Definitions:

Emergency: An unexpected occurrence leading to a sudden need for action.

 

First Aid: Immediate help given in the case of injury or sudden illness given by a lay person before the arrival of a veterinarian.

If you know what is normal for your horse, it will make it much easier to assess what is abnormal should an emergency arise. I believe that every horse owner should take the time to observe his or her horse over a period of time to find out what normal behavior is for that animal. Evaluation of your animal should include the following:

Behavior:

• How does your horse act normally?
• How often does he roll?
• How often does he vocalize?
• How often does he stretch?
• How alert is he?
• How of ten does he lay down?
• Does he seem to be interested in food?

Defecation and Urination:

• How often does your horse urinate?
• What is normal color and consitency of urine for your horse?
• How often does your gelding drop his penis out of his sheath?
• Does he seem to have any difficulty urinating?
• Is your horse passing manure?
• Does his manure seem to be normal in consistency?
• When you listen to your horse's abdomen with a stethoscope, what sounds do you hear? How loud are they? How do they change before and after a meal?

Musculoskeletal System:

• Does your horse have any swellings or lumps that are not normal for him?
• Does your horse have any abnormal swellings?
• Does he seem to be lame or sore anywhere?
• Is he reluctant to move?

Objective Assessment:

Heart rate:	Normal Adult: 36-48 beats/minute Normal Foal: 36-66 beats/minute
Respiratory rate:	Normal Adult: 8-16 breaths/minute  Normal Foal: 8-32 breaths/minute
Temperature:	Normal Adult: 99-101 degrees Fahrenheit Normal Foal: 99-102 degrees Fahrenheit
Mucous membranes:	Gums should be pink, not grey or brick red. They should be moist, and when touched, they should go back to pink within 2 seconds.
Digital pulse:	The pulse on the back of the pastern should be difficult to feel and should not have a strong beat. The feet should not be hot.
Abdominal sounds:	Gurgling sounds should be heard on both sides, but excess rumbling should not be heard.

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FIRST AID KIT

A good first aid kit is invaluable in the event of an equine emergency. The following is a basic list of items which are easily acquired and helpful in many cases. Gathering these ahead of time is much better than scrambling to find them at the time at which an emergency occurs! Keep a checklist in the kit so that you know what it should contain, and so that you can restock items as they are used.

1. Diagnostic Equipment:

• Stethoscope
• Thermometer
• Flashlight with fresh batteries
• Hoof pick

2. Bandaging Material:

• Scissors
• Non-stick wound covering (Telfa Pads)
• Gauze wrap (Kling)
• Leg cottons (Fleece leg wraps, roll cotton, or quilt batting)
• Adhesive elastic bandages (Elasticon)
• Adhesive non-elastic bandages (white medical tape or duct tape)
• Ace bandages
• Non-adhesive wraps (Vetwrap or Co-Flex)
• Diapers (these make nice, clean, absorbent temporary wraps)

3. Medications:

• Disinfectant (Povidone-iodine solution (Betadine ))
• Antibacterial ointment (Furacin or chlorhexidine)
• Phenylbutazone (bute)
• Contact Lens Sterile Saline (can flush wounds or flush matter from eyes)

4. Other equipment:

• Clean plastic bucket
• Clean warm water
• Clean towels
• Twitch (Can use binder twine + hammer handle with a hole drilled in it.
• Your veterinarian's phone number and list of alternatives
• Please note that it is preferable to talk to your veterinarian before attempting first aid on your horse, especially with regard to splinting, treating or wrapping wounds or using medications such as phenylbutazone.

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EQUINE EMERGENCIES

1. COLIC

Colic is a general term which simply means abdominal pain. Colic may originate from any part of the abdomen, such as the intestinal tract, abdominal cavity, genital tract, or urinary tract.

