Anyone who has owned horses long enough knows that a life-or-limb threatening medical emergency can happen without a moment's notice. These sudden emergencies lead to trauma for the horse and moments of desperation for the horse's caretaker.

With a little forethought and first-aid preparation, these life-and-limb threatening scenarios can be brought under control with a calmer horse and a more confident caretaker.

Because of instinctive behavioral traits and physical make-up, horses are especially accident-prone. Their instinctive flight-or-fight responses, their sensitive digestive systems, their slender legs and small hoofs that carry heavy weight contribute to many situations where knowledge of emergency first aid can prevent permanent damage and in some cases can save the horse's life.

Traumatic injury accompanied by severe bleeding, colic, acute lameness,shock, and choking are emergencies for which all horse owners need to be prepared. As a horse owner, it is important to know how to recognize serious problems and respond promptly.

A priority related to prompt, correct first aid is knowing when to call a veterinarian. An observant equine owner is in a position both practically and mentally to make knowledgeable health care decisions in emergency situations which in the long run can save both time and money.

Severe bleeding in your horse

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.

A horse losing a lot of blood is a frightening situation, but a horse can lose what seems like a lot of blood, and remain healthy with appropriate intervention and veterinary attention.

The good news is that the average horse has over 12 gallons of blood in its body, and can lose over three gallons before showing signs of shock. In most cases, blood loss is minimal and constant pressure for several minutes allows the blood to clot. However, if blood is gushing or if application of pressure does not stop the bleeding in a leg or body wound in a horse, the veterinarian should be called immediately.

Spurting blood indicates that an artery is most likely involved and calls for immediate action to stop the flow. On the other hand, dark blood oozing through the skin indicates that the bleeding is venous and not immediately life-threatening.

When a horse is bleeding, the first consideration should be to get it to a safe place and keep the animal as calm as possible. People and other animals should be kept away. The wound should be bandaged securely and pressure applied to reduce the blood flow.

If the area is too large to be bandaged, a clean pad made from gauze or other clean fabric should be placed against the wound. If blood is squirting, a tourniquet may be necessary. This is often the case with leg injuries.

Call a vet immediately and get advice as to whether the tourniquet might cause harm. A tourniquet should be loosened every 15 to 30 minutes for a duration of approximately 5 minutes to allow blood to temporarily flow back into the limb.

If a horse loses too much blood in proportion to body size, emergency fluid replacement will be needed and a veterinarian needs to be involved.

If the wound is deep or near a vital structure, surgical repair by a veterinarian will be necessary once the bleeding is under control. If the wound is relatively minor, proper cleansing and disinfecting of the area accompanied by hair clipping where necessary and application of an appropriate bandage may be sufficient.

When your horse shows symptoms of colic

Colic is the #1 emergency seen by horse owners, trainers, and veterinarians. Signs of colic can range from subtle changes only an owner would notice to severe demonstrations of pain and distress.

Once you have recognized an episode of colic, it is most important to stay calm and assess the situation. Write down the horse's behavior and vital signs so you can track his progress and give the veterinarian the most accurate description of the situation over the phone.

You should also be able to tell your vet about any recent changes in diet or exercise and your current vaccine and deworming protocols. Remove all hay and feed from the horse, as most conditions will be worsened by additional feed in the GI tract.

Because early treatment is the key to success, it is important that you understand the clinical signs of colic, how to recognize them, and what you can do to help your horse while waiting for the vet to arrive.

Signs of colic include loss of interest in food and water, strange postures, pawing, rolling, biting at flank, bloating, sweating, grinding of teeth which is specifically indicative of gastric ulcers, increased respiratory rate with flared nostrils and an absence of gut sounds.

The symptoms can range from a mild episode, where a horse is merely sluggish coming for food, to severe pain where the horse is covered in sweat and can no longer stand.

The first action if you suspect your horse has colic is to remove all feed and water. Depending on the horse's situation, some veterinarians recommend calmly walking the horse if possible to relieve discomfort and help pass manure.

If the horse is not in the throes of severe pain, hand walking can be helpful for mild cases of gas colic. However, do not attempt to walk a horse that is attempting to fling himself to the ground. You cannot prevent a horse from rolling if it is determined. Always consider human safety first.

Do not administer any medication to a horse with colic symptoms. Pain killers, such as Bute or Banamine, may produce enough relief to mask some symptoms, making it more difficult for the veterinarian to determine the cause of the colic.

