Medical Care

Medical Care

Vital Signs
Intramuscular Injections

Vital Signs

Vital signs will be more meaningful once you have established normals. To do this, take the vital signs twice a day for three days and average the readings. Choose various times of the day but always when the horse is at rest, not when he has just been working or is excited.

Taking Temperature

Choose an animal thermometer that has an eye at the end. Thread a string through the eye and tie a small clip or clothespin to the end. Check the thermometer to be sure it is reading below 96 degrees. If it registers a temperature from the previous use, hold it securely at the top and shake it sharply to get the mercury to drop down. Then apply a small amount of lubricating jelly to the business end of the thermometer. The lubricating jelly should be at room temperature, somewhere around 65 degrees. An assistant should be holding your horse, or your horse can be tied if he is used to having his temperature taken. Move your horse's tail off to one side. This tends to cause less tension in the horse than lifting the tail up. You will be inserting the thermometer into the anus at a slight upward angle. Gently ease the thermometer inward and upward until about 2" remain outside the anus. Do not insert the thermometer all the way. If you do, it has a greater chance of contacting warm fecal material, which will give you an inaccurate reading. Move the tail back into position. Clip the string onto the horse's tail so that in case the horse defecates suddenly, the thermomter won't drop to the ground and break. After two minutes, take the reading. Wash your hands and the thermometer with anitbacterial soap when finished. The range of average resting temperatures for adult horses is 99-100 degrees. Temperature increases with exertion, excitement, illness, and hot, humid weather. Temperature decreases with shock, and a horse's temperature can also be a few degrees lower in very cold weather.

Taking a Pulse

Choose an artery close to the surface of the skin. Lightly press your fingertips against the artery. Count the beats for 15 seconds and then multiply by 4 to get the rate per minute. The maxillary artery, on the inside of the jawbone, is one of the easiest places to find a strong pulse, even on a quiet, resting horse. It's best not to let your thumb rest on the horse when you take a pulse as you might pick up a throbbing from your own heartbeat and get a misreading. Another easy-to-find pulse spot is the digital artery located on both the inside and outside of the horse's leg, just above the fetlock.

Normal resting pulse rates are as follows: 2 weeks old - up to 100; 4 weeks old - 70; Yearling - 45-60; 2 years old - 40-50; Adult - 30-40.

Measuring Respiration

A horse's normal resting respiration rate is usually between 12 and 25 breaths per minute. A foal's rate will be at the high end of the scale. One breath is measured as one inhalation and one exhalation. The ratio of the pulse to the respiration rate is often a more significant measure of stress than each of the actual figures. Depending on the horse's age, his normal resting pulse to respiration ratio should range from 4:1 to 2:1. If the ratio becomes 1:1 or 1:2 (called inversion), the horse is suffering from oxygen deprivation, which indicates serious stress. Call your veterinarian immediately.

When a horse is exercising heavily, it is easy to measure his respiration rate by watching his nostrils dilate and relax or by watching his ribs move in and out. The best way to determine a respiration rate is to use a stethoscope on the trachea. Press the bell firmly into the underside of the horse's neck about 4 inches below the throatlatch. Count for 15 seconds, and multiply by 4. Alternatively, you can listen to his lungs, but it takes more practice and experience to obtain a respiration rate this way. Place the stethoscope midway down the heart girth on the left side. You will hear the quality of the breathing process in his lungs but might not be able to identify definate breaths.

Using a Stethoscope

To determine a pulse or listen for heart function abnormalities, press the bell of the stethoscope into the horse's left armpit area. If you are using this method to take the pulse, count the heartbeat for 15 seconds and multiply by 4 to get the number of beats per minute. To listen to the intestines, select several sites on both sides of the horse. Steady the horse by placing your left hand on his back and using plenty of body-to-body contact with your left arm and shoulder. This way your horse won't be surprised when you place the bell of the stethoscope firmly into his belly. Become very familiar with what your horse's intestines normally sound like by spending 5 to 10 minutes for several days in a row listening to his gut both before and after he eats. As you move the stethoscope to other locations on the abdomen, try to classify the nature of the sound you hear to develop an ear for what is normal. Generally, you wnat to hear a moderate amount of gurgling, creaking, and swooshing. No sound could mean that the contents of your horse's intestines have become bound up (impacted), often from lack of proper moisture. Excessive gut sounds could be normal or could mean the horse has a hyperactive gut or diarrhea, such as might occur from a succulent pasture or rich alfalfa hay.

