Equine Emergencies

This publication outlines 10 of the most common emergencies horses and their owners encounter. In all situations, the best treatment is prevention. All emergencies cannot be prevented, but a sound health program and a close working relationship with your veterinarian will help decrease the incidence and severity of emergencies.

Abdominal Problems

Abdominal pain (colic) can be associated with a large number of management, environmental, and individual problems. Causes of abdominal pain include but are not limited to insufficient water intake, changes in diet, changes in weather, adverse weather, concurrent illness (usually respiratory infections), intake of extremely fibrous feed stuffs (e.g., bedding), changes in exercise routine, shipping, stress (most commonly at horse shows), and a host of other causes. The number one cause of death in horses is attributed to abdominal problems. Symptoms of abdominal pain include the following:

• Rolling, kicking at the belly;
• Depression, anorexia, sweating, and an inability to get comfortable;
• Getting up and down repetitively, and
• Diarrhea, hard feces, or no feces present.

Treatment

It is acceptable to allow the horse to lie down, but do not let the horse roll. This seemingly innocent action can create a surgical lesion. It is not true horses that roll have a displacement they are trying to correct - rather, they are in pain and may create a displacement or volvulus (twisted intestine). It is not necessary to walk the horse all night; in fact, this practice may be damaging. Sick horses need rest. If the horse is violently painful, moderately to mildly painful for greater than 2 hours, completely anorexic, or has a heart rate greater than 60 beats per minute, call your veterinarian. Ideally, if your horse is violently painful, it should have analgesics (pain killers) before being placed in a horse trailer. A horse thrashing in a trailer can fracture a leg or suffer other trauma that could lead to death.

Grain Overload
(Overeater's Disease)

This disease is generally a result of a horse's escaping from its stall and bingeing for several hours in the feed room. Horses can be affected after eating as little as 10 to 15 pounds of grain, depending on the size of the horse and its normal grain intake. Depending on how soon the problem is discovered, the horse might still be looking fairly happy; however, if the horse is not treated for overeating, disruptions in the normal gastrointestinal flora lead to colic and/or laminitis. Horses with grain overload often can be successfully treated with laxatives, mineral oil, fluids, and anti-inflammatories. Call your veterinarian immediately.

Non-Weight-Bearing Lameness

Another emergency is any lameness where the horse refuses to stand and/or bear weight on all four limbs. Potential causes include a sole abscess, infection of a joint or tendon sheath, fracture, or dislocation of a joint. All of these conditions are potentially life threatening. It is preferable not to move or trailer the horse if it has a non-weight-bearing lameness. However, this is not an option when a veterinarian cannot come to the horse within a reasonable amount of time. Should you have to trailer a horse with evidence of fracture, it is extremely important to support the affected limb with a large bulky leg wrap, with or without splints, if the fracture is below the carpus or hock. Without this precaution, a fixable fracture may turn into a nonfixable fracture enroute to medical help.

In addition to the non-weight-bearing lameness, tying-up needs to be on the list of emergency lameness. Tying-up is a syndrome where the horse is unwilling to move after being ridden for a period of time. It is frequently associated with a horse that is not properly warmed up before exercise, a horse that is in poor athletic condition, or a horse that has been laid off work for a short time but remained on a high carbohydrate diet. If you suspect your horse has tied-up, it is important to rest the horse immediately. Do not force the horse to exercise; rather, put him in the nearest confined area and cover him with a blanket. Call your veterinarian. Continuing to exercise a horse that has tied-up causes irreversible muscle damage.

Upper-Airway Obstruction

Contrary to what is commonly believed, horses in respiratory distress can be active and become frantic. Upper-airway obstructions usually result from strangles (when the lymph nodes around the trachea become large, swollen, and filled with pus). The lymph nodes can put enough pressure on the airway to cause it to collapse. This severely restricts the horses's ability to obtain air. Horses with strangles that have significant swelling of the throat should be evaluated by your veterinarian. It may be necessary to perform a temporary tracheostomy to prevent the horse from suffocating.

Esophageal Obstruction (choke)

Choke is caused by a variety of factors, mostly from eating too quickly, eating rough or bulky feed stuff, or having esophageal lesions already. Poor teeth can also cause choke if the horse is unable to chew its food properly.

For whatever reason horses develop choke, the symptoms remain fairly consistent. Since the esophagus is obstructed, horses will be unable to swallow and will have saliva and feed stuffs coming out at the nostrils. A number of horses will not be discouraged and will attempt to continue to eat. This may lead to aspiration pneumonia. In addition, if the choked condition is not relieved promptly, necrosis of the esophagus will occur and may lead to chronic problems or a severe and uncontrollable necrotizing infection.

Lacerations and Puncture Wounds

Don't panic! Horses can lose large volumes of blood before having any trouble from blood loss. Even a small amount of blood looks like a lot of blood when spread around a stall. Stop the bleeding with a compression bandage or direct compression over the lacerated area.

Keep the wound area as clean as possible. Do not put any cream or ointment in or on a contaminated wound. All you will be doing is holding the dirt against the tissues. This is particularly important when you anticipate the need to have a veterinarian out to suture the wound. You will have effectively doubled the work of cleaning the wound by putting in a foreign substance.

