EMERGENCY - Equine Emergency

Question 1

How do you prepare for an equine emergency?

Answer 1

• Know phones numbers of your colleagues, referral practices and disposal contact
• Check your car to make sure you have everything you need such as PPE, equipment, drugs etc

Question 2

How should you triage over the phone for an equine emergency?

Answer 2

1. Determine if this is really an emergency
2. Gather signalment information
3. Gather a history
4. Provide the client with guidance whilst they wait for you to arrive

Question 3

What are the main steps involved in triage for an equine emergency?

Answer 3

1. Identify the stability of the animal
2. Identify your patient using their passport, determine signalement and take a history
3. Identify and treat injuries that are immediately life threatening and identify which injuries could be exacerbated by moving the animal
4. Thorough clinical exam
5. Make a differential diagnosis list and plan your treatment and management

Question 4

What guidance should you provide a client with a colicing horse whilst they wait for you to arrive?

Answer 4

Remove all food from the area and if the colic is violent stay away from the horse and don’t risk human safety

Question 5

What guidance should you provide a client with a horse with a penetrating hoof injury whilst they wait for you to arrive?

Answer 5

Tell the client not to remove the penetrating object if it is deeply penetrated, however, if the penetration is superficial it may be beneficial to remove it to prevent further trauma if the horse pushes it further in etc.

Question 6

What guidance should you provide a client with an actively bleeding horse whilst they wait for you to arrive?

Answer 6

Apply pressure to the wound if safe to do so and do not remove the pressure

Question 7

What do the ABCD principles stand for in equine emergencies?

Answer 7

Airway
Breathing
Circulation
Drugs

Question 8

What should you do if a horse has an upper airway obstruction?

Answer 8

Emergency tracheostomy

Question 9

How do you carry out an equine emergency tracheostomy?

Answer 9

1. Surgically scrub and administer lidocaine at the upper third of the trachea (if there is time)
2. Carry out a midline vertical incision at the upper third of the neck
3. Divide the stenothyrohyoideus muscles overlying the trachea
4. Stab incision through the annular ligament between the tracheal rings and extend this inision to either side big enough to allow for the placement of the tracheostomy tube
5. Secure the tracheostomy tube to the neck

Question 10

What is the circulating blood volume of a horse?

Answer 10

60 - 70ml/kg

Question 11

When will a horse begin to decompensate due to haemorrhage?

Answer 11

A horse will begin to decompensate due to haemorrhage of they suffer from approximately 30% acute blood loss

Question 12

List five clinical signs of significant haemorrhage in horses

Answer 12

Tachycardia
Tachypnoea
Hyperpnoea
Pale/white mucous membranes
CRT more than 2 seconds

Question 13

What should you do if a horse has severed an artery?

Answer 13

Clamp the artery but be careful of nerves as they often sit very close to arteries

Question 14

When in an equine emergency can it be useful to use xylazine as a sedative?

Answer 14

Xylazine is good to allow you to assess a fractious colic as it can be administered IM and has a short duration of action so you can carry out a safer clinical exam and then reassess the animal when the sedation wears off

Try to get a heart rate before administering the xylazine

Question 15

What should you be aware of if using detomidine to sedate a fractious colic?

Answer 15

Detomidine is a more potent analgesic than xylazine and this can mask esalating pain which could indicate a worsening colic and alter your treatment plan. Ideally you should only use detomidine for horses with severe and relenting colic pain

Question 16

Which seven side affects of α2 agonists should be aware of in horses?

Answer 16

Bradycardia
Reduces gastrointestinal motility (be careful as can cause colic)
Sweating
Diuresis
Hyperglycaemia
Worsen upper airway obstruction
Tachypnoea in pyrexic horses

Question 17

How do α2 agonists worsen upper airway obstructions in horses?

Answer 17

α2 agonists cause muscle relaxation which can exacerbate pre-existing airway obstruction

Question 18

Which opioid is commonly used in combination with α2 adrenoreceptor agonists in horses?

Answer 18

Butorphanol

Question 19

Why is butorphanol commonly used in combination with α2 adrenoreceptor agonists in horses?

Answer 19

Butorphanol has a significant potentiating effect on the sedative and analgesic effects of α2 adrenoreceptor agonists

Question 20

How should you generally administer sedatives to horses?

Answer 20

Generally you administer and top up sedative drugs via an IV bolus

Question 21

How should you administer sedative drugs for longer procedures?

Answer 21

Administer an IV loading dose followed by continuous infusion

Question 22

What are the three key clinical signs of colic in horses?

Answer 22

Pawing
Flank watching
Rolling

Question 23

(T/F) The majority of colic cases in horses require surgery

Answer 23

FALSE. The majority of colic cases can be managed medically

Question 24

Which significant side effect of NSAIDS should you be aware of in horses?

Answer 24

Right dorsal colitis

Question 25

What classifies as euthanasia on humane grounds?

Answer 25

-Euthanasia due to a strangulation lesion of the small intestine that cannot be corrected
- Euthanasia of an adult horse with a displaced radius fracture
- Euthanasia of a horse with terminal illness

Question 26

Which drug should you use for euthanasia in horses?

Answer 26

Somulose

Question 27

How should you administer somulose?

Answer 27

Place an IV catheter and administer the drug over 10-15 seconds

Question 28

(T/F) Somulose is very unsafe for humans

Answer 28

TRUE. Somulose can be very dangerous if absorbed through your skin or mucosa