First, do no harm: How to help your horse (and your vet) when your horse gets hurt

When Dr. Gary McEntyre of Airway Veterinary Hospital in Colorado Springs, Colo., gets a call from a frantic horse owner, he asks for vital signs from the get-go.

“What’s the pulse? What’s the temperature? That gives you a start on diagnosis,” Dr. McEntyre says. So it’s helpful if the horse owner has a stethoscope and thermometer on hand, and knows how to use them.

He adds that it’s especially important to take those vitals before administering treatment. Banamine, for example, is a useful painkiller — but it can mask a horse’s symptoms by lowering their body temperature and slowing their heartbeat, making a horse’s condition seem more stable than it may actually be.

Horse owners are likely to see a myriad of different ailments and injuries in their lifetimes.

Two veterinarians, Dr. McEntyre of Colorado and Dr. Drew Hummel of Owyhee Vet Clinic in Homedale, Idaho, weigh in on how to handle some of the more common problems they field questions on.

Wound Care

Dr. McEntyre starts with a couple basic rules for wound care. “Wash it, clean it up. Use a disinfectant, like Betadine. Then you want to get a wrap on it and keep it moist.” Suturing a wound becomes much harder if a wound dries out, he adds.

Antibacterial ointments, salves and sprays can help keep infection at bay and keep a wound moist. Use them directly on the wound, and then dress open wounds with cotton dressings and bandaging tape.

Bandages should be snug, but not too tight. A lot of bandaging tape, like Vetrap, has wrinkles. Dr. Hummel suggests pulling the tape until the wrinkles nearly disappear, then laying it on.

Wounds over a joint tend to be more serious, and are often worth a call to the vet.

“When a horse sets up a joint infection in their leg, they go profoundly lame — like three-legged lame,” Dr. Hummel explains. A vet will often be more aggressive with antibiotic use from the get-go when treating a wound over a joint.

Most wound care involves simply keeping the wound clean. However, for some wounds that can’t be sutured, the body can get a little carried away with healing itself.

In vet-speak it’s called exuberant granulation tissue, but most horse owners just know it as proud flesh — or, more importantly, something to avoid.

Granulation tissue is important for healing wounds that aren’t covered by skin, but when granulation tissue grows beyond the edges of the wound, it becomes proud flesh. It often looks reddish and lumpy.

Dr. David Ramey, an equine practitioner who also writes extensively about horse health, says on his blog that once the wound is filled up with granulation tissue, keeping a bandage on it will help prevent proud flesh from forming. A corticosteroid ointment can also help because it keeps granulation tissue from growing, but can slow the healing process, so consult with your vet before taking this step.

Ramey says a good rule of thumb is to put anything you want on a wound, as long as you wouldn’t mind putting it in your eye, so for the most part stick to keeping it clean with water and applying vet-approved ointments.

Dr. McEntyre says horse owners should especially keep an eye out for proud flesh when tending leg injuries below a horse’s knees or hocks.

“There’s not much soft tissue to cover up those areas,” he adds, which makes them hot spots for proud flesh growth.

Treatment involves cutting excess granulation tissue from the wound.

Dr. McEntyre says he typically tries to debulk proud flesh until it’s back to skin level, usually a job for a veterinarian. Then the healing process resumes.

Left untreated, residual scarring from proud flesh can impede movement, especially if the original injury was over a joint.

Treat lower-leg wounds judiciously by cleaning them, preventing infection, and using bandages appropriately. When in doubt, call your veterinarian.

Hoof Injuries

Puncture wounds in the foot, like stepping on a nail or a fence staple, can be serious.

If a nail is lodged all the way into a horse’s foot, Dr. Hummel suggests leaving it and having a vet do the removal. “If it’s going to cause the horse more trauma if they put down their foot, then take it out,” he adds.

Dr. McEntyre says the next step is to protect the hoof from infection. “You should try to flush the wound with Betadine or iodine if you have it,” he says.

Throwing a shoe is another cause of hoof injury. “Some can become very lame, very fast,” Dr. Hummel says. He suggest carrying an extra hoof boot if you’re planning to be in the backcountry for long stretches at a time.

