The cold weather can make life as horse owners challenging. Unfortunately, in the cold weather we tend to see and increased incidence of horses who have laid or fallen down, and are not able to get up on their own. Down horses are technically referred to as “recumbent”.
There are two basic categories of recumbency in horses. The first, and simplest, are horses that are systemically well, but are unable to get up normally based on environmental circumstance. This includes otherwise sound and healthy horses that lay down and are not able to get back up due to poor footing (ice, mud, etc), or positioning (cast against a wall, legs are uphill compared to back, etc.). The second, and more challenging, are horses that are systemically unwell. The obvious horses in this category are those that are sick, dehydrated, colicky, etc., but horses with musculoskeletal problems, such as laminitis or arthritis are also included. It is important to remember that in the context of down horses, the musculoskeletal system can “fail” just like any other organ or body system. Sometimes, this can be challenging to remember in cases of otherwise bright and happy horses that are down because they are very arthritic.
When faced with a down horse, the most important thing to do is remain safe, and call the veterinarian as soon as possible. One or two people alone are very unlikely to be able to meaningfully help a down horse (if it were that simple, they would be up on their own!), and are very likely to get hurt in the process. Calling the veterinarian in a timely matter is of the utmost importance. Horses do not tolerate prolonged recumbency well, and with time even the otherwise healthy recumbent horses may become dehydrated, aspirate and develop pneumonia, and accrue muscle and nerve damage, all of which make put them into the category of systemically unwell horses. While waiting for the veterinarian to arrive, try to clear the area around the horse from any hay bales, buckets, etc., and remove any other horses. When working around a down horse, you must remain calm and remember to always be within the “safe zone”, which is along the back of the horse from withers to tail. Down horses can become frantic, and it is important to remain out of the range of their heads and legs at all times.
The first thing a veterinarian will do is establish which of the above categories the down horse is in. Is the horse systemically well or unwell? If the horse is systemically unwell, what body systems are affected, and is there anything we can do to help? These questions are answered by our physical exam findings. Although limited due to safety concerns, we are able to get a lot of information from evaluating the horse’s attitude, ability to move each leg, heart and respiratory rates, mucous membranes, pulse and rectal temperature.
If the horse is systemically well, the next thing we do is develop a plan to help change the horse’s position while keeping everyone safe. If done correctly, this is actually fairly simple and safe to do. Typically, one of the first things we will do it try to flip the horse onto its other side. This will relieve any “pins and needles” they may be feeling from prolonged muscle and nerve compression. If this is not enough, there are several rescue maneuvers, such as forward drag and backward assist, which can be used to drag the horse to a more favorable location, either onto better footing, or away from fences, walls, hills, etc.
If the horse is systemically unwell, we first try to correct any fixable problems we have identified on physical exam. This often means placing an intravenous catheter, administering bute, banamine or steroids, and giving intravenous fluids. Unfortunately, the prognosis for horses that are down and systemically unwell is generally very poor; whatever disease caused them to go down and stay down in the first place will still be present, even if we temporarily get them standing. However, there are circumstances where rehydrating the horse and providing some pain relief can get them standing again, and then we can determine what their primary problem is, and if/how we can treat it and prevent them from going down again. In certain cases, a sling suspended from a sturdy beam can be used to lift and support a horse that we are unable to otherwise get up. The sling will support most of the horse’s weight and prevent them from going down again while we examine them and institute therapy. Typically, the sling is reserved for horses that we think will tolerate the device well, and that have problems that we believe to be fixable with some time and support. At B.W. Furlong and Associates we have one large hospital stall fitted for the sling system, and have successfully used the sling in the field under the appropriate circumstances.