In some cases, certain horses tend to have repeated bouts of colic and if this is the case with your horse, your veterinarian may be able to provide you with information about preventing further episodes and also what to do in cases of mild colic.

Veterinary treatment may include a physical examination including rectal exam, sedation, passing a tube from the nose into the stomach (nasogastric or NG tube) to relieve pressure upon the stomach, and the use of pain-relieving medications.

Veterinarians may also recommend further diagnostic tests such as X-rays, ultrasound, blood work, fecal examination, or an abdominocentesis (belly tap). Because horses are so large, and there are many causes of colic, it may take quite a bit of work to determine the cause.

Once the cause of the colic is determined, the veterinarian will recommend either medical treatment or surgery. Some conditions causing colic such as torsions, and most enteroliths and displacements can only be cured by abdominal surgery. Surgeries are usually performed at referral hospitals.

The causes of colic are varied and sometimes difficult to pinpoint but the following can all cause colic: inadequate water intake (summer or winter) changes in diet, adverse weather, ingestion of unusual material such as sand, bedding, grass clippings, plants, grain overload, infection, changes in exercise or shipping, and other stresses.

Poor dental conditions, internal tumors, and infestation with worms are common colic causes in the older horse.

Preventing cases of colic should be a priority for all horse owners. Many of the digestive causes of colic are related to meal feeding and can be reduced by a slow, consistent feed intake.

In addition, horses require large amounts of water to move feed material through their gut. Be sure to provide access to clean, fresh water at all times. Also, adding salt to the diet as the weather changes may keep water intake consistent and help to reduce colic.

Proper parasite control and routine dental maintenance can also decrease incidences of colic.

Sudden acute lameness in your horse

Recognizing that your horse is lame is relatively easy. Diagnosing the leg or joint or cause of the lameness generally requires the expertise of a veterinarian or farrier.

The most common causes of sudden acute lameness are:

• Infections: Infected wound, skin, or joint; foot abscess
• Traumatic Injuries: Injuries to the musculosketetal system, including bones, muscles, cartilage, tendons, ligaments, and joints; damage to the nervous system, including the brain, spinal cord, and nerves
• Degenerative Diseases: Arthritis, bursitis, degenerative joint disease, or osteoarthritis
• Metabolic Diseases: Laminitis, navicular disease, or azoturia (tying up)
• Developmental Conditions: Epiphysitis or osteochondrosis
• Mechanical Malfunction: Overload of a structure that causes wear and tear or breakdown of the structure

Any rapid onset, severe lameness (i.e. non-weight bearing lameness, “toe-touching” or overtly lame at the walk) should be taken very seriously. It could be caused by a benign hoof abscess, a potentially catastrophic fracture or a myriad of other infections or injuries.

Hoof abscesses or sole bruising are the most common cause of sudden onset lameness in one limb. Examine your horse for any wounds, heat or swelling in the affected limb. Check the foot especially well for a penetrating wound or foreign body (i.e. nail in the foot) or for any problems with a shoe.

Although it seems counter intuitive, DO NOT remove a foreign body from your horse's foot. It is extremely helpful for the vet to be able to see it in place and possibly take an x-ray with the foreign body in place to determine exactly what structures of the foot may be involved.

If the horse is willing to walk, get him/her to a safe place. If the horse is resistant or appears to be in distress do not force him/her to move. Check your horse's temperature, since the presence of a fever with acute onset lameness is a significant concern.

Due to the nature of lameness, a specific diagnosis of what is causing a horse's lameness is often difficult without an examination by a veterinarian who will be able to use diagnostic imaging, if needed. The veterinarian will determine the best course of action with the help of your accurate description of the situation.

In some cases, your farrier may be able to advise you about emergency first aid for acute lameness, but because of the seriousness and the potential for damage to the horse's foot and leg structures, professional advice becomes a necessity in cases of acute lameness.

When your horse goes into shock

Just as humans go into shock when the circulatory system fails to meet the body's need for oxygen, equines, too, can go into shock. This life-threatening condition occurs when the body does not get sufficient blood flow to provide necessary oxygen to the brain and major organs.

Severe bleeding, severe colic, dehydration, profuse diarrhea, excessive sweating, severe colic, heat stroke, snake bite, multiple bee stings, poisoning or major trauma can cause a horse to go into shock.

