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SPRING 2016 ISSUE
EQUINE MATTERS
16
NURS ING HORSES
Food and water must be put close to the
patient so they can access it easily. The
patient will often need to be hand fed if
they do not have a good appetite. If the
patient is not drinking, an intravenous (IV)
catheter will need to be inserted and IV
fluids given
(figure 2)
.
The patient will need to be kept seated in
sternal recumbency (on their chest) as much
as possible. This aids adequate ventilation
and prevents fluid build-up in one
dependent lung. If this is not possible, the
patient should be turned at least every 6-8
hours. Human safety is a major concern
during this process, especially if the patient
is an adult horse. Prevention for decubital
ulcers includes padding the vulnerable
areas, providing deep, clean, dry bedding
and massage to encourage blood flow to
the area
(figure 3)
.
Grooming is very important for recumbent
patients, not only does this increase the
blood flow to compromised muscles, it
also facilitates social contact between the
patient and the nurse. As horses are
gregarious animals, meant to live in herds,
they can often become depressed when
isolated and this can compromise their
recovery.
In summary, nursing recumbent patients
is time consuming, difficult and sometimes
dangerous. However, it does present a
real nursing challenge and can be an
incredibly rewarding process when the
patient begins to improve.
Veterinary nurse
Marie Rippingale
XLEquine practice
Scarsdale Veterinary
Group
Marie Rippingale REVN, Dip HE CVN, Dip AVN,
Scarsdale Veterinary Group
●
atypical myopathy (sycamore poisoning)
●
malnutrition and emaciation
Nursing the recumbent horse
●
laminitis
●
myopathy (muscle damage)
Horses can become recumbent for a
number of different reasons such as:
●
arthritis
Management of recumbent equine patients
requires intensive nursing care as well as
management of the primary disease.
Subsequently, this level of management
presents a serious challenge to the veterinary
team providing care for the patient. Horses
do not cope well when recumbent for the
following reasons:
●
They are designed to stand up for 23
hours a day
●
The weight of their body pressing down
on their diaphragm can make breathing
difficult
●
The blood supply to the muscles is greatly
reduced when the horse is recumbent and
this can lead to soreness and discomfort
●
Horses develop pressure sores (decubital
ulcers) on bony prominences such as the
elbow and stifle
●
Horses find it difficult to eat, drink, urinate
and defecate when recumbent.
When nursing these patients the basics need
to be covered first. A deep, clean bed should
be provided and if possible, the patient
should be placed in a padded recovery
room. These rooms, often used when inducing
anaesthesia often have a winch and
overhead runner beam installed. This means
there is provision to sling the patient to get
them to stand if this is appropriate
(figure 1)
.
Figure 1.
A sling can provide support for
weak horses to help them stand while they
recover from illness or injury
Figure 2.
Many
recumbent
horses require
intravenous
fluids. This
horse is being
monitored while
receiving a
whole blood
transfusion
Figure 3.
Deep
straw bedding helps
reduce the risk of
pressure sores.
Foals that cannot
stand must be
turned regularly