To Call or Not to Call
Picture yourself walking out to the barn and your horse hasn’t eaten his grain. What is the first thing that you do? Be honest… most of you run inside, grab the phone and call me and say, “Something is seriously wrong because my chow monger is not eating!” But there are some other things you should really consider doing prior to calling me. Hopefully with this article we will better prepare you for an emergency, help with care that you can provide before the veterinarian arrives and help you decide whether you have a true emergency or not.
To assist in this endeavor I’ve separated the most common emergencies into some easy to define formats. Most emergencies consist of a horse bleeding, drooling, colicking, limping, not eating, down, squinting, getting out, foaling or acting drunk. Lumping them into these broad categories will allow us to discuss each one more specifically and the different things that may be occurring in each instance.
Your Horse is Bleeding…
If your horse is bleeding it generally is an emergency, however, it does depend on the nature of the bleeding. We first have to observe from where the bleeding is coming. Usually the origin is a laceration or cut somewhere on the body. Lower limbs and heads will bleed like you turned on a faucet… even if it seems like a small laceration. In turn a huge laceration across a large muscle belly in the rump may bleed minimally. The first thing you need to do is stay calm; if it’s bleeding lightly (and your horse allows it) you can run cool water over the wound and evaluate it further.
If it’s bleeding quite extensively, especially if it’s shooting straight out of the wound or pulsating out, it may be arterial and don’t worry about the cool water. The best thing you can do is apply direct pressure. If it’s a lower limb wrapping the wound with a firm bandage is best. If it is someplace that you can’t wrap you need to apply direct pressure with a bandage and your hand until the bleeding subsides. The best way to apply pressure is to apply it and LEAVE it. Don’t remove the bandage every 3-5 minutes and take a “peek” to see if the bleeding has stopped. Leave it on with pressure, if the bandage soaks through with blood apply MORE bandages over the soaked bandage but don’t remove the bandage next to the wound. The body will use that “scaffolding” of the bandage to help form a clot and each time you remove it you breakdown the process.
If it is a laceration that you believe will need sutures, you can use water or a water soluble jelly (e.g. KY Jelly®) to keep the wound moist. DO NOT… I repeat DO NOT use anything inside the wound that is caustic (like hydrogen peroxide or iodine) or any oil based product (like Vaseline®, Neosporin®, Nitrofurazone, SWAT®, Corona®, etc…). If you use something caustic it will “kill” the blood vessels and healthy tissue and the wound will not heal properly if we stitch it closed. If you use an oil based product I will have to attempt to wash it out (you know the old adage oil and water don’t mix), it will take a long time to hopefully get it all out and I will grumble the entire time.
Bleeding excessively post foaling can be an emergency, but generally if it is something severe such as a uterine artery rupture you will not see anything external. The bleeding will occur within the body and you only may see clinical signs of weakness, pale mucous membranes and signs of colic. Extensive bleeding from the nostrils (that has not been caused by passage of a stomach tube) can be an emergency too. It is rare, but a horse can fatally bleed out from a rupture of the carotid artery that will bleed out from the nostrils. There is nothing ANYONE can do… even if your horse is on a surgery table under anesthesia prepped for a tie off it still wouldn’t work. I’ve only had this happen twice and I haven’t made it to the horse before it died either time. I usually don’t make it more than 2 miles down the road.
Your Horse is Drooling...
A drooling horse may or may not be a true emergency. Here are some things to check before you call me. Is your horse wanting to eat? If he’s eating and drinking in the face of drooling then we have a couple choices. If your horse is out on pasture and the pasture has clover in it, it is likely a reaction to a fungus that can sometime grow on clover. The true name is slaframine, and though the toxicity is generally not a huge problem it sometimes can be a messy one. Rinsing the mouth out with water from a hose and mowing your pasture are usually what we recommend. If there is no history of being on pasture, it could be dried clover in the hay (not real common). If still no history of anything like that we may need to do an oral examination… I’ve seen horses losing baby teeth, with infected teeth and with foreign bodies stuck in their mouths all drool and still want to eat.
If we have an excessively drooling horse that does not want to eat and there are other clinical signs such as anxiousness, discharge coming from BOTH the nostrils and the mouth, excessive coughing to the point of retching, etc… your horse may be choking. A choke in a horse is not like a human choking and not being able to breathe. When a horse chokes they get something (usually food) stuck in their esophagus and they can’t get it the rest of the way down into the stomach. The worst thing about a choke other than the obvious fact they can’t drink or eat, is that the discharge can sometimes accidentally get inhaled down in to the lungs and cause an aspiration pneumonia. I usually recommend the owner to massage the left side of the throat (that’s where the esophagus runs down), keep him quiet and let him drop his head (helps drainage). Most chokes work their own way out. If not, we need to evaluate, treat with a smooth muscle relaxant (to relax the esophagus) and sometimes flush it if necessary.
