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Equine Emergency First Aid

EQUINE EMERGENCY FIRST AID Adapted from the Online Horse Health Course My Horse University

A medical emergency is something all horse owners dread. When an emergency does occur, knowing what to do and being adequately prepared can make the difference between life and death for your horse. Have the necessary supplies on hand. Practice emergency procedures so that both you and your horse will be comfortable with them. It is also extremely useful to know your horse’s normal vital statistics so that you can recognize and report any abnormalities during an emergency.

Being Prepared Equine emergencies can easily become overwhelming if you don’t have the knowledge, skills, and supplies to cope with them properly. To prevent that from happening, horse owners, like Boy Scouts, should take the motto “Be prepared” very much to heart. Being prepared for a health emergency means having good horse handling skills; a well-stocked first aid kit; an easily accessible list of emergency contacts; and whenever possible, a well-mannered horse used to the kinds of handling one might need to perform in an emergency. It also means having a working understanding of basic first aid procedures and practicing those procedures before they are ever needed.

Horse handling and first aid skills: Even the best trained, most docile horses can become difficult to handle when they are frightened or in pain. Your ability to remain calm and reassuring can help settle a frightened horse; but you should also be comfortable with catching, holding, and restraining procedures. You also want to be able to pick up a horse’s feet, take vital signs, flush eyes, load and unload your horse into a trailer, and apply wraps and bandages. A good way to learn these skills is to work on them with a trainer, veterinarian, or experienced horse handler. Some colleges offer first aid courses for horse owners. These are definitely worth attending.

Emergency contacts: Don’t wait until an emergency to establish a relationship with a veterinarian. Having a rapport with a vet who knows your horse is an important part of safeguarding your horse’s health. If possible, get to know two or three of the vets in your area, and keep all of their names and phone numbers handy. It is a good idea to post these numbers in your barn for your own use and in case there is an emergency when you are not around. Other numbers on your emergency list should include horse-knowledgeable friends and neighbors, the police department, fire department, and several people with horse trailers (if you don’t have your own).

Training the horse: Veterinarians will tell you that a horse that is well-mannered and used to handling has a better chance of surviving a medical emergency. To give your horse the best chance possible, you should make sure your horse leads, backs and ties well; trailer-loads easily; and yields to pressure on any part of its body (lowering its head when asked, moving a shoulder or hip over). You should also practice handling every part of the horse’s body until the horse is completely relaxed with your doing so. You should also practice procedures such as taking its temperature, spraying and hosing, flushing its eyes with saline, and wrapping its legs.

Horse having temperature taken rectally

Figure 1. Practicing basic first aid procedures, like taking the horse's temperature will help increase your understanding of first aid and increase your horse's chances in a medical emergency. (Image right)

Ask your veterinarian to help you put together a emergency supply kit. Keep it all in one place in your barn in a waterproof container. Keep another in your trailer. Make note of supplies that have an expiration date and replace them as necessary. Items you may want to have in your kit include the following:

  • emergency contact phone numbers

  • syringes (large and small)

  • cotton leg wraps

  • sterile gauze

  • non-stick pads

  • cling wrap

  • duct tape

  • white medical tape (1 inch is a good width)

  • disposable diapers (good for padding, etc.)

  • Vet-Wrap or similar product

  • disinfectant such as Betadine or Nolvasan

  • sterile saline solution

  • thermometer

  • stethoscope

  • flashlight (Newer LED types use less battery power and are very bright.)

  • spare halter

  • hoof pick

  • tweezers

  • bandage scissors

  • latex exam gloves

  • clean toweling

  • wire cutters

  • small roll of strong twine

  • farrier’s nail/shoe puller

If you live in a region that has freezing conditions during the winter, take steps to have the kit in an area that is above freezing temperature or place freezable items in a separate container and store appropriately.

Equine first aid kit

Figure 2. First aid kit. Source: Flickr_Robert_Thomson (Image left)

Assessing Horse Health If you suspect that your horse is ill or injured, there are a number of checks you can perform to help you assess how serious the problem is.

Visual and tactile inspection: Giving your horse a good “once over” with your eyes and hands can help you discover many types of problems. Look closely at all parts of the horse for any wounds, swelling, bumps, irritations, or discharge. Check feet for punctures, cracks or other abnormalities. In addition, run your hands over the horse’s body to feel for tight muscles. Make sure the horse is standing square for this so that both sides are even, and also feel the legs for any excess heat. Pay attention also to your horse’s stance: a horse standing with the front legs camped forward in a “sawhorse stance” may have laminitis, while a hunched posture can be a symptom of colic or other types of pain.

Vital Signs: In the absence of an injury requiring immediate attention, a check of the horse’s temperature, pulse, respiration, and gum color/capillary refill time is a good course of action. Any abnormalities should be noted, but if one or more of these critical indicators are significantly out of the horse’s normal range, contact your veterinarian immediately.

