First Aid in Equine Emergencies

By Margaret Evans

Virtually all horse owners will encounter an equine emergency at some point. Whether it's caused by a horse’s natural curiosity, a mishap on a trail ride, or interactions with herd mates, accidents can lead to cuts, bruises, kicks, and bites. Scrapes, stone bruises, punctures, sprains, and sores can happen unexpectedly, while more serious conditions like abscesses, colic, or bacterial infections can arise without warning. While consulting a veterinarian is essential for serious issues, many minor health conditions can be managed on-site with the right knowledge and first aid supplies. To make the most of these on-hand solutions, it's crucial to have specific protocols in place to ensure you and others caring for your horse are fully prepared.

Related: Wildfire! Flood! Earthquake! Horse-Specific Emergency Planning

Sometimes small wounds, like punctures, can be more serious than they first appear. If there is nothing in the wound, clean it and watch for signs of infection. If a foreign body is embedded in the puncture, it should be removed by a vet. Photo: Shutterstock/Konstantin Tronin

BE PREPARED

With some advance planning and basic knowledge of first aid, you’ll be better equipped to handle a horse health emergency when it happens.

Emergency contact information, such as the phone numbers and email addresses for the vet and farrier, should be posted in the barn and saved on your phone. Maintain a health record of your horse’s vaccinations, dewormings, past injuries and incidents, and any allergic reactions, and have it readily available, along with a record of his normal vital signs.

Know how to use all the medications and washes, and practice bandaging before you need to do it in an emergency.

Make sure you have access to a truck and trailer that is accessible on short notice. Teach your horse to load quietly and safely in a trailer; in the middle of an emergency is not the time for a trailer loading lesson.

Keep your first aid kits for the barn, trailer, and trail rides well-stocked and easily accessible.

When her mare, Tenley, was found with a head injury, Chelsey Henley knew right away that veterinary attention was needed. “Our mare split her head open to her cranial ridge!” She has no idea how it happened, but it looked as if Tenley hit the tree head on. “The wound was way beyond our skills, but I will say that having syringes and a form of pain meds is super important.” She also stresses the importance of being able to load the horse into a trailer quickly and quietly. Photo courtesy of Chelsey Henley

Know Your Horse’s Vital Signs

As the person responsible for the horse’s care and well-being, it’s important to know what is normal for your horse so you can quickly determine when he is not well. Start by recording your horse’s normal vital signs when he is healthy and calm, and store them where they are easily accessible. In the event of illness or injury to the horse, being able to check and report his vital signs to your veterinarian can help him to determine the horse’s condition.

Temperature — The body temperature of an adult horse at rest can vary from about 37 degrees C to 38.6 degrees C. With the horse secured, body temperature is taken with a thermometer positioned just inside the anus. Today’s digital thermometers do not necessarily need lubricating and a temperature reading can be achieved quickly. Temperatures higher or lower than the horse’s normal range should be cause for concern.

Heart Rate — The pulse is the rhythm of the blood flow in response to the heartbeat. A horse’s pulse rate is 30 to 40 beats per minute at rest and it can be taken by feeling the artery just under the cheekbone. Using the flat side of your fingertips (not your thumb or you’ll feel your own pulse), press inward and upward against the inner edge of the lower jaw until you detect your horse’s pulse. A simple way to measure is to count the number of beats in 15 seconds, then multiply by four to get the rate per minute. More than 60 beats per minute at rest, or a weak or irregular heartbeat, should be cause for concern.

Hydration — During dehydration, skin elasticity decreases due to loss of water from the skin. Two simple ways to check your horse for proper hydration are the capillary refill test and the skin pinch test.

Related: Reduce Your Horse's Transport Stress

Left above: Take the horse’s heart rate by locating the facial artery on the inside edge of his lower jawbone with your fingertips. Photo: Pam MacKenzie

Right above: Check your horse for dehydration using the skin pinch test or the capillary refill test. Photos: Pam MacKenzie

The skin pinch test is done on the neck in front of the shoulder by taking a fold of skin between your thumb and forefinger, lifting it away from the underlying tissues, twisting it slightly, and releasing. The pinch fold should disappear within one second. A fold that remains for more than two seconds indicates dehydration.

