Equine emergencies – making decisions that save lives

Posted on March 07, 2016

Vet attending horseEquine practitioners are faced with emergency situations on a fairly regular basis, nevertheless, such events are often the most challenging aspects of the job. These calls never come at the best time, and require veterinary surgeons to keep a cool head in a sea of chaos, often in a resource limited setting.

In these litigious times, vets may also be faced with the realisation that inadequate or inappropriate first aid could even exacerbate the situation, leading to an unfavourable outcome for the horse and emotional and financial distress for the owner.

Despite this, there is no doubt that equine emergencies can also be one of the most rewarding aspects of practice, and far from being situations in which an individual is out of their depth and in a state of hidden, or overt, panic, they offer an opportunity for leadership and personal satisfaction.

An equine case study

It's Friday afternoon, the calls are finished for the day and you’re about to begin an evening of consulting when the receptionist tells you there’s a horse to attend. It’s a local highland pony owner whose yearling colt that you castrated this morning has something hanging from its inguinal region. A short drive to the farm and your worst fears are realised, a loop of small intestine is swinging between the pony’s hind legs - an eventration.

Of course you remember the castration lecture, you know this is a recognised complication, its not your fault and you’ve an idea that you have to support the intestine to stop more of it leaving the abdomen, but in the dark of the stable, with an uncooperative patient and a traumatised owner you’re having some trouble focusing on the detail - what happens next?

Horse with eventrationYou perform a quick clinical examination, sedate the pony, and donning sterile gloves you wash the single loop of intestine, and push it gently into the incision which you close with a purse string suture. The pony is given NSAIDs and further antimicrobial cover and loaded onto a trailer to the nearest referral hospital where it arrives in a good condition for surgery and only requires a small portion of small intestine to be resected from which it recovers well.

…..Or under pressure, and un-sure how to proceed, with a very uncooperative patient you try briefly to replace the intestine only to be met by flying legs from the pony and concern from the owner, so you load the horse, knowing its only a short journey to the referral clinic. When the ramp is opened after a 30-minute drive, the pony is standing on its jejunum, which under the force of gravity and by the action of peristalsis has continued to eventrate and is now irreversibly compromised. The pony is euthanised.

How can we improve our response to the emergency call?

Although equine emergencies are by definition unexpected, that does not mean vets need be unprepared. A few simple steps can be taken to develop strategies to arm yourself and the practice for almost any eventuality. Such steps might include developing a rescue/emergency kit, training reception, nursing and veterinary staff for dealing with the emergency call, and forging links with local stakeholders, such as riding clubs, studs, livery yards and the local fire and rescue service.

So why not join us for a case based approach to equine emergencies at BVA HQ on 19 April 2016. The course will cover emergency scenarios focusing on first aid and decision making to maximise the chance of a positive outcome for horse and vet.

Patrick J PollockWritten by Patrick J Pollock BVMS, CertES(Soft Tissue), FHEA, DipECVS, MRCVS
European and RCVS Recognised Specialist in Equine Surgery

Follow @PJPollockVet and @WeipersEquineUofG

Patrick is Senior University Clincian in Equine Surgery at the Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow.