Basic equine first aid

Be prepared!
A simple first-aid kit, kept in the tack room or stable yard, is a necessity for every horse keeper. A few essential items, stored safely in a clean, dry box, can save a lot of panic if an equine emergency occurs. The box should be labeled clearly, and should include contact numbers for the veterinary surgeon. Any used or expired items should be replaced immediately.

An equine first-aid kit should also be part of the equipment taken to shows or whilst traveling. Carrying a separate human first-aid kit is also advantageous.

First-Aid Action
The aim of first aid is to take immediate action when an injury is discovered, to prevent the condition getting worse while awaiting veterinary assistance.
· Prevent further injury, by taking charge of the horse in a place of safety.
· Briefly assess the injury and be ready to relay details to the veterinary surgeon.
· Call the veterinary surgeon and act on the veterinary advice received.
· Identify what caused the injury and take measures to prevent it happening again. 
 
If in doubt, always call the vet!
A call to the veterinary surgeon might not necessarily result in a visit. Advice over the telephone can give reassurance to the keeper and ensure correct first-aid treatment is given. Calling the veterinary surgeon early is essential. It is false economy, and may cause suffering to the animal, if attempts are made to treat an injury (or if the severity of the injury is underestimated), only then seeking professional help when things have got much worse.

Assessing wounds
Cuts and grazes are the most common injuries likely to need attention, to stop bleeding and to prevent infection. The type and location of a wound, and the manner in which it was caused, can affect its severity and treatment. It is important to assess the wound quickly and to contact a veterinary surgeon in all cases other than very minor cuts and scrapes.
 
Veterinary attention is always advisable and is essential if:
· the horse keeper is in doubt or lacks experience to assess and treat minor wounds;
· the wound is more than skin deep or more than a few centimeters long;
· there is a lot of bleeding or the injury involves the eyes or joints;
· the wound is very dirty and/or difficult to assess;
· the horse is lame and/or other underlying, or internal, injury is suspected;
· the horse is not vaccinated against tetanus.

Types of wounds
Clean-cut (incised): caused by something sharp; can be serious as there is often a lot of bleeding. The edges of the wound appear clean and straight, and the wound can be a lot deep into the tissue than may first appear.
Torn (lacerated): caused by something hard but blunt, for example barbed wire. The edges of the wound are irregular and jagged, although bleeding is not usually as profuse as for clean-cut wounds. There may be associated swelling.
Puncture: caused by a piercing object, such as a nail or thorn. These wounds can be far deeper than the external wound suggests, and they pose a considerable risk of infection. They are also more easily overlooked.
Grazes (abrasions): may appear superficial, but have a large surface area that poses an increased risk of infection; there is often associated bruising and they can take a long time to heal.

Bruises, lumps, swellings and inflammation (even in the absence of an obvious wound) can be evidence of an underlying injury, and veterinary advice should be sought.

Types of treatment
The aims of treatment of wounds are to:
· stop bleeding
· cleanse and prevent infection
· promote correct healing.
Inflammation and swelling can be reduced by addressing their cause, and by applying cooling treatments. All treatments should be carried out in accordance with veterinary advice.

Bathing
Use a clean swab of warm water (containing a small amount of a suitable cleanser or antiseptic) to gently cleanse a wound. If several swabs are required, each should be used once and then discarded.

Cold hosing
Apply a steady stream of cold water, washed (for approximately 15 minutes at a time) over an injury, to sooth and reduce swelling.
 
Poulticing
Apply a poultice (hot or cold) to aid treatment. Cold poultices are used to reduce inflammation caused by kicks or knocks. Hot (but comfortable to the touch) poultices are used to increase blood supply to the injury and to help to draw-out any infection that may be present.

Types of bandages and padding
Surgical or self-fixing disposable bandages are useful items in the first-aid box. They are flexible and can be applied easily, to provide support or hold dressings in place on the legs and even on areas (such as joints and hooves) that are more difficult to bandage.

In addition to bandaging on the lame limb, an exercise or stable bandage is often applied to the opposing, weight-bearing leg, to provide additional support.

Padding is essential beneath all bandages, to even out and reduce pressure and to provide protection. Gamgee, fibregee and leg wraps are all acceptable forms of protection for use under bandages.

Bandaging cautions
Bandages must be fitted correctly, to avoid causing permanent damage. They must be applied over the padding, with even pressure throughout, and with no wrinkles in either the bandage or the padding. Care also needs to be taken when finishing the bandage so that it fastens on the outer side of the leg, with the fastening being secure but no tighter than the bandage itself.

Bandages that are either too tight or are left on too long (or where insufficient padding has been used) can cause permanent hair loss or white hairs on the legs. Further, secondary injury to the tendons can occur if bandages or their ties are too tight, where pressure points are caused from a twist in the bandage or a knot positioned at the back of the leg. Inflammation and bruising of the cannon bone can also result. Loose or poorly applied bandages can be dangerous and cause problems if they slip down.

When removing bandages the horse’s leg should be rubbed to encourage circulation.

Taking a horse’s temperature and pulse
The horse’s normal temperature is 38°C, though this may vary by half a degree either way. The temperature is taken using an equine thermometer (modern digital versions are preferable to mercury-based ones). Care must be taken when performing this procedure – ideally, the horse should be held by an assistant. After being lubricated, the thermometer should be partially inserted into the horse’s rectum and tilted slightly so that it rests against the rectal wall. The thermometer should be held in place for a full minute before being removed and wiped clean. The reading may then be viewed.

The pulse rate of a horse at rest is 30-40 heartbeats per minute. This rate increases normally with exercise and excitement, but can also increase when the horse has a fever or is in acute pain. Likewise, the horse’s normal breathing rate can also alter or appear labored, indicating possible ill-health or distress.

The pulse can be taken at the point where the facial artery passes under the lower jaw. Once the artery has been located, light pressure should be applied, using the flat of two or three fingers. The number of pulses over a period of 15 seconds should be counted, and then this number multiplied by four to obtain the pulse rate. If the horse shows signs of a fever or appears to be in pain, a veterinary surgeon should be consulted.

Nursing a sick or injured horse
The advice of the veterinary surgeon should be followed in respect of treatment and care during recovery. Additionally, the veterinary surgeon should be contact if there is any worsening of the horse’s condition.

A sick or injured horse being kept confined to its stable (referred to as box rest) needs additional care and attention to ensure its well-being and aid recovery. If a horse is ill, it is more important than ever to observe the animal regularly and to ensure your horse is comfortable and the environment clean.

Effective ventilation of the stable is essential, and a lightweight-rug can help keep a convalescing horse warm.

Clean fresh water must be available at all times. If water intake has to be monitored buckets should be used rather than automatic drinkers.
 
An infectious horse should be kept in isolation. All equipment associated with the horse should be kept separate from that of other horses, and disinfected thoroughly when the horse has recovered. Handlers should adopt strict hygiene measures to prevent the spread of infection.

Feed should be tempting and palatable, to encourage a sick horse to eat. Good clean hay should form the basis of the ration and this may require soaking prior to being fed, to increase its palatability and minimize dust. The veterinary surgeon may advise a special diet if the horse has a digestive problem or a nutrition-related condition. A horse that was in regular work prior to injury should have its feed ration reduced, to take account of its change in activity.

The horse’s feet should be picked out twice daily and, depending on the nature of the injury, the horse may benefit from being groomed regularly.

Boredom can be alleviated by subdividing the hay ration into several small feeds throughout the day. If necessary, stable toys or a neighboring companion horse can be provided.