Your Horse is Colicking...
We’ve discussed colic at length in previous newsletters (Confronting Colic) but we’ll do a brief overview here again. Colic means abdominal pain and although the majority of times a colic is due to GI problems, they can also be caused by liver disease, kidney disease or other problems. Signs of colic usually include restlessness, not wanting to eat, laying down, pawing, lifting their upper lip, rolling, kicking or looking at their side, etc… If your horse is acting like this I usually recommend a temperature and heart rate be obtained if possible and then contact me. Depending on what is going on, the history of the horse and the owner’s wishes we may attempt to treat with flunixin meglumine (aka Banamine®) first and re-evaluate in 45 minutes. If it is a simple gas colic usually that will help relax the colon and let the gas pass out. If it is more complicated and the signs aren’t gone… the horse will need to be evaluated further.
We’ve also discussed what NOT to do in the face of a colic… but I feel so strongly about them I wish to go over them one more time.
- Do not force your horse to walk hours upon hours. If your horse isn’t improving after at least one hour of walking, chances are 5 hours aren’t going to do anything more than tire him and make him weaker and dehydrated.
- Same thing goes for lunging. If you were experiencing abdominal distress, would you go out for a jog to make yourself feel better? Of course not, so don’t expect your horse to want to do it either.
- Do not keep repeating flunixin meglumine (Banamine®) administration over and over to see if multiple doses work. If the first one doesn’t work; there is obviously more wrong than just gas. Do not give it more than once without consultation.
- Do not call everyone under the sun BUT your veterinarian. If you are concerned enough to make 15 phone calls to several horse friends and colleagues and attempt all their tried and true remedies, then please make at least call number 2 or 3 be to your veterinarian.
Okay, with that off my chest let’s continue.
Other things that may be mistaken for GI colic can include tying up (the horse may not want to move from where they are standing and sweat profusely), fever (the horse will not likely eat with a high fever), dental problems (not eating), choke (not eating, drooling), uterine artery rupture and bleeding into broad ligament (post foaling weakness and discomfort), urinary tract disease (discomfort), peritonitis (discomfort due to an infection in the fluid around the GI system), etc…
Your Horse is Limping…
I must admit a lame horse is not usually a dire emergency. The owner may be sure that it is since the horseshow tomorrow will not be a possibility now, but a simple lameness is not a life or death emergency to the horse itself. However, there are obvious instances such as a broken limb or severe injuries that may result in a lame horse that need immediate attention. A sudden, non-weight bearing lameness with no outward clinical signs of trauma often ends up being a hoof abscess. I usually recommend the owner to feel the entire limb and hoof for heat, tenderness or swelling and clean out the foot and verify no stones or nails are embedded in the sole. An abscess may blow out the coronet band (will result in a painful swelling around the coronet band) or out the sole and need to be pared out. A good swift kick to the shoulder may cause swelling around the radial nerve and cause a horse’s limb to get temporarily “paralyzed” and not allow it to move forward (but it can still bear weight fine). The signs usually go away with anti-inflammatory medications. Blown or torn tendons can cause some obvious incorrect movement through a horse’s limb. Broken bones are generally obvious as well, but smaller fractures or incomplete fractures may need to be confirmed with radiographs.
Your Horse is Anorexic…
If your horse is not eating it usually ends up being a problem. As most of us know if our hungry hippos don’t dive into the feed when they come in the stall, we tend to get a bit panicked. So where do we start? Come on everyone, you know the first thing I’m gonna ask as soon as you call me so you may as well do it first. What is the horse’s temperature? Now I realize that some of the horses out there in grumpy land may not appreciate a rectal temperature, but most tolerate it well and it should be something you learn to do on your horse. Fever is a common reason for anorexia. If the temperature is normal we then check for clinical signs of colic, discomfort, drooling, foul smell from the mouth, etc… and that may pinpoint the other common reasons for anorexia: colic, choke or dental problems.
Your Horse is Down…
No one wants to find a down horse. The worst thing I have to deal with when I have a down horse is that I can’t pick up the horse. Unknown to most of my clients when they are faced with a crisis like this, I have no magic cure for a down horse. I am not strong enough to lift the horse (unless it’s a miniature) and often the care is only supportive. First things first… Why is the horse down? Is he acting colicky? Is she dehyrdrated or ill? Is she foaling? Is he neurologic? Is she extremely old, weak and arthritic? Is he in a deep mud pit, cast in his stall or in a ravine? I will admit that the majority of down horses I see are either colicky (and showing other clinical signs such as rolling, groaning, up and down, etc...) or they are very old and debilitated and generally in a bad situation such as cast in the stall or in the mud.
