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Articles

Common Emergencies, Part 2


2015/03/02






Dr. Kakki Wright and Dr. Ellen Yungmeyer are completing the two-part ASK THE VET article about the ten most common emergencies seen in our practice.  Last month, we discussed the fearsome five – colic, sudden lameness, lacerations, eye injuries and laminitis.  Following are next five most common emergencies.

6. CHOKE. Quick, who knows the Heimlich maneuver?  Just kidding.  Horse choke is not the same scenario we think of when a person has food lodged in the airway, because it is caused by a bolus of food lodged in the esophagus.  How do you know when a horse is choking?  The most obvious sign is profuse nasal discharge, often containing feed material.  Some horses will hold their neck in a strange position and make repetitive chewing or gagging noises.  Why do horses choke?  Sometimes, choke is just a one-time freak incident.  Unfortunately, some horses become prone to it due to poor dentition, a tendency to eat too fast, or abnormalities in the function of the esophagus.  While choking, they usually aspirate some saliva and feed material into their lungs, so many horses that choke end up needing treatment for pneumonia.  What to do?  Take away all feed and call your veterinarian!

7.  DYSTOCIA.  Dystocia is defined as difficult or prolonged labor.  When a mare is foaling, there can be a lot of variation in what is considered “normal” behavior and progress.  Then, how do I know when to call the veterinarian?  Thankfully, there a few hard and fast rules to follow.  One, is that the second stage of labor should not take longer than one hour. The second stage of labor begins when the mare’s amnion ruptures (like water breaking in a human) and concludes when the foal is fully expelled from the birth canal.  Another rule of thumb is that if 15 minutes pass without any progress, there is likely a problem, such as malpositioning of the foal.  Finally, the mare needs to pass her placenta within 3 hours of foaling.  A retained placenta can lead to serious illness and even death of the mare.  Observe your mare’s labor, especially if it is her first foal or she has had problems delivering previous foals.  If she isn’t meeting any of these time guidelines, call your veterinarian immediately!  Dystocia is a time sensitive emergency and action needs to be taken quickly in order to have a live foal delivered and preserve the health of the mare. 

8.  FOAL EMERGENCIES.  Just as there are time limits on mom’s progress during and after foaling, the foal needs to meet several milestones, as well.  A new foal should stand within 1 hour of birth and be successfully nursing within two hours.  Failure to do so could be a sign of prematurity and missing out on colostrum (mare’s first milk containing antibodies) will leave the foal susceptible to life-threatening infections.  If your foal does not stand and nurse, it needs to be seen by a veterinarian as soon as possible.  In the following weeks and months, even with foals that do get adequate immunity from colostrum, it is important to watch for lameness, joint swelling, coughing, hard breathing, nasal discharge, swelling or redness of the umbilical stump, diarrhea, or general malaise, all of which could be signs of infection.  Normal temperature for a foal is 99.5° – 102°F, so if your foal has a fever, any of the above signs, or just isn’t doing its normal foal routine of nursing, playing and sleeping, it should be seen by a veterinarian.  Foals are relatively fragile compared to adult horses, so anything out of the ordinary that you might “wait and see how it goes” in an adult horse is probably reason to call your veterinarian in the case of a foal.  For mom and baby’s health, remember the 1, 2, 3 rule: once the foal is born, it should be standing in 1 hour and nursing in 2 hours and the mare should pass her placenta within 3 hours of giving birth.

Equine Reproduction has a good sequence of foaling photos: http://www.equine-reproduction.com/articles/Foaling.shtml

9. DOWN HORSE.  Perhaps this one shouldn’t be toward the end of the list! Unfortunately, this is one of the most common emergencies we see during the winter months, especially in older horses.  What causes a horse to be “down?”  Horses lie down and are unable to get up for a variety of reasons, but the most urgent point is that they can’t survive for long on the ground. Horses are not meant to lie on one side for more than a couple of hours. The weight of their body occludes blood flow to muscles and nerves, potentially leading to permanent damage and the lung on the down side collapses. Unable to get to feed and water, they become dehydrated and debilitated within a few days. What can you do about it? There’s one trick that makes a difference in many cases!  Often, if the horse can be rolled to its other side and you can get its feet positioned downhill, the horse can stand up on its own.  This can be dangerous, so if the horse is thrashing and kicking or in a confined space, do not attempt this on your own. However, if you can safely wrap a lead rope around the fetlock (ankle) of each down leg and pull the horse over to its other side, the horse will often be able to get up on his/her own. If you succeed, you may still need to call your veterinarian to address the underlying issue, but at least the horse is on its feet. If you do not succeed in getting the horse up, it definitely warrants picking up the phone!

10. NEUROLOGIC DISEASE.  Any abrupt change in the neurologic status of a horse is considered an emergency.  What constitutes abnormal neurologic behavior?  There is a huge variety, but in general any movement that seems weak, uncoordinated, or uncontrolled, or any behavior that seems as if the horse is confused.  Ataxia is the term we use to describe poor control of the limbs resulting in a wobbly gait – in an ataxic horse you may see swaying, tripping, and failure to step over/around obstacles.  With certain types of neurologic diseases, horses will display muscle tremors or extreme rigidity or flaccidity of leg and back muscles, as well as throat and facial muscles.  This can lead to problems chewing and swallowing or weak, droopy ears and eyelids.  Severe neurologic behavior can include circling, pressing the head against the wall, sudden blindness, etc.  Why are these things an emergency?  Neurologic diseases are an emergency because of their tendency to progress quickly and, the more severe the horse becomes, the less chance of recovery and the more danger to the horse and caretaker.  So be careful if this situation arises and call your veterinarian!

We could go and on listing other emergency conditions, more than one of you is probably wondering why I didn’t mention pneumonia or diarrhea or a host of other cases that have presented under dire circumstances.  Those listed above are the most common emergencies seen in my practice, but certainly not the only ones. The truth is – any emergency that you have encountered is memorable and unpleasant.  There are many established horsemen out there who can handle emergency situations and I thank you for it, because it makes the veterinarian’s job easier to have good eyes to help with an evaluation prior to arriving (how fast do we need to drive?) Regarding your veterinarian, the bottom line is, “when in doubt call them out!”  It is always better to err on the side of caution than have done too little too late.  In our experience, catching an emergency early often makes the difference between a quick, favorable outcome versus a protracted and unfavorable one. 

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