in the morning, below 38.5°C in the evening. Slightly higher in warm weather or in foals.

Pulse: 36-48 beats per minute.

Capillary refill time: 1-2 seconds to recolour gum after blanching.

Respiration: 6-8 breaths per minute. Breath should smell sweet.

Intestinal Sounds: Gurgles, squeaks and rasps from intestinal area behind rib cage. You can hear them with your ear.

 

Colic

Colic simply means ‘pain in the abdomen’, and in itself it isn’t a diagnosis, but represents a group of symptoms exhibited by horses with abdominal pain. There are a large number of organs present in the abdomen, including; stomach, small intestine, caecum, large intestine, liver, kidneys, and spleen and pain in any of these structures can result in ‘colic’.

As such it is important to get a physical examination performed for any horse showing signs of colic, to narrow down what structures are involved and create a targeted treatment plan. Common diseases that result in colic include, but are not limited to; impactions, nephro-splenic entrapments, torsions (twisted intestines) and diarrhoea and each disease will display certain signs and require different treatments. Keep in mind that the longer a ‘colic’ is left untreated, the poorer the prognosis of recovery.

Identification of colic symptoms is important, and veterinary advice should be sought immediately if you see any of the following:

  • Excessive pawing
  • Flank watching
  • Stretching
  • Dog sitting (often in Miniatures)
  • Excessive lying down
  • Inappetant (not eating)
  • Not passing manure, passing diarrhoea or sand
  • Rolling

Before you ring the vet make sure you have a clear list of any/all symptoms your horse is showing, and if you can, get an idea of your horses pulse, temperature and gut sounds (see Normal Values above). If you don’t have access to a stethoscope, place the back of your hand behind the left elbow and you can often feel the heartbeat.

If veterinary treatment has to be postponed, follow these three emergency steps:

  • Take away all food
  • Attempt to get the horse to drink water
  • Periodic, vigorous exercise

Most horses with colic will be inappetant, but ensure to take all food away as soon as you notice signs of colic. Continuing to top-up the intestinal system with food in cases of colic can often make the problem worse.

Dehydration often plays an important role and getting horses to drink water is very important. Plain water is best, but molasses water can be given (make it up to weak tea colour). Keep in mind that molasses water does change the sugar balance in the intestines and can cause some further upset.

Warm beer is also an option, and may aid in breaking up impactions, but shouldn’t be given in place of veterinary treatment. Berg oil consists of wood tars, metho and turps and SHOULD NOT be given in any circumstance. Imagine drinking a cup of metho and turps. Please read the list of ingredients before administering any oral treatments.

Exercise can be very beneficial, but recent research suggests that continuous walking makes no difference to the likelihood of a horse getting a twisted intestine. Of more benefit is vigorous, periodic exercise, such a lunging every 1-2 hrs for 5-10 mins. This type of exercise is great at stimulating gut motility and assisting with passage of manure through the intestines. It also gives you, and the horse, a chance to rest between lunging.

If you are a long way from veterinary care, and only have it available, phenylbutazone (bute) can be used as a pain relief. However bute is best used for musculoskeletal pain and is not that good for abdominal pain, and hence it should not be used when an alternative is available through veterinary care. If bute has been given please advise so we can modify what analgesia we give to protect the kidney and intestines. Please seek advice from our veterinarians before administering any pain relief.

We are happy to give you advice any time of the day. We realize that you may be trying to avoid after hour fees so early contact with our veterinarians may help you with decisions regarding your horse.

 

Lacerations

As a horse owner these can be scary, and potentially very dangerous for your horse. Rapid assessment must be made of the location, depth and pain associated with the wound and whether or not veterinary assistance should be sought. The “golden hour” is a term used often when considering ideal suturing time. If you want sutures for a leg laceration call us as soon as you see the wound to maximize healing.  Most lacerations on the head and eye can wait much longer.

Any wound near/over a joint or tendon must be examined very closely to ensure the joint/tendon capsule has not been penetrated. Excessive heat, pain to touch, or severe lameness associated with these wounds, or a sticky, honey-like substance coming from the wound, may indicate joint/tendon involvement. These are a VETERINARY EMERGENCY and you need to seek care for your horse immediately.

