How to be prepared and what to do until your veterinarian arrivesAmberlistentoheart

Written by Dr. Amber Myers, c/o Moore Equine Veterinary Centre, Ltd.

Accidents happen and the most important thing a horse owner can do, although at times it may be the most difficult, is to stay calm.  To prepare for the inevitable equine emergency, a horse owner can learn a few simple techniques to assess the condition of the horse, and to help the veterinarian in the case of an emergency. This article will cover how to take a horse’s vitals, some common horse emergencies, how to differentiate colic from choke, and what to do while waiting for the veterinarian to arrive.

Measuring your horse’s vitals:
There are a few measurements commonly referred to as vitals that horse owners can learn to measure on their horse. It is best to practice taking vitals before emergencies happen.  Being able to take these values and report them to the veterinarian can help the doctor better determine the current condition of the horse.  Some of the vitals include heart rate, respiration rate, temperature, gum color, gut sounds and a measurement called capillary refill time.  It is common to see variations among normal values for different horses.  This is another reason why it is important to practice taking these values when the horse is healthy and relaxed.  Knowing what is normal for your horse can greatly help the veterinarian in the case of an emergency.amberpulse-sm

A horse’s normal heart rate can range from 25 to 45 beats per minute.  The heart rate can be obtained from pulse rate or by using a stethoscope to listen to the heart.  There are a few places on a horse’s face where a pulse can be felt.  The easiest to find is just behind the eye.  This is called the transverse facial artery.  To obtain the pulse rate a person would take two to three fingers and gently place them on the horse’s skin. When checking for a pulse it is important to remember not to push too hard.  Too much pressure can collapse the artery in which case the pulse could not be felt.  Be patient, it may take a few seconds before a pulse is felt, as horse’s have a much slower heart rate than humans.  Another location on the face where a pulse can be felt is on the jaw.  To obtain a pulse rate in this location, slide fingers underneath the jaw, apply light pressure pushing toward the jaw.  The artery can be felt between the fingers and the mandible (jaw).  Another location where the pulse can be found is called the jugular groove.  The jugular groove is the long depression toward the bottom of the neck.  There is a jugular groove on both sides of the horse’s neck.  To obtain a pulse rate in this location place 2-3 fingers where the jugular groove meets the neck and apply gentle pressure.  A horse’s heart rate can also be obtained by listening to the heart with a stethoscope.  Lub-dub is equal to one beat.  The heart rate or pulse is usually reported as the number of beats per minute.  For example if a horse will only stand still long enough to get a pulse for 15 seconds and 10 pulses are felt then the horses heart rate would be 40 (10 beats x 4) beats per minutes.amberpulse2-sm

Respiration rate can be measured a few different ways.  A normal resting respiration rate for a horse can vary from 8-16 breaths per minute.  One way to observe the respiration rate is to watch the horse’s flank and count the number of times it expands per minute.  Sometimes with a fidgety horse it can be hard to count the number of breaths by watching the flank.  Another technique is to place a hand in front of the horse’s muzzle and to feel each expiration.  This technique can work but one would  have to be careful that the horse is not sniffing the person trying to take the measurement, as this can lead to a false respiration rate.

amberpulse3-smA horse’s temperature is taken rectally.  This can be done with a digital or a mercury thermometer.  Digital thermometers are faster, but aren’t always as accurate.  If using a mercury thermometer remember to shake down the mercury before putting the thermometer in the horse to avoid inaccurate readings.  A digital thermometer generally requires a person to hold during measurement, where as a string with a clip can be added to a mercury thermometer and it can be clipped to the horses tail.  Leave a mercury thermometer in for approximately 3 minutes before reading. The normal range for a horse’s temperature is 37.5-38.5 C (99.0-101.5 F).  When taking a horses temperature stand at the animal’s hip, facing the horse’s hind end.  Gently lift the tail off to one side with one hand and insert the thermometer with the other.  Lubricant such as KY Jelly, Vaseline or saliva can be used to aid in insertion of the thermometer.  When obtaining a horse’s temperature take care to stand in a safe place.  If it is not possible to obtain a temperature reading safely, forgo the measurement.  The information gained is generally not worth the injury that could occur if the horse is unwilling or uncooperative.amberpulse4-sm