Equines are subject to 5 major classes of shock:

• Cardiogenic shock - shock associated with heart problems or heart failure
• Hypovolemic shock - shock caused by inadequate blood volume as a result of heavy bleeding, a spinal injury, or dehydration
• Anaphylactic shock - shock caused by a severe allergic reaction
• Septic or toxic shock - shock caused by a severe infection
• Neurogenic shock - shock caused by damage to the nervous system

Typically, an equine that is in a state of shock will appear anxious or agitated, have low or no urine output, may have diarrhea, have a rapid, but weak pulse accompanied by shallow breathing, will sweat profusely and show signs of confusion. As the vital organs shut down because of lack of oxygen, the horse may lose consciousness and without immediate treatment may die.

1. Call your veterinarian.
2. If the horse is unconscious, check and make sure the airway is open, clear secretions from the mouth and pull the tongue forward to prevent blockage of the airway and, if possible, keep the head level with the body
3. If the horse is conscious, calm the horse by speaking soothingly and allow the horse to assume the most comfortable position possible to sustain breathing
4. Control any bleeding from wounds or injuries
5. If bones are broken, splint or support them before attempting to move or treat the horse
6. Cover the horse loosely with a coat or blanket
7. Your veterinarian will most likely rehydrate the horse with large volumes of intravenous salt solutions and may administer oxygen, blood transfusions if necessary, corticosteroids, antibiotics and drugs that support the circulation

Cases of systemic anaphylactic shock usually require immediate diagnosis and treatment since the outcome depends on how quickly treatment is initiated.

In cases of anaphylactic shock due to an acute hypersensitivity to an allergen such as multiple bee stings, penicillin, antibiotics, vaccines or immune serums, administration of epinephrine solution intravenously through the jugular vein or intramuscularly or subcutaneously is called for.

Administration of additional epinephrine every 15 minutes is necessary, and, if time permits, the veterinarian may establish a permanent IV line for additional medications and large volumes of fluid to support the horse's circulation.

Once the horse is stabilized, your veterinarian will determine the root cause for the shock.

In most cases, the cause will be apparent, but in cases of severe infection, damage to the nervous system, or foal septicemia further evaluation will be needed.

When your horse is choking

Choke usually occurs when a horse bolts down incompletely chewed feed or foreign objects. Hay is often the culprit, or it may be a large chunk of food such as a piece of apple, carrot, beet pulp, or other object.

Choke can also be caused by tumors, strictures, and cysts. Neck and mediastinal masses, as well as vascular anomalies such as defects of the heart and major blood vessels can also lead to choking behavior.

When horses have had esophageal trauma, or if they have dental abnormalities or ongoing dehydration that compromises swallowing action, they may become predisposed to choke.

Once you are aware that a horse is choking, the horse should be prevented from eating or drinking anything further. Keep the horse standing with its head down. This will help prevent food from going into the horse's airway, which could cause respiratory complications. Use a head-collar/halter to hold the horse and keep it standing. However, do not attempt to hold the horse if your safety is at risk.

If possible, carefully clean out the horse's mouth. If you know it is food and can tell where the impaction is, you may try massaging the left side of the neck over the lump to help move it along.

If there is any chance that the impaction is caused by a hard or sharp object, such as a piece of wood, a large carrot, or a corncob that might cause damage to the esophagus, it is best to wait for the veterinarian. In the meantime, you may walk the horse and allow it to lower its head.

Although in the past mineral oil was suggested to help move the object through the esophagus, mineral oil should never be used when a horse is choking because of the risks associated with aspiration.

Frequently, the obstruction will clear just from the movements and efforts of the horse. Occasionally, the lump of food can be felt on the left side of the neck and gently massaging the area will help it disperse.

If the problem does not clear up shortly or if the horse is in extreme distress, a veterinarian's assistance is necessary. The vet may sedate the horse to decrease esophageal spasms and to encourage the horse to relax and put his head down.

It may be necessary to pass a nasogastric tube through to the stomach and use warm water to clear out the obstruction. Surgery (esophagostomy) is the last choice in most cases.

Secondary complications of choke may become problematic. They include dehydration, blood pH abnormalities, aspiration pneumonia, esophageal ulceration, strictures, ruptures, or enlargement.

Follow-up care is extremely important, and the horse should be kept off food for 48 to 72 hours to allow the esophagus to heal. To prevent choke in horses, make sure treats such as carrots and apples and cubed feed are in small, bite size pieces to keep them from getting stuck in the horse's esophagus.