For the capillary refill test, lift the upper lip of the horse and look at the gums above the teeth. These mucous membranes should be a healthy pink, shiny, moist, and slippery. If they are pale, dry, or tacky this can indicate dehydration. Mucous membranes that are pale white, jaundiced, brick red, bluish, purplish, or muddy are indicative of a serious problem. Next, press your thumb or finger on the gum to push the blood out from under the finger to determine capillary refill time. Upon release of the pressure, the pressed spot will be white and should return to pink within 1.5 seconds. A delay of two or more seconds is cause for concern. A prolonged capillary refill time may also be a sign of shock.

Gut Sounds — Check your horse’s gut sounds by pressing a stethoscope or your ear against his barrel behind the ribs, in front of the stifle. Normal gut sounds vary widely, but gurgles and growls should always be present. Faint, infrequent, or absent gut sounds usually indicate colic and your veterinarian should be called.

Weight — Use a weight tape to estimate the weight of your horse, which is valuable information when calculating some medications.

Learn the Signs of Pain or Illness

Familiarize yourself with the following symptoms horses can display when they are in pain and discomfort:

• Restlessness and sweating on neck and flanks.
• Anxiety.
• Repeatedly lying down and getting up.
• Depressed appearance.
• Dilated pupils, glassy eyes or eyes either dulled or staring.
• Flared nostrils and increased breathing.
• Muscle tremors.
• Increased pulse/heart rate.
• Difficulty moving, abnormal gait or changes in weight bearing.
• Loss of appetite.
• Rolling, pawing, or flank staring.

Four Essential First Aid Rules

When an incident happens, remind yourself and anyone helping you to follow these first aid rules:

Remain calm — Your calm attitude will help reduce the horse’s sense of panic. The worse the situation, the calmer you should be.

Identify the problem — Try to determine what happened, and if the horse is in danger or at risk of further injury.

Assess the situation — Assess the horse’s condition in terms of breathing, bleeding, or an injury that is preventing the horse from moving.

Take action — Get the horse out of danger. Take the horse’s vital signs, stop the bleeding, minimize shock, administer first aid, call for veterinary assistance if necessary.

EXPECT THE UNEXPECTED

Most often, it’s the incidents that happen at home that require first aid attention.

“Horses get themselves into pickles,” says Gayle Ecker, director, Equine Guelph. “They can get tears, pokes, and lamenesses. Domestic situations are where we see a lot of horses get into trouble when they are turned out with others. These are behavioural issues. A horse can get pinned in the corner and get kicked, or run away and slip. Often, it’s a first aid situation. The implied thing is that horses are ‘stupid’ and get hurt, but owners might not always appreciate the importance of the pecking order.”

Horses live in a hierarchical community, with a leader and followers in descending order of rank. The order is rarely changed, but if one horse feels crowded or a newcomer is trying to find its place in the band, feet and teeth can fly. But what might appear to be a flesh wound could actually be something more complex. On our farm, an example of this resulted from introducing a boarding horse to our band of horses. The new horse seemed to settle in well but unfortunately, our broodmare, Daisy, got caught in the middle of a conflict.

We found Daisy standing by the gate with her face covered in blood. Thinking she had torn herself, we brought her to the barn to wash her face and found she had a four-centimetre gash below her left eye. I washed the cut with a saline solution and applied a gel product to promote healing. The cut healed well but when her nose started to dribble, a vet check led to the conclusion that she had likely been kicked in the face. She now had a sinus infection as well as a bump between her eyes. Antibiotics didn’t fully take care of her dribbly nose and an X-ray revealed some dead bone under the bump. She went for surgery to clean out the dead bone and returned home wearing a mask fitted with tubes. For the next ten days, the surgical site was flushed with saline administered through the tube by her ears, and the fluid drained through her left nostril. It healed well, but it all likely began with a pecking order dispute.

