I’VE just gone out to check the horses in I think one of them might have broken his leg! Can someone please come out as quickly as possible?”

Unfortunately a phone call like this is one any horse owner could find themselves having to make.

It’s often perceived that horses only suffer fractures in competition but the reality is that these injuries are not confined to racehorses: they can happen when any horse is working or turned out at home.

No matter how careful you are, equine anatomy means that those long legs (with so little in the way of protective soft tissues) can suffer major injury if a horse gets spooked and gallops into a fence, falls, gets kicked or just slips while enjoying a buck and a gallop.

Signs of a fracture:

  • Not bearing any weight on the limb or severe lameness (only touching the toe on the ground or dragging the leg).
  • Signs of shock: sweating, trembling, rapid breathing, pale gums.
  • +/- abnormal shape or angle of the limb (see Fig 1).
  • +/- swelling around the site of the injury.
  • +/- bleeding, if a wound is present.

    • What should you do?

    If you think your horse might have a fracture, call your veterinary surgeon immediately. It’s helpful if you can supply the following information:

  • Your exact location, so time is not lost finding the way to you.
  • Your phone number, so the veterinary surgeon or the practice can call you back if necessary.
  • Any obvious abnormalities e.g. leg deformity, unusual stance, bleeding.
  • Signs of shock e.g. sweating, trembling, rapid breaths, pale gums.
  • The horse’s pulse rate.
  • If the horse is insured.
  • A photo or video of the injury from your smartphone.

    • While waiting for help to arrive:

    Do not try to move the horse - this is the single most important thing you can do to increase the horse’s chances of survival. Put on a head collar and lead rope or take the reins over the head and remove the saddle if the injury happened during exercise.

    Keep the horse as still and calm as possible (many animals will stand quietly so just stay at their head).

    Place a rug over the horse if they are cold. Do not give any medication unless instructed to do so by your veterinary surgeon (even a normal dose of painkillers or sedative can be harmful in a shocked animal). Avoid touching or manipulating the injury, as this will cause pain and could result in further damage.

    If the horse is bleeding heavily from a wound, put on disposable gloves before applying pressure with a clean towel. This can be secured in place (if necessary) with a bandage or silage tape until the veterinary surgeon arrives. Try to avoid causing extra discomfort and do not endanger yourself if the horse is uncooperative.

    If the horse is down and thrashing around/unable to get up, do not approach its limbs or attempt to handle it. Stay calm at a safe distance and wait for help to arrive. The horse is unable to run away so there is nothing to be gained by trying to hold its head down or restrain it.

    In most cases it will calm down and lie quietly after a few minutes so just leave it be: it is likely to start struggling again if approached.

    Once the vet arrives:

    Sometimes the nature of the fracture will be immediately apparent to your vet. If they have a portable X-ray system, they may take some views on the spot (depending on the location of the injury), before stabilising the limb. This normally consists of a heavily padded bandage with a splint placed over it. The splint must immobilise the joints both above and below the injury to be effective. Only once the fracture has been effectively immobilised is it safe to attempt to move the horse.

    Traditionally, fractures were splinted with pieces of timber, PCV piping, brush handles or any other rigid material that was on hand. This is still a viable option but it has the disadvantage of taking time to assemble and fit and might not be strong enough, especially if the horse has to be loaded for travel to a surgical facility.

    In the 1970s a Californian WW2 veteran and metal worker called John Kimzey designed an aluminium splint that can be easily strapped onto a horse’s lower limb over a heavy bandage (figure 2).

    In the years since, the Kimzey Leg Saver splint has been used all over the world to assist countless horses in making it to the operating theatre without any further damage to the tissues, nerves and blood supply in the affected limb.

    Can the injury be fixed?

    This will depend on the location of the injury, its severity and the weight, age, temperament and value of the animal plus the likely outcome e.g. return to athletic career versus pasture soundness or breeding. Some fractures carry an excellent prognosis while others cannot be repaired. The animal should not be put through any extra suffering and your vet will advise you if euthanasia is in the horse’s best interests.

    These difficult decisions are rarely made based on the available budget alone: all the money in the world cannot fix a truly catastrophic injury and many low-budget animals are priceless to their owners.

    Table 1 is an example of veterinary guidelines used to help guide good welfare decisions in often very difficult circumstances. Table 1: AAEP guidelines to assist in making humane decisions regarding euthanasia of horses.

  • 1. A horse should not have to endure continuous or unmanageable pain from an incurable condition.
  • 2. A horse should not have to endure a medical or surgical condition that has a hopeless chance of survival.
  • 3. A horse should not have to remain alive if it has an incurable condition that renders it a hazard to itself or its handlers.
  • 4. A horse should not have to receive medication to relieve pain for the rest of its life.
  • 5. A horse should not have to endure a lifetime confined to a stable for prevention or relief of unmanageable pain or suffering.

    • If the fracture consists of a single crack in the bone with the overlying skin and blood supply still intact then the prognosis for a successful surgical repair is much better (but never guaranteed!).

    Your veterinary surgeon and you can take some time at this stage to decide what is the best way to proceed based on the individual circumstances.

    Hopefully you will never find yourself having the make a phone call like the one described at the outset.

    But if you are unlucky enough to come across a stricken horse, knowing how to provide effective First Aid in that crucial first hour can literally be the difference between life and death.

    Karen Dunne MVB MA, CertEm (Stud Med) is a vet and veterinary nursing programme director at Dundalk Institute of Technology.

    She’s a member of Veterinary Ireland Equine Group.

    E-mail: hq@vetireland.ie

    Telephone: 01-4577976