Equine Medical Alert:

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Equine Medical Alert
How to Deal With Muscle Disorders, Shock and
Woundson the Trail

• Susan Garlinghouse, DVM, MS
• www.allcreaturesanimalhealth.com
• Chris White, ESMT
• HorseMasseuse_at_aol.com

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Muscle disorders

• Lots of names for similar symptoms
• Charley horse (least severe)
• Recurrent exertional rhabdomyolysis
• Tying up
• Paralytic myoglobinuria
• Set fast
• Monday morning disease
• Azoturia (most severe)

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Muscle disorders

• Sudden onset of muscle spasm
• Reluctance to move out normally
• May want to canter instead of trot
• Anxiety
• Shortened stride (usually behind)
• Muscles of back and hindquarters feel hard

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Tying up

• Ischemia blood flow to muscles compromised by
  spasms
• Disruption of intracellular environment of
  muscles
• Cant get rid of waste products
• Cant deliver required substrates
• Muscles freeze in contracted state
• Cramp, pain, cellular damage
• Peeing coffee myoglobinuria, kidney damage

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Tying up

• Common causative factors of muscle problems
• Exhausted horse syndrome
• Electrolyte depletion
• Dehydration
• Overexertion
• Exhaustion
• Heat stress
• Selenium deficiency
• High grain rations during rest, followed by
  sudden onset of exercise

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Tying up

• Less common causative factors
• Young nervous fillies (hormonal influence?)
• Hereditary, breed relationships
• Post-viral infections, esp. rhino
• Trauma, injury
• Cold weather
• Laminitis
• Ionophore intoxication (blister beetle, gossypol,
  ruminant feed additives, cassia, etc)
• Shock
• Tetanus

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Severity

• Important to be able to differentiate between a
  minor muscle cramp and severe rhabdomyolysis
• Important to be able todifferentiate between
  earlyonset and late onset

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Severity

• Making the wrong choice can lead to severe muscle
  damage and kidney failure
• Rhabdomyolysis is potentially life-threatening

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How to tell the difference?

• Did the symptoms appear early on, or late in the
  ride?

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How to tell the difference?

• Did the symptoms appear early on, or late in the
  ride?
• Hardly even warmed up? First few miles?
• Minor muscle cramp, OR
• Early onset exertional rhabdomyolysis

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How to tell the difference?

• Did the symptoms appear early on or late in the
  ride?
• Late in the day, hot, sweaty, tired?

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How to tell the difference?

• Did the symptoms appear early on or late in the
  ride?
• Late in the day, hot, sweaty, tired?
• Minor muscle cramp, OR
• Late onset exertional rhabdomyolysis

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What muscle groups are affected?

• Loin, largemuscles ofhindquarters,upper thighs
• If affecting an isolated muscle group, more
  likely just a cramp
• If affecting only one side, more likely just a
  cramp

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What muscle groups are affected?

• If entirehindquartersare affectedON BOTH
  SIDES,more likely rhabdomyolysis

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What do I do next?

• STOP RIDING
• Continued forced exercise muscle injury, pain
• In severe episodes, cellular disruption gt
  release of myoglobin into circulation gt filtered
  out by kidneys gt renal damage gt ARF/CRF
• Loosen girth or unsaddle
• Obtain extremely important piece of treatment
  equipment

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• Now take a deep breath, and sing to your horse
  until the peppermint is gone.
• Yes. Really.
• No fair biting the peppermint

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• Take care of your own safety!
• A painful horse is a lot more likely to kick
• Theres no such thing as a horse that DOESNT
  kick, only horses that havent kicked YET

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Reassess the situation

• If muscle spasms have relaxed, may be okay to
  slowly hand-walk back to nearest trailer-out
  point or barn
• Late onset usually will eventually be able to
  walk home
• Early onset can be extremely severe, forcing to
  walk can cause severe muscle and renal damage
• If still reluctant/unable to walk, must bring
  veterinary help to horse
• Keep muscles covered and warm

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What if no vet is available?

• Early onset
• Bute or Banamine
• Often treated with muscle relaxants, sedation,
  fluids
• Late onset exhausted horse syndrome
• Bute or Banamine can cause further renal damage!
• Ace causes drop in blood pressure -
  contraindicated
• Horse needs IV fluids to correct fluid and
  electrolyte deficits, diurese kidneys
• Transport to clinic ASAP

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Injuries on the trail

• Supplies to carry with you on the trail
• Leatherman tool with pliers for cactus, wire, etc
• Vetrap
• Pressure bandage wrap terrycloth hand towel
  will do
• Thick feminine napkin works great

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Poor mans Panalog

• Mix equal partsMaximum Strength Lanacane1
  hydrocortisoneTriple antibiotic (generic
  Neosporin)
• Good for galls, bug bites, abrasions (humans,
  too)
• Do NOT put into eye injuries
• Do NOT put onto injuries needing sutures

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Eye injuries

• Steroid ointments(dexamethasone,
  prednisone,hydrocortisone) effective for topical
  irritation
• Never EVER apply steroid ointments until eye has
  been examined by veterinarian
• Steroids can make corneal abrasions worse
• Melting ulcers can cause blindness
• Always trailer with fly mask
• NEVER let your horse travel with head out window

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Eye injuries

• BNP Prescription ophthalmicointment
• Always safe for any eye injury
• Bacitracin, neomycin sulfate, polymyxin sulfate
• More highly refined form of Neosporin

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Eye injuries

• In emergency, use new tubeof Neosporin in eye
• Single use packets very useful
• Small dab on clean finger, pull down eyelid,
  place in lower eyelid pocket
• Apply 3-4 times a day until vet can examine

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Wounds needingsutures

• Dont hose exposed tissuewith plain water
• Body tissues 0.9 salt
• Hypotonic water disrupts exposed damaged and
  undamaged tissue

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Wounds needingsutures

• One-stop shopping for cleaningANY wound
• Clean tap water
• Add Betadine solution (NOT scrub) to make
  solution the color of weak tea
• Add pinch of salt (any kind) per quart
• Use clean spray bottle on stream setting
• Removes surface bacteria without damaging tissue

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Wounds needingsutures

• Once clean, apply light wrapto protect
• DONT apply ointments ortopicals of any kind if
  going to be sutured
• Dont second-guess if the vet is still going to
  be able to suture
• Golden window 8 hours
• Can close wounds weeks old

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Wounds

• If not going to be sutured, dont apply any
  ointments other than Neosporin (triple
  antibiotic) unless directed by vet
• No Wound Dust, furacin, BlueKote, scarlet oil or
  other caustic agents
• Much more likely to cause proud flesh

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The End (is it happy hour yet?)