If your horse is down here are some guidelines. Obviously try to get them up and move them a bit. If they can’t get up then try to improve the footing around them (using straw or shavings to help with mud or snow). If they have been down on one side for an extended period roll them over to the other side and rub down the newly exposed side to bring circulation back to it. Try to keep the horse propped up sternal with a hay bale as they breathe easier this way. Offer them fresh water and hay if they want it. Often times these simple things are enough to get an old horse up. Often times you also need to wait and give them some time to muster up the strength to get up after they’ve been struggling a while. One of my tricks after we’ve done everything above is to attempt to rectal them (not recommending you do this) but you’d be surprised how many pop up after that is attempted. I’ve had a down horse in the snow over 24 hours come back to do well, and I’ve had down horses due to West Nile disease never stand again. It really varies due to the cause of the recumbency.
Your Horse is Squinting…
Here’s a perfect example. I went out to feed my horses yesterday and my old guy stood up, stretched and came over for his morning kiss (yep, he’s spoiled, so sue me) and the tissue around his left right eye was twice the size of his right. Opening his eyelids I removed the 1/2 inch by 1/2 inch piece of sawdust out of eye and lavaged his eye several times (much to his chagrin) with saline. Then I lavaged his tear duct, stained the eye to check for a corneal ulcer, treated with ophthalmic ointment and systemic anti-inflammatories. You may not be able to do all of that on your own, but finding the large piece of sawdust should be a no-brainer. So first thing to check for with swelling around the eye… yep, foreign bodies. I’ve found bugs, sawdust, dirt, plant awns, you name it. If you see nothing then try to rinse the eye with saline, cool pack the eye and contact your veterinarian for further instructions. Swelling around the eye, excessive tearing, squinting, reluctance to be in the light, etc… can also indicate a corneal ulcer (scratch on the eye) and should be evaluated immediately. If your horse has excessive tearing but the eye looks normal and is wide open, it may only be a blocked tear duct that needs to be flushed… not a true emergency but should be addressed in a timely manner. In general, eyes should be evaluated quickly and you should not “wait to see if it gets better”.
Eyelid lacerations should be dealt with quickly as well. It is best if at all possible to best preserve the integrity of the eyelid to help prevent tears spilling over onto the skin, to best protect the eye from trauma and to keep the eye lubricated properly.
Your Horse is Out…
We’ve all probably had it happen at least once in our lifetime. You go out to the barn in the morning to feed, not expecting to find your horse belly up to the bar in the feed room eating himself into oblivion. So two things first off… 1. Make sure your horse is safely in his stall. Your horse being SO SMART that he can open anything is not a good excuse. They make pretty extensive locks that I can barely open with opposable thumbs and I’m pretty sure your horse can’t get it open unless he runs through the door itself. 2. Make sure your grain is locked away safely so on the off chance your horse does get out he can’t get into the feed room. If a horse does get into the grain, he may look completely normal AT FIRST. If you don’t have an exact amount that the horse got into then I really feel there is no other choice but to treat the horse immediately. Let me reiterate, the horse may appear normal at first, but once the horse starts acting abnormal… it may already be too late. A large amount of concentrate (grain) can settle in the colon, start producing toxins which can get lodged into small blood vessels causing blockage. They love to do this in the feet and cause laminitis or founder. So we need to treat preventatively in situations like this by oiling them like a slick (coating the colon with A LOT of oil will help prevent absorption and everything inside will get a quick one way ticket to the outside out the back end), treating with anti-inflammatories to prevent the endotoxin action and sometimes with blood thinners to prevent the little blood clots from forming. I will say, any horse I’ve treated like this no matter how much they ate ended up with no clinical problems (knock on wood).
If your horse got into medications like dewormer, call me and we’ll discuss the toxic potential of the product. If he got into hay that he’s used to eating, he’ll likely be fine. If he got into a pasture he’s not used to, we may deal with a colic from the feed change and may need to treat as well. I will admit most horses will not leave the property, and oftentimes not even leave the barn. Come on, their buddies are in there and they want to poke fun that “I got out and you didn’t”. But I have treated a horse HBC (hit by car) before that got himself out, then turned his buddy loose and they hit the town.
Your Horse is Acting Drunk…
Neurologic disease in a horse is usually an emergency as well. It generally revolves around the fact that we have a 1000 pound animal that is not walking in a straight line, may not really know where his feet are being placed, may be falling, etc… overall not a safe situation. I saw many horses like this when West Nile hit so hard a few years ago and owners found their horses down, walking drunk and running into things, stumbling, tripping excessively, high stepping, etc… There are other obvious trauma situations such as flipping over and hitting the top of their head, getting their head stuck somewhere and pulling aggressively, getting stuck in a rope, a lay person inadvertently injecting medication into the artery (and bathing the brain with medicine) instead of the vein, etc… that may result in the same clinical signs as a viral encephalitis. Horses with Cushing’s disease sometimes show clinical signs of seizures or “fainting” episodes when their head is lifted up. Seizuring can occur if your horse has bloodlines consistent with HYPP or in an aged horse that you end up suspecting a brain tumor in. Usually, any type of neurologic disease should be evaluated when observed.
