Building an equine first aid kit

By Madison Hardcastle, DVM

It’s a proven fact that the longer you own horses, the more likely you are to experience an emergency. While majestic and beautiful creatures, our horses are consistently developing new ways to make your veterinarian scratch their head and ask, “HOW did that injury happen?!” Don’t worry, mule and donkey enthusiasts — your pals may have a lower incidence, but they aren’t immune. The goal of this article is to help you feel a little more comfortable and prepared when the inevitable happens.

Before you reach for the first aid kit: Is this an emergency?

Step one in an equine emergency is truly not to panic. It doesn’t matter if you are a seasoned pro or maybe still a little green to horsemanship — when emergencies strike, we all tend to get a little flustered. Keep your veterinarian’s emergency number written somewhere in the barn and saved in your phone for quick access.

Before you enter the spiral of panic, I have a few questions for you to ask yourself.

Is there blood?

• Yes, a ton! — Horses, unlike you and me, can lose a fairly large amount of blood before they become compromised. They also have a pretty incredible spleen that keeps a reserve of red blood cells available in times of need. What may seem like a tremendous amount of blood to us may not always be as concerning for our equine friends as it initially appears.
• Regardless of the volume, apply firm pressure using clean material such as a cotton roll and bandaging material. Before covering the wound, take a photograph if it is safe to do so. That photo can be incredibly helpful when you call your veterinarian.

Is your horse lame?

• Yes, severely! — A lot of things can make a horse lame, but we become more concerned when they don’t want to put any weight on the limb. If you see your horse in the pasture with dramatic lameness or they are completely reluctant to move, stop and take a good look.
• Is a leg swollen or hot to the touch? Are there any wounds? Pick up their feet and inspect them to see if they have stepped on something. If you find a penetrating object, please DO NOT remove it. Do the hooves feel unusually warm to the touch?
• Lastly, if you are suspicious of a fracture, contact your veterinarian before attempting to move your horse. Videos are always great to have, and we will often ask you to send one so we can be on the same page as you.
• Yes, but it’s not that noticeable! — Just like above, look your horse over. Can you tell which leg is lame? Don’t worry if you don’t feel confident identifying a more subtle lameness; these can be tricky! Take a video of your horse moving and have it on hand when you call your veterinarian.

Is your horse down?

• Yes, and they are stuck in something! — In these cases, not panicking is especially important. Horses can get themselves stuck in fences, stalls, trailers and all sorts of other places they have no business being. The most important thing is keeping both you and your horse safe.
• I recommend reaching out to your veterinarian ASAP. In certain situations, sedation can make removing a trapped horse significantly safer for everyone involved, including your horse.
• Yes, and they won’t stand! — There are several reasons a horse may be down, and a horse that cannot or will not stand can represent a life-threatening emergency. As with the previous example, it is important to keep everyone safe. Approach your horse with caution and contact your veterinarian right away.
• They just keep rolling! — This could be a sign of colic. If this is the case, remove hay, grain and other feedstuffs from their stall and contact your veterinarian.

Is there a wound?

• Yes, but it’s just scrapes or superficial cuts on the neck or body. — These may be wounds you can clean up at home and discuss with your veterinarian during normal business hours.
• Yes, and it’s near a joint or tendon — or involves the eye, nose or mouth! — These wounds may need more immediate veterinary attention. I recommend reaching out to your veterinarian and, as always, having a photograph on hand.
• We can’t always tell from a photograph whether a joint or other synovial structure is involved, but pictures really do help us get a better sense of the problem.

Information your veterinarian will want

When you call your veterinarian, there will often be follow-up questions depending on the problem at hand. Don’t forget that pictures and videos are priceless pieces of information for us.

We may also ask about your horse’s temperature, heart rate, gut sounds, appetite, manure production or other basic information depending on the emergency. Having the tools to collect some of this information can help you give your veterinarian a clearer picture of what is happening before they ever arrive at the barn.

So, to help you be the best prepared — and hopefully a little less likely to panic — let’s put together an equine first aid kit!

Your equine first aid kit

The basics: Thermometer and stethoscope

• Thermometer: Thermometers are useful for determining whether your horse has a fever. Taking your horse’s temperature is fairly easy: simply insert the thermometer into the rectum and wait until the device beeps. Do try to avoid placing the probe directly into a fecal ball, as this can cause a falsely low reading.
  • The normal temperature of an adult horse is 99.0°F – 101.5°F, and we expect foals to be 99.5°F – 102.1°F.
• Stethoscope: Stethoscopes don’t have to be expensive to be functional! Having one on hand is useful for determining your horse’s heart rate and listening for the presence or absence of gut sounds. We often use heart rate as one indicator of pain and being able to share that information with your veterinarian can be helpful.
  • A normal adult horse’s heart rate is 28-44 beats per minute, and a foal’s heart rate is 60-80 beats per minute with a newborn being 80-100+ beats per minute.
  • A normal adult horses’ respiratory rate is 8016 breaths per minute, and a foal’s respiratory rate is 20-40 breaths per minute compared to a newborn being 60–80 breaths per minute.
• Gut sounds: Listening for gut sounds is easier than you may think. In an adult horse, we generally listen in four quadrants. You may hear noises that resemble gurgling, rumbling or even a toilet flushing.
  • On each side of your horse’s body, there is an upper quadrant near the flank but below the point of the hip and a lower quadrant along the more ventral portion of the abdomen. Think slightly lower than where your cinch normally sits and farther back toward the stifle.

