Veterinary Care Provision at Equestrian Events Flashcards
What is the EPSL?
Equine Prohibited Substances Lsit -> prohibited for use during FEI events
This includes:
1. ‘Banned substances’ -> not permitted for any use at any time
2. ‘Controlled MEdication’ commonly used in equine medicine but potential to affect performance
List some detection times for common drugs?
Whats the difference between detection times and withdrawl times
» Detection time: the approximate period of time for which a substance or its metabolite remains in a horse’s system such that it can be detected by the laboratory.
» Withdrawal time: adds a safety margin to the detection time, chosen with professional judgment and discretion to allow for individual differences between horses such as size, metabolism, degree of fitness, recent illness or disease etc.
What is the role of BHA Vet officer at racing events?
- Passports and vaccination check
- Infectious diseases – eg ringworm
- Dope testing
- Pre-race examinations at bigger meetings
- Examination of horses and advising stewards (Whip? poor
performance? ridden too hard?)
What about treating vets?
provide treatment as necessary
What requirements for being a racecourse vet?
- ≥5 years experience in a practice (or equivalent clinical capacity) with a
significant (≥50%) equine case load, including the need to regularly attend to
injured horses as part of the normal working week. - Attendance at an approved Casualty Management Seminar within the last 5
years.
Why is 5 years necessary ?
a. Develop the clinical expertise to manage the treatment of a wide range of equine
injuries.
b. Be competent communicating with unfamiliar owners, trainers and other personnel
in often emotional and difficult situations, sometimes in the public eye
What common injuries in Racing?
- SDFT
- SL injury
- Carpal fract +/- chip/slab
- 3rd MEtacarpal/tarsal condylar fract
- Proximal phalanx dorsoproximal fractures
- Traumatic injuries after falls
What different vet roles are there in EVENTING?
- FEI Official Vets
- FEI Permitted Treating Vets
- Team Vets
- OIndividual athlete’s private vet, physio …
Describe FEI Official Vets?
- National head FEI vet
- Veterinary Delegate, Foreign VD, Associate VD
- Holding box vets (Assistant VDs)
- Measuring vets (official measurements at pony
championships) - Examination vets (limb sensitivity)
- Testing vets
What common injuries in Eventing
1 -> Hitting fences
#2 -> Falls
- Skin wounds - most common in comp
- Tendon & ligament injuries - most common in training (SDFT & SL)
- Interference (over-reach) - bruising, heel bulb stud, synvial penetration ..
- Brushing injury
- fractures
- Post fall
- Foot injuries
- Exertional rhabdo
How do we prevent rotational falls?
- Frangible technology -> devices that shatter on impact
- Inflatable vests - body protector with gas canister connected to saddle
What vets at endurance events?
- FEi vets (as per eventing)
- Tx vets
- Vet gate vets
What common issues in endurance?
Heat stress dehydration, ER
What role of Vet gate vets in endurance?
- Large numbers of horses to be checked
- Heart rate taken at each gate and after race
- (must be <64 within 15min)
- Trotted up to ensure sound
- Only if ‘passes vet’ can horse continue and win, even if finished first
- 2 nd opinion on hand
- “Best condition award”
What vet attendance for polo events?
» Vet ‘on-call’ for smaller events
» Vet In attendance for Hurlingham Polo
Association (HPA) tournaments
Injuries for polo ?
» Many of the same injuries as racing:
* SDFT tendonitis
* SL injuries
* Proximal phalanx chip f#
» Fetlock injuries; RF>LF?
What are the proffesional responsibilities when attending these events?
- Professional Indemnity insurance
- Human injury insurance
- Equipment and drugs
- Communication
- Lead the team
- Animal welfare
Main things to know on the day?
- sPot the hazards
- have the correct equipment
- Know your support team
Communication ?
- DUTY OF CONFIDENTIALITY
- Exchange mobiel numbers with other vet,s horse ambulance etc at start of the day
if you deal with an emergency or problem…?
» Discuss with owner
» Discuss & send clinical notes to the usual vet
» Discuss with referral centre if relevant
» Stressful circumstances – emotions can run high
* Firm but sympathetic communication
What equipment should you need?
» Preloaded sedation (alpha-2 agonists and butorphanol)
» Drugs for euthanasia
» Syringes, needles, catheters
» IV NSAIDs: flunixin, phenylbutazone
» IV Dexamethasone
» Adrenalin
» Bandages and dressings
» Scissors & haemostats
» Stethoscope
» Headcollar & rope
Equipment pt 2?
» Compression boots, assorted splints, casting, bandaging & dressings
» Surgical kits, skin staples, scrub solution, alcohol, local anaesthetic, saline,
sterile & non-sterile gloves, clippers
» Anaesthesia drugs – ACP, butorphanol, ketamine, diazepam
» Oxygen?
» Colic equipment & drugs: stomach tubes/funnel & jug, Mg2SO4
, electrolytes,
buscopan, rectal gloves and lubricant
» Antibiotics, IV fluids, more Somulose®…
» Endoscope and light source, ultrasound machine, x-ray machine
» Paperwork (eg Consent forms, endoscopy pads, elective euthanasia forms,
directions & maps to local referral centres, etc).
» Twitch
» Farriery equipment for shoe removal
» Microchip Scanner
» Waterproofs, reading material, food!
Equine fracture support kits?
- 2 Compression Boots
- Rigid external support for all distal limb fractures
- 2 Flexion (Kimsey type) Splints
- Set of aluminium module adjustable splints
Soft tissue injuries ?
- Compression/ coaptation as required
- NSAIDs
- Steroids?