A horse’s gums, also know as mucous membranes, are normally pink to light pink in color and moist to the touch.  This can be evaluated by lifting up a horse’s upper lip to assess the color.  Be careful not to pull the lip up too much, as this can actually lead to blanching out of the color.  Another measurement that can be taken while assessing the color and moisture of the gums is called capillary refill time.  The capillary refill time is a tool that veterinarians use to assess how well the body is providing oxygen rich blood to the periphery of the body.  This is done by pressing a finger into the gum to blanch the color out and then releasing and counting the time it takes for the color to return.  The normal capillary refill time in a horse is 2 seconds or less.  A person can practice this technique on themselves by pressing down on their thumb nail then releasing to see how rapidly the color returns.  Changes in color of the gums and increased capillary refill time can be suggestive of a variety of problems or conditions.

amberlisteningtogut-smA horse’s gut sounds are commonly evaluated especially when a horse is presenting complaint is colic. Gut sounds are evaluated on both the left and right side of the horse using a stethoscope.  They are typically evaluated by quadrants.  There is a dorsal (upper) and ventral (lower) quadrant on both the left and right side.  The dorsal quadrant is located just in front of the hip bone.  The ventral quadrant is located directly below the level of the dorsal quadrant more in the region commonly referred to as the flank.  It is important to listen to gut sounds in a few different locations as they can vary from location to location.  It should be possible to hear gut sounds on both sides and in both quadrants.

Emergency Preparedness:
For general emergency preparedness it is always recommended to have emergency numbers and the address or coordinates of the barn easily accessible.  It can also be extremely helpful for the barn to have a first aid kit.  A first aid kit will help keep all of the supplies that may be needed in an emergency in one location so it won’t be necessary to search for supplies when an emergency does occur.  First aid kits are commercially available or can be easily made.  Listed below are some common items recommended for a first aid kit. 

• Betadine
• Chlorhexidine
• Alcohol swabs
• Plastic gloves
• Stethoscope
• Thermometer
• KY jelly
• Duct tape
• Flash light
• Extra batteries
• Extension cord
• Scissors/Clippers
• Watch
• Sterile Gauze
• Bandages
• Roll cotton
• No bows
• Polos, vet wrap, standing wraps
• Kling gauze roll
• Baby diaper/sanitary pad
• Splints
• PVC piping
• Kimzey
• Bute paste/Banamine paste
• Electrolyte paste
• Clean bucket

Common Horse Emergencies:
The most common horse emergencies include colics, lacerations and acute lameness.  Some other common emergencies seen with horses include choke, eye trauma, extertional myopathy/exhaustion, reproductive, and foal emergencies. 

Colic vs. Choke:
The word colic means abdominal pain.  This is a very broad term and is used to describe a variety of conditions commonly seen in the horse.  By definition anything in the abdomen that could cause pain could be the source of the colic.  Veterinarians sometimes use more descriptive words such as gas colic, or displacement to better describe the cause for the abdominal pain and discomfort. 

A horse with colic can exhibit varying clinical signs.  Common visual clinical signs exhibited in horses with abdominal pain can include pawing, rolling, circling in the stall, kicking at abdomen, camping out or standing stretched out and/or looking back at flank.  While many owners would notice these signs unfortunately some horses do not exhibit such obvious clinical signs.  Some horse might just be quieter, dull, or less rambunctious than normal.  Some horse’s will stand very stoic in the stall but will have heart rates 2-3 times normal.  Whereas another horse can have a mildly elevated heart rate but will be thrashing in the stall.  Because of the variety and severity of clinical signs that can be seen vary, it is important to contact a veterinarian if colic is suspected.  A veterinarian can help determine the severity of the current problem and how to proceed with treatment.