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All horses have worms. A good deworming program should target strongyles (bloodworms), ascarids (roundworms), Oxyuris equi (pinworms) and Gasterophilus (bots). Adult horses should be dewormed every two months, year-round. Foals should be dewormed from one month of age, every month until they are weaned, then every six weeks until they are one. Then they can be on the adult cycle of deworming.

At least twice a year, use a product such as ivermectin that is effective against all worms and bots. There are two strategic times to use a bot dewormer. One is during early spring just before bot larvae leave the horse's stomach. The other is in late fall, after a killing frost and after all bot eggs have been removed from the horse's coat. The other four times, you can also use ivermectin or you can choose from other dewormers, paying close attention to their effectiveness against strongyles, which are the biggest parasite threat to your horse's health.

The easiest and most effective way to deworm your horse is to use paste dewormer in a tube. Most equine dewormers are either a low-volume dose (about 6ml) or a high-volume dose (about 20ml). Most ivermectin products are a low-volume dose. Low-volume dewormers are easier to administer: There is less to insert in the horse's mouth so there is less chance for mess and waste, and the smaller syringes are easier for small hands to operate one-handed. Dewormers should be at a low room temperature when administered. If they are too cold, they can be stiff and difficult to dispense from the tube. If they are too warm, they won't stick to the horse's tongue and palate well. Check the expiration date on the dewomer box or tube to be sure it is fresh.

Clean any food out of your horse's mouth so that your horse does not mix the dewormer with the food and spit it out. If you are working alone, you can hold the lead rope and the cheek portion of the halter with your right hand and clean out the mouth with your left hand. Insert your fingers at the corners of your horse's lips and enter the interdental space where there are no teeth. Often just the presence of your fingers will cause your horse to begin moving his tongue and jaw and drop any hay wads he has hidden in the recesses of his mouth. Other times you will have to reach into the safe zones to remove wads of feed. To further clean your horse's mouth, flush it out with warm water. Remove the needle from a 60 cc plastic syringe and fill it with warm water. Hold the lead rope and the cheek piece of the horse's halter with your left hand. You may find you have more control if you slide your hand over to the noseband instead. Insert the syringe full of water into the corner of your horse's mouth between his teeth and his cheek. Then angle the syringe across toward his tongue and depress the plunger, releasing the water into his mouth. You may need to flush with two or three syrninges of water if your horse's mouth was particularly full of food. Wait a few minutes in order to let him work all the water out of his mouth before you proceed. The dewormer won't stick to a very wet tongue or palate.

If you are using a low-volume dose dewormer, adjust the syringe to the proper dosage according to your horse's weight. Remove the cap from the syringe. Use the same basic procedure to administer the dewormer as you did for flushing the mouth. With the halter or noseband in your left hand and the syringe in your right, insert the tube at an upward angle between the horse's premolars and cheek. Turn the syringe into the mouth cavity. If you are deworming a horse that opens his mouth and works his tongue right away, you'll be better off applying the dewormer to the roof of his mouth. If you apply it onto a busy tongue, he will likely spit it out as soon as you apply it. If you are using a high-volume dose dewormer, adjust the syringe to the proper dosage according to your horse's weight. Lock the ring into position so when you depress the plunger, it will stop dispensing at the desired dosage. If you are deworming a quiet-mouthed horse, insert the large tube just a few inches. Turn the dewormer tube inward and dispense the product onto the tongue. If the dewormer was at low room temperature, it will dispense easily. It is always a good idea, but especially if you are using a high-volume dose, to hold the horses head up for a minute so the dewormer has time to dissolve in his mouth. If some dewormer has ended up on your horse's lips, wipe it off with a damp cloth.