Rather than worrying about becoming an expert in what every sound means, get familiar with what is normal for your horse. That way, when something changes, you are more likely to notice — and you can describe what you are hearing to your veterinarian.

Bandaging basics

• Triple antibiotic ointment: If you are working with minor, superficial wounds, products like triple antibiotic ointment are available over the counter and can be useful for providing topical antimicrobial activity.
• Manuka or silver honey: These are also good topical products to have on hand when addressing minor wounds.
• Dressings: If you have a larger wound that needs to be bandaged, using a nonstick dressing or Telfa pad directly over the wound is recommended.
• Cast padding: I often like to use cast padding to help hold my dressing in place over the wound and provide another layer of padding.
• Cotton roll or standing wrap: This is the next layer of your bandage. You can purchase rolled cotton or have washable standing wraps on hand. This layer provides padding and support to the area of interest. If you need to wrap an entire leg, having two to three of these on hand can be helpful!
• Vet Wrap: This is your seatbelt holding everything in place. It is important to leave about ¼ to ½ inch of padding exposed at the top and bottom of your bandage. Vet Wrap should never be applied directly to the skin.
• Elastikon: This is the glue that helps hold your bandage together. You can apply Elastikon at the top and bottom of the bandage or use it to cover more of the bandage from top to bottom. Either option works; the goal of this layer is to provide a little extra security.

Don’t forget the feet!

• Diapers: A diaper is an excellent material to use for a hoof abscess wrap or heel bulb injury. I recommend keeping a size on hand that fits your horse’s foot. Your average-sized horse will typically fit in a size 3 or 4 diaper.
• Poultice pads: My personal favorite when trying to draw out a hoof abscess is 3M Animalintex. I recommend keeping at least one pad on hand for those unfortunate hoof abscesses. One pad can be cut into smaller pieces and used for multiple bandage changes.
• Epsom salts: Useful to keep on hand for foot soaks.
• Magnapaste: Another option commonly used when managing hoof abscesses.
• Duct tape: To give a foot bandage a little more longevity, a layer of duct tape can provide an additional barrier of protection. One easy trick is to make a duct-tape grid ahead of time and place it over the bottom of your finished hoof wrap.

Scrubs, cleaning supplies and disinfectants

• Chlorhexidine scrub: This is often the blue or pink solution you see us use to scrub for procedures like joint injections or catheter placements. It can also be useful when cleaning around certain wounds but should NEVER be used in or around the eye.
• Betadine scrub: Betadine scrub is another antiseptic cleanser commonly used in veterinary medicine. This is another useful product to have available when you need to clean the skin around an injury.
• Alcohol: First aid alcohol — typically 70% isopropyl or rubbing alcohol — is best used for disinfecting intact skin, sanitizing tools like tweezers and prepping skin before injections.
  • Alcohol may also be used as part of cooling efforts in certain cases of extremely high body temperature, but this is something I recommend discussing with your veterinarian.
• Saline: Sterile 0.9% saline is an essential first aid component and can be used to safely flush debris from minor cuts and scrapes. It is also a much safer option to have on hand when you are dealing with the eye.
• Gauze: 4 x 4 gauze pads are standard medical sponges used for cleaning, dressing and absorbing fluid from cuts, scrapes and wounds. You may see them advertised as woven versus non-woven. For the purposes of your first aid kit, either option is fine to keep on hand.
• Rubbermaid containers or Ziploc bags: Keep a few cheap plastic containers handy so that when you need to clean a wound, you have somewhere to pour or mix your cleaning solution and use your gauze without contaminating the original container.
  • I find that keeping scrubs and solutions in their original containers and pouring out only what I need helps prevent contamination and keeps products from going to waste.
• Rechargeable clippers: These aren’t an absolute necessity, but they can be handy if your budget allows. If you have a wound surrounded by a ton of hair, we will often clip the surrounding area so we can actually see what we are dealing with and help keep the area clean.
• SWAT: This product is an ointment designed to help deter flies. I will often use it to paint a barrier around a wound rather than applying it directly to the wound itself.

