I define an “equine emergency” as any problem with your horse where a delay of appropriate treatment might endanger their future quality of life or their soundness. Horses have a unique ability to injure themselves, often seriously. This is due to a combination of size, power and speed coupled with an overdeveloped fight or flight response. They are also notoriously sensitive for their size. Equine lower limbs and intestinal tracts are two anatomical areas that are especially predisposed to injury and illness.
Horse owners should be well prepared for the common equine emergencies. This preparedness is founded on basic veterinary knowledge, access to the right supplies and equipment, and a solid relationship with your equine veterinarian. In this article, I briefly discuss what I consider to be the most significant and common types of equine emergencies. I also explain the importance of the veterinary–client-patient-relationship (VCPR) as it pertains to emergencies; a subject that is rarely discussed and is very important.
The most important thing you can do as a caretaker for your horse is to have a good relationship with your equine veterinarian. They are ultimately the best resource for you to turn to in an emergency. The better able you are to communicate effectively with them, especially in stressful situations, the better care the horse gets and the better the outcome. Mutual trust is critical in the VCPR.
Here are some ways that you can contribute to that mutual trust:
1. Contact Information. Know how to reach your veterinarian in an emergency. Good locations to keep veterinary contact information are your horse trailer, cell phone, stall door or posted on the refrigerator. These days it is easier than ever to stay in contact.
2. Early Contact. Call at the first sign of a problem that could become an emergency – not when it has progressed to a crisis! Even if your veterinarian does not recommend an examination, at least they are put on notice and can advise you on a course of action.
3. Horse Owner Self-Help. If you call your equine veterinarian at the outset of a problem, your horse may not need to be seen. The safest and best thing for a horse is to be directly examined by a veterinarian, because we can only learn so much over the phone. However, for clients who I know and trust, I often try to help manage simple problems without a visit. Generally, I don’t charge my regular clients for telephone help. With good information and communication, I can often help make a determination as to whether or not the horse needs to be seen on an emergency basis. I am always careful to follow-up to ensure resolution of the problem.
4. Cost. Equine veterinary practice is expensive to deliver, and 24 hour care is an especially hard service to provide in this day and age. The costs for the luxury of 24 hour emergency care must be passed on to horse owners. You should always anticipate being charged an emergency or after-hours fee. I try to give clients an estimate before I come out, whether they ask for it or not. If cost is a concern, ask your veterinarian to give you an estimate before they commit to the visit.
5. Your Skills. Learn to competently take and record your horse’s temperature, pulse and respiration. Understand why these finding, as well as a complete history, are important to your equine veterinarian. All of this information can be very helpful in trying to make a determination regarding whether or not he or she needs to see your horse immediately, in a day or two, or not at all.
6. Your Supplies. A limited stock of supplies and equipment can be very helpful for a horse owner to have in an emergency. This is especially true for clients who live a long distance from their veterinarian. An inexpensive stethoscope and thermometer can be bought at a drug store. Learn how to use these instruments. They allow you to provide very useful additional information. Your equine veterinarian can help you assemble and maintain an inventory of supplies and equipment (an emergency kit).
7. Medications. As with supplies, it may be helpful for horse owners to have a small number of medications handy in case of an emergency. However, you must have a basic understanding of how to administer them, what they do, and their limitations. There is strong legal regulation on veterinarians regarding dispensing prescription medications. Your veterinarian’s willingness to dispense items will depend on the existence of a good VCPR. Improper or careless use of drugs and veterinary equipment can be fatal to a horse and dangerous to handlers. I only dispense medications to clients who I trust and who fully understand their benefits and limitations. If I dispense a prescription medication for emergency use – such as Banamine® – I ask that my client call me before giving it to their horse. For more information, see my other article Bute & Banamine®: What Horse Owner’s Should Know.
8. Routine Preventative Care. In order for me to advise a client over a phone regarding an emergency, it is extremely helpful if we already have an established VCPR. I encourage my clients to let me get to know them and their horses in health by doing routine well-horse exams along with preventative care in both spring and fall. This enables me to become familiar with the owner, horse and facility and better prepares me in the event of an emergency. A strong VCPR often provides me with the ability to find problems before they evolve into emergencies.
THE MOST COMMON EQUINE EMERGENCIES
EQUINE COLIC (ABDOMINAL PAIN): Colic is one of the most common emergencies and is often the most distressing for horse owners. You should be able to recognize colic signs. Keep in mind that these can range from very subtle (like being slightly off feed or laying down a little more than usual), to obvious signs (like rolling, pawing, and kicking at the belly). See Colic Surgery: What Horse Owners Should Know and my other articles on equine colic for more details.
- Horses with signs of colic can be dangerous to handle because they can suddenly collapse, roll, paw or kick. Be especially careful when handling these horses. Sometimes, the best thing you can do is leave them alone until your veterinarian advises otherwise.