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Intramuscular Injections

An 18-gauge needle 1.5" long (also called 18 x 1 1/2) is the preferred needle size for administering an intramuscular injection of liquid anitbiotic to a horse. As the numbers get larger, the size of the needle gets smaller. So, a 20-gauge needle is smaller than 18 gauge and although such a needle would insert easily, it is too thin to dispense a thick liquid. The preferred length is 1 1/2" to get the liquid where it needs to go, deep into the muscle tissue. A shorter needle would more likely deposit the antibiotic too superficially under the skin. A longer needle would present dangerous risks of contacting bone or joint structures.

Wipe the top of the antibiotic bottle with an alcohol-soaked cotton swab. You can use either isopropyl or ethyl alcohol. With the protective cap still on the needle, attach an 18-gauge 1.5" needle to a sterile 35cc syringe. Note whether you are using a needle with a slip-on hub or a screw-on hub. The syringe must be of corresponding type. Remove the protective cap from the needle. Pull the syringe's plunger out to about the 30cc mark. Insert the needle into the rubber bottle top. Angle the bottle so that the tip of the needle is in the air-space above the liquid. Depress the plunger to add air to the bottle. This will make it easier to draw out the liquid. Note: If you insert the air into the liquid itself, you will create bubbles in the liquid that can make filling the syringe more difficult and will make dispensing the bubbly liquid uneven and possibly dangerous. Now position the needle tip so that it is in the liquid and begin drawing back on the plunger until you get the required dose, often 20 or 30cc. Note: You will have to exert more effort pulling back on the plunger when the bottle is almost empty than you did when the bottle was full. Put the protective cap back on the needle until you are ready to administer the injection. You can hold the barrel of the syringe in your hands or under your armpit to bring the temperature of the refrigerated antibiotic closer to body temperature before administering.

There are several ways to give an injection: in the vein (intravenous), under the skin (subcutaneous), and in the muscle (intramuscular). Intravenous injections should not be attempted by the horse owner. The risks are too great. Subcutaneous injections are suitable for administering dog vaccines, but they have little application with horses. The third method, intramuscular (IM) injection, is common and appropriate for horse vaccinations and antibiotic administration. Ask you veterinarian to help you administer your first IM injection. The following will help familiarize you with the process.

IM injections are given in places of the body where the muscle tissue is thick. The safest and most conventional areas are the side of the neck, the buttocks, and the chest. When a horse is on a long antibiotic regimen, it is necessary to rotate among all six areas (two on each side) so no one spot gets sore.

Prepare the site for the injection by removing loose hair and debris by grooming or washing and thoroughly drying. Then clean the spot with an alcohol swab. In some instances, your veterinarian might instruct you to clip the injection site. Remove the cap from the needle on the filled syringe. Remove any air bubbles by tapping the upright syringe until the air bubbles rise to the needle hub. Slowly depress the plunger to push the air out of the needle. Take the needle off the syringe. Holding the needle perpendicular to the muscle tissue, insert the needle all the way into the muscle with one quick motion. Attach the syringe to the needle. Pull back the plunger just a bit (aspirate) to see if any blood appears in the white liquid. If you see blood enter the syringe, it means a small blood vessel has been crossed. Withdraw the needle about 1/16" and aspirate again, or choose another site. If you target the are correctly, use the correct size needle, and insert the needle perpendicular, there is usually no problem. Once you're in a safe site, depress the plunger steadily with moderate speed. If you push too hard or too fast you can blow the syringe off the needle and lose the antibiotic. If you go too slowly, your horse might lose patience. It should take approximately 5 to 10 seconds to empty 20cc into the horse's muscle. Withdraw the needle and syringe together in one careful but swift movement, pulling directly out in the same direction the needle went in - perpendicular to the horse's neck. Rub the spot to massage the liquid into the tissue and reestablish contact with your horse.

References: Horse Health Care, Cherry Hill


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