Nursing Care of the Recumbent Horse

CHAPTER 203 Nursing Care of the Recumbent Horse



Jaime L. Miller


Multiple conditions, including laminitis, rhabdomyolysis, traumatic injury, arthritic changes, and neurologic or muscular disease, can render horses recumbent with the possibility for recovery. There is no doubt that excellent nursing care is a key contributor to the welfare and the recovery of these horses.


Nursing care of recumbent horses includes special attention and procedures related to postural adjustment, stimulus reduction, and sedation to limit thrashing; nutrition and hydration; fluid therapy; urinary and fecal care; hygiene; skin and wound care; assessment of and support for standing; physical and mental stimulation; and vigilant monitoring of all body systems for signs of complications. Detailed information pertaining to pain control, hydration, and nutrition is covered elsewhere in this volume.



POSTURAL ADJUSTMENTS


Much of the effort in maintaining a recumbent horse involves frequent repositioning to minimize development of pressure lesions and respiratory complications. Because muscle damage can develop in a recumbent horse in as few as 2 hours, horses that are unable to rise or roll and turn themselves should be repositioned into sternal recumbency or to the opposite side every 2 to 6 hours.


Concern for the safety of personnel should be of paramount importance during repositioning of disabled horses. Personal protective gear, including a safety vest, protective limb guards, and safety helmets, is recommended. Assistants who are inexperienced with recumbent horses should be briefed on the particular hazards, including the potential sudden thrashing and range of motion of the limbs and head of a recumbent horse.


For certain smaller horses and ponies that are compliant with manipulation, repositioning can be accomplished with as few as three or four trained staff members (Figure 203-1). The horse’s limbs can be tucked in toward the abdomen and the body pushed to roll over onto the limbs, permitting the horse to rest sternally for as long as possible. Straw bales or wedge pads can be used to prop the horse in sternal position. Many horses appear to favor one side and tend to go from sternal to lateral on the favored side if not encouraged to rest sternally or to roll to the opposite side. In such cases the horse must occasionally be repositioned to lateral recumbency on the unfavored side.


image

Figure 203-1 A nursing team repositioning a recumbent yearling onto a mattress. A, Retucking a left hind limb to facilitate rolling the animal from right to left lateral recumbency. B, Using body ropes to position the horse on a mattress. C, Positioning the head on a pillow.


(Photographs courtesy of Teresa Lewis.)


In most instances, the horse is not compliant with tucking the limbs, so sedation is required to proceed. If sedation alone is not effective, the limbs can be hobbled and the ropes guided under the horse to assist in tucking the limbs before the horse is rolled into sternal position. The Anderson sling or the Large Animal Lift can be useful in positioning the horse on the sternum or in lifting the horse even higher for turning to the other side. In a deeply unconscious horse, the limbs can be hobbled and the horse rolled over its back onto its other side. This should not be attempted in a conscious horse because most horses panic when manually rolled onto the back.


Horses that can get up should be encouraged to stand as often as every 2 to 3 hours, depending upon the risks of injury during the process of rising and lying down again. For some horses, simple auditory, visual, or tactile encouragement are effective stimuli to rise. In addition, a lead rope attached to the halter can be used to assist the horse in rising by gently pulling the horse forward while it is being encouraged to stand. Many horses need considerable manual assistance to rise from lateral to sternal recumbency. One handler can lift and guide the head using a halter and lead rope, while an assistant pushes at the shoulder. Once sternal, some horses will voluntarily rise. If further encouragement or assistance is needed to rise from sternal recumbency, the forelimbs can be manually positioned out in front. A tail rope positioned over a rail or stall wall can be used to guide the rising horse. Recumbent horses often appear to vary from day to day in their physical ability or willingness to rise. Moreover, it is often challenging to determine whether a horse is physically unable to rise or whether it is reluctant to rise because of discomfort. Humane care often includes trying to balance adequate stimulation and encouragement of the horse against risks of physical injury or psychologic stress to the horse and staff.



STIMULUS REDUCTION AND SEDATION TO LIMIT THRASHING

Related posts:

  1. Adverse Drug Reactions
  2. Equine Viral Arteritis
  3. Headshaking Syndrome
  4. Strangles: Immunology and Management

Stay updated, free articles. Join our Telegram channel
Tags:
May 28, 2016 | Posted by in EQUINE MEDICINE | Comments Off on Nursing Care of the Recumbent Horse

Full access? Get Clinical Tree
Get Clinical Tree app for offline access