Movement: Lameness or irregularity in your horse’s movement can also indicate illness or injury. Assessing your horse’s movement is, therefore, an important part of determining its health status, particularly when other clinical symptoms may not be evident. What you are looking for is any hitch, shortness of stride, unevenness, reluctance to move, toe dragging, head bobbing or difficulty turning. To assess a horse’s movement, you should first observe the horse at the walk, and if no clear irregularities are noted, ask the horse to trot. It is useful to have someone else move the horse in a straight line coming towards you and heading away from you so that you can have a clear view from these angles. You may also want to have the horse move in a circle around you since circling is more demanding and more likely to reveal lameness. If the horse’s head is bobbing, noting what leg the bob corresponds with will tell you which leg is hurting. The rule of thumb is that for front end problems, the horse’s head bobs down when the sound leg touches the ground. Remember “down on sound,” and up when the sore leg touches down. The reverse is true for the hind end, but many people find it easier to discern a hind end problem by watching the level of the hips as the horse moves away on a straight line. The hip on the sore side will often rise higher and/or drop lower than the hip on the sound side.

If you are concerned that your horse may have a fractured or broken bone, do not move the horse. Get veterinary assistance immediately.

Listening to a horse's heart rate

If you suspect a horse is ill or injured but do not notice any visible signs, taking the horse's vital signs might reveal any unseen abnormalities. (Image right)

Signs of Pain Horses vary greatly in the ways they react to pain, but there are certain signs that generally indicate some sort of pain or physical distress. Here is a partial list, but be aware that some of these can also be caused by factors other than pain.

Acute Pain

  • elevated pulse and/or respiration

  • restlessness/anxiousness

  • profuse sweating

  • rigid stance

  • dilated pupils, fixed staring, glassy eyes

  • flaring nostrils

  • muscle tremors

  • decreased eating/drinking

Abdominal Pain

  • decreased appetite

  • excessive rolling or thrashing

  • circling, pawing, or getting up and lying down frequently

  • biting, kicking, or looking at belly/flank

  • groaning, Bruxism (grinding the teeth)

  • sweating

  • lying down, but not rolling

Musculoskeletal Pain

  • reluctance to move

  • limbs held in unusual positions

  • shifting weight from limb to limb

  • rigidity

  • head bobbing or other signs of lameness

  • excessive lying down or reluctance to lie down

Horse biting at its sides

Biting, kicking, and looking at their belly may be a sign that your horse is in pain. For more information on what to do if your horse colics, read the January 2010 e-tips article. Equine Colic: Causes, Symptoms, Treatment and Prevention

Overview: Dealing with Emergencies When an emergency is actually happening, it may be some time until your veterinarian can get to your location. You should become as familiar as possible with the steps you can take to give your horse the best chance of making it through. The following material outlines some of these steps for puncture wounds, severe bleeding, and fractured limbs. However, please keep in mind that there is no substitute for the expertise of a veterinarian, so always be sure to call yours as soon as possible in the event of an equine emergency.

Puncture Wounds It is said that puncture wounds are often worse than they look. It can be difficult to assess the depth and internal damage of the wounds, and puncture wounds provide the perfect environment for bacteria to grow. Puncture wounds in or near the joints are always worrisome as are punctures to the chest or abdomen.


  • obvious: a protruding object.

  • less obvious: a wound of any size that appears to have a hole in the center.

  • harder to find: swelling or soreness in an area that may have “closed up” over the actual puncture. Such is often the case with puncture wounds to the frog or heels.

What To Do Until the Vet Arrives

  • If the puncture is on the bottom of the foot and there is still an object such as a nail protruding, wrap the object and foot so that the object cannot penetrate further until the veterinarian arrives. The veterinarian can then assess the depth of puncture to see if any vital structures have been affected.

  • If an object is protruding from the legs or body, stabilize the object by holding or wrapping it in place. Keep the horse as still as possible until the vet arrives.

  • If there is no object but there is an open hole in the chest or barrel area, listen to discern if there is any air being moved into or out of the wound (aspiration). If you hear such sounds, cover the hole with something like a piece of clean plastic wrap and tape it on to stop the air flow.

What Not To Do

  • Do not flush the wound with anything unless instructed to do so, since this could push foreign material deeper into the wound.

  • Though it is awful to see a foreign object sticking into your horse, removing it can cause further damage or bleeding, so it is usually best to leave it in until the vet arrives.

  • Do not apply pressure to or bandage a puncture wound unless there is a life-threatening loss of blood, the need to stabilize a protruding object, or air moving in and out. Leaving the wound open will facilitate drainage, which is helpful.

Deep puncture wound

Source: flickr_Kathy's Dustry Trails

Puncture wound sutured with a drain

This horse received a puncture wound from a tree branch embedded into the muscle. The wound was properly treated and had a full recovery. Source: flickr_Kathy's Dusty Trails

Severe Bleeding A horse losing a lot of blood is a very scary thing, but a horse can lose what seems like a lot of blood to us, and still often make it through just fine with appropriate intervention and veterinary attention. The good news is that the average horse has over 12 gallons of blood in its body, and can lose over three gallons before showing signs of shock.

