"Cachexia secondary to medical disorders — such as severe parasitism or neoplasia, liver or kidney disease and neurologic
conditions such as botulism, encephalitis and equine protozoal myelitis — can all possibly contribute to producing a recumbent
horse," Slovis says.
Trauma is another important concern in cases of recumbent horses seen by both Drs. Slovis and Gimenez, yet it is often overlooked.
All too often, the desire to initiate a rescue operation, often by well-meaning samaritans, gets in the way of a complete
assessment of the initial situation.
Dr. Gimenez, in a paper presented at the American Association of Equine Practitioners Convention in 2002, writes: "An unjustified
difficult, dangerous or high-tech approach is sometimes employed by rescuers ... The excitement of rescues tends to break
down the use of teamwork and common sense." This may be the most important role for the equine veterinarian in such scenarios.
A veterinarian should perform a thorough physical examination and assessment of the animal and the overall situation. Is the
horse injured? Are there any fractures or lacerations? Is the horse exhibiting signs of neurological problems, disorientation,
dehydration or shock? Answers to these questions will often determine the conditions of the rescue or even if a rescue should
proceed. Placing rescuers at risk and putting a horse with a severe fracture that might not be repairable through a possible
painful rescue procedure might not be advised. It is often said that the first thing to do in an emergency situation is to
take your own pulse. This is a reminder to relax and step back to assess the entire situation before responding. Often the
veterinarian can provide this objective evaluation and overview in what is usually an emotional situation.
Veterinarians are also encouraged to learn about their individual state's regulations regarding rescue of animals. Some states,
such as Kentucky, view horses as personal property, so fire and rescue personnel are mandated to help save horses as they
would try to save a burning house. The chief of the rescue operation might be the person taking full responsibility for the
scene and may use the responding veterinarian for consultation and assistance. Alternatively, the equine veterinarian might
be consulted for direction as other states differ about who is in charge and responsible. This can be a potential problem.
"A veterinarian called to the scene of a highway accident involving a horse encounters fire/rescue, emergency medical and
law enforcement personnel and often finds confusion in terms of who is in charge of the situation," Gimenez says.
Some veterinarians have been shocked to learn that they would have been held responsible in some states if any rescue personnel
had been injured in the operation. It is important to know the rules in your area and which rescue personnel you can easily
and responsibly work with.
Problems with dehydration and electrolyte imbalance can cause profound muscle weakness and make a horse unable to stand or
help itself rise. This is commonly seen in hot, humid environments where the exertions done in attempting to stand often result
in a very sweated horse that has lost tremendous amounts of fluids and electrolytes. Though a physical examination is often
difficult, given the circumstances, it is still the first and most important place to start. Correction of dehydration/electrolyte
loss should be started while the rescue plan is being formulated. Large-gauge catheters (10 gauge) should be used to permit
the delivery of large volumes of fluids (20 to 40 liters in general and usually containing some dextrose as an energy source,
B-vitamins and possible additional calcium provided there are no medical conditions that would preclude such a choice) rapidly
because the more time that the animal spends recumbent, the weaker some muscle groups can become due to pressure and poor
perfusion. Attention to the need for possible sedation should be considered to ensure the safety of the rescuers as well as
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