If you have a wound that is suturable, please do not apply any topical substances before calling a veterinarian. Wounds can be cleaned of debris with dilute betadine or chlorhexidine, but should then be wrapped without topical ointment or left open until the veterinarian arrives. If a wound is bleeding excessively, apply padding and a firm pressure bandage (i.e. Vetwrap/Coflex) until help arrives. If it bleeds through this, apply another bandage over the top, do not remove the first wrap.

Superficial wounds (not through the skin) or small full-thickness wounds (through the skin) may be treated at home provided there is no joint/tendon involvement. Cleaning of the wound with dilute betadine (weak to strong tea colour) or dilute chlorhexidine (hibitane) can be performed to remove dirt and debris. While hydrogen peroxide is a powerful disinfectant, please remember it is also toxic to healthy tissue. For very dirty wounds that are not suturable, sugardine (betadine and sugar mixed to the consistency of a thick syrup) is a great first topical solution.

Once an assessment has been made of the severity of the wound, and the wound cleaned, a bandage can be applied. Please see our ‘How to’ on Bandaging the Hock for a description of bandaging technique. A topical ointment can be applied to the wound to assist with ongoing antibacterial and wound healing properties. Below is a list of common topical ointments used, and their suitability:

  • Flamazine: a white cream, this silver based ointment has great antibacterial properties and is suitable for all wounds. It can make wrapped wounds very damp, so consider other ointments if the wound has large amounts of discharge.
  • Prednoderm: a green paste, this ointment has both antibacterial and anti-inflammatory properties and is suitable for some wounds. It is sticky enough to also be used when not wrapping the wound.
  • Yellow lotion: a yellow liquid, this antiseptic is great at cleaning up dirty wounds and controlling proud flesh, and is suitable for all wounds. Remember it is toxic to healthy skin tissue, so consider a different topical once proud flesh is under control.
  • Manuka honey: a great product for wound healing, is potentially has some antibacterial properties and is suitable for all wounds.
  • Suagardine: a combination of sugar and betadine made into a thick syrup, this is great for drawing debris out of dirty wounds.
  • Others: Solosite, Pottie’s white ointment, Cetrigen (purple spray), Betadine cream, Orbenin

Inappropriate topical ointments:

  • Tuff rock: this is NOT SUITABLE for any open wounds (superficial or full-thickness). It does not have any antibacterial properties and consists of clay/ash (i.e. dirt).
  • Hydrogen peroxide (prolonged use): while good for initial cleaning of a wound, prolonged use will destroy healing tissue and prolong healing time.
  • Copper sulphate

Puncture wounds need special attention and can often result in more complications than large lacerations. If they are near joints or tendons, serious infections can occur, while puncture wounds in other locations can lead to cellulitis.

Any wound can be a site for tetanus. Tetanus is a toxin produced by the bacteria Clostridium tetani which is found in soil. Wound granulation beds and pockets are the perfect site for the bacteria to replicate and produce tetanus. Tetanus can be prevented by getting your horse vaccinated with Equivac Tetanus Toxoid. Its manufacturers now recommend annual vaccination. If your horse is not covered for tetanus, it will need a tetanus antitoxin injection, which is much more expensive, but can be given with a toxoid vaccine if separate injection sites are used.

 

Lameness

Most lameness’s are not emergencies and can be booked in for routine examinations to determine the cause of the problem. On the other hand, non weight-bearing lameness’s may be an emergency. You need to be able to differentiate between foot abscesses and a fracture or joint infection.

The majority of severely lame/non-weight bearing lameness’ we see are actually hoof abscesses. These are acutely painful and can present very suddenly. When checking for hoof abscesses make sure you feel the digital pulse (located at the back of the fetlock), and clean out the hoof to look for draining tracts. See our ‘How to’ on Sole Abscesses for how to treat this condition.

When assessing the emergency lameness you want to also check a number of other things. First, flex the joints in the lame leg to see if there is a pain response higher up the limb. Check for any areas of heat or swelling and in the case of fractures you can sometimes hear and/or feel crepitus (crunching of bone) when handling the leg. If you suspect a fracture you can splint the leg with PVC and/or bandaging until a veterinary assessment can be made.

If there is any suspicion of infection, such as heat, swelling or puncture wounds, then pain relief alone will not be enough and your horse will most likely require antibiotics. If there is a non-life threatening lameness with heat or swelling, icing for periods of 20mins will help reduce pain and inflammation. Please seek veterinary advice before administering any pain relief as it may limit our options for diagnosis and treatment.


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