Your horse has banged his head in the horsebox and is bleeding profusely. Do you know what to do? Accidents happen, as the saying goes, but what happens straight after an accident is critical. When faced with an emergency, how should you react and what are the first steps you should take?
Firstly, don't panic. You need to assess the injury calmly and decide on the correct action to take, be it to start some kind of treatment yourself or to simply stabilise the situation until the vet arrives.
Joe Collins, MRCVS, from the veterinary department of UCD, is a member of the equine group of Veterinary Ireland. He says the most important message to get across to horse owners is that preventing injuries is infinitely better than treating them.
"A little bit of thought before you go to do something is the best to prevent a lot of accidents," he says.
"I've had to shoot multiple horses because they were loaded into horseboxes with rotten floors, bad ramps and holes where a horse's foot has slipped through.
"Too many accidents are preventable." He advises owners to check horseboxes for signs of damage, particularly the floor and ramp, and boxes with gaps that a foal's foot could slip through.
"People can be very lax about what's lying around in the yard -- nails, forks etc," he says. "So, have a look around at the potential accident-causing objects."
Showjumping cups left in the uprights are often the cause of tear injuries to horses and ponies, he says, while using old tack is another area where accidents can happen.
Preventing accidents"The tetanus vaccination is imperative because tetanus is much easier to prevent than treat. It is fatal for horses in most cases," says the vet.
The initial tetanus vaccine requires two injections four to six weeks apart, followed by an annual booster injection.
"It's an excellent vaccine that works very well compared to other horse vaccines, so owners should be using it."
So what are the most common injuries and what can you do while you wait for the vet to arrive?
Small puncture wounds, such as a nail in the foot, are commonplace and, although they may look harmless enough, can cause potentially disastrous effects.
When examining a nail in the foot, it is useful to draw two imaginary lines across the hoof. If the nail has pierced the first third nearest the heel, or the third nearest the toe, these are potentially less serious than if the nail has punctured the middle third.
Punctures to the centre of the hoof and frog area are most dangerous because of the vital structures located underneath: the navicular bone, deep digital flexor tendon and coffin joint.
"If the middle third of the foot is pierced, I would recommend leaving the nail in place until the vet arrives, because if you pull it out it can be almost impossible to find the spot again," says the vet.
If the horse has pierced a hind foot, he will rest the foot himself; even if the puncture is a forefoot, he will take the weight off himself.
The priority for a puncture wound to the foot is to make the hole bigger to allow drainage of the wound.
"Bacteria, particularly anaerobic ones such as tetanus, love deep wounds that seal up and allow infection to fester inside.
"The worst thing you could do would be take the nail out, let the hole close up, say the horse is fine and leave the wound susceptible to that type of infection," says Joe.
"In four days time you could have a disaster on your hands.
"An old teacher of mine used to say that 'the solution to pollution is dilution' and he was right."
He recommends opening up the hole and flushing the wound to reduce the level of infection. Even tap water will do to reduce the level of bacteria present.
Some owners may decide to call their farrier to deal with foot-related injuries and the vet says this makes sense in many cases.
"Your farrier is a very good option because he can open up the wound for you and they are usually excellent at working with feet. However, you will need the vet for injuries to the middle third of the foot, for tetanus shots and possibly sedation for younger animals," he adds.
Puncture wounds to other areas of the body, such as a blackthorn in the knee or fetlock joint or into the tendon sheath, should always be examined by a vet.
"They are potentially disastrous because infection can build up in the sealed synovial cavity and there is no drainage if the hole outside closes up."
However, the more visually dramatic wounds such as head injuries and flaps of skin torn away are often less problematic than you would first imagine.
Head injuries, in particular, can look terrible because the head has a very good blood supply.
"You might think your horse needs a blood transfusion because he has been bleeding profusely. In reality, horses only lose a small amount of blood and this can look worse because it gets diluted with water," says the vet.
"Something like 8pc of the horse's bodyweight is made up of blood so he has litres and litres of it."
Arterial blood will be bright red and spurt out under pressure as the heart pumps. A common site for this type of bleeding is on the side of the fetlock where there is an artery that is easily knocked.
Bleeding from a vein is slower and drips rather than spurts in a steady flow. It is darker in colour, dark red or purple to look at.
The first action to take for a wound that is pumping out blood is to stop the bleeding.
Unfortunately, we can't do to horses what is recommended for humans: to raise the bleeding part, so pressure is applied instead.
A clean pad should be applied to the wound and the area bandaged firmly to slow the flow of blood until your vet arrives.
"In most instances, the bleeding will have been beneficial in helping to flush out contamination before you apply a really clean bandage," he says.
However, even the ugliest of tears can heal quite easily with help from the vet. Colic is another fairly common occurrence with horses. Some 90pc of colic turns out to be spasmodic, which needs little treatment and passes with time.
Getting comfortable 
While the traditional advice to owners has always been to prevent the horse from lying down and to keep the animal moving, Joe says some owners take this advice too far.
"I disagree somewhat with not letting animals lie down because I've gone out to yards where the horse is exhausted from being walked to an unreasonable extent," he says.
"I think it is perfectly reasonable to allow a horse to lie down and even roll occasionally, as long as he is not going to injure himself through rolling.
"The animal is only trying to get into a more comfortable position.
"With some young horses this means lying on their back with their legs in the air."
He compares mild colic to human bellyache, where the most comfortable thing to do is lie down on the sofa or bed until it passes.
"Some exercise and walking is okay, but certainly not to the point of exhaustion," he concludes.
A first aid box is always useful in an emergency and one should always be kept in the yard or brought along when travelling.
Clean bandages, gamgee tissue and a poultice are essential, while a bottle of sterile fluid for flushing wounds should also be kept.
"A hoof knife is another useful thing to have.
"You're not going to become a farrier but it can be handy for opening wounds in the hoof," says Joe.
He does not recommend stocking up on drugs because they are likely to go out of date by the time they are used and are then useless.
Over-zealous application of disinfectants can do more harm than good, he says.
"Very often chemicals are used too concentrated and while they may kill infection, they can also damage the tissue.
"Iodine diluted to the colour of weak tea is the most effective. Dilute it correctly and use copious amounts to flush out wounds," he recommends.
Just remember what the teacher said: the solution to pollution is dilution.
- Caitriona Murphy
Irish Independent