Common Causes:

Intestinal parasites:	The larvae of such parasites as Strongyles ("bloodworms") can cause scarring of the mesenteric artery as they travel through the horse's body. The mesenteric artery supplies blood to the small intestine, and this scarring can lead to loss of blood supply to parts of the small intestine, which in turn may become unhealthy and serve as a source of colic. Roundworms may also cause colic by causing intestinal blockage, especially in foals, while tapeworms may cause intermittent spastic colic.
Impaction:	A variety of substances can cause blockage of the intestine, such assand, hay or other feeds, or foreign objects (I pulled a plastic trash bag out ofa horse's rectum once!).Displaced or twisted intestines: Intestines may twist or fold over on themselves,which over time leads to increased pressure in the intestine, loss of blood supply to part or all of the intestine, eventual rupture, and death. Displacedor twisted intestines are a life-threatening emergency, and usually require surgery within a few hours.
Spasmodic:	Horses that eat too much grain, or are fed hay that is much richer than they are normally fed may colic because of gas.
Peritonitis:	Infection of the lining of the abdominal cavity.

Signs of Colic:

The signs of colic are related to the pain involved. Behavioral signs may be some or all of the following:

• Depression
• Turning to look at sides
• Loss of appetie
• Pawing the ground
• Kicking at the belly
• Stretching
• Dropping penis out of sheath as though trying to urinate
• Rolling
• Shaking or trembling

Body system signs:

• Increased heart rate
• Pale, grey, or brick red mucous membranes
• Gums take longer than 2 seconds to go back to pink after touched
• Gut sounds may be increased or decreased
• Abdominal distension-horse may look bloated

What to do before calling your veterinarian:

When a client calls me with a possibly colicky horse, I find it helpful if the client has some or all of the following information ready:

• Physical Examination and History
• What is your horse's heart rate?
  Heart rate is most easily taken with a stethoscope placed on the left side of the horse's chest, just behind the elbow. If your horse has been laying down and you have just gotten him up, wait at least a minute before checking heart rate or it is likely to be higher than it actually is.
• What is your horse's gum color? Are gums pink, pale, or brick red? Do they go back to pink within 2 seconds of being pressed?
• Check gut sounds. Are gut sounds less than normal or are they much greater than normal?
• How long has your horse been colicky? Over that time, does he seem to be getting better, getting worse, or staying the same?
• DO NOT GIVE ANY MEDICATIONS BEFORE DISCUSSING YOUR HORSE WITH YOUR VETERINARIAN.

What else to do:

• Call your veterinarian
• Remove food and water
• Prevent from rolling and injury:
• Walking may be beneficial, but if your horse is lying quietly, I prefer that owners not walk him, because it may up doing nothing more than making him more exhausted. An exception to this is if it is very cold out, or if your horse is extremely wet, in which case it may be beneficial to walk your horse in order to keep him warm.

2. MYOSITIS

This is also known as "tying up", or "Monday morning disease". Myositis is the sudden onset of severe muscle pain and inflammation, most commonly involving the hind legs and back. It occurs most commonly in the regularly excercised horse who is given a day or two off, and then put back on his regular schedule. When the horse resumes exercise, the excess energy stored in his well-trained muscles leaks out of storage and damages the muscles.

Signs of tying up are usually noted 5-30 minutes after the start of exercise. Signs include reluctance to move, especially the hind legs, anxious expression, hard rump muscles that are painful to the touch, and brown or reddish urine caused by chemicals from damaged muscle fibers. Horses with myositis may have secondary kidney damage due to toxicity from these chemicals.

What to do:

• DO NOT MOVE THE HORSE! Moving the horse will cause further muscle damage and may be fatal.
• Call your veterinarian
• Hip muscles should be hot packed with warm moist towels
• Anti-inflammatories:
  (Bute) should be given only after the horse is assessed by your veterinarian. Since bute can be toxic to the kidneys, giving bute to a horse that already has kidney damage is a bad idea. Your veterinarian may want to assess kidney function before recommending bute for your horse.
• Rest:
  Stall rest until your horse seems to be recovering from his soreness, which may take several weeks, followed by a very gradual return to work, accompanied by the preventative measured mentioned below.

Prevention of Myositis

There are several practices which if followed may prevent a horse from tying up:

Warmup	Give your horse a gradual warmup whenever he is worked, at least 5-10 minutes to allow his muscles to stretch and loosen before starting his normal workout.
Selenium	Make sure that your horse is receiving an adequate level of selenium in its diet. A simple blood test can check your horse's selenium level.
Diet	Decrease or eliminate your horse's grain the day before and the days of his "vacation". This helps prevent the buildup of excess glycogen in the muscles. Products such as "Natural Glo" (Moorman's Feed Co.) may also help prevent tying up by decreasing the amount of glycogen stored in muscle fibers.

