Arty had a freak accident this past Thursday which ended up with some severe head trauma. After the accident he was bleeding out his nose, was very dazed, and could not eat or drink. I took him to the vet who stitched him up but didn’t have much to say about his stupor. He seems as if he is heavily drugged all the time, and even three days later has no real desire to eat or drink. His coordination is slightly off, he knows where his feet are but has trouble getting in and out of the trailer. I’m worried sick and all the vet has to say is to continue to watch him. He seems to get slightly more alert each day but is still far from normal. Is this like a human concussion that just takes a month or two to heal from? Or do you think this could be permanent brain damage? Just wondering if anyone else has similar experiences.
At a barn I was at years ago, a horse went over backwards in hand on the asphalt driveway. He was bleeding founts of blood out of his nose and mouth and ears and was unable get up on his own. We kept him down and stable while awaiting the vet (I cannot emphasize enough how much blood–I was soaked in it and just threw everything I was wearing away).
The vet immediately put him on a schedule of warmed iv fluids infused with high doses of DMSO and a massive cocktail of other drugs. It took eight people to get him on his feet and into the stall. He managed to stay on his feet but leaned against the wall, and had a serious head tilt and nistigma (sp?–uncontrolled eye movement).
He had heavy duty round the clock care for WEEKS and a LOT of meds to reduce the swelling in the brain (I lived in a barn apartment and everything stunk of DMSO for what seemed like months). He was given a less that 30% chance of survival and was a critical care case for weeks. He did survive, but the head tilt was permanent, he lost the sight in one eye, and we believed he was rendered deaf. He was neurologically compromised, but unfortunately 2 years post accident the owner decided he was “just fine” and tried to ride him and he fell and broke his neck.
Honestly? I’d want much more serious intervention than you’re getting. If your horse has swelling in the brain every day that passes is more irreversible damage done. At best it’s the difference between him returning to normal and being compromised. At worst its life and death. Good luck and best wishes, but I’d get a second opinion immediately.
OP … I agree w/Phoenixfarm & would seek other vet opinions. Hopefully you can find somebody more experienced in head trauma & treatment of. I wish I had read their post years ago when I had a horse flip & hit its head. I think I gave up too quickly & didn’t have aggressive (enuff) treatments.
If my horse had survived I’m positive the horse would serve ONLY as a pasture ornament. Which is something else to seriously consider - usefulness & quality of life. I think also that safety is a concern. If a horse survives w/indefinite neurological issues then concern of both horse & human becomes a legitimate concern. A 1200 lbs animal with neurological issues is going to be a greater danger to work around. Also maybe another consideration is that a horse w/such issues may need a specialized or changed living environment.
Agreed on a second opinion. We have a mare that was kicked in the head as a foal and she has a permanent head tilt and is just not quite normal. Otoh the horse I compete now fractured his skull in the field and never had any problems other than swelling.
My driving pony had a neuro episode this summer - as best we can figure he was yahooing around the pasture and somehow lawn darted himself into the dirt. No control over back end, dazed, wicked head twitch to the right and nystagmus (eye jerk). My vet gave him a “thumping big dose” of dexamethasone, and the symptoms resolved themselves over the course of 36 hours. Within four hours he looked and acted normally, the neuro “tells” - slow response time to placement tests took a little longer and the retinal bleeds resolved over time as well. Fred got several weeks off, even though he recovered rather quickly from what had to have been a massive bell ringing.
I will be vote three that you need more agressive treatment or another vet.
Agree with everyone else. He needs DMSO and dex. We had a horse whack his head this summer and came up looking neurological. We treated him aggressively for several weeks and now aside from a head tilt he is totally fine.
I was a groom for a top level jumper who flipped over a fence and landed on his head. Also bled from the nose. We got him back to the barns and he was put on a DMSO IV drip and I iced his head. To do that, I stood in his stall on a step stool holding a towel and small ice bag to his head. I knew he was hurting because he LET me do that… After an hour or so he was better (and wouldn’t let me ice him ;). Was never so happy to have a horse try and throw me into the wall. And by that night, he was totally normal. Gave him a light week and then he went back to work. His rider has more long lasting injuries…her back was pretty sore for a while. He was never staggering…just the blood and the fact that he was too quiet was how we knew something was wrong…that and we all saw him land on his head. The vets at the show were on it…and fast. I don’t think it is an uncommon injury at shows.