What To Do Until The Vet Arrives

  • If possible, get the horse to a calm, quiet, safe area. If it will take more than a few minutes to get there, better to treat the horse where it is. Immobilize the horse as best you can. If you have help and are able to do so safely, take the horse’s vitals: heart rate, respiration, temperature. Monitor gum color, capillary refill time, and check hydration.

  • For a wound on the body where you cannot apply a wrap: Apply direct pressure to the area where the blood is coming from. Use a clean, dry cloth or sterile pad. Disposable diapers can do in a pinch. Keep the pressure on for 10-15 minutes. Do not remove the pad, but try to ascertain if blood has stopped flowing. If it has, you can tape the pad on (surgical tape works well, since it can be removed from hair more easily than duct tape), but be prepared to add pressure again if there is evidence of further bleeding. If bleeding isn’t stopped, try to keep pressure on until the vet arrives. If at any time the padding becomes completely soaked, do not remove it. You may disturb any clot that has started to form. Instead add more material to the top and continue holding. Apply an ice pack to the area if the source of the bleeding is inaccessible.

  • For a wound on a limb: You can apply a pressure bandage to a limb, similar to the way you would apply a support wrap. Start with an inch thick pad of gauze or clean cloth. Press this against the wound, then wrap firmly with a roll of gauze or strip of cloth to keep the pad in place. Next, wrap a layer of thicker padding around the area and hold that on with an outer wrap that will apply firm, even pressure like Vet-Wrap or a knit bandage. Leave some padding sticking out at the top and bottom. Remember that you want the bandage firm, but not overly tight.

What Not To Do

  • Avoid wiping or dabbing at the area. Doing such can promote bleeding by disrupting the forming clot.

  • Do not attempt to clean the area until bleeding is well stopped. Any aggravation to the area may promote further bleeding.

  • Do not administer any drugs unless advised to do so by your veterinarian. Some people think giving acepromazine (ace) will be helpful to keep the horse calm, but it can lower blood pressure and worsen shock.

  • Do not continually remove a pressure bandage to see if the bleeding has stopped.

  • If applying a pressure bandage to a leg wound, do not apply too tightly or you can cause injury to the leg.

Serious cut on a horse's knee Day 1

A cut on a horse's front leg (day 1). Source: flickr_steffofsd

Healed cut on a horse's knee Day 70

The same cut almost 70 days later with proper treatment. Source: flickr_steffofsd

Fractured Limb In the past, a fractured leg was often a death sentence for a horse, but medical and technological advances have made it possible to save many horses that would previously have been hopeless cases.


  • sudden, usually extreme lameness

  • refusal to move

  • refusal to bear weight on a limb

  • protruding bone (compound fracture)

  • unnatural crookedness of the limb

What To Do Until The Vet Arrives

  • Keep the horse calm, but consult the vet before administering any tranquilizers.

  • Immobilize the limb with a splint. First wrap the limb in two or more layers of padding--you want it fairly thick. Next use slats of wood or split PVC pipe (wide enough to firmly hold the leg and padding) to form a brace. Place the braces in two places: one on the side, and one on either the front or back of the leg to provide stability in all directions. Use plenty of duct tape to FIRMLY tape the braces into place over the padding.

  • If the fracture is below the fetlock, splint from above the knee to the ground.

  • If the fracture is above the fetlock, splint the entire limb.

  • A “rule of thumb” for splinting a fracture is to splint the joint above and below the area of fracture.

  • Gather vital signs to report to veterinarian.

  • If there is bleeding, follow instructions above for SEVERE BLEEDING.

What Not To Do

  • Do not move the horse any more than is necessary.

  • A bandage that slides down or is too low provides more weight to the leg and makes the injury worse. So if the facture cannot be put in a proper splint/bandage, leave the fracture alone until the veterinarian arrives.

Horse with wrapped fractured leg

This horse fractured a front leg and the leg is in a cast while it heals. Source: Photobucket/ferox_thyla

Summary It is important to remember that an equine emergency can be extremely stressful and can test the skills of even very experienced horse handlers. For that reason, it is critical to practice emergency procedures, including the taking of vital signs, on a regular basis, and to firmly establish your horse’s ground manners. Remember that your ability to handle every part of your horse and keep him calm can make the difference between a good outcome and a disastrous one.

Additional Resources

Griffin, Ashley. Wrap or Bandage a Hock. eXtension HorseQuest Article.

Griffin, Ashley. Wrap or Bandage a Knee. eXtension HorseQuest Article.

Pioneer Equine Hospital. Emergency Chart. American Association of Equine Practitioners Article.

Standing Bandages. eXtension HorseQuest Article.

Wood, Craig. Basic First Aid Kit for Horses. eXtension HorseQuest Article.

Wood, Craig. Proper Bandaging Techniques and Types of bandages in horses. eXtension HorseQuest Article.

Wood, Craig. Treating Cuts and Tears in Horses. eXtension HorseQuest Article.

Wood, Craig. Wrap or Bandage the Forearm. eXtension HorseQuest Article.

Wood, Craig. Wrap a Leg Below the Knee or Hock. eXtension HorseQuest Article.

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