The initial veterinary fee for the author’s mare, Daisy, was a few hundred dollars. By the time her runny nose had led to two rounds of antibiotics, an X-ray and surgery to remove dead bone, plus the post-surgical care with two weeks’ supply of saline solution and more antibiotics, the veterinary care rounded out at over $5,000. Photo: Earthways Media

Trailering horses is done so often and so casually that safety checks are sometimes overlooked. But trailer mishaps will invoke their own emergencies.

“Check the flooring, the brakes, hitch, and divider,” says Dr. Susan Raymond with Equine Guelph. “People have to look at their trailers, especially if their use is seasonal. But people look at what they are putting into it, rather than the trailer itself.”

Judy Todd, an Abbotsford, BC-based physiotherapist with a specialty in hippotherapy, can really relate to that.

“I can still remember the shock of dropping the trailer ramp at the show and finding the horses in a heap!” she says. “My niece’s pony had bumped up the central divider and was lying against the dislodged divider at 45 degrees on top of my horse, who was sitting like a dog. Our birthday treat for this little girl was a weekend with her pony at our farm and a trip to her first horse show, so we were in their trailer and (mistake #1) I hadn’t checked the securing pins on the divider, and (mistake #2) I took my brother-in-law’s word that their pony was a good traveller.

“Burly men materialized from around the show ground to push the completely unharmed pony upright and out of the trailer, then my horse was able to scramble up on his own. There were superficial cuts on his back legs above the shipping boots and he had sprained a few hind end joints. My vet knowledge back then was woefully inadequate, but I had extensive first aid experience as a sports physiotherapist, so I applied the rest-ice-compression principals and he recovered completely within a couple of weeks. My first aid kit was in my trailer at home (mistake #3), but the kind men who helped us provided wound cleaning supplies and I found a hose with a limitless supply of cold water for the swelling. I palpated his spine, as I would a human, and he seemed pain free. A lot of lessons were learned that day!”

Tony Wass discovered that trailers used seasonally must also be checked for wasps’ nests.

“In August 2007 we trailered Jed and Soleil to Sooke Potholes Provincial Park, [Vancouver Island] BC. I felt a bit of kicking activity from the trailer but could not stop on the road. On arrival, we found Soleil has a gash on her inner left rear hock. It looked like she had raked herself with her right rear shoe. After much soaking and standing in the Sooke River to cool her down, as she was sweating and fretting, we used our towels and duct tape to bandage her. The bleeding had long since stopped but we returned home, the vet arrived, and Soleil had stitches. She needed stall rest and bandage changes for a few weeks.”

A second trip to the Sooke Potholes resulted in the same injurious behaviour. That’s when Wass further examined the trailer, found the remains of a wasp nest, and concluded that Soleil had been stung, kicked out, and injured herself — twice.

Related: Emergency Preparedness for Horses

“Aloha injured himself somehow in his paddock and it was found too late to be stitched,” says Riki Davies. “I had to irrigate it with saline twice a day and pack it full of Polysporin until it healed and closed up on its own. At first it was a major fight to irrigate it, but by the end I could do it while he was lying down.”Photos courtesy of Riki Davies

A HOLISTIC APPROACH

A flesh wound may be the immediate priority, but don’t assume it is the only one. Carefully examine the whole horse and observe his general demeanor.

“It’s quite often the tiny ones, the punctures, that people don’t pay attention to,” says James Carmalt, professor, Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan. “You’ve got a wound on one hock, and a small puncture wound on the opposite hock, and it turns out that the small puncture wound went into the joint; the big one is an eyesore, but it will heal. It is the little ones that might cause real damage.

“The modern cell phone is a blessing. I can ask where’s the wound? Is it halfway up the leg? On the joint? What part of the joint… the pointy bit? Clients can send me photos of the wound and it takes seconds. Remember that a photo is great, but it is not a replacement for hands-on examination.