I agree with the others…I would have like to see more aggressive treatment. I wonder now if the DMSO and Dex would help as much but I definiately would be speaking to my vet. If he isn’t eating or drinking well…I’d want him to at least get some fluids and try to avoid other complications (like colic).
I remember a youngster who used to play “wild stallion” with another youngster. He came in one day , head held low, and slightly cocked. We suspected that he had gone over in one of their tussles.
He got dex, and some down time in a small paddock with a babysitter, for a week. But his was a mild case, and we were guessing.
I had one just like Phoenix, above. Bleeding out nose and ears, at the track due to a flip on pavement. I had two racetrack employed vets offering to put her down for me, and my own vet trying to save her. People coming together to hold her down initially, then holding her up with arms locked under her belly when we allowed her to try to stand. Long story short, she survived. Had the eye tick too. Racetrack vets said that if she was human, she would have been in surgery to save her. As a horse, and under the circumstances, none of this was available. She was six weeks in a stall, and did fall down regularly, especially in the first week or so. But she survived. If she had been a gelding, I think I would have given up and put her down early. But I was hoping to save her as a broodmare prospect (even though she was crazy, she was an outstanding individual).
In my searching of things to help her, (mostly in order to give her the best chance of successfully loading into my trailer and getting her home in one piece), I learned that valium is one of the drugs of choice to treat ataxia, loss of balance due to head injury. Some of her problem appeared to be damage to the inner ear, thus her inability to keep her balance. My farm vet had suggested valium when I said she needed something to keep her calm but not sleepy. Then I learned of this OTHER use for valium, of which my vet was unaware. We filled her up with valium, and I think it made the difference for her. She loaded herself into our trailer, rode home without falling, and unloaded and walked into her stall at the farm, six weeks after the injury. She survived, and produced three foals, one very good one. She was a horse of unbelievable inner strength. So consider using valium if your horse’s brain injury is similar to this situation. Good luck.
Was his skull radiographed? This would be a starting point for me. I’m assuming the regular vet already gave corticosteroids and DMSO. He needs to be on Gastrogard also. It’s never wrong to hospitalize these cases. Call some referral clinics in your area and see what advice you get.
I have had 2 horses with nosebleeds who were immediately put on antibiotics. Did the vet prescribe them for you? I was told if they get a nosebleed, their lungs could become infected and you will have bigger problems. Not sure if this is true (I am not a vet) but that is what we did. Hope your horse feels better soon.
We had a very old mare who had some sort of incident in the pasture that involved a head trauma - we didn’t see it but we think she had a stroke that caused her to bolt through the fence and run into the clothesline pole. She lived for about 2 more years, but vision and hearing were compromised, and she had the head tilt as well. Her balance and body control were never quite the same and cold weather made things much worse. It’s frightening and you never really know how they will recover.
(Nystagmus is the word for the involuntary eye movement -there’s the sort of vertical rolling associated with having a stroke, and then there’s the horizontal quiver that indicates someone is intoxicated. Probably others.)
[QUOTE=CLV;7885035]
I have had 2 horses with nosebleeds who were immediately put on antibiotics. Did the vet prescribe them for you? I was told if they get a nosebleed, their lungs could become infected and you will have bigger problems. Not sure if this is true (I am not a vet) but that is what we did. Hope your horse feels better soon.[/QUOTE]
Was this after an accident?
Nosebleeds out of the blue can have some other nasty causes.
Not a vet, but a human neurosurgeon.
You are already out of the peak window for brain edema (within 72 hours of injury.) if he is getting a bit better as you say, I wouldn’t be looking for any pharmaceutical remedies. DMSO and Dex have some theoretical uses in this situation, but only early on in the immediate aftermath of the injury. I think they are more likely to cause harm then good at this point. Whatever neurologic damage he sustained is fixed at this point - now you just have to watch and wait to see how he recovers. Aim to evaluate that over a couple of months, not weeks.
