Equine Emergencies

James A. Orsini, Associate Professor of Surgery, University of Pennsylvania. Nora S. Grenager, Director of Internal Medicine, Steinbeck & Peninsula Equine Clinics, Menlo Park Clinic, Menlo Park, California.

• PART I. EMERGENCY PROCEDURES AND DIAGNOSTICS Section 1. Important Diagnostic and Therapeutic Procedures for Emergency Care 1. Blood Collection 2. Medication Administration and Alternative Methods of Drug Administration 3. Intravenous Catheter Placement and Venous Access 4. Regional Perfusion, Intraosseous, and Resuscitation Infusion Techniques 5. Biopsy and Fine Needle Aspirate Techniques 6. Technique of Negative Pressure Wound Therapy (NPWT/VAC) 7. Abdominal Palpation Per Rectum Section 2. Laboratory diagnostics, monitoring, and emergency imaging and endoscopy 8. Laboratory Diagnosis of Bacterial, Fungal, Viral, and Parasitic Pathogens 9. Emergency Laboratory Tests and Point-of-Care Diagnostics 10. Fluid Analysis and Cytology 11. Emergency and Critical Care Monitoring 12. Imaging Techniques and Indications for the Emergency Patient 13. Emergency Diagnostic Endoscopy PART II. DIFFERENTIALS AND TRIAGE OF COMMON PRESENTATIONS Section 1. Problem-based Differentials 14. Problem-based Differentials Section 2. Triage and Stabilization of Most Common Emergencies 15. Ataxia/Acute Neurologic 16. Colic Triage 17. Triage of Collapse 18. Down Horse (adult) 19. Dyspnea and Respiratory Distress 20. Fever 21. Nasal Discharge 22. Reluctance to Move 23. Shock 24. Triage of the Sick Neonatal Foal PART III. EMERGENCY CONDITIONS BY BODY SYSTEM Section 1. Cardiovascular 25. Cardiovascular Workup and Procedures 26. Arrhythmias 27. Murmurs 28. Myocardial Disease 29. Congestive Heart Failure 30. Pericardial Disease Section 2. Gastrointestinal 31. Gastrointestinal Workup and Procedures Section 2.1 Oral Cavity 32. Dental Emergencies 33. Tongue Emergencies - Lacerations, Fox Tail, Ulcers 34. Hypersalivation Section 2.2 Esophagus 35. Esophageal Obstruction 36. Esophageal Perforation Section 2.3 Stomach 37. Equine Gastric Ulceration Syndrome 38. Gastric Impaction 39. Acute Grain Overload and Gastric Dilatation and Rupture Section 2.4 Intestine 40. Small Intestine 41. Large Colon and Cecum 42. Small Colon and Rectum Section 2.5 Other 43. Peritoneal Cavity Section 2.6 Diarrhea 44. Adult Diarrhea 45. Foal Diarrhea Section 3. Hemolymphatic 46. Hemolymphatic Workup and Procedures 47. Non-hemorrhagic Causes of Anemia 48. External Hemorrhage 49. Internal Hemorrhage 50. Snake Bites 51. Guttural Pouch Hemorrhage Section 4. Hepatic 52. Hepatic Workup and Procedures 53. Causes of Hepatic Disease 54. Therapies for Hepatic Disease Section 5. Musculoskeletal 55. Diagnostics and Therapeutics: Lameness Workup Section 5.1 Adults 56. Adult Fractures 57. Adult Joint Luxations 58. Severe Soft Tissue Injuries 59. Synovial Punctures/Lacerations 60. Hoof Wall and Coronary Band Injury 61. Foot Abscess 62. Penetrating Hoof Injuries 63. Laminitis Section 5.2 Myopathies - Adults 64. Acute exertional rhabdomyolysis 65. Anesthetic myopathy and malignant hyperthermia 66. Muscle trauma 67. Botulism 68. Tetanus 69. Clostridial Myositis 70. Hyperkalemic Periodic Paralysis (HYPP) 71. Hypocalcemia 72. Exhausted horse syndrome 73. Vitamin E and selenium deficiency disorders 74. Immune-mediated myopathies 75. Toxin-related myopathies Section 5.3 Pediatrics 76. Septic Arthritis in Foals 77. Pediatric Septic Physitis 78. Fractures in Foals 79. Flexural Deformities 80. Angular Limb Deformities 81. Soft Tissue Trauma 82. Myopathies Section 6. Neonatology 83. Foal