The Veterinary clinics of North America. Equine practice
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The emergency clinician is frequently in the position of receiving, evaluating, and initiating treatment on horses with ophthalmic emergencies or orbital trauma. In the best of circumstances, an ophthalmologist is available to guide initial therapy and ultimately assume responsibility for the management of the patient during the remainder of its hospitalization, but this is not always the case. ⋯ The article provides initial information regarding prognosis, descriptions of indicated diagnostics and procedures that may need to be performed on an emergency basis, and suggestions regarding early therapy. Whenever possible, the management of such cases should be overseen or assumed by a veterinary ophthalmologist after the emergent stabilization of the patient.
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Thoracic trauma represents an important cause of morbidity in mortality after injury in human beings and animals. After any form of suspected chest wall trauma, initial emergency management should include assurance of a patent airway and adequate ventilation, along with treatment for shock if present. ⋯ Types of trauma to the thoracic region of the horse include pectoral and axillary lacerations, penetrating chest wounds, flail chest, fractures of the ribs, blunt thoracic trauma, and several potential sequelae that include pneumothorax, pneumomediastinum, hemothorax, pleuritis, fistulae of the sternum or ribs, and diaphragmatic hernia. Emergency management of these various forms of thoracic trauma is discussed.
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Vet. Clin. North Am. Equine Pract. · Apr 2004
ReviewCardiac emergencies and problems of the critical care patient.
Cardiac disease and dysfunction can occur as a primary disorder(ie, with pathology situated in one or more of the cardiac structures) or can be classified as a secondary problem when it occurs in patients with another primary problem that has affected the heart either directly or indirectly. Primary cardiac problems are encountered in horses presented to emergency clinics; however,this occurs much less frequently in equine critical patients than cardiac problems arising secondary to other conditions. Nevertheless,if primary or secondary cardiac problems are not identified and addressed, they certainly contribute to the morbidity and mortality of critical care patients.
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Sepsis develops in horses when the host response to the invading pathogens is not properly balanced according to the severity of the insult. Several clinical conditions frequently encountered in equine practice may be associated with the development of sepsis and have the potential to progress to more severe forms, such as severe sepsis, MODS, and septic shock. ⋯ Fortunately, we can learn from the important advances made recently in the treatment of human sepsis patients;hence, rapid progress may be expected in a near future, especially as more and more veterinarians show interest in the discipline of equine critical care. With the completion of several genome projects and the availability of high-throughput genetic techniques, one hopes that we will further refine our understanding of the events underlying the development of severe sepsis and septic shock, which could lead to more appropriate therapeutic intervention targeted to each individual according to the state of the immune response in that horse.