Top 12 equine emergencies

We asked specialists from Colorado State University Equine Field Service to shed light on the top emergencies they come across in equine ambulatory medicine. Learn to recognize the most common maladies that could affect your horse, along with their causes and treatments.

Education on equine health, horsemanship and preventative care is a rapidly advancing aspect of modern horse ownership. Veterinary medicine and the diagnostic and treatment capabilities of ambulatory and referral practitioners are also evolving. Becoming familiar with equine emergencies is a vital part of this growth, and knowing what to watch for will help you spot trouble early on.

1. Lacerations

Causes of laceration are multi-factorial – a combination of equine curiosity, and sometimes, just plain bad luck. Depending on the size, location and age of the wound, your veterinarian may elect immediate or delayed closure of the lesion. Anti-inflammatories and broad-spectrum antimicrobial therapy are indicated, as wounds are a source of discomfort and possible infection. Superficial lacerations or wounds can be effectively managed in the field; however, wounds involving joints/tendon sheaths or bones are more efficiently managed at a referral center.

2. Colic

Colic is a catchall term describing abdominal pain. Horses may display many characteristics of abdominal/visceral pain, including rolling, pawing and flank-checking. Treatment for colic varies, as multiple causes including gastrointestinal disturbances, pneumonia, and even some orthopedic abnormalities like laminitis can be implicated. Studies have shown that 80% of cases can be treated with medical management, while the remaining 20% may require referral to a hospital. Your veterinarian will use a number of parameters to assess the overall severity of your horse’s colic. In cases where the pain might be indicative of tissue destruction (e.g. intestinal torsion), referral or humane euthanasia are, unfortunately, often the only options.

3. Choke

Any number of factors, including improper dental care, dehydrated feed and motility disorders, can cause choke. Classic presentation includes gagging/coughing with food material exiting from both nostrils. The mainstay of treatment involves the hydration and breakdown of the blockage with movement into the stomach. Choke that does not resolve with initial lavage (warm water sent through a stomach tube) can consequently result in serious infections, such as aspiration pneumonia, and may be managed in the field or at a referral center.

4. Tying up

“Tying up” is a colloquial term encompassing a number of disease processes. These range from the active breakdown of muscle tissue due to excess exercise (rhabdomyolysis), to genetic abnormalities such as polysaccharide storage myopathy (an inheritable glycogen storage disease known as PSSM). The immediate crisis of tying up can be toxic to the kidneys, so IV fluids are the mainstay of treatment. Referral is suggested when kidney damage is apparent; however, some owners and farms have the capability to manage in the field.

5. Puncture wounds to feet

Nails or other foreign bodies penetrating the foot can be either innocent or incredibly serious. Further, it is impossible to know what structures might be involved without taking radiographs. Therefore, a foreign body should be left in place until your veterinarian can assess its location. Treatment will depend on the structures involved. Wound flushing, sterile bandaging, anti-inflammatories, antibiotics and even surgery might be implicated to provide full resolution.

6. Fractures

Fractures are traumatic for both horse and owner. Initial treatment includes pain control, sedation and stabilization for transport or radiographs. Some fractures may require extensive operations and housing at referral centers, while a few might be managed in the field. However, humane euthanasia may be the most economical and beneficial option for some fractures.

7. Eye trauma

Trauma, windy environments and puncture wounds all cause damage to the eye. Consulting with your veterinarian early on is important – slight abrasions left untreated can develop into serious injuries that may result in loss of the eye or blindness, and are often a significant cause of pain. Severe ophthalmologic cases in which loss of the eye is a possibility are often time-intensive and time-sensitive, and therefore warrant referral.

8. Foaling emergencies (dystocia)

Until birth, foals are completely dependent on oxygen supplied by the placenta. Therefore, premature placental separation from the uterus, or prolonged labor that may be caused by abnormal presentation of the foal, results in prolonged delivery and puts the foal at risk of death. As time is of the essence, the foal must be delivered as quickly as possible for the health of both the mare and offspring. Difficult dystocias may only be corrected under the assistance of general anesthesia, and referral clinics are best equipped to deal with this.

9. Anaphylaxis

A natural reaction of the immune system, anaphylaxis is a result of appropriate yet over-zealous response to a trigger. It may occur when an abscess in the abdomen bursts, or if a horse has vaccine reactions or severe allergies. Immunosuppressant therapies are the mainstay of treatment. Once the initial crisis is resolved, these patients are often effectively managed in the field.

10. Laminitis

Inflammation of the sensitive hoof lamina is poorly understood. Increased incidence of laminitis has been associated with overeating grain, bacteria in the blood stream, metabolic diseases, and other factors. Anti-inflammatories, along with providing mechanical relief to the hoof, are standard treatments. Horses experiencing acute-on-chronic (an acute exacerbation of a chronic illness) episodes of laminitis might benefit from deeply bedded stalls or sand, and ice therapy applied directly to the distal limb.

11. Inability to rise

Significant trauma, viral or parasitic neurologic diseases, malnutrition or colic can result in a horse that can’t rise. Safety for both owner and horse is paramount when cases are found in the field. Care might be largely supportive and medically aggressive. In some cases, the most humane option may be euthanasia. A downed horse is best managed around the clock at a referral center.

12. Fever

Infectious, non-infectious, autoimmune and inflammatory events may all cause an elevation in body temperature (>101.5°F). Anti-inflammatories are essential, and antibiotics or immune-suppressants might be used, depending on the cause. Common sense biosecurity with hand and boot protection and animal isolation are vital. Fevers of unknown origin, or with concurrent blood work abnormalities (e.g. low white blood cell count) are best managed at a referral center.