Your Horse is Foaling…
Usually a mare can do this well and most clients need to relax and let nature take it’s course. So no, a mare foaling is not an emergency. However, a malpresentation or a red bag are both emergencies and should be identified quickly. A normal bag should be a light blue to white bag with clear fluid within it. It usually is the first thing you see presented. Often times you can see the feet through the bag as well. Normal presentation should be both front limbs extended out with a nose resting on around the knees. How do you know it’s the front limbs? Well the hooves should be facing down, not up… and check for knees. If you have one leg and a nose, a nose with no legs, two legs and no nose, etc… we obviously have a problem. If the feet are facing up, likely another problem. Also, if the first thing that you see is a dark red bag that looks like worn carpeting, that is what’s called a red bag. The “red bag” is actually the placenta, and if it’s coming out first the baby will not be getting oxygen through the umbilical cord for very much longer, there is likely a malpresentation problem, and it is a DIRE emergency
Overall, I hope these overviews give you a better idea of what to expect and what to look for. As always I recommend you have an emergency consent form filled out for all your horses that will help any caretakers, family members and your veterinarian best know what you want done in the case of an emergency if you cannot be reached. These emergency consent forms can be downloaded from our website or requested if you do not have internet access. Also, we have an emergency kit list that you can download as well which recommends what you should have in an emergency kit as well as a brief discussion on when to use the product. Common ingredients that we recommend in an emergency kit includes: leg cottons, vet wrap, elastikon tape, Bute paste, Banamine® paste, antibiotic ointment, antibiotic eye ointment, KY jelly®, thermometer, inexpensive stethoscope, latex gloves, topical wound spray, saline and 4x4s. For your convenience we can put an emergency kit together for you for purchase as well
And as a final thought I’ll leave you with a list of what a veterinarian doesn’t want to hear when she answers her phone during emergency hours. And don’t laugh too loud, I’ve actually heard each and every one of these things before, if not more than once…
- Friday, 9:00 pm… My horse isn’t eating or drinking. How long? Oh, he’s been doing this since Monday.
- 3:30 am, weekday… Oh… I didn’t think you’d actually answer the phone now. I was just wanting to leave a message about an appointment.
- You’re not my regular veterinarian. I use someone else for all my routine vaccinations and care, but I can never get a hold of my regular veterinarian when I have an emergency.
- My horse has a large cut that I think needs sewn up. I’ve cleaned it with water then put peroxide in it until it fizzed really good, then put iodine in it to make sure it was really clean.
- I really don’t have a regular veterinarian. To tell you the honest truth, my horses are just so healthy I’ve never worried about vaccinations and stuff like that. This is really the first time I’ve ever had a problem.
Did You Know?
The Pennsylvania Department of Agriculture confirmed that a horse, which passed through a Livestock Auction on June 29, has tested positive for equine infectious anemia (EIA). Officials said that the owner was alerted to the horse’s positive test and acted contrary to instructions when he took the horse to the auction for sale. Currently the horse is under quarantine. Just wanted to remind everyone that EIA is out there and there is a reason why you need to test your horses for this very serious and untreatable disease.
Congratulations to all the new babies listed below that we performed neonatal examinations on post foaling:
Mares that had fillies: Raffinaee owned by Ted and Jackie Peck on 03-02, Reba owned by Bob and Virginia Rudofski on 03-13, Mary owned by Cindy and Mike Birky on 03-18, Jolene owned by Donna and Leonard Shaw on 04-10, Suzie owned by Kenny and Sue Stamper on 05-17, Goodie owned by Vicki Karius on 05-19, Roxie owned by Wisdom Ranch on 05-25, Bess owned by Hodson Farm on 06-01, Lilly owned by Gigi Challas on 06-01, Annie owned by Pinky and Rolly Janota on 06-02.
Mares that had colts: La Dama owned by Janet Veach on 04-13, Faith owned by Tara and Bob Kaper on 04-23, Melody owned by Gigi Challas on 05-18, Honey owned by Kryl Sadowski on 05-25, Sweetie owned by Kim and Tim Seabolt on 06-01, CoCo owned by Kryl Sadowski on 07-05.
The Right Horse
Thanks to Cheri for sending me this comical way of knowing for sure that you’ve found the right horse.
“You’ll know when you’ve found the right horse when it costs exactly the amount you don’t currently have.”