- Cold therapy
What soft tissue injuries are usually not suitable for repiar?
Complete breakdown of suspensory apparatus; rupture of SDFT at the
musculotendinous junction; bilateral SDFT rupture; and lacerations involving SDFT,
DDFT and SL
Fractures?
- Protect and REFER
- Euthanasia on humane grounds
What type of fractures are condylar fractures of the third metacarpal/ tarsal bones?
- stress fractures from high- intensity training (racing)
- small defects act as stress risers
what can happen with a stress fracture at race speed?
Fetlock joint can disarticulate
how should we splint condylar fractures of 3rd metaC/T bones?
‘Splint weight-bearing’
-> Do NOT put condylar fractures in DORSOCOTICAL Alignment
Compression boots are suitable
When IS dorso cortical alignment indicated?
Marked fetlock sinking when weight bearing => suspensory apparatus or flexor tendon breakdown, or sesamoid/P1 pamar / plantar process frac
describe recumbency during the race?
» ‘Winded horse’ - Usually bright, breathing heavily
» Internal haemorrhage or cardiac failure (fatal arrhythmia)
» Fractured cervical/thoracic spine/limb/pelvis
Trapped horse?
- More likely with plain ditches, trakehners, ditch & rail/palisade, open-parallels, u-banks
Recumbency AFTER the race / away from a fence?
- Overheating/ heat stress
- Internal haemorrhage or cardiac failure
How should we tret the recumbent horse?
- Remove tack if safe & ensure restraint
- Oxygen?
- IV NSAID
- Diazpam if seiure
- Roll horse if appropriate
- as determined by PE -> sedation, woudn cleaning euthanasia..
- Consider screens
Describe heat stress?
- Racing, polo, XC and endurance
- Medical emergency, high mortality
- Horses lost heat: through evaporation of sweat (65%) and through respiration
What signs of heat stress?
- High temperature (>40oC)
- Reluctant to move, discomfort
- Altered brain activity
- Very high or low, but desperate respiration
- Often agitated, anxious, unsettled, violent
- May progress to loss of postural stability, collapse, seizures,
loss of consciousness
Risk factors to heat stress?
- Hot day
- High humidity
- Poorly conditioned horse
- Recent transport
- Impaired thermoregulation
- High intensity short duration exercise
Treatment of Heat Stress?
» Remove saddle
» Rapid cooling - Cold water over main muscle mass & scrape off
» Walking, shade, fans, breeze
» Monitor temp
» Offer ad lib water
» O2
therapy?
Prevention of Heat Stress?
» Fitness
» Electrolyte/salt supplementation (NaCL, KCL)
» Acclimatisation to new (hot/humid) climate: 14 days
» Rider/team recognition & training
How much do horses sweat ?
10-12L of sweat/ hour -> horse sweat is hypertonic
What acid-base disturbances can occur?
- Metabolic alkalosis (Cl loss in sweat)
- Respiratory alkalosis (increased alveolar ventilation to increase heat loss in hot humid conditions)
- Racehorses, eventers, elite endurance horses at high speed: metabolic acidosis
What is the primary stimulus for thirst?
Plasma hypertonicity (Na+) -> attenuated by loss of electrolytes in sweat -> horses don’t feel thirsty so don’t drink
How much fluid loss for what clinIcal signs?
Fluid therapy options?
Oral fluids -> plain, salt paste, salt water
Iv fluids: Aggressive isotonic, volume nmore important than actual fluid > typically hartmann’s
( Large bore cath/ giving set )
Exhaustion may be a combination of what?
Hyperthermia, severe dehyd & hypovol chock, plus electrolyte imbalance and energy depletion
What potential delayed signs of exhusation?
Laminitis, hepatic/ renal failure
Describe Synchronous diaphragmatic flutter “thumps”?
» Occasionally seen in eventers at end of XC, endurance horses, racehorses.
» Usually associated with dehydration & exhaustion
» Loss of calcium in sweat
What does ‘Thumps’ cause?
» Increased irritability of phrenic nerve
- Stimulated by atrial depolarisation
- Contraction of the diaphragm occurs in time with heartbeat
Tx for Synchronous diaphragmatic flutter?
Rehydrate & give IV Calcium borogluconate
-> calcium should be diluted
Tx goals for exertional rhabdomyolysis?
: Alleviate pain & anxiety, maintain fluid and electrolyte balance and limit further
muscle injury.
Tx for ER?
» Fluid therapy oral or IV (rehydrate & prevent renal damage)
» NSAID (care)
» Acepromazine – anxiolytic & improves blood flood to muscle
» Courtesy trailor/horse ambulance
» Ensure suitable to transport home, if not then should remain at competition site
What can cause sudden death in these events?
- Respiratory dx - EIPH ..
- CV dx - myocarditis , rupture of chordae,aneurysm, dissminated haemorrhage …
Are gross cardiac lesions common on PME?
No -> in of 4-12h survival post injury necessary for the characteristic microscopic lesions of myocardial necrosis to develop
Why can collection of blood sample right after death be helpful?
- cardiac troponin 1
- Electrolyte abnormalities
What is involved in event euthanasia?
- Screens
- Consent form
- second opinion
Technique for euthanasia?
- Sedative - high dose if excited/high levels circulating catecholamines
- Secobarbitol /Quinalbarbitone & Cinchocaine (Somulose®
, Dechra) - Inject over 10-15 seconds
- 14-gauge catheter
- Gun? – ARVS course, certification, PPE (ear defenders)
- Guns not allowed on many racecourses. Must have silencers.