The exact root cause of colic is unknown although there are a variety of causes that are associated with colic.  Good barn management and horse care can greatly decrease a horse’s chance for developing colic.  The following precautions will decrease the likelihood of a horse developing colic.  Establish feeding and exercise routines and try to stick to them.  Feed a high quality diet of primarily roughage or forage.  A horse should receive a minimum of ½ its’ energy through hay or forage so avoid feeding excessive concentrates.  Frequent small portion feedings are better than one to two large feedings.  Avoid feeding on the ground when sand is present.  With the help of a veterinarian set up a routine parasite control program.  Ensure that clean, fresh water is available at all times. When changing a horses exercise routine do so gradually.  Reducing stress can also help decrease the likelihood of a horse developing colic.

Choke refers to esophageal obstruction.  Choke happens when the lumen of the esophagus becomes obstructed.  The esophagus becomes obstructed with feed, such as dry beet pulp, wood chips or bedding.  Choke commonly occurs in horses with ravenous eating habits and as well as in the older horse fed pelleted feeds. The most common clinical signs associated with choke are excessive salivation, retching, coughing, and saliva with food coming out the nostrils.  Enlargement of esophagus can often be felt.  The most common areas of obstruction are in the beginning portion of the esophagus and where the neck meets the shoulder.  This area is called the thoracic inlet and is where the esophagus enters into the thorax.  A veterinarian should be contacted immediately if a horse is experiencing choke.  All feed and water should be removed until the veterinarian can arrive and assess the horse’s condition.

When the veterinarian arrives they will likely sedate the horse.  A choke is treated by passing a large bore tub through the nose down into the esophagus.  A smaller bore tube is then passed down the large bore tube.  The small bore tube has water pumped through it and the water and feed material comes back out through the large bore tube.  A potential complication with choke is aspiration pneumonia.  Aspiration pneumonia is when material is inhaled into lungs and results in an infection.  Aspiration pneumonia is a serious complication requiring close monitoring and treatment with broad spectrum antibiotics.

Choke can be prevented with good barn management, regular dental work and feeding routines.  If a horse is unable to properly masticate food, they are at a higher risk for developing choke.  A yearly dental evaluation is recommended for all horses. Routine dentals are an easy way to help prevent choke.  To slow down the eating habits of a ravenous horse try placing large rocks in the food bin so they have to eat around the rocks.  If feeding beet pulp always soak it before feeding as it expands a great deal once it becomes moist.  With older horses it can also help to water down their complete feed to help decrease the likelihood of choke happening.

What to do while you’re waiting for your veterinarian to arrive:

1. Stay calm. 
• If you are able to stay calm it will likely help to calm the horse while you are waiting.
2. Call for help.
• If you are the only one around call friends or family to help you while you wait.  They can help get the first aid kit or perform other duties so you can stay with your horse and focus on keeping the animal calm and safe.
3. Make sure the horse is in a safe location
• Only move the horse if it can be done without further injury to horse of human or if they are in immediate danger where they are located.
4.  Call your veterinarian
• Do so as soon as you can and be prepared to give them the directions to your location and the horse’s vitals.  The more information your veterinarian has the better they will be able to assist you over the phone until they arrive on site.
5. Do not administer any drugs or sedation unless specifically directly to do so by your veterinarian.
• Certain medications can mask clinical signs that can help your veterinarian determine the severity of the problem.

Practice taking your horse’s vitals regularly while they are healthy so you feel comfortable and confident in your skills should you need to use them in an emergency situation.   Accidents do and will happen but being prepared will help them run more smoothly when they do occur. Good barn management and routine veterinary care can greatly decrease the likelihood of colic, choke and a variety of other conditions.  Remember to stay calm and to call your veterinarian if you have any questions or concerns.  


References:
"Colic Prevention Tips." American Association of Equine Practitioners. N.p., February 2011. Web. 16 Nov 2011. <http://www.aaep.org/health_articles_view.php?id=191>

Orsini, J., & Divers, T. (2008). Equine emergencies treatment and procedures. (3 ed., pp. 117-120). St. Louis, Missouri: Saunders.

"Guidelines to Follow During Equine Emergencies." American Association of Equine Practitioners. N.p., February, 2011. Web. 16 Nov 2011. <http://www.aaep.org/health_articles_view.php?id=50>.

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