There is going to be a time during your horse ownership that you are likely to encounter a medical emergency.  This may be in the form of cuts, bites, bruises, or puncture wounds, or health issues like colic, tying up, seizures, or foaling.  You must be able to recognize and respond promptly to any signs of distress and apply first aid techniques while waiting for your veterinarian.

RECOGNISING THE SYMPTOMS

When a horse is physically injured, it is easy to spot the cause of distress. But only the knowledge of what is normal in your horse can show you when your horse is feeling unwell. All horse owners need to know and write down, your horse's normal vital signs, including temperature, pulse and respiration (TPR), as well as its normal stance, feeding regime, times and amounts of droppings, sleep patterns. Only by knowing the normal behaviour, can you recognise signs of distress or discomfort.

WHAT'S NORMAL?

Just as in humans, the temperature, pulse rate and respiration are slightly different for different horses. Write down the normal ranges for your horse and put it in a prominant position - near the phone, in the first aid kit - somewhere where other people (like your Vet) might notice it if you are not present during the emergency.

Normal ranges for adult horses are:

• Pulse rate: 30-42 beats per minute.
• Respiratory rate: 12-20 breaths per minute.
• Rectal temperature: 99.5' to 101.5' F. If the horse's temperature exceeds 102.5' F., contact your veterinarian immediately. Temperatures of over 103' F indicate a serious disorder.
• Capillary refill time (time it takes for color to return to gum tissue adjacent to teeth after pressing and releasing with your thumb): 2 seconds.

Other observations you should note:

• Dehydration is tested by pinching or folding a flap of neck skin and releasing. It should immediately snap back into place.
• Color of the mucous membranes of gums, nostrils, conjunctiva (inner eye tissue), and inner lips of vulva should be pink. Bright red, pale pink to white, or bluish-purple coloring may indicate problems.
• Discolouration of urine or droppings can indicate a problem. If you keep your horse's area clean from droppings, it is easy to determine the frequency.
• Signs of distress, anxiety or discomfort - unusual pacing, bug -eyedness, rolling eyes, snorting excessively 
• Lethargy, depression or a horse that's "off-feed."
• Presence or absence of gut sounds .
• Evidence of lameness such as head-bobbing, reluctance to move, odd stance, pain, unwillingness to rise.
• Bleeding, swelling, evidence of pain.
• Seizures or paralysis

WHAT TO DO..

In any emergency situation, a well thought out plan will prevent any panic.

1. Keep your veterinarian's number (including after hours numbers) by each phone, and in the first aid kit. Also have a back-up Vet number in case your usual Vet is unavailable.

2. Keep directions to your house next to the phone. Also give a copy to the Vet to put in your horse's files.

4. Phone a friend/neighbour to help you through the emergency. A companion not only helps calm the nerves but can be handy to run errands, like opening the gates for the Vet.

5. Make sure your first aid kit is always accessible and that you and  family members are aware of the contents and how to use them.

6. Carry first aid kits in the car/float and in saddle bags for trails.

FIRST AID KITS

Always keep a full first aid kit in the stable. This can be based around the typical St John's kit. If you decide to make your own, there are some essential items.

•  Stretch bandages
• *Cling wrap
• *Gauze pads, assorted sizes
• *Gauze wrap
• Adhesive tape
• Leg wraps
• Sharp scissors
• Hemostats  
• Rectal thermometer with string and clip attached
• Surgical scrub and antiseptic solution (ie Betadine scrub and purple spray)
• Latex gloves
• Flashlight and spare batteries
• Permanent marker pen
• Pliers (to pull nails)
• 6" diameter PVC tubing cut in half the long way (like a gutter) into lengths of 1-1 /2 to 2 feet (for emergency splinting)

EMERGENCY WOUND CARE

The sight of blood may unnerve you, but maintaining your presence of mind can save your horse's life. The initial steps you take to treat a wound can prevent further damage and speed healing. How you proceed will depend on your individual circumstances, and you must exercise good judgment. The following should be viewed as guidelines:

(pic and guidelines from Bayer - see below)

1. Catch and calm the horse to prevent further injury. Move the horse to a stall or other familiar surroundings if this is possible without causing distress or further injury to the horse. Providing hay or grain can also be a good distraction.
2. Get help before attempting to treat or evaluate a wound. It can be difficult and very dangerous to try to inspect or clean the wound without someone to hold the horse. You cannot help your horse if you are seriously injured yourself
3. Evaluate the location, depth, and severity of the wound. Call your veterinarian for a recommendation anytime you feel your horse is in need of emergency care. Here are some examples of situations where your veterinarian should be called:
   1. There appears to be excessive bleeding.
   2. The entire skin thickness has been penetrated.
   3. The wound occurs near or over a joint.
   4. Any structures underlying the skin are visible.
   5. A puncture has occurred.
   6. A severe wound has occurred in the lower leg at or below knee or hock level.
   7. The wound is severely contaminated.
4. Consult with your veterinarian regarding a recommendation before you attempt to clean the wound or remove debris or penetrating objects, as you may precipitate uncontrollable bleeding or do further damage to the wound. Large objects should be stabilized to avoid damaging movement if possible. Don't put anything on the wound except a compress or cold water.
5. Stop the bleeding by covering the wound with a sterile, absorbent pad (not cotton), applying firm, steady, even pressure to the wound
6. Do not medicate or tranquilize the horse unless specifically directed by your veterinarian. If the horse has suffered severe blood loss or shock, the administration of certain drugs can be life-threatening.
7. If the eye is injured, do not attempt to treat. Await your veterinarian.
8. If a horse steps on a nail or other sharp object and it remains embedded in the hoof, first clean the hoof. Consult with your veterinarian regarding a recommendation before you remove the nail. If your veterinarian advises, carefully remove the nail to prevent the horse from stepping on it and driving it deeper into the hoof cavity. As you remove it, be sure to mark the exact point and depth of entry with tape and/or a marker so the veterinarian can assess the extent of damage. Apply antiseptic to the wound, and wrap to prevent additional contamination.
9. All horses being treated for lacerations or puncture wounds will require a tetanus booster

OTHER EMERGENCIES

There are a multitude of things that can happen to your horse, but regardless of the situation, it's important to remember these points:

1. Keep the horse as calm as possible. Your own calm behavior will help achieve this

2. Move the animal to a safe area where it is unlikely to be injured should it go down.

3. Get someone to help you, and delegate responsibilities, such as calling the veterinarian, retrieving the first aid kit, holding the horse, etc.

4. Notify your veterinarian immediately. Be prepared to provide specific information about the horse's condition, as mentioned above, and other data that will help your practitioner assess the immediacy of the danger and instruct you in how to proceed.

5. Listen closely and follow your Vet's instructions.

6. Do not administer drugs unless specifically instructed to do so by the veterinarian.

SUMMARY

Risk assessment is an important part of horse keeping. Make sure that your property is as "horse-proof" as possible. Remove any sharp objects, star pickets, fill in holes. Horse management is equally important. Your horse should be given clean fresh food and water should be available at all times. Try to keep a routine so as not to upset the horse . This includes the feed it is given - changes should be implemented gradually.

 Be prepared for an emergency and make sure that anyone looking after your horse is also prepared. Never hesitate to call your Vet for advice. Any good Vet will prefer you to ask questions to avoid a serious incident than to be called too late.

A happy healthy horse is a pleasure to own and it only takes a bit of time, forethought and preparation to keep your horse safe.