A few other topicals

• Furazone or Fura-Free: These are products you may see used as part of a sweat wrap when managing certain types of swelling. If you are going to sweat a leg, I recommend having your veterinarian show you how and when they want you to use one, particularly because not every swollen leg should be treated the same way.
• Plastic wrap: If your veterinarian recommends a sweat wrap, plastic wrap is commonly placed over the topical product, followed by appropriate padding and an outer bandage.
• AluShield bandaging spray: AluShield is a water-resistant, breathable, aluminum-based barrier spray that can be used over certain minor cuts, scrapes and abrasions. I think of this more as an additional protective barrier than a replacement for actually cleaning and appropriately treating a wound.

Syringes

• Catheter-tip syringes: These are useful for administering certain oral medications and for irrigating wounds. I recommend having 35 and 60 mL syringes on hand. They are inexpensive, take up very little space, and you will probably find more uses for them than you expect!

The other things you’ll be glad you have

• Exam gloves: To help keep both you and your horse safe, I recommend keeping disposable exam gloves on hand — especially when dealing with wounds.
• Scissors: Go ahead and keep a handy pair of scissors in your first aid kit. They will come in handy more times than not!
• Flashlight and batteries: Horses find themselves in emergencies day and night, and having a flashlight other than your phone will make assessing the situation easier and safer. Just remember to check the batteries every once in a while!
• Emergency information and identification
  • Phone numbers and emergency instructions: This is extremely important if you board your horse somewhere or have someone else checking on them while you are on vacation.
    • Anyone involved in your horse’s care should have access to your veterinary team’s contact information and know when you want your veterinarian called. They should also know what you want them to do if you are unavailable.
    • This is one of those things that seems obvious until an emergency actually happens, so write it down!
• Engraved tags: Have your horse’s name, your name and your contact information available on an engraved tag. These can be especially handy in the event of significant weather emergencies, such as tornadoes.
  • You can place a tag on your horse’s halter — remember to use a leather or breakaway halter rather than a standard nylon halter — and I also recommend having a way to braid identification into the mane during severe weather events. Metal dog tags with a ring work well for this.
• Livestock marking paint or marking stick: These can also be helpful to have on hand in case of severe weather. You can temporarily write identifying information on your horse’s body or hooves as an extra precaution.

Medications to discuss with your veterinarian

This section is a little different from everything else in your first aid kit. All prescription medications should come from your veterinarian within an active veterinarian-client-patient relationship (VCPR). Your veterinarian should also give you instructions for when, how, and how much of each medication to give your horse.

The medications your veterinarian recommends keeping on hand may be different depending on your individual horse and situation. However, there are a few medications you will commonly find in equine first aid kits.

• Flunixin meglumine (Banamine): Banamine is an NSAID we commonly use in cases of pain and is frequently used when managing horses showing signs of colic. It is available in oral and injectable formulations.
  • One important thing to remember: injectable Banamine should never be given in the muscle, and Banamine should not be combined with another NSAID, such as phenylbutazone, unless specifically directed by your veterinarian.
• Phenylbutazone (“Bute”): Bute is another NSAID we commonly use, particularly when musculoskeletal pain or inflammation is the primary concern. It is available in several formulations, including oral paste and tablets as well as an injectable formulation.
  • Like Banamine, injectable phenylbutazone should never be given in the muscle, and Bute should not be combined with Banamine or another NSAID unless specifically directed by your veterinarian.
• Neo-Poly-Bac ophthalmic ointment: Eye problems are one of those situations where I recommend calling your veterinarian rather than simply treating the eye on your own. Your veterinarian may recommend that you keep an ophthalmic medication like Neo-Poly-Bac on hand and may direct you to use it while you are waiting for the eye to be examined.
  • Most importantly, never put an ophthalmic medication containing a steroid such as dexamethasone into a painful or injured eye unless specifically directed by your veterinarian. Steroids can make certain corneal problems dramatically worse.
• Silver sulfadiazine cream (SSD): Silver sulfadiazine is a prescription topical antimicrobial cream that may be useful for certain wounds, burns, or skin injuries. This is another product I like owners to discuss with their veterinarian so they know when — and when not — to reach for it.

Keep your kit ready

Putting together a great first aid kit doesn’t do you much good if everything inside expired three years ago!

Make it a habit to go through your kit at least a couple of times a year. Check expiration dates, replace medications and supplies as needed, make sure your flashlight works, charge your clippers and restock anything you used.

I also recommend keeping everything together in a container that is easy to grab and easy to find. Emergencies have a funny way of happening at the least convenient times, and you don’t want to be searching three different tack trunks for Vet Wrap while your horse is bleeding. Fishing tackle boxes can be helpful or Packout or Toughsystem kits are particularly great to have at your barn.

Most importantly, remember what your first aid kit is actually for. It isn’t meant to replace your veterinarian — it is there to help you assess the situation, communicate with your veterinary team and safely care for your horse until you can determine what needs to happen next.

Being prepared won’t prevent your horse from finding their next creative way to injure themselves, but hopefully it will make that inevitable “HOW did you even do that?!” moment a little less stressful.