If he was mine, I would just provide supportive care. Make sure he is getting adequate liquids in. Further testing (X-rays, etc) is unlikely to affect the treatment at this point.
I too have heard of head injuries being treated with DMSO and Dex (to control swelling).
I would get a second opinion OP!
[QUOTE=blackwly;7885139]
Not a vet, but a human neurosurgeon.
You are already out of the peak window for brain edema (within 72 hours of injury.) if he is getting a bit better as you say, I wouldn’t be looking for any pharmaceutical remedies. DMSO and Dex have some theoretical uses in this situation, but only early on in the immediate aftermath of the injury. I think they are more likely to cause harm then good at this point. Whatever neurologic damage he sustained is fixed at this point - now you just have to watch and wait to see how he recovers. Aim to evaluate that over a couple of months, not weeks.
If he was mine, I would just provide supportive care. Make sure he is getting adequate liquids in. Further testing (X-rays, etc) is unlikely to affect the treatment at this point.[/QUOTE]
That was my thinking as well. I’ve only heard of giving them the DMSO right away…I would think 3 days later is too late. But I would strongly consider giving him a few bags of fluid just as supportive care and otherwise, keeping him quite and just watching. It may take a long time for him to recover.
It is also a bit out of the box…but if I had a good acupunturist…I might have them work on him as well. I tend to think of that sort of treatment as supportive and not likely to do damage. Might help him a bit–especially if he is body sore elsewhere, and wouldn’t be invasive.
Horsenic, Please keep us posted, Arty is such an awesome pony. Sending you and Arty lots of jingles.
Thanks for the replies. Read through them all and now I’m terrified, also angry at myself and confused with my vet. Maybe she’s never dealt with something like this before, I don’t know. I called her a few days later with an update and all she said was “Odd, keep watching him”. I should have gotten a second opinion. All she prescribed for him was some bute. No corticosteroids, DMSO, nothing. I asked if we should do X-rays or anything when it happened, she said no. I’ll never forgive myself if he doesn’t recover from this.
He never had an eye-twitch or head tilt. He was always able to walk straight, and he knows where his feet are. He’s just been super sluggish and out of it, as well as klutzy when it comes to the trailer. His responsiveness gets a little better each day. I haven’t even been able to check for lameness yet as there’s no way I could get him to trot. On the once-over the vet did there was no swelling or heat, which was a miracle. That was only an hour after the accident though. The list of things that could be wrong with him in my head is way too extensive.
Anything else you guys would suggest? Any time I go out with warm water he drinks lots. I think part of his problem is that it’s been -35 C since the accident, I know that doesn’t do him any favors. Do you think I should still get X-rays and get him on DMSO? There were some very differing opinions on that. Just want to do whatever I can. I can only get out to see him every second day as it’s finals week and I’m slammed. Couldn’t have happened at a worse time.
I am going away for four months Dec. 25- May. 8. He was leased out for that period but I think I’m gonna have to cancel that and give him a long vacation.
What happened? Reason I am asking is because the mechanism of injury would have influenced your vet’s treatment decision. If you saw the accident happen and related it to your vet, that might explain their prescribed care.
(You don’t have to share on here, but I know that as a ski patroller responding to emergencies on the mountain, my husband does take into consideration mechanism of injury - velocity of impact, object hit, etc)
Try not to beat yourself up too much. But yes, I fear you are probably right that your vet just doesn’t have much experience with that kind of injury.
When we had our case, our usual vet, who had worked the ER department at Penn/New Bolton for several years and had seen EVERYTHING was on a call about 45 minutes away. GIven the severity, she suggested we call a vet who lived around the corner to stabilize him until she could get there. When that vet drove on to the scene she got out of her truck and when she saw us all lying there in a pool of blood, she screamed, “Oh my GOD! What HAPPENED?” and proceeded to freak the eff out. She had NO idea what to do. THe only useful thing she