Workup and Procedures 84. Newborn Foal Evaluation and Resuscitation Section 6.1 Special Situations 85. Meconium Impaction 86. Congenital Abnormalities 87. Ruptured Bladder 88. Umbilical Infection 89. Patent Urachus 90. Perinatal Asphyxia Syndrome 91. Sepsis and the Systemic Inflammatory Response Syndrome (SIRS) in neonates 92. Dysmaturity, Prematurity, and Postmaturity 93. Neonatal Isoerythrolysis Section 7. Neurologic 94. Neurologic Workup and Procedures 95. Acute Cranial Nerve Signs 96. Acute Mentation Changes 97. Acute Ataxia 98. Acute Peripheral Nerve Disease Section 8. Ophthalmic 99. Ophthalmic Workup and Procedures 100. Ophthalmic Trauma 101. The Ocular Surface 102. The Swollen Eye and Intraocular Emergencies 103. Miscellaneous Ophthalmic Emergencies Section 9. Renal 104. Renal Workup and Procedures 105. Acute Renal Failure 106. Discolored Urine 107. Renal Tubular Acidosis 108. Uroperitoneum or Uroretroperitoneum Section 10. Reproductive 109. Reproductive Workup and Procedures Section 10.1 Male Reproductive Problems 110. Swollen Sheath 111. Scrotal Enlargement 112. Post-Castration Complications 113. Paraphimosis 114. Priapism/Persistent Penile Erection 115. Hemospermia Section 10.2 Female Reproductive Problems 116. Abortion 117. Late-Term Pregnancy Problems 118. Uterine Torsion 119. High-Risk Pregnancy Management and Maternal-fetal Medicine 120. Monitoring the Late-Term Mare 121. Dystocia 122. Cesarian Section 123. Peripartum Problems 124. Lactation Issues Section 11. Respiratory 125. Respiratory Workup and Procedures 126. Upper Airway Obstruction 127. Nasal Discharge 128. Epistaxis 129. Dyspnea without Upper Respiratory Tract Noise Section 12. Shock, Systemic Inflammatory Syndrome (SIRS), and Multi-organ Dysfunction Syndrome (MODS) 130. Work up and Procedures in SIRS, Sepsis, and MODS 131. Therapies for SIRS, Sepsis, and MODS Section 13. Skin and Wounds and Burns, Anaphylaxis, Heat Stroke 132. Workup and Procedures 133. Pruritus 134. Wounds Section 13.1 Generalized or Regional Swellings 135. Anaphylaxis 136. Cellulitis/Lymphangitis 137. Snake Envenomation 138. Regional Swellings: Purpura Hemorrhagica Section 13.2 Miscellaneous Lumps and Bumps 139. Hematoma 140. Insect and Spider Bites 141. Pigeon Fever 142. Injection Site Abscess Section 13.3 Miscellaneous Skin Conditions 143. Burns 144. Hypothermia 145. Heat Stroke PART IV. TOXICOLOGY 146. Decontamination and Diagnostic Procedures 147. Toxins Listed by Body System 148. Specific Acute Adverse Drug Reactions and Recommended Treatments PART V. ADDITIONAL EMERGENCY CONSIDERATIONS Section 1. Emergency Procedures 149. Cardiopulmonary Resuscitation in Foals and Adult Horses 150. IV, Enteral, and Rectal Fluid Therapy and Blood Transfusion Section 2. Field Anesthesia and Euthanasia 151. Field Anesthesia 152. Humane Euthanasia Section 3. Analgesia 153. Analgesia Section 4. Nutrition 154. Medical Management of the Starved Horse 155. Nutritional Guidelines for the Injured, Hospitalized, Post-Surgical Patient Section 5. Biosecurity, Public Health Considerations, and Zoonoses 156. Contagious and Zoonotic Diseases in North America 157. Global Infectious Diseases 158. Standard Precautions and Infectious Disease Management 159. Public Health Considerations Section 6. Considerations in Specific Types of Horses 160. Draft Horses 161. Miniature Horses 162. Emergency Considerations in Donkeys 163. Geriatric Horses Section 7. Disaster Medicine and Technical Emergency Rescue 164. Triage and Stabilization of Patients 165. How to Set up a Field Emergency Site in a Disaster 166. Technical Rescue