Colic

Colic is the cause of some of the most fraught calls to veterinarians — but it’s also an ambiguous term to most horse owners, who associate colic with a twisted gut.

“Colic is simply abdominal pain. It doesn’t always mean an intestinal problem,” Dr. Hummel says.

“Horses will go off feed, off water,” Dr. Hummel explains. “They may look at their abdomen, or stretch all the way out like they’re trying to pee. They’ll check their sides. They’ll roll.” Those are general symptoms of discomfort.

Dr. Hummel advises using an analgesic like Banamine to ease the pain, and taking the horse off feed for at least 12-24 hours. “All the gas and feed needs to move through them without more food in there,” he says, but notes that horses should always have access to water.

Dr. McEntyre suggests keeping a horse up and walking, while mulling questions like, “Is the horse in more pain? Or does he seem to be feeling better? When did this start? Have I changed his feed lately?” That knowledge can all be helpful in the event a vet is called.

For equine first-aid trainer Theresa Allen, choke is a less common ailment that hits uncommonly close to home. She describes it like this:

“You can see [a horse] trying to cough something up. They’re straining their neck. Their mouths are open, but they can’t vomit. Sometimes you can actually see a lump on the left side of the neck — like if they’ve swallowed an apple whole, for example,” Allen explains.

A couple weeks after teaching a first-aid clinic, Allen heard from one of her students who ran a boarding barn. One of the boarders was distraught her horse was colicing. She called the manager right away, who recognized it immediately as choke. They were able to pass what the horse was choking on, saving the barn a vet call and preventing further distress to horse and owner.

Losing a horse isn’t always preventable, but preparedness and a basic grasp of equine first aid can help prevent small injuries from ballooning into big ones.

BASIC EQUINE FIRST AID KIT

• non-stick wound dressings
• cotton dressings
• antiseptic solution (like iodine or Betadine)
• wound spray or salve (like Vetricyn or Nitrofurazone ointment)
• bandaging tape (like Vetrap, or even an Ace bandage)
• diapers or maxi-pads for wound dressings
• a pair of blunt-tipped scissors for changing dressings
• plastic gloves
• thermometer
• stethoscope

Other items to consider: Banamine paste for pain relief and anti-inflammation; an oral antibiotic like SMZ tablets or Sulfa pills; rehydration salts; and sutures, if you’re comfortable using them and will be away from vet care.

Dr. Drew Hummel suggests keeping a basic first aid kit in your saddlebags, with a more comprehensive one at the barn or in the trailer.

Every horse owner has a different level of comfort and expertise treating equine injuries. When in doubt, seek advice from a trusted veterinarian.

EQUINE VITAL SIGNS

Pulse. Feel for an arterial pulse under your horse’s jawbone. When you find the rhythm, set a timer for 60 seconds. Count the number of pulses. Knowing what’s normal for your horse before illness or injury will help you know when something’s wrong. You can also locate a pulse using a stethoscope, with practice.

Respirations. Place a hand on your horse’s ribcage or belly. Count the number of inhalations for one minute. Respiration rate can vary depending on a horse’s activity or stress level, but generally, 8-15 breaths per minute is normal.

Temperature. A normal temperature in an adult horse is typically in the 99-101-degree F range. Temperatures taken rectally are the most accurate. Gently insert a thermometer into the horse’s rectum and wait for a reading.

Mucous membranes. When you lift the upper lip of a healthy horse, it should appear moist and soft pink — about the same color of your thumbnail. Push your thumb against the horse’s gum until it turns white, then release. It should take 1-2 seconds for the gums to return to their original color. This is called capillary refill, and it can be helpful in assessing circulation. Training your horse to accept having its mouth handled will be helpful before performing this test.

Gut sounds. Use a stethoscope to listen to the area around a horse’s barrel, behind the ribs. Gurgling and rumbling noises are normal. The absence of gut sounds can be indicative of a problem. (Fun fact: By their scientific name, gut sounds are aptly called borborygmi, pronounced BOR-burr-ig-MY, which has the ring of a gut sound when you say it out loud.)