- If you see signs of colic, call your veterinarian immediately and tell them that your horse is showing colic signs. Do this before you give your horse any medications. Be ready to describe the signs of colic and your physical findings (if you were able to safely take them), including temperature, gut sounds. Heart or pulse rate are especially helpful pieces of information to provide to your equine veterinarian, if you can.
- 70% of colic cases are simple gas or spasm causing pain, and resolve spontaneously or with simple treatment. Your veterinarian may ask you if you have access to a pain reliever and if so may ask you to give it and give the horse some time. Always take feed away from a horse that has been treated with a pain reliever. Many drugs can mask the signs of colic, delaying proper treatment.
- Horses that do not respond to medical therapy require a proper diagnosis. Colic is just a sign of an underlying problem – usually abdominal pain, and that the task is to diagnose what is causing the pain. Some diagnoses may require emergency colic surgery. Colic surgery now averages about $7,500.00 nationally, depending on the diagnosis and procedures performed. It is important for you to have a general sense of whether or not you would have your horse operated on if you had to make a choice. The key to this is educating yourself about the pros and cons of colic surgery, and balancing that with your financial wherewithal. Your veterinarian can help you answer these questions.
WOUNDS: Wounds are also a very common equine veterinary emergency. If you have any doubt about the severity of a wound sustained by your horse, call your veterinarian immediately. Time is an important factor in the effective management of wounds.
The most important factor in assessing the severity of a wound is not how large the wound is, but where it is located and whether it might involve a critical structure like tendon, bone or especially a joint or tendon sheath. For years now, I have asked clients to e-mail digital photos of wounds to me. This is an excellent way for me to determine those wounds that I need to see from those that the client can manage themselves. In general, potentially serious wounds are those that:
- Are near or involve a joint, tendon or tendon sheath. This is true for most lower limb wounds.
- Involve the coronet or hoof.
- Involve the eye or eyelid.
- Punctures that may involve deep structures within the abdomen or chest.
Less serious wounds are those that are to the heavily muscled upper limb, chest or body and do not involve deeper structures. See my other article Equine Wounds: What Horse Owners Should Know.
Blood-loss is rarely a life threatening problem for horses. The vast majority of even large and apparently severe wounds stop bleeding before enough blood is lost to be life threatening. That said, it is important to be able to control bleeding if you must. The critical skill to know is how to apply direct pressure to a wound. This does not mean applying a tourniquet. It means consistent, firm pressure focused right on a bleeding vessel. You can do this with a finger and a thick wad of gauze or a pressure bandage with a wad of gauze focused only on the bleeding area.
GENERALIZED TRAUMA OR SWELLING: Cases of swelling of a location are common reasons for horse owners to call their veterinarian. Often, these are traumatic in origin but can be due to stings, snake bite, and local allergic reactions. Again, providing your veterinarian with good photographs can be helpful, in addition to providing the results of your whole horse assessment.
LAMENESS: Severe or non-weight bearing lameness is always an emergency. Mild lameness can often wait for a scheduled appointment. Lameness should always be taken seriously and when in doubt, you should call your veterinarian. Most lameness is in the foot, so pick it up and examine it, feel it for heat and compare the temperature of it to the other feet. Examine further up the limb and compare this to the other limbs. Stand in front and to the side and compare the lame limb to the others visually. Run your hands up and down the limb, feeling for swelling, heat, pain, or wounds. Take your horse’s temperature. Learn to take digital pulse.
Provide all of this information to your veterinarian when you call. When dealing with severe lameness, always rest a horse in a box stall until the veterinarian can examine him or her. The most common cause of sudden severe lameness is sole abscess and sole bruise. However, fractures, infected tendon joints or tendon sheaths and other problems can also cause non-weight bearing lameness.
EYE INJURIES: Disease affecting the eye should be thought of as an emergency as well. The eye is a vulnerable, sensitive, complex and vital organ. Disease processes of the eye can progress quickly, resulting in irreversible damage and potentially permanent blindness. The most common cause of emergencies involving the eye relates directly or indirectly to trauma. Call your veterinarian immediately when your horse has an eye problem. Use a quiet, darkened stall and/or a fly mask to protect it until your veterinarian arrives. See my other article The Equine Eye: What Horse Owners Should Know.
Other examples of common equine emergencies that may require veterinary attention include:
- CHOKE: Esophageal obstruction, a/k/a choke is a common problem in older horses or horses fed pelleted feeds or beet pulp. When a horse is choking you often see nasal discharge with feed, severe salivation, and gagging.
- GRAIN OVERLOAD: This can result from a horse gaining access to grain storage and eating large quantities of grain.
- DOWN OR CAST HORSE: A relatively common complaint is a horse, which is down and unable to rise.
- DIARRHEA: This problem in the adult horse is uncommon but is also considered an emergency.
I have discussed above what I consider to be the most common and significant types of equine emergencies, but the variations are limitless. Ultimately, a horse owner must use common sense, knowledge and instinct to determine what constitutes an emergency.
Remember that good communication with your veterinarian is a critical factor. Guidance is just a phone call away and can mean the difference between the life and death of your horse.