ENDURANCE HORSE POST-RIDE MALADIES
By Thomas R. Timmons, DVM
Pay close attention to the details of your horse following the ride as you did on the trail, at the vet checks and at the trailer on ride day. Following are a few thoughts on maladies that may take place post-ride and when you should address them. A red flag comment is a recommendation to seek veterinary assistance.
Dr. Jamie Kerr’s famous acronym and now a standard mantra — Eating, Drinking, Pooping and Peeing (EDPP) — should still be applied at home, especially post-ride. Take note of hay and water consumption and adjust for minor variances. Red flags should be flying high when any horse refuses their typical feed. Be suspicious if hay is refused but their favorite grain or carrots are sluggishly accepted.
Listen to gut motility at the flank area on both sides and compare to previously known normal activity. If never done before, it is more important to know that there is activity as opposed to none. If there is no activity and food has been refused: red flag.
Water consumption may vary widely, especially if your horse is on pasture or the hay is soaked; a minimum intake should be approximately eight gallons in 24 hours.
Loose stools are not uncommon after traveling, but a seasoned road warrior that typically fills the trailer with formed stools and who unexpectedly switches to loose stools deserves a red flag. Most horses should return to normal stools within 24 hours of arriving home and being back on their regular diet.
Though not a part of the GI tract, the urinary tract and end result — urine — is part of the EDPP mantra. Urination post-ride should continue as it did before the ride, in character and color. Normal color will range from clear to light yellow to dark yellow. The latter may indicate high concentration, which may be just fine as re-hydration post-ride is still taking place. Be concerned if you are trying to determine if the urine is dark brown or black. Red flag this one.
This is a general catch-all category; owners can tell quite readily if something has gone awry just by observing behavior. Once you have confirmed that the all-important GI tract is functioning normally and behavior is typical, move on to the next category or run though the following for drill.
If behavior is depressed, further investigation is warranted and red flags are likely to be raised. The following items may provide clues as to what systems of the horse may be affected. Check mucous membrane color at the upper or lower gums, which should be a salmon pink color. Other sites include the inside of the nostril or the inside of the upper or lower eyelid. Bright red or plum-colored mucous membranes are to be flagged.
Next, press firmly on the gum line to effect blanching, then quickly remove the pressure and count how long it takes for the color to come back. Normal capillary refill time is approximately two seconds. Refill time greater than three seconds with other abnormal findings should be red flagged. Note whether the gums are slick and wet. If dry and tacky and coupled with abnormal color and refill time, this should also be red flagged.
A rectal temperature should be obtained; normal temperatures will range from approximately 99.9 to 100.5F. Rectal temperatures in horses immediately after traveling can easily bump into the 102F range. Before red flagging the temperature, check again after 30 minutes.
Consider the impact to the human body if we jogged 25 to 100 miles! At least humans are treated to a nice vehicle seat on the way home while the muscles, tendons and ligaments of the horse are still heavily utilized on the trailer ride home. While there will be obvious fatigue post-ride and post-travel, horses know when they are home and are generally happy to be there.
After the celebratory roll in the grass or dirt, give them 30 minutes to settle in and then do a quick check. Run your hands up and down the legs, feeling for heat, swelling and pain. Do not be alarmed by “stocking up” or mild swelling from the carpus/tarsus to the fetlock joint if it is equal on the opposite limb or if this is a typical pattern for your horse. Red flag your inspection if the opposite limb is very different and the swelling is focal to a specific site along the tendons or specific to a joint.
Visually check the outline of the lower joints and that the outline is similar to the opposite. Next, have someone trot your horse 125 feet out and back. Circling both directions may be worthwhile, instead of a straight trot, but be prepared for some degree of lameness. There is a good reason why horses are not circled as part of a vet exam: during the course of a ride; many horses will show lameness in a circle but not in a straight line.
Watch for symmetry of gait. Is there unusual head movement in the front or lack of symmetry in the rear? If there is, re-inspect the legs with closer scrutiny, check the hooves and look for bulging pads (if present and typically flat). With the hoof off the ground, wrap your hands around the walls and try to detect any heat. Palpate the coronets and heels to detect sensitivity. If nothing is found, palpate each and every muscle group on your horse to see if you can find a sensitive area. If nothing else, your horse may enjoy the attention.
While hoof pad/packing problems deserve the attention of your farrier, joint and tendon injuries can be career-ending. Use great caution if you determine that whatever you find will benefit from a dose of phenylbutazone (Bute) or flunixen meglumine (Banamine). Keep in mind that post-ride, horses are still restoring their fluid and electrolyte balance days afterward. One gram of phenylbutazone can have a substantial negative impact in compromised horses. Leverage physical therapies such as cold water/ice and wrapping for swelling before reaching into the drug cabinet.
Treatment received at rides
Lacerations, bumps and bruises do occur and are often treated at the ride by an on-site veterinarian. Seeking help and engaging with a veterinarian to treat your horse should be no different than engaging with your veterinarian at home. A treatment veterinarian should advise as to whether follow-up is recommended by an attending veterinarian. If there is doubt or uncertainty, contact should be made for clarification with the treating veterinarian at the ride site.
Any horse treated for metabolic reasons or failure to recover should be seen by the attending veterinarian within 24 hours of discharge from a hospital or arriving home from a ride site. At minimum, contact should be made within that time frame. Delays in re-examinations or simple communication can allow smoldering medical issues to evolve into a catastrophic event.
Horses that have received intravenous fluids via catheter should be monitored for complications of phlebitis or thrombophlebitis twice daily for one week after the catheter has been removed. Signs or evidence of phlebitis or thrombophlebitis are swelling, pain and thickening/filling along the jugular furrow. The jugular furrow is the faint line of depression along both sides of the neck that extends from the throatlatch area to the thoracic inlet.
While dime-size swelling around the immediate area of the catheter puncture site is not uncommon, this swelling should not be present more than 24 to 48 hours after the catheter has been removed. This swelling should diminish, not increase, over the 48-hour period.
Patency of the vein may be checked by wetting the jugular furrow with rubbing alcohol and holding off the jugular vein for 10 to 15 seconds with the head in neutral position. You should be able to visualize filling of the jugular vein and then sudden collapse after quickly removing pressure. Any evidence or suspicion of phlebitis or thrombophlebitis should be flagged and addressed immediately.
Horses that have received nasogastric tubing should be monitored for coughing, nasal discharge and delayed esophageal obstruction/choke. A mild cough or nasal discharge usually requires no follow-up treatment and resolves over time. These are usually due to an irritated oropharyngeal cavity and resolve within 24 to 48 hours.
Esophageal obstruction is very uncommon but can occur from two minutes to two hours after nasogastric tubing. It is more likely due to sedation, if used, than the nasogastric tubing procedure. Esophageal obstruction can be avoided by withholding feed for at least an hour after sedation and the procedure. Before feed is reintroduced, be certain that the horse is alert and has well-coordinated chewing and swallowing reflexes and provide soaked or mashed pellets or soaked hay only. It is good practice to maintain this diet form over the next 24 hours.
For the horse, the ride has not necessarily ended immediately after the finish line, the walk to the trailer or even at turnout at home after arrival. Though the healing process may appear to be rather quick after a 25- to 100-mile event, medical issues can surface a few days to several days following strenuous exercise.
Working through a systematic check-off list will allow early detection of problems post-ride. Communicating with your regular attending veterinarian or the treatment vet from the ride site can make the difference between recovery and disaster.