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LAMINITIS ("founder")

Laminitis, also known as founder, is inflammation of the soft tissues that lie between the hoof and the coffin bone (the bone in the foot). This inflammation will cause tissue damage and may cause the coffin bone to rotate downward, in extreme cases causing the tip of thecoffin bone to protrude through the sole. Laminitis typically will affect both front feet, but not usually the hind feet.

Signs include:

• Reluctance to walk
• Leaning backward onto the haunches to take as much weight off the front feet as possible
• Heat present in the front feet, and a stronger than normal digital pulse
• In extreme cases, the horse may lay down to take the weight off his feet and refuse to get up.

Causes of Laminitis

Severe diseases or infection:	Diarrhea-Salmonella, Potomac Horse Fever, Colitis-X, etc. Colic Pneumonia Uterine infection Retained placena Any disease which causes a high fever for a length of time
Cushing's disease	Recently, Cushing's disease, caused by a pituitary tumor, has been recognized as a cause of laminitis. Horses which have Cushing's are often extremely obese, have very cresty necks, do not shed out their hair coats, and have patchy sweating. There are several blood tests used to diagnose this disease, and there are medications which are at least somewhat effective in controlling the signs.
Grain/Carbohydrate Overload	A horse which breaks out of his stall and finds your grain bin, then eats a large amount of grain should be treated as a horse which may founder. Similarly,a horse which is fed a hay that is much richer than he is accustomed to, or is put out on very rich pasture is at risk for laminitis.
Excess work on hard surfaces	A horse that is worked hard on paved or very hard surfaces may founder dueto the chronic damage and stress put on his feet.
Lameness	If a horse is very lame on one foot, he may founder on the good foot because of the extra weight he constantly bears on it.
Obesity	Obese horses are at higher risk for laminitis. If your horse is overweight, he could benefit from a reduced calorie diet, or may possibly have Cushing's disease or another metabolic disorder.

Diagnosis and treatment of Laminitis

In addition to diagnosing founder based on the signs listed above, your veterinarian may perform x-rays to assess the severity of coffin bone rotation. If there is not an obvious reason why your horse has foundered, your veterinarian may also perform blood work to evaluate your horse for such things as Cushing's disease or other systemic disorders.

Treatment of founder

Decrease inflammation	Phenylbutazone and other anti-inflammatories
Increase circulation to feet	Walk the horse 10 minutes 2-3 times per day Medications may also be used
Diagnose and remove causes of founder	No grain, no rich hay Treatment of metabolic and systemic disease
Corrective trimming or shoeing	In acute founder, elevation of the heel may be helpful to decrease stress on the coffin bone. A correctly applied heart bar shoe may also be helpful in order to supply support to the frog. In chronic cases, trimming back the excessively long heel accompanied by squaring of the toe maybe helpful.
Surgical procedures	In acute cases which do not respond to medication or corrective shoeing, cutting of the deep digital flexor tendon, and/or removing the front 1/3 of the hoof wall from bottom to coronary band may be helpful.

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PREVENTATIVE MEDICINE

Spring is almost here, and horse owners everywhere are preparing for another busy year of riding and showing. After a winter of inactivity (at least for most of us in snowy Michigan and the Midwest!) horses are suddenly worked harder and are exposed to stresses such as the new insect and parasite population, as well as other horses and their diseases. bexause of this, it is the time when it is most important to consider a preventative maintenance program that will help ensure your horse's health throughout the summer.

Vaccinations

EFT ("4-WAY"): This vaccine contains protection against several different diseases:
Encephalitis ("Sleeping Sickness")	This is a viral disease that attacks the nervous system of mammals (including humans), and is almost always fatal. It is spread via mosquitos, and should be given annually in the spring, although if your horse moves to a part of the country with year-round mosquitos, bi-annual vaccination is recommended. There are three different varieties of encephalitis: Eastern, Western, and Venezualan. If your horse resides in the midwest, it is unneccessary to vaccinate for Venezualan encephalitis unless he is traveling to Southwestern states such as New Mexico or Texas.
Influenza ("Flu")	This is a viral disease, and is spread by contact with an infected horse. Affected horses will have various signs, including fever, cough, and muscle soreness. Vaccination should be performed at least annually, and horses which are exposed to many other horses, such as during shows should be vaccinated at least twice a year.
Tetanus ("Lockjaw")	Horses are extremely sensitive to the tetanus toxin, which is produced by a bacterium which will grow in wounds, especially deep puncture wounds. Tetanus toxin will cause horses to have generalized extreme muscle contractions as well as paralysis of the diaphragm muscles which will render the horse unable to breathe. Tetanus in horses is usually fatal once signs appear, and treatment is generally unsuccessful. Tetanus vaccination should be repeated annually

