Horse First Aid

General information on first aid for horses

Every person who is in regular contact with horses should regularly refresh his first aid knowledge for horse and human both in theory and practice. The more confident and experienced one is, the more objectively one can evaluate the various situations and react accordingly and sensibly. It is important to note that first aid is not a substitute for the veterinarian or the veterinary clinic.

It is used to mitigate life-threatening situations, relieve pain, reduce complications, and improve conditions for veterinary treatment.

The obligation to provide first aid is based on legal principles:

• Horse owner
• Caregivers appointed by the owner
• Persons who deal commercially with horses
• Important! No one is required to provide first aid if their own life is endangered
• Everyone is allowed to give first aid (at their own risk), even without consultation with the owner and cannot be held accountable for mistakes made
• Costs incurred during first aid must be borne by the owner

It is especially important that horses let themselves be touched everywhere. Even by strangers. Allow yourself to be tied up, give hooves and have medication administered. Attention can be paid here to medical training.

Provide first aid in an emergency

• Remain calm yourself and reassure the owner if necessary
• Calm horse
• Assess situation
• Make necessary phone calls (numbers of veterinarian, owner, and surrounding clinics should be accessible).
• If people are injured, the first thing to do is to call the emergency doctor
• Inform veterinarian and describe current situation as objectively as possible (specify location, number of injured persons/horses, leave callback number)
• If necessary, secure the accident site
• Instruct helpers and send away unnecessary spectators
• Choose helpers only with horse experience and with good physical conditions
• Do not hold the horse by the rope alone and do not wrap the rope around the hands.
• If possible, move the supply to a quiet, dry, well-lit and non-slip place
• When applying a dressing, have a helper lift another limb (not suspected fracture)
• In the event of an accident involving a mare and foal, it is important to keep both close by. If the foal is injured, the mare is tied, the foal is fixed and pressed against the mare. If the mare is injured, the foal must remain close by so that the mare does not become further agitated.
• In case of serious accidents with several severely injured horses, life-support measures must be taken first: Keep airways clear, stop heavy bleeding, prevent hypothermia / overheating.

Vital signs of the horse

The aim is to determine the acute state of health of the injured horse by determining the vital signs. Important! Determine the vital signs regularly on your own healthy horses, so that you get a routine and know exactly the normal values of your own horse.

PAT values (pulse-respiration-temperature) important for the phone call with the veterinarian

Pulse: 28 - 40 pulse / heartbeats per minute for adult horses.

• In foals 100 - 120 heartbeats per minute are normal
• Palpable on the lower jaw or next to the eye
• Do not use the thumb when keying (this has its own pulse)
• Assess pulse strength (weak - strong)
• Heartbeats are audible with a stethoscope on the left side behind the elbow
• Count number of strokes for 15 seconds and then x 4

Respiration: 8 - 16 breaths per minute for adult horses.

• In foals 20 - 30 breaths per minute are normal
• Breathing in the horse is visible and palpable on the chest, abdomen and flank
• Observe nostril width and breath sounds

Temperature: 37.5 - 38.2 °C at rest

• In foals 38.3 - 39.3 °C is normal value
• Rectally measurable with digital thermometer 
• From 38.5°C one speaks of fever, from 39°C it is threatening

Mucous membranes

• Eye = conjunctiva, nostrils, mouth = gums, vulva = pubis
• Normal condition: pale pink, moist, smooth and shiny
• Abnormalities: Paleness, severe redness, small hemorrhages, discharge or swelling.

Capillary filling time 

• Test on the gums by finger pressure, the gums become pale. Afterwards, the blood supply should be restored in max. 2 seconds if the cardiovascular function is good.
• In shock, only the vital organs (brain, heart and lungs) are supplied with blood. Mucous membranes become pale and ears become cold

Fluid balance

• Pull skin fold on the neck, passes immediately in a healthy horse and should not stand for more than 3 seconds.

