Presenter: Dr Gayle Hallowell, Associate Professor of Large Animal Medicine, Nottingham University
If I was told there was a horse in distress and I needed to go and help, I’m not ashamed to say I would turn somewhat pale and feel very much out of my comfort zone especially as I haven’t dealt with a large animal for over 15 years. In this situation the key is ‘not to panic’ according to Dr Hallowell who led last week’s veterinary webinar discussing ‘Large Animal Emergencies for the Small Animal Practitioner.’ Dr Hallowell reassured us that we have all been well trained across the species having acquired a great deal of knowledge and with a little memory jogging we should all be well equipped to deal with any emergency coming through the door.
She explained that on approaching a large animal emergency we may not be able to rely on our pattern recognition skills built up over years of small animal experience. Assessing these animals will have to be taken right back to basic principles and a problem based approach will need to be implemented. A primary survey is performed to recognise any life threatening injuries and this evaluation is very similar to the small animal approach using the principles of ABC. Dr Hallowell also referred to the useful evaluative mnemonic ‘A CRASH PLAN’ which is explained further within this webinar.
Once life threatening injuries have been assessed and stabilised she advises performing a secondary survey. Dr Hallowell described how to assess the body systems of various large animal patients including some of the differences we may encounter. Sheep, goats, camelids, horses and cattle were some of the species discussed. Of course just physically assessing these animals can be more challenging than our small animal patients and offered advice on methods of restraint, sedation, analgesia, anaesthesia and euthanasia.
According to Dr Hallowell ketamine is considered the ‘go to drug’ for anaesthesia in large animals as it has a wide safety margin and although not licensed in the UK, MRLs are available in Europe. If euthanasia is necessary, ‘Somnulose’ is the best choice as it allows for a small volume to be administered. However most small animal practices will not have this in stock and in this scenario Dr Hallowell always recommends sedating and anaesthetising the patient prior to euthanasia which should be performed either using KCL or pentobarbitone where large volumes will be required.
Dr Hallowell discussed a number of scenarios where we may be called upon to intervene and relieve the suffering of a large animal. Trauma and birthing difficulties were high on the list but some of the time we may just be presented with a recumbent and painful animal. It is unlikely, under these circumstances, that our recumbent large animal will have heart failure or endocrinological disease such as Addison’s, some of the differentials we may consider for small animal patients. Gastrointestinal disease is the most likely underlying cause for a recumbent painful large animal and can include conditions such as bloat in the ruminant and FB obstruction in the pig.
‘The Webinar Vet’ has yet again organised a webinar which delivers so much information, it frustrates me that I cannot tell you all the little gems offered by Dr Hallowell within this blog. In fact I am considering re watching the entire webinar so I can really soak up all the practical advice and on the fateful day when I am called to, let’s say, a horse which has fallen into a swimming pool, my nerves, although I’m sure rattled, will no longer be in overdrive.
The Stethoscope (MRCVS)