RHINOPNEUMONITIS ("Rhino")

This is also a viral disease, spread by contact with infected horses. Signs include fever, coughing, and nasal discharge. there are several Rhino vaccinations available, some of which prevent the cough, and others which prevent abortion caused by a different variety of the virus. It is important that your horse be vaccinated with the correct type of vaccine for the situation. Horses should be vaccinated every three months while exposed to other horses, such as during the show season.

POTOMAC HORSE FEVER

This is caused by a microorganism, and causes diarrhea, fever, colic, and founder. It may be fatal in some cases even with supportive medical care. Although the exact mechanism by which the disease is spread is unknown, it is believed to be spread by ticks or other blood sucking insects. Diarrhea from infected horses is not infective. Vaccination for this disease should be performed annually.

RABIES

Although the risk of your horse contracting rabies in many areas is still small, the fatal nature of the disease and danger to humans has led many more horse owners to vaccinate for rabies than in the past. New strains of the disease, as well as increasing populations of raccoons and skunks in some areas are also factors in the number of vaccinated horses. In horses, rabies vaccination should be performed annually.

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OTHER SPRING HEALTH CARE

Preventative spring care should also inclued a thorough exam. Teeth may need to be floated, your horse may have sand in his intestine which may cause colic or cause your horse to lose weight, or have other health needs. Other beneficial care may include a blood selenium test to ensure that your horse does not have a deficiency of this important mineral. A low selenium level may seriously effect your horse's ability to perform as the year progresses and he begins to be worked harder, and may also decrease his resistance to infection. Spring care should also include a fecal exam to determine the effectiveness of your worming program.

Spring is also a good time to have your gelding's sheath cleaned if he has not had it done for some time. Although some horses are willing to let an owner clean a sheath without sedation, frequently the only way that a sheath can be thoroughly cleaned is if a horse is tranquilized.

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WORMING

There is much debate over the most successful way to keep horses free of intestinal parasites. One thing that is agreed upon is that no matter what kind of wormer you use, rotating your wormer is essential to a good program. The following recommendations are based on recent research into the resistance patterns of parasites which are emerging, and how best to counteract these newly resistant worms.

There are five different classes of wormer:

• Ivermectin (Zimectrin, Equvalan)
• Pyrantel (Strongid)
• Oxbendazole (Anthelcide)
• Benzimidazoles (Active ingredient ends in -zole)

Please note that Quest is not mentioned because the present claims of the manufacurer are not reasonable given what we know about the life cycle of the parasites, and until more is known about the actual effectiveness of this wormer, I am not adding it to this worming program. I do believe that you could reasonably assume that anywhere that you use Ivermectiin, you could use Quest.

For areas in which the winter temperature drops below freezing, I do not believe that it is neccessary to worm during the winter. In other areas, worming should be performed year-round. I believe that Ivermectin should be used twice a year every year, and other wormers should be used monthly, with a change to a different monthly wormer being made annually.

Confused? Here are two diagrams, one for a warm-weather state, the other for a state which has cold winters.

• I = Ivermectin
• S = Strongid
• A = Anthelcide
• B = Benzimidazoles

WARM WINTER STATE YEAR-ROUND WORMING PROGRAM:
MONTH	YEAR 1	YEAR 2	YEAR 3
December	S	A	B
January	S	A	B
February	S	A	B
March	S	A	B
April	I	I	I
May	S	A	B
June	S	A	B
July	S	A	B
August	S	A	B
September	S	A	B
October	SS*	SS*	SS*
November	I	I	I
December	S	A	B
**Note: SS is a double dose of Strongid given at least once a year to treat horses of tapeworm, a parasite which seems to be increasing in prevalence. I would recommend this if your horse is pastured with many other horses, if fecal exams show that your horse has tapeworm (although many infected horses will test negative on a fecal exam), if your horse is a "poor doer", or if he is prone to frequent bouts of colic. Ivermectin is given spring and fall to treat for bots, since this is the only wormer other than Quest that kills bot larvae in the stomach.