If the wound is not going to require sutures, you can hasten healing by cleaning the wound, performing hydrotherapy with vigorous spray from a garden hose, protecting the wound from dirt and the elements (particularly flies and frostbite), confining the animal, and administering a tetanus toxoid booster. Substances that prevent "proud flesh" actually delay wound healing and lead to a less cosmetic end result.

Wounds that are particularly of concern are those located near or directly over critical areas, such as joints or tendon sheaths. Deep wounds to the abdomen or thorax are also serious emergencies if either of these cavities has been entered.

Trauma to the Eye

Ophthalmic injuries in a horse are generally believed to be emergencies because the loss of an eye in a horse could preclude its use as an athlete or competitor. Many diseases of the equine eye are volatile, and the difference between treating the injury today or waiting to treat it until tomorrow might result in loss of the eye.

Commonly, horses with serious eye lesions will not want to open their eye(s). The eye will be painful and may tear. The horse may refuse your attempts to get a better look in the eye. If you wait until the horse gets comfortable enough to open its eye, it may be too late. Causes of eye problems include corneal ulcers or lacerations and recurrent uveitis (moon blindness). Each of these problems could lead to loss of vision in the affected eye(s) if left untreated.

Guttural Pouch Mycosis

Guttural pouch mycosis is an uncommon equine emergency that may show up as chronic nosebleeds without evidence of external trauma. It is caused by the growth of a fungus on one of the arteries in the horse's head. The fungus causes a disruption in the wall of the affected artery and can lead to a fatal nosebleed.

Any horse with bleeding at the nose should be evaluated immediately by your veterinarian. Other disease situations show up with blood present at the nostril, but they are not potentially fatal. Your horse will require an endoscopic examination to rule out the exact cause of the bleeding.

Dystocia

Dystocia is a difficult delivery that might require assistance and has the potential of injury for the mare, the foal, or both. Although the frequency of dystocia in the horse is less than with other domestic animals, its occurrence constitutes an emergency that warrants immediate veterinary intervention.

Normal foaling occurs in three stages. In stage 1 the mare is restless and displays signs similar to colic. The pain is intermittent and corresponds to the uterine contractions. Stage 1 generally lasts 1 to 4 hours. Stage 2 begins with rupture of the membrane (breaking water), which corresponds with the entrance of the fetus into the birth canal. Stage 2 should average 20 minutes and not exceed 1 hour. If this period approaches 1 hour without delivery, call the veterinarian. Also, if the membrane fails to rupture and a red velvety membrane protrudes from the vagina (red bag), emergency action is indicated, since this indicates premature placental separation. Premature placental separation is a condition where the placenta (afterbirth) becomes detached before the foal's delivery. The placenta is the organ of oxygen exchange for the foal during pregnancy, and premature separation or detachment interrupts this function, placing the foal in danger within minutes.

If Stage 2 has proceeded normally, its conclusion and the beginning of stage 3 occur with the completed delivery of the foal. Stage 3 is the passage or delivery of the placenta (afterbirth). Failure to pass the afterbirth within 3 to 4 hours can lead to a septic infectious process that can lead to laminitis (founder) and death.

In summary, veterinary intervention is needed whenever the membrane fails to rupture (red bag), the second stage lasts more than 1 hour, or the afterbirth is not passed within 4 hours.

Foal Emergencies

There are several conditions, all potentially life-threatening, that you should look for and recognize so your veterinarian can intervene early, and hopefully save your foal. Failure of passive transfer (FPT) occurs when the foal does not receive immunity from colostrum because of an inadequate amount of colostrum produced by the mare or the foal's inability to nurse adequately. A postnatal exam and a blood test for immunoglobulins will help identify this condition while there is time to correct it.

Uroperitoneum is caused by rupture of the urinary bladder during the birth process. Most foals are 3 to 5 days old when signs occur. The signs are abnormal urination, decreased appetite, and depression. The straining the foal does is similar to meconium (first bowel movement) impaction. Call your veterinarian regardless of the cause.

Neonatal isoerythrolysis (NI) is a condition in foals that occurs when a mare makes antibodies to her foal's red blood cells. Although there are 32 blood groups known for horses, the Aa & Qa antigens are most frequently involved. If the mare does not have this blood type and the foal inherits one of these from the stallion, the condition is likely to occur. Signs to look for are anemia, jaundice (yellow coloration of eyes and skin), and labored breathing. High-risk mares can be identified through blood typing and managed to prevent further episodes. Foals can be successfully treated with blood transfusions.

There are also a number of conditions attributed to different infectious problems that occur to the foal or placenta during pregnancy. Prematurity or premature development for length of gestation, breathing in of the meconium, and viral, bacterial, or fungal infections of the placenta are conditions that impact on the foal's ability to survive. Any signs following birth, such as soft velvety short hair coat, floppy ears or muzzle, and inability to suckle, signal this type of situation. Trust your intuition. If the foal just doesn't seem right, contact your veterinarian immediately. The foal normally should be able to rise and nurse soon after birth. You should observe the foal for odd behavior as it develops coordination, and check for pain or straining whenever it defecates or urinates.

By Ann Rashmir-Raven, DVM, MS, Diplomate, ACVS, and Richard M. Hopper, DVM, ACT

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Publication 2110
Extension Service of Mississippi State University, cooperating with U.S. Department of Agriculture. Published in furtherance of Acts of Congress, May 8 and June 30, 1914. Ronald A. Brown, Director

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