Bowel sounds

• Can be listened to with the ear directly on the abdominal wall or with a stethoscope
• Listening possible in 4 areas: right and left flank and left and right lower abdomen

Feces / urine output

• Quantity, color, odor, consistency

Behavior

• Eye expression, facial expression, gestures, apathy

Nasal discharge

• Whitish/yellow: dental problems, respiratory tract infection
• Food debris coming out of the nose: Gullet blockage, stomach overlay

Musculoskeletal system

• Limb position and loading, hoof temperature, croup height

Apply the dressing in 4 steps

• Wound covering (compress, handkerchief, etc.)
• Wadding for padding in the limb area
• Elastic bandage for fastening, this must not be wound too tightly 1-2 fingers should still be able to be inserted between them. The absorbent cotton should extend beyond the upper edge of the bandage
• Tape to fix the bandage

Bandages must always be well padded to protect the bones. Similar to bandaging, start in the middle of the tubular bone then wrap downward without wrinkles and then still on top. Wrap all utensils in the same direction to avoid wrinkles. If waiting for the veterinarian, do not use ointments or sprays as they make it difficult to accurately assess the injury. Excess flaps of skin should never be cut off arbitrarily. After applying the bandage, the horse should be backed up once so that the load is taken up and no stumbling occurs resulting in a fall.

Simple dressing

• can start as a normal bandage from the fetlock joint or start as a deep bandage with a pad in the crook of the fetlock down to the hoof

High dressing

• first apply a deep dressing as a support bandage
• then cushion the carpal joint / ankle joint well and do not apply pressure to the area when wrapping the bandage

Pressure dressing

• wrapped like a simple bandage but with several compresses or a gauze bandage, which is still rolled up
• If the first pressure dressing is not sufficient, further pressure dressings can be applied over it
• Nevertheless, it is important not to pull the bandage tighter than with a simple bandage, otherwise a circulation disturbance can occur.
• If tying is necessary, which is very rare, the area about a hand's width above the bleeding must be tightly tied with a wide and preferably elastic object (belt, bicycle inner tube, etc.). It is important to loosen the bandage after 60 minutes at the latest.

Splint dressing

• Only in case of emergency in case of a fracture or a suspected fracture with which the horse has to be transported
• First apply a simple bandage, then pad it significantly more with absorbent cotton and tighten the bandage more tightly
• Then fix the splints (broomstick, several crops, a strong branch, etc.) on the first dressing layer, paying particular attention here to good underpadding.
• Now apply a second layer of dressing over the splints and fix it again with a bandage

Hoof dressing

• The first layer of dressing is the absorbent cotton. 
• Waddle at least to above the crown joint
• Fix with elastic bandage, it is important that the absorbent cotton sticks out above the bandage here as well
• Apply waterproof layer over bandage (tape, hoof shoe, etc.)

Sprue dressing

• First of all, apply a hoof bandage
• This is then infused with liquid
• Pour 0.5 - 1 liter of disinfectant solution into the dressing approx. 2x a day
• Do not leave the sprue dressing for longer than 2 - 3 days
• Then apply a dry hoof dressing

Head / eye bandage

• Head bandages are very difficult to apply correctly and durably
• Often, for head and eye injuries, it is enough to move the horse to a quiet place and prevent it from rubbing against the injury until the veterinarian arrives

Individual emergencies in horses

Injuries (lacerations, bites, peel/peel injuries, stab wounds, blunt trauma, fractures)

Causes:

• Accident (traffic, grazing or riding)
• Pasture/stable companions
• Injuries to protruding nails, tools
• Hanging in wire/strand, other fence violations

Symptoms:

• Wound with usually more or less severe bleeding
• Foreign body in wound, if applicable
• Pressure sensitive
• Wound area swollen and warm
• Bone pieces recognizable
• Nosebleed

Injury Assessment

• Location of injury: near the joint or eye can be dangerous even with minor injuries
• Depth of the wound: if the skin is completely cut, it requires veterinary treatment
• For a wound suture, the injury must be treated within 6-8 hours otherwise the wound must heal on its own 

Severe Hazards in Case of Injuries

• Tetanus (tetanus) -> always check vaccination protection in case of injuries
• Gas gangrene (Clostridia)
• Phlegmone = bullet hole
• Infection of joints, tendons, bursae