COLD WINTER STATE YEAR-ROUND WORMING PROGRAM:
MONTH	YEAR 1	YEAR 2	YEAR 3
April	I	I	I
May	S	A	B
June	S	A	B
July	S	A	B
August	S	A	B
September	S	A	B
October	SS*	SS*	SS*
November	I	I	I
**Note: SS is a double dose of Strongid given at least once a year to treat horses of tapeworm, a parasite which seems to be increasing in prevalence. I would recommend this if your horse is pastured with many other horses, if fecal exams show that your horse has tapeworm (although many infected horses will test negative on a fecal exam), if your horse is a "poor doer", or if he is prone to frequent bouts of colic. Ivermectin is given spring and fall to treat for bots, since this is the only wormer other than Quest that kills bot larvae in the stomach.

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EPM

1. What is EPM?

EPM (Equine Protozoal Myeloencephalitis) is caused by a protozoal parasite (Sarcocystis neurona), carried by birds (especially cowbirds), as well as the opossum, which is the animal that transmits the parasite to horses. Transmission occurs when horses eat hay, pasture, or grain contaminated with opossum feces containing the parasite. Horses are a "dead end" host, which means that an infected horse CANNOT transmit the disease to other animals or horses.

The parasite invades the central nervous system of the horse and causes damage to the brain, spinal cord, and cranial nerves. Any neurologic sign present in a horse may be caused by EPM, including:

• lameness
• weakness
• back soreness
• stumbling
• muscle atrophy, either local or generalized
• paralysis
• head tilt
• roaring
• quidding (dropping food out of mouth)
• chewed food flowing from nostrils
• difficulty with balance, showed by base-wide stance
• ear droop
• muzzle deviation

Other diseases such as the equine herpes virus, wobblers, tumors, and trauma may also show some or all of these signs.

Presently, in Ohio, Pennsylvania, and Kentucky, EPM accounts for 25-45% of all the neurologic cases in university settings, with young horses affected more than older horses.

Infected horses may start to show signs anywhere from 1 month to 2 years after exposure.

There are presently several diagnostic tests for EPM. The most common test is a blood test to check for the presence of antibodies to the parasite. This test does not tell whether a horse is presently infected with the disease, because many horses become infected and kill off the parasite before they show clinical signs, and a horse which has fought off the disease will still test positive for months to years after being exposed. In some states, 40-60% of the horses test positive on a blood test, even though a much lower percentage actually have the disease. Basically, a blood test for EPM is only a screening test. If your horse tests negative, it is very likely that he does not have EPM, but if he tests positive, you may need to have further testing done to find out if he actually is infected.

Another test involves taking spinal fluid from the horse and checking this for antibodies. A horse which tests positive on a spinal tap is highly likely to be infected with EPM. At this time, this is the most accurate test for the parasite, although researchers are still developing other tests.

There are various treatments for EPM, which vary in price and effectiveness. Treatments involve a variety of specific antibiotics which have been proven to kill or inhibit the parasite, coupled with anti-inflammatories such as bute and sometimes DMSO to decrease inflammation in the central nervous system. Infected horses should be treated for a minimum of four months, and many require treatment for longer periods of time. Ideally, horses should be treated until a spinal fluid test is negative, since blood tests will stay positive for an unknown length of time. Prognosis once treated is reasonably good, however some horses never recover despite aggressive therapy, and die or have to be destroyed. Other horses relapse whenever treatment is discontinued, and need to be treated for life.

Prevention of EPM involves good stable hygiene such as keeping feed bins covered so that possums are denied access, and keeping garbage cleaned up so that possums and other wildlife are discouraged from feeding where horses are present. Possums discovered in barns should be shot or relocated at least 5 miles from their present location, since they will often return if moved shorter distances. Some day, prevention may also include a vaccination for EPM, but research into this area is still in the preliminary stages.

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