First Aid for Your Horse
Imagine the nightmare scenario – as you walk out into the field to bring your horse in, you find him standing on his own unable to move. What should you do? Should you ring the vet straight away? Perhaps a slap on the horse’s rump and just drag him in? Should you phone a friend or ask the audience? There are many different approaches to first aid which may depend on your horse’s temperament as much as what is available and practical in the field. Hopefully this article will give you some ideas of how to deal with the common injuries which you may not have faced already.
First of all, you should perform a thorough check of the horse to establish the nature of the injury. Obviously if he is in a lot of pain or distressed, avoid getting kicked yourself. It never helps the situation if the first thing the vet has to do is take the owner to the hospital. The correct first aid instituted promptly may significantly improve the outcome of any injury. The various common injuries can be divided into the following categories.
BUMPS AND SWELLINGS
Haematomas and seromas will be amongst the largest swellings you will commonly encounter. They are most often in the anterior chest or rump and are caused by blunt trauma (such as a kick) to a large muscle mass resulting in haemorrhage under the skin. They can be painful to palpate but are not always so and once formed will take weeks to resolve. Immediate pressure applied to the area can help as well as cold hosing. Once formed and settled, massage and ultrasound therapy can help to disperse the blood clot. Large haematomas may heal quicker if drained surgically.
Insect bites and stings are usually present as single or multiple focal swellings which are painful to touch. They are most common on the neck and trunk. Bees will leave behind a tell-tale sting which may be difficult to find in the coat. Horse flies may leave behind a small central blood spot visible within the swelling. Rarely, I have seen a lymphangitis-like reaction following a sting or bite in which the whole limb will swell and become painful, requiring large doses of anti-inflammatory drugs. For more minor reactions cold compresses may help. Wasp stings are alkaline therefore counter irrigation with acid solution (vinegar) may help. Conversely , bee stings are acidic and bicarbonate solutions are appropriate.
Bruising and diffuse swelling following trauma may have associated skin damage which may limit topical therapy. Cold hosing/ice packs/bandaging/clay poultices can all be affective. Arnica is widely used but is scientifically not proven to have any effect.
PUNCTURE WOUNDS
By their very nature these are small full depth skin wounds which are easily overlooked or ignored. They are most commonly kick wounds to the upper limb region delivered by a shod horse. The wounds are associated with deeper trauma, tearing the skin from the underlying connective tissue, muscle and ligaments, whilst leaving only a small skin entry wound. Once the skin is broken the sterile barrier has gone and infection will occur. It is essential that this puncture is recognised early and the wound flushed out if possible. What ever happens, these wounds are rarely sutured for fear of sealing infection inside and creating an abscess. Flushing with clean tap water straight from the hose may be appropriate but with small punctures may not penetrate the skin wound adequately. Hydrogen peroxide solutions were traditionally used but can cause more tissue damage if too concentrated. Well diluted iodine based antiseptics are acceptable irrigating solutions. Hydrogel applications are now frequently used as they are non-irritant and are available as sterile packs easily stored in a simple first-aid kit. Older wounds may respond to warm poulticing, which will soften the skin and encourage any fluid to exit the wound. Beware of poulticing over tendons in the cannon region, though.
Remember that some puncture wounds, especially those close to tendons and joints, will need veterinary attention so that the direction and depth of the wound can be assessed. More intensive treatment, such as joint flushing under general anaesthesia, may be required. If in doubt, ring you vet. Do not, however, ring up just to ask for antibiotics. Unless adequate cleaning, flushing, and drainage have been established, antibiotics alone will not remedy the situation. In fact, antibiotics may not even be required if wound has been seen early and been well managed. ‘Pus in the foot’(being a type of puncture wound peculiar to the foot) is a very good example of a condition best managed without antibiotics.
Pus in the foot
LACERATIONS
These are larger skin wounds which may also have associated muscle/tendon damage. Where at all possible these will be sutured, so the first aid that you as the owner apply may well determine the speed and quality of the healing process. A severe laceration of the lower limb may well damage the digital arteries and/or veins resulting in significant haemorrhage and blood loss.
EQUINE LEG WOUND & SAME WOUND SIX WEEKS LATER.
Application of a sterile wound dressing underneath a heavily padded pressure bandage will help to control the bleeding. Suitable dressings might include Allevyn on the skin followed by Orthoband and Knitfix. Multiple padded layers can be provided by such simple things as layers of cotton wool or Gamgee and elasticated tail bandages. Remember that pressure bandaging can only be used when there are sufficient layers to prevent a tourniquet effect.
BANDAGE MATERIALS.
Where there is an open skin wound with no significant bleeding, hosing with tap water will often be the most effective way of cleaning and decontaminating the wound. This should help flush out the majority of mud, grass and hair usually found in open wounds.
Injuries from falling on the road, such as broken knees, will have grit and dirt driven into the exposed subcutis which will not readily flush out. These may require surgical debridement by your vet or application of a warm poultice to encourage a natural exudate to form, bringing with it the grit particles.
MISCELLANEOUS
Nails or wire fragments can penetrate the sole or frog causing instant and severe lameness. These tend to occur when the ground hardens during the summer months or in frozen ground in the winter. Any piece of wire or nail that becomes fixed in the ground is able to then strike through the tough frog or sole as the horse treads on it. If you find a foreign body like this in your horse's foot it is best left in position so that the vet can see the exact position and direction of the penetration. Once removed, it can be surprisingly difficult to find the entry point especially if it is in the lateral frog sulcus. These wounds nearly always constitute a veterinary emergency as deeper foot structures such as the navicular bone and its associated bursa, as well as the deep digital flexor tendon all lie deep to the frog and injury or infection here can result in permanent lameness.
Swelling around the eye should be treated with caution. Where swelling of the eyelids is excessive, it may not be possible to see the globe or conjunctivae and therefore these cannot be assessed. Any ocular discharge, especially if profuse and discoloured, could indicate damage to the eye itself and again will require veterinary attention. Insect bites or stings should only cause lid swelling and cold water compresses may help reduce the swelling. Generally however, these swellings are painful to palpation and are not amenable to topical treatment without some form of pain relief administered by your vet.
By Mike Daly MRCVS, Woodlands Veterinary Centre, Cheltenham, Glos
Woodlands Veterinary Centre