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Equine Intensive and Critical Care Services at LSU: An Inside Look

Equine emergency and critical care is a growing facet of veterinary medicine with more and more horses requiring specialized, immediate, and advanced veterinary care. The intensity of emergency care required is dependent upon the underlying disease and any accompanying abnormalities, and services may often range from body temperature control to emergency surgical intervention. With the diagnostic and therapeutic advances made in recent years in equine medicine and surgery, emergency and critical care can play a major role in the successful treatment and rehabilitation of horses faced with performance-limiting and life-threatening conditions or diseases.

This is especially true at the LSU School of Veterinary Medicine where the Veterinary Teaching Hospital Equine Clinic identifies 20-25 percent of its patients as emergency cases. Internists, surgeons, theriogenologists, ophthalmologists, and numerous other specialists, technicians, and students join efforts daily to save and sustain critically ill equine patients.

"Patients are generally presented for emergency and critical care services for any of the following reasons: acute gastrointestinal tract disease (colic), traumatic injuries, respiratory distress, neurologic disease, ophthalmic diseases, and respiratory tract emergencies," explained Dr. Rustin Moore, director of LSUs Equine Health Studies Program (EHSP). In addition, many of the horses presented for emergency or critical care are also dehydrated and are predisposed to developing secondary conditions such as laminitis (founder), pressure sores, diarrhea and weight loss.

Gastrointestinal tract disease is estimated to account for 60 to 65 percent of all emergency work at LSU. These horses generally require extensive evaluation upon arrival at the hospital. They usually undergo a thorough physical examination, including passage of a stomach tube to evacuate accumulated liquid, a rectal examination, abdominal ultrasound, and other diagnostic tests. The need for surgery is obvious in some horses, while in others it is not. Some patients will be constantly observed and will undergo repeated evaluations to determine if the problem should be treated through medical or surgical means.

Neonatal foals with life-threatening illnesses also comprise a large majority of emergency or critical care services, especially in the spring. "Neonatal care is often the most intellectually challenging and technically demanding care provided because of the fragile nature of foals, the multiple disease processes occurring, and because of their inability to lie, stand or walk," said Moore. Foals usually need an individual devoted entirely to their care to administer medication, assure they are nursing, feed them, observe their progress, and help them maintain their sternal position to facilitate breathing.

Horses presented with acute neurologic disease are a major challenge for equine clinicians because of the intense level of care required, including the administration of necessary diagnostic tests, prevention of self-trauma, and prevention of trauma to the attendants. Rabies, viral encephalitis, equine protozoal encephalomyelitis (EPM), cervical vertebral malformation (wobblers), head or spinal trauma, and herpes myeloencephalitis are all possible causes of the severe ataxia (incoordination) and weakness and subsequent recumbency (inability to rise) that plague such horses. The LSU Equine Clinic has two Andersen rescue slings which suspend neurologic patients in the necessary position to support and treat them. Without such assistance, many of these horses would die or require euthanasia, either because of the primary disease or secondary complications such as rhabdomyolysis (tying up).

Traumatic injuries, including lacerations, fractures and open-joint injuries, require immediate stabilization and quick response with suturing, wound cleansing and fixation of fractures. Without a quick response, administration of first aid, and stabilization of these patients, successful rehabilitation and return to athletic performance could be very unlikely.

When an individual anticipates that their horse may need emergency or critical care, Moore explains that certain steps may be very helpful to equine clinicians upon treating the patient. For example, he recommends having a local veterinarian first examine the patient, and then stabilize the patient before it is relocated to an emergency facility. He also urges individuals to contact the emergency facility, alerting them to the horses condition and giving them an estimated arrival time.

"Our total equine case load has increased over 15 percent each year since 1990. Due to the steady and substantial increase of horses requiring LSUs emergency services, the EHSP is currently raising funds to expand, improve and update its emergency and critical care operations," explained Moore.

The new equine intensive care unit, projected to cost $845,000, will be expanded from a two-stall facility to a 10-stall facility to better meet the growing demand. The new unit will include four stalls designed for critically ill neonatal foals and their dams, one stall with padded walls for patients with severe neurologic or musculoskeletal disease, and five stalls for critically ill and injured adult horses.

The program has currently raised over $460,000 and hopes to secure the remainder through its multiple-breed, Internet stallion service auction, which begins September 1. "The Stallion Service Auction offers mare owners the opportunity to select top quality stallions for breeding with potentially discounted fees," said Moore.

Stallion owners from Louisiana, Texas, Arkansas, Mississippi, Kentucky, Virginia, California, Oregon, New York, and other states have currently donated over 110 stallion breedings to the auction. Benefits to stallion owners include: no direct costs incurred for the donation of a stallion; recognition as participants in the auction; promotion of the stallions and the farms in numerous local, regional, and national equine publications and the Internet; and a tax deduction of contributions in the full amount of the stallions regular stud fee, regardless of what it brings in the auction.

All stallion services offered in the auction are intended for the 2002 breeding season and individuals may bid on any number of stallion services. Bidding on the stallions opens September 1 and closes October 15 at noon CDT. Bids will be placed on the auction website with the highest bid always being current, and bids made over regular stud fees are tax deductible for the mare owners. Auction winners will be notified by October 16 and the auction results will be announced on the website by November 3.

Detailed auction information and bids are available athttp://www.equine.vetmed.lsu.edu. Individuals interested in donating a stallion service, placing bids on the stallion services, or receiving more information on the Stallion Service Auction can visit the auction website listed above, contact Dr. Rustin Moore at (225) 578-9500, or e-mail ssa@vetmed.lsu.edu.

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