“So, if you’ve got a wound on the leg, look for something else. Chances are, it’s not the only thing. Check the opposite, normal leg. If there’s a bit of drainage or something stuck, or it’s a bit wet, ask yourself why it’s wet — especially if it’s not normally wet there.”

Carmalt stresses the value of a first aid approach and pre-vet visit work.

“There are more and more clients who have a thermometer and a stethoscope, and know how to use them,” he says. “That, for me, is fascinating. You send me a picture or a short video from your iPhone, and you couple that with information about whether the horse is off her food, other physical symptoms, her temperature, her heart rate, her respiration rate. Now we can get a whole lot closer to saying that you should be okay overnight or that you really need to bring her in to see us.”

Carmalt firmly believes that the horse owner should know the whole horse – behaviour, attitude, reaction to things. Quoting Dr. Thomas McCrae who famously said that more is missed by not looking than by not knowing, Carmalt says, “If you go over your animal with a fine-tooth comb, you may not understand what you are seeing, but at least you have seen it and you can describe it. If you don’t look [or observe behaviour], you are in deep trouble.

“If there’s a leg wound, what else is there? Why is he walking kind of funny? Don’t just focus on the wound or the colic or this or that. Look at the whole horse. Know the subtle signs.

“With colic, people think of it as gas pain but it’s not always gas pain. The client will know the horse hasn’t eaten her food. It’s not normal for her. Not eating is a big deal. So maybe there is something. She’s not throwing herself on the ground and rolling with classic colic, but there’s something here we need to keep our eyes on. If we blow it off, then something bad could happen. It’s a holistic approach.”

Related: Barn Safety Tips: Plan Ahead to Improve Your Chances of a Positive Outcome

THE ESSENTIAL RAINY DAY FUND

The price of veterinary horse care can climb alarmingly between first aid treatment and surgery, which is why Carmalt strongly advises setting aside funds for a rainy day.

“[Maybe] it’ll cost $300,” says Carmalt. “That’s not too bad. But it’s not just $300. By the time you have nursed that horse at home for the next few months there will be additional costs. Don’t spend it all at the hospital as you will need more money at home for all the after-surgery care. Think carefully about the price that is quoted.”
He cautions horse people to know what they can afford and be realistic. People know what a car or a saddle cost, says Carmalt, but they come to the vet and it’s a hell of a surprise that treatment is going to cost this much.

Keep a rainy day fund for your horse’s veterinary care, and remember to budget for the costs of at-home care and rehab if needed during the recovery period. Photos: Patricia Barker

“It’s 3 in the morning and you’ve got a horse of 20 years throwing itself on the ground, that is not the time to have to make a decision. Do people have $10,000 lying around to spend on the horse? It becomes a big family discussion about what to do. There are all these emotions and people start dipping into the college fund or remortgaging the home. What are you doing?! Everyone needs rainy day money.”

Some horse owners are fortunate to have equine insurance. Insurance providers offer a variety of coverages, such as horse mortality, medical, surgical, transport, loss of use, infertility, and public liability. Discuss options with your insurance broker or talk to your provincial organization for advice on an insurance company specializing in services to suit your needs and budget.

FIRST AID EDUCATION

Even the most basic first aid knowledge can help you treat your horse in a crisis. Opportunities to learn about the value, importance, and applications of first aid are available at both Equine Guelph and Equi-Health Canada.

“A lot of people hope nothing happens,” says Ecker. “Hope is not a strategy. If you are not ready to take care of this, the horse pays the price of tuition with suffering.”

Equine Guelph offers a variety of online first aid courses. In addition, they developed their Large Animal Rescue Training program, working with Dr. Rebecca Gimenez Husted, Technical Large Animal Emergency Rescue Inc., renowned for training in difficult and technical rescues.