Bleeding

• Vein: blood slowly seeps from the wound, blood is dark red-bluish in color
• Artery: pulsating blood loss, blood is bright red
• The amount of blood of the horse is about 8% of the body weight -> 500 kg horse = 40 l blood one speaks from 20% (8 l) of the amount of blood of a dangerous loss and from 40% (16 l) of the amount of blood of a fatal loss

First Aid When a Vein is Affected

•  Wash out wound with clean water and cut off possible hair/ fur 
• Remove small foreign bodies
• Leave large penetrating foreign bodies and shorten if necessary
• When the vet is called, do not apply ointment and spray
• Apply bandage
• Cooling

First Aid When an Artery is Affected

• Apply a pressure dressing directly
• If dressing is bled through, leave it in place and apply a new dressing over it

First Aid for an Open Abdominal Injury

• Definitely get vet
• Prevent lying horse from standing up
• Calming and covering the horse
• Keep protruding organs clean and moist if possible 

First Aid for Fractures

• If the fracture is open, carefully cover the wound
• Do not move and calm horse
• Only if no veterinarian can be reached apply a splint bandage and transport the horse

First Aid for Injuries to the Head

• Head wounds usually bleed quite heavily
• Often no bandage possible, therefore work with cooling
• If nosebleed is severe, collect blood to determine amount and cool below eye

Nail Kick

Causes of Nail Kick:

• Entering sharp objects such as nails, stones, broken glass
• Risk of infection of surrounding bones, joints and tendons

Symptoms of Nail Kick:

• Horse suddenly goes lame
• First aid: wash and disinfect hoof sole
• If there is a risk of the foreign body penetrating deeper, remove it but keep it and mark the entry point and note entry depth and waving
• Apply sprue dressing
• Check tetanus vaccination
• Always call vet

Stomach Blockage

Causes of Pharyngeal Obstruction:

• Feeding of swelling feeds without prior soaking 
• Swallowing too large pieces of food due to greed or painful processes in the mouth
• The food cannot pass through the esophagus and due to the increased saliva production there is a high loss of fluid

Symptoms of Pharyngeal Obstruction:

• Salivating
• Stretched throat, coughing, snorting
• Feed remains from the nostrils
• Sometimes thickening in the upper throat area noticeable
• Difficult breathing
• Panic if necessary
• Circulation problems

First Aid for Stomach Blockage:

• Call vet
• Remove food remains
• Keep airways clear as much as possible
• Massage the throat (in the direction of the mouth)
• Lead on the long rein
• Keep head low
• Calm horse

Colic = Pain in the Abdomen and Pelvic Area

• Often intestinal colic but also renal colic possible

Causes of Colic:

• Stress
• Weather change
• Fluid deficiency
• Parasites
• Dental problems
• Wrong feeding
• Stomach ulcers / gastritis
• Urinary stones
• Vertebral blockages

Symptoms of Colic:

• General restlessness or apathy
• Scraping
• Tail slap
• Snatch belly
• Lying down / rolling
• Flehmen
• Sweating
• Feed refusal
• Tightened breathing

Assessment of Colic:

• PAT values measurement
• Control mucous membranes
• Observe urine and feces output
• Listen to bowel sounds
• Successful defecation does not mean that it cannot be a bowel obstruction.

First Aid for Colic:

• Contact a veterinarian even at slight signs, a slight cramping colic can quickly turn into a life-threatening situation due to regurgitation/displacement of intestinal parts.
• Withdraw food and offer enough water
• If the horse shows signs of lying down, provide adequate space
• Let roll, lead around quietly
• Cover sweated horses
• Massage belly
• Administer Colosan every 60 minutes

Eye Diseases with and without Foreign Body

Causes of Eye Disease in Horses: 

• Dust, insects, straw, small twigs
• Bacterial / viral infections
• periodic inflammation of the eyes
• Blocked nasolacrimal duct 

Symptoms of Eye Disease in Horses:

• Pinching the eyelids
• Tear flow
• Light shy
• Foreign body (not always recognizable)
• Reddened conjunctiva
• Opacity of the cornea

First Aid for Eye Disease in Horses:

For injuries with foreign bodies:

• Foreign body floats on the cornea -> rinse with clear water or push the foreign body towards the inner corner of the eye with a clean cloth. Never use tweezers near the eye.
• Foreign body is stuck in the cornea -> do not remove, possibly cover eye

