After-hours equine emergency admissions at a university referral hospital (1998 - 2007) : causes and interventions

Abstract

Medical records of equine after-hours admissions from 1998 to 2007 are reviewed. Data extracted from the medical records included signalment, reason for admission, pre-admission treatment, clinical presentation, procedures performed, final diagnoses, complications occurring in hospital, length of stay and outcome. Eight hundred and twenty after-hours admissions were available of which 75 % were classified as emergencies. Most horses originated from Gauteng province (82 %), with Thoroughbred, Arabian, and Warmbloods representing 46 %, 10 % and 7 % of horses. Horses had a median age of 7 years and were predominantly male (60 %). Gastrointestinal (64 %) and musculoskeletal (19 %) disorders were the primary reasons for admission. Anti-inflammatories, sedation and antibiotics were given in 51 %, 20 % and 15 % of cases respectively prior to referral. On admission, 23 % of horses had surgical intervention. Intravenous catheterisation (64 %), rectal examination (61 %), nasogastric intubation (56 %), abdominocentesis (33 %) and ultrasonography (19 %) were the procedures performed most frequently. Surgical and medical colics constituted 28 % and 27 % respectively of the overall diagnoses, while piroplasmosis was diagnosed in 5 % of horses. Post-admission complications occurred in <2 % of horses. The median length of stay was 4 days (95 % CI: 1 to 21 days). Overall survival to discharge was 74 %. This study demonstrates that the majority of after-hours equine admissions to a university referral hospital required medical intervention and were mostly due to gastrointestinal disorders. Information obtained from this study can be used in emergency referral planning

Review of Equine Piroplasmosis

“…The apparent global variation in clinical disease might be caused by a variety of factors contributing to emergence of infection and disease. Infection with T. equi in South Africa often results in severe disease, requiring treatment . In contrast, in the outbreak identified in the United States, in which 475 horses were affected, only 1 horse was reported to exhibit mild clinical signs .…”

“…The prevalence and distribution of the infection within the Caribbean nations are questionable, but the disease has been reported on most islands, including Trinidad and Cuba . Disease is widespread in Africa and Asia with the highest prevalence reported in South Africa . Not all countries report identified cases to the OIE, making an accurate understanding of the current parasite distribution difficult.…”

“…Uniformly, infection with T. equi typically results in more severe clinical disease than B. caballi . Disease signs and severity can vary significantly from 1 region to another …”

“…8,29,30 Disease is widespread in Africa and Asia with the highest prevalence reported in South Africa. 31,32 Not all countries report identified cases to the OIE, making an accurate understanding of the current parasite distribution difficult. Countries such as Mexico and China are not considered endemic because the OIE routinely receives no information regarding distribution of piroplasmosis cases in those countries.…”

“…4 Disease signs and severity can vary significantly from 1 region to another. 7,31 Clinical Disease Clinical disease can manifest in different forms. With acute T. equi infection, clinical signs are usually related to marked hemolysis and resulting anemia.…”