Heather Davis, executive director, Equi-Health Canada says she receives regular inquiries, which she refers out to their instructors.

“We also have a Certified Safe program where a facility that hosts the first aid basic, first aid advanced, and disaster planning courses receives their Certified Safe status, a listing on our website, and we send them a certificate for their barn wall. Many boarding barns are in the process of obtaining this certification, in order to ensure that their boarding clients feel safe and comfortable with where their horse is living. Equi-Health Canada has also just finished revamping its safe trailering practices course and are currently working on upgrading the Livestock Handling and Safety for First Responders course.”

Equine Guelph online courses are available at The Horse Portal.

Equi-Health Canada online courses at offered at Equi-Health Canada.

FIRST AID FOR COMMON HORSE AILMENTS

Lacerations - Lacerations can be anything from a superficial scratch to an open flesh tear. The immediate priority is to clean with gentle running water from a hose or a spray bottle of saline. A clean wound will heal faster and with fewer complications. If the wound is deep and continues to bleed, clot with layers of bandage. A vet visit may be necessary. Wounds should be covered unless it is impractical, in which case healing jells that stay in place are an excellent solution.

Puncture wounds -  These present greater challenges since any foreign object or bacteria can be trapped inside and primed for infection, which will show as swelling, tenderness, a smell of pus, or the horse having an elevated temperature. A vet exam is necessary.

Stone bruise - These are common and often the result of the horse mis-stepping on rough ground. Hosing the foot, an anti-inflammatory such as bute, and rest all help, but watch for any signs of an abscess forming which will require veterinary treatment.

Colic signs - Colic is not always a gas pain. It often presents with the horse rolling frequently, showing anxiety, not eating or drinking, and becoming restless. Using the stethoscope, listen for gut sounds on both sides and take the horse’s temperature. Gut sounds may be weak or absent. Call the vet and have that information ready, as well as your horse’s normal readings or gut behaviours. It may be a gas pain, but it could be a variety of other issues.

Lameness - The cause of lameness can be obvious, such as swelling on a leg, or obscure such as pulled shoulder muscle, or foot issues related to a bruise or laminitis. Rest, cold water hosing, and support wrapping may be appropriate until you can reach your vet for a full diagnosis.

A Cautionary Tale

“It had been raining, and the homemade bridge across the road from my property, which we cross regularly, felt a bit slippery under Zulu’s shod feet,” recalls Judy Todd. “Before I had a chance to warn my friend to dismount and lead my second horse Bo across, his hoof boots turned into a pair of skates and he did a macabre kind of tap dance before he went down, one back leg hanging off the bridge, his front legs struggling to get a purchase. With my friend and I pulling on the saddle and any part of him we could access, he finally managed to pull himself up, only to get caught under the wood railing and pushed back down again.

“This time his left leg was caught underneath the bridge while his right was half off. At that point he gave up the struggle and took a breather, so I phoned home for ropes, blankets, and mats for a better grip, and tried to imagine who might have a backhoe handy, but before I got through, he started up his efforts again. We got his left leg unhooked, and slid him forward on his belly until he was able to struggle up without getting caught under the railing.

The fateful bridge seen through Bo’s ears. Photo courtesy of Judy Todd

“Amazingly, he was able to weight-bear and had accumulated only minor-looking cuts and grazes. The girth was shredded, and we had damaged the stirrup bars from all our pulling. Unwilling to lead him back over the bridge (which was also damaged), we elected to lead both horses to the nearest road where my husband met us with the trailer, first aid kit, and blanket. His vital signs were good, and I addressed the skin abrasions before encouraging him to hobble up the ramp.

“His rehab was extensive, and it involved hip and pelvis musculoskeletal trauma from his efforts to get up, but he made a full recovery over a few months. Had he not been small, calm, and trusting, he could have panicked himself right off the bridge, and the outcome would not have had a happy ending!”

Related: How to Make a First Aid Kit for Horses

More by Margaret Evans

Main Photo: iStock/Alina555