For injuries near the eye

• Bring to quiet, fly-free place without direct sunlight 
• No independent application of eye ointments 

Heat Stroke/Overheating

Causes: 

• overexertion especially at high outside temperatures
• Horses that drink too little in the heat
• Heat transport

Symptoms:

• Increased respiratory rate
• Often intense sweating
• Apathy 
• Swaying to the point of falling over

Laminitis = Aseptic Inflammation of the Hoof Corium

Causes of Laminitis:

• Excessive load
• Metabolic diseases
• Poisonings
• Sepsis
• Certain medications
• Stress

Symptoms of Laminitis:

• Stiff gait especially the forelimbs are affected
• Sawhorse position
• Warm hooves
• Sweating
• Pulsation at the arteries of the fetlock head
• Trembling
• Fixed
• Shoeing

First aid for Laminitis:

• Cooling
• Heavily padded hoof bandage
• Stabling in box with soft floor
• Only hay and straw feeding
• In any case, contact a veterinarian and have an X-ray of the coffin bone taken

Poisonings

Causes of Poisoning: 

• Poisonous plants when riding out, in the paddock, in the silage/hay.
• Herbicides/Insecticides/Fungicides
• Treated seed corn
• Colors/varnishes
• Dead rodents in hay

Symptoms of Poisoning:

• Very dependent on the particular toxicant
• Salivating
• Unrest
• Diarrhea
• Colic
• Circulatory weakness
• Shortness of breath
• Central nervous disorders

First Aid in Case of Poisoning:

• Prevent further poison ingestion
• Do not feed but provide sufficient water
• Stabling in box with soft floor
• Pick up poisonous plant for identification
• Measure temperature
• Often there is no specific antidote and only the symptoms can be treated
• Poisonous plants: Yew, false acacia, arbor vitae, boxwood, laburnum, deadly nightshade, oleander, ragwort, autumn crocus, sycamore, bracken.

Allergic reactions

Causes:

• Insect bites
• Poisonous plants
• Care products
• Feed
• Medication

Symptoms:

• Hives, wheals, redness, hair loss, itching, fever, edema, indigestion with diarrhea, accelerated pulse, shortness of breath.

First Aid:

• Eliminate triggering allergen 
• Cool affected body parts
• Protect from blazing sun
• In case of diarrhea only hay and water feeding and after calming down yogurt feeding possible to regulate the intestinal flora

Burns

Causes:

• Barn fire
• Traffic accident
• Sunburn
• photoactive plants

Symptoms:

• Skin damage: redness, blistering, cohesive separation of the skin.
• Consequential damage: circulatory collapse, massive infection, laminitis

First Aid:

• Stabling
• Cool skin/injuries
• Offer water to drink
• Call the veterinarian at the latest from 2nd degree burns

Bullet Hole

Causes: 

• overlooked injury, hoof ulcer, mallenders

Symptoms:

• Swelling
• Heat
• On limbs a throbbing metatarsal artery
• Painful
• Fever
• Lameness

First Aid:

• Cooling
• If opening visible, disinfection and dressing
• Call the vet in case of fever or severe lameness

Crossverschlag

Causes:

• Cold start after rest days with constant feeding
• Metabolic diseases

Symptoms:

• Shortly after starting work clammy gait
• Increasingly increased respiratory rate and pulse rate
• Sweating
• Muscle tremor
• Stiffening of the hindquarters
• refusal to move, buckling in the hindquarters

First Aid:

• An absolute emergency and requires a visit to the vet
• Horse no longer move
• Return to the stable only in the trailer
• Immediately warm tuck
• Offer water to drink

Stable pharmacy horse

Should Always be Present:

• Digital clinical thermometer
• Liquid disinfectant
• Sterile saline solution
• Dressing material
• Scissors, tweezers, lamp
• Ointments or sprays
• List with important phone numbers
• Rubber gloves

May be Present in Addition:

• Soap
• Disposable razor
• Towel
• Syringe with attachment
• Tick Pliers
• Stethoscope
• Muzzle
• Nose brake
• Mouth syringe
• Sharp knife
• Medication

You can find a list of equine clinics here: