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Equine tier 1 call outs

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Jen Spiers
Jen Spiers

You are called out to examine an unvaccinated horse that is moving slowly and stiffly with difficulty chewing. The owner had treated a leg wound on the horse 5 days prior when it was otherwise normal. Differential diagnoses include tetanus, septic arthritis, botulism, and various causes of lameness or difficulty chewing. A physical examination and diagnostic testing would be needed to confirm the diagnosis, with tetanus requiring anti-toxin and antibiotics treatment along with wound care. Further vaccination is also recommended to prevent future cases.

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You are called out to… … an unvaccinated horse which is moving slowly and stiffly and having difficulty chewing. The owner had treated the horse for a leg wound 5 days previously, at which time it had been otherwise normal.
Differential Diagnosis • Tetanus • Septic arthritis • Botulism • Lameness: Laminitis, arthritis, trauma, soft tissue injury, tendon/ligament injury, rhabdomyalysis • Difficulty chewing: Dental disease, trauma (broken tooth/jaw fracture), tooth abscess. • Pleuropneumonia
History Questions • When did the wound happen? • Where is the wound? • Was it lame on that leg initially? • When did you notice stiffness? • Has there been any swelling of the leg • When did the difficulty eating begin? • What have you been feeding the horse • Are they dropping food? • Have you given any medication to this horse for condition?
Physical Examination • Observe horse in environment & demeanour • Vital parameters • Examination of wound • Examination of stiff leg- palpation of leg, joints & digital pulses • Examination of gait • Examination of head ▫ Ocular exam – Tenatus causing protrusion of 3rd eyelid. ▫ Dental examination • Tail head, facial expression, hyperalgesia, sweating, flared nostrils
Confirm Diagnosis • Tetanus ▫ History, clinical signs ▫ Gram stain from wound • Septic Arthritis ▫ Swelling of joint ▫ Pain on palpation ▫ Aseptic arthrocentesis • Botulism ▫ History of feeding
• Rhabdomyalisis – ▫ CK on biochemistry (massively elevated) • Laminitis ▫ other clinical signs and radiographs • Dental disease/trauma/abscess ▫ dental examination • Pleuropneumonia ▫ auscultate thorax, pyrexia, chest tap
Treatment of tetanus • Tetanus anti-serum ▫ 100,000-250,000 IU IV (Knottenbelt) ▫ 300,000 IU - slow IV (Merck) • Tetanus toxoid ▫ 1ml deep IM • Penicillin • Sedation? • Clean & debride wound and bandage • Fluids ▫ NG tube or IV catherisation • Food & water offered from a height • Deep bedded stable
Further Prevention • Tetanus vaccination ▫ Dose 1: Day 1 ▫ Dose 2: 4-6weeks later ▫ Booster 6 monthly ▫ Clean wounds thoroughly ASAP ▫ Mares vaccinated 4-6 weeks before parturition  Foals given anti-toxin at birth ▫ Start vaccination after 4-5 months of age after maternal antibodies waned.

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Equine tier 1 call outs

  • 1. You are called out to… … an unvaccinated horse which is moving slowly and stiffly and having difficulty chewing. The owner had treated the horse for a leg wound 5 days previously, at which time it had been otherwise normal.
  • 2. Differential Diagnosis • Tetanus • Septic arthritis • Botulism • Lameness: Laminitis, arthritis, trauma, soft tissue injury, tendon/ligament injury, rhabdomyalysis • Difficulty chewing: Dental disease, trauma (broken tooth/jaw fracture), tooth abscess. • Pleuropneumonia
  • 3. History Questions • When did the wound happen? • Where is the wound? • Was it lame on that leg initially? • When did you notice stiffness? • Has there been any swelling of the leg • When did the difficulty eating begin? • What have you been feeding the horse • Are they dropping food? • Have you given any medication to this horse for condition?
  • 4. Physical Examination • Observe horse in environment & demeanour • Vital parameters • Examination of wound • Examination of stiff leg- palpation of leg, joints & digital pulses • Examination of gait • Examination of head â–« Ocular exam – Tenatus causing protrusion of 3rd eyelid. â–« Dental examination • Tail head, facial expression, hyperalgesia, sweating, flared nostrils
  • 5. Confirm Diagnosis • Tetanus â–« History, clinical signs â–« Gram stain from wound • Septic Arthritis â–« Swelling of joint â–« Pain on palpation â–« Aseptic arthrocentesis • Botulism â–« History of feeding
  • 6. • Rhabdomyalisis – â–« CK on biochemistry (massively elevated) • Laminitis â–« other clinical signs and radiographs • Dental disease/trauma/abscess â–« dental examination • Pleuropneumonia â–« auscultate thorax, pyrexia, chest tap
  • 7. Treatment of tetanus • Tetanus anti-serum â–« 100,000-250,000 IU IV (Knottenbelt) â–« 300,000 IU - slow IV (Merck) • Tetanus toxoid â–« 1ml deep IM • Penicillin • Sedation? • Clean & debride wound and bandage • Fluids â–« NG tube or IV catherisation • Food & water offered from a height • Deep bedded stable
  • 8. Further Prevention • Tetanus vaccination â–« Dose 1: Day 1 â–« Dose 2: 4-6weeks later â–« Booster 6 monthly â–« Clean wounds thoroughly ASAP â–« Mares vaccinated 4-6 weeks before parturition ï‚– Foals given anti-toxin at birth â–« Start vaccination after 4-5 months of age after maternal antibodies waned.