Horse left to suffer by small animal vets

[Polonaise]

Found this story interesting for a few reasons

1) What response time would you expect from your vet in an emergency? The horse died in 15minutes, would any vet have got there in that time and would any pain relief have had time to kick in?
2) Would the local branch of a small animal practice stock pain relief and euthanasia solution for horses, let alone have any idea how to use them?
3) Would the local small animal vet have any idea how to handle a distressed horse, would they have appropriate footwear etc?

I now have an image of someone wearing scrubs and crocs trying to euthanase a horse using a dog sized canula and dog strength euthanasia solution, it's not pretty and I'm not sure how it would have helped?!?

 

[jrp204]

1) Prob not.
2) Why would they stock it, they should know how to use it as it would have been part of the vet training.
3) May have covered it at vet school but personally I would rather wait for a large animal vet experienced in dealing with large ill, stressed animals to come. Doubt you need too much protective footwear for small animal practice but then again those darn hamsters can be vicious.

No idea what this story is about but I appreciate how stressful it must have been having a seriously ill horse and not getting help when you need it, even though it may not have been possible to save the animals life. But you wouldn't go to a gynaecologist for an ear infection.

 

[twiggy2]

can we have a link to the story so we know what it is about.

1)Not in my opinion

2)I think you will find a lot of the drugs used in small animal practice can be used for horses, but they may lack some of the larger equipment needed. yes it is covered at vet school so they may be rusty but should be ok

3)just like to say that just because they work in a small animal practice does not mean they have never worked with large animals. 3 out of our current 5 vets have at some point specialised in equine medicine.

 

[Capriole]

I imagine it's this, I googled the thread title.

http://www.horseandhound.co.uk/news/horse-left-to-suffer-by-small-animal-vets/

 

[ester]

I guess in the situation they did not know that they horse would be dead in 15 minutes- it could have been significantly longer in which case you would want euthanasia asap- so the expected response time being in less than 15 mins isn't really relevant IMO.

I imagined they would have sufficient stocks of euthatal to kill a horse, though perhaps not the size of needle or syringe required- and may need to look up how much was actually required. I am also pondering whether small animal vets are covered to carry such things in their cars (if any cover is needed) and if they are insured to treat a horse - ie if anything went wrong/someone injured due to incorrect application of euthanasia would there be liability issues?

 

[ihatework]

When phoning around vets, there would have been no knowledge on how long the horse was going to survive for.

I wouldn't expect a small animal vets to be able to do much, but I would expect them to have painkiller in stock, and if at all possible to attend the scene. I don't think there is sufficient information in this case to decide whether the local vets should have made an effort to attend the scene.

 

[AmyMay]

. “They just refused on the principle that they were ‘small animal practices’.”

Regardless of the fact the animal died within 15 mins, the fact that the practice refused to come out is appalling.

Hopefully the person at the end of the phone who said no is now on their way to the job centre.

 

[maxine1985]

Regardless of the fact the animal died within 15 mins, the fact that the practice refused to come out is appalling.

Hopefully the person at the end of the phone who said no is now on their way to the job centre.

Completely agree!

 

[star]

We have had calls to attend horses before and usually try and suggest they try all the local equine vets first but call us back if needed as we are seriously ill equipped to deal with horses. I'm the only one in the practice who has horse gear on them. Others do come to work in crocs and scrubs and have no need to bring boots etc. We don't have any catheters big enough or long enough to get into a horse jugular. I imagine it would take more than the 2 bottles of euthatal we keep in stock to kill a horse given it takes half a bottle to kill a 50kg dog and a half job would be worse than nothing. We could potentially provide some analgesia but sadly it would be limited to that alone.

 

[AshTay]

Perhaps lessons should be learned from this and all small animal practices should keep a small amount of essential equipment in stock for just such an emergency? And it wouldn't take much for vets to keep a pair of boots in their car.

 

[trakehnersrock!]

Given the amount of horses and livery yards in Bexley, I'm amazed there wasn't an equine vet nearer to hand.

 

[MiJodsR2BlinkinTite]

Hmm, I donno, there ARE two sides to this:-

Firstly, whilst I would agree that perhaps the "small animal practice" has a "duty" as it were to render emergency care in a situation like this, there is a case for saying that IF you've got a lot of vets who are NOT experienced in large animal work and/or haven't got any of the right kind of equipment, then TBH if they DO attend an emergency incident with a large animal and are ill-equipped to cope with what they find, they may be worse than useless in that situation. Most small animal vets would have NEVER (apart from their vet school training) dealt with a large animal since qualifying, and if a vet - or anyone for that matter - is, to put it bluntly, *****e scared of a horse, then they're gonna be as much use as a nun in a punchup TBH.

On the other hand........one COULD argue that as vets, whether they liked it or not, they have a "duty" to relieve suffering and that in this instance they patently failed in that "duty".

Unfortunately vets now are mostly "small animal" - and large animal/farm practices are in the minority and tend to be very spread-out geographically; some of us can remember the days when ALL vets had to deal with large AND small animals, and every vet would carry a humane killer in their boot for instances just such as this.

 

[hnmisty]

Unrealistic to expect a vet to arrive in 15 mins. It would be pure chance if they were actually able to.

Had a small animal vet come out and tried to euthanise the horse with an incorrect dose, or didn't have a syringe big enough to deliver the dose in one go, then the horse would have suffered what would likely have been an equally distressing death.

Back in the days when my dad worked for a practice (he works for DEFRA now) he came across a horse who had jumped out of its field and broken both its legs. He carried a gun in those days, and it was clear that the horse was a goner. He was about to shoot it when the marksman (who had been called out, but they hadn't known how quickly he'd arrive) turned up. Apparently he just said very quietly to my dad "a little to the left" or similar. My dad's aim would have done the job quickly, but the marksman was more the expert. If it is not a technique or an animal with which the vet is familiar, then the vet may understandably be reluctant to deal with it. I would also be very surprised if a small animal vet carried a gun/captive bolt gun with them.

It is a very sad story, and I am surprised that a SA vet didn't come out to at least see if there was anything they could do to help ease the horse's suffering.

 

[NellRosk]

Similar thing (but not as bad) happened to my mum's best friend's horse a few weeks back, horse was choking and she had to call emergency vet. The vet they had on call was a small animal vet and she didn't know how to tube the horse. Repeatedly tried and the horse was close to death. Luckily a livery was there who was a vet and she managed to tube the horse and save it's life. Absolute nightmare and something needs to be done about this!

 

[hayinamanger]

A lot of SA vets have never laid a hand on a horse.
Vet students get very little hands on opportunities when seeing practice.
Once qualified, they may have worked in a mixed practice, or gone straight into SA work.
A solely SA practice will have none of the drugs or equipment required to deal with a horse, let alone one with catastrophic injuries.

 

[twiggy2]

without knowing all the details it is hard to comment on this one,

many SA vets though do not routinely do call out visits anymore,
the vets at the practice may have been in surgery which means they are unable to leave their current patient,
they may already have been dealing with an emergency, we had 5 emergencies come in to the practice in 90 mins one evening this week, we had one vet and 2 nurses working-we had to call another vet back from a different surgery after their shift had finished, we would have had to have said no if this call had come in at that time.

small animal emergencies are expected to go to the vets surgeries so many do not have the staff or equipment to deal with a emergency visit like this

correct me if I am wrong but I thought a vets duty was to treat any suffering animal they are presented with, I dont know how that varies if it is a visit request.

 

[star]

We are required to respond to a request for help whether it's a visit or not. Someone got struck off recently for refusing to go out on house visit for a dog the owner couldn't/wouldn't bring to the surgery.
However we can't just keep Somulose just in case we might get called to a horse - it's expensive and goes out of date quicker than were likely to use it. None of us are trained to use a gun so that would be a recipe for disaster and captive bolts are illegal to use in horses.
If I had to go to a call like that I could provide some pain relief but that's it. We do get trained in equine stuff at uni but if you don't use that training you quickly forget. I freely admit my equine vet knowledge is lacking these days as I went straight into small animal work and that's with me having my own horses and keeping as up to date as I can reading stuff -nothing substitutes for regular practical experience. (Although any vet should be able to do stuff like pass a stomach tube as the technique is the same in all animals)

 

[stacie21]

It's a horrible incident but let's be honest it's a bit like expecting a doctor to be partially trained in operating on people all they can do is first aid untill ambulance ect turn up yes maybe the small animal vet could have offered minimal first aid and was a bit off just saying no but very unrealistic to expect them to carry equine equipment, boots ect for the one off chance that they will be called out for a horse they normally choose sa for a reason THEY DON'T LIKE THE BIG ONES imagine the story if they had tried to help and either half killed it or made distressed the animal by struggling with wrong needles emagine the up roar then

 

[MadisonBelle]

Regardless of the fact the animal died within 15 mins, the fact that the practice refused to come out is appalling.

Hopefully the person at the end of the phone who said no is now on their way to the job centre.

There is a small animal vets just a 5 minute WALK away from where this incident happened........ To have not come out and given some kind of pain relief is just too sad really

 

[AmyMay]

It's a horrible incident but let's be honest it's a bit like expecting a doctor to be partially trained in operating on people all they can do is first aid untill ambulance ect turn up

And that's all the small animal vet had to do. I hope the practice will be named and shamed.

 

[Murphy88]

I don't think anyone can pass judgement here without hearing both sides of the story.
If they were 100% small animal practices (which it sounds like they were) it is doubtful they would have had the drugs available in stock anyway, regardless of whether there were staff available. If you took away the large animal store room at my practice, there would be no pain killers appropriate for use in horses - no bute, no flunixin, metacam but in such low concentration/volume that it would be useless, likewise with sedative drugs, they wouldn't be the right strengths or volumes to have any effect. Somulose (the euthanasia drug of choice for most equine vets) is not used in small animal practice. Pentobarbitol is used, but as Star has pointed out, in a solely small animal practice it probably won't be stored in enough quantity to kill a horse.

It may be that the small animal practice felt that they would not be able to offer any real help in terms of first aid, that perhaps a competent horse person could not provide. Still not an ideal situation, but as already been stated, it could potentially have been a lot worse had a small animal vet attempted to treat/euthanase and messed it up. Though in todays litigious society I suspect the sensible thing would have been for a vet to go out and do nothing, so at least they could say they had attended. Realistically, if the horse was bad enough to have died within 15 minutes, a police marksmen should have been called to hopefully arrive before the equine vet, and they would have been able to euthanase.

 

[hayinamanger]

At last, the voice of reason!

 

[Welly]

I have just googled vets near Bexley one practice has 16 vets and 20 nurses. I find it astonishing that not one new how to treat a horse in need, shame on them.

 

[hayley.t]

I agree that perhaps someone could have gone to help but then realistically what could they do? I can't think of any small animal analgesia that they would stock that would be suitable for a horse.

 

[Pearlsasinger]

A horse which had escaped her field was in collision with a car at 11pm near us a few years ago. None of the local vets was able to come out (I don't know all the reasons, at least 2 large animal practices not too far away). The mare was in great distress and pain, so the local rabbiter brought his fire-arm and shot her within a few minutes.
I can't imagine that small animal practices would carry many horse drugs or the equipment to administer them.

 

[Aru]

What could a small animal vet have done though?

They would not have any drugs suitable to euthanize a horse or any suitable pain medication or sedatives.. They wouldnt even have had a large enough gauge needle or catheter to give the drugs either.....trying to put down a horse with a dog catheter would be an absolute disaster to be honest and you would likely need to use several bottles of small animal euthanasia solution to put down a horse(im estimating 3 to 4 bottles)....delivering that volume of drug through the wrong size needle or catheter without any sedation if you are not a horse competent person would not be a pleasant situation for anyone involved.

Also if it was a scenario where the horse was not near death but was severely injured what could a small animal vet have done then? They would not have the hands on experience required to deal with equines if they did they would be a mixed or equine practice.Yes we all get do learn the basics in vet school but its the experience in the field that matters. All they could offer was to put the animal to sleep with unsuitable drugs and equipment and they would not be able to offer suitable pain medication. What use is that to a horse or owner in an non critical emergency?

A 100 percent small animal practitioner in an equine emergency would be about as useful as a chocolate teapot. Waiting for the person with the correct equipment..ie a a mixed practice/ equine vet or a marksman was all that could be done in this scenario

Poor Horse though

 

[star]

Am trying to think what I could feasably have done in that situation.

Realistically if horse was going to die within 15mins me going out and giving it a shot of metacam would be like you taking some ibuprofen if you'd been hit by a car.

Trying to think of other drugs we have that might be of some use. I guess maybe some torbugesic would sedate it a bit. Could you use Domitor in a horse in an emergency instead of Domosedan? Personally I know I can hit a horse jugular as I sedate mine regularly but doubt any of my colleagues would find it so easy. Maybe some morphine - can you give that IV or IM in horses? Not sure we'd have enough in stock to have much effect but it would be worth a go?

I think we've established the small animal vet is not going to be able to euthanase the horse. I've never put an IV catheter in a horse aside from not having the equipment or the correct drugs to do the job. Personally I would feel quite useless in this situation despite being perfectly comfortable around horses - not having the right equipment for the job is going to leave you helpless. For someone non horsey they could easily make the situation worse or get themselves or others injured.

Oh, and just to clear one thing up - small animal vets dont just do small animals because they're scared of big ones! Some of us like to keep horses to a hobby and enjoy the increased variety that comes with smallies.

 

[Polonaise]

Wow, that opened a can of worms!
Star I also ruled out anti-inflammatories as a viable option (too slow), butorphanol and buprenorphine can be used iv in horses but buprenorphine must be used with an alpha2 as can cause tremors/excitement, I've never tried domitor in horses, would you stock xylazine as an alternative to domidine? Morphine or Ketamine are options but again you need some decent sedation first.
In reality no-one would have got there in time (especially after looking up drugs and doses) but it's an interesting one for the RCVS to consider.

 

[Kenzo]

Very interesting topic, I would have thought even at a small animal practice there would be a vet that could use the gun in such emergency situations if a larger animal required it? seems quite worrying if not.

 

[Tnavas]

Regardless of the fact the animal died within 15 mins, the fact that the practice refused to come out is appalling.

Hopefully the person at the end of the phone who said no is now on their way to the job centre.

Totally agree.

Interestingly no one has mentioned the 'humane killer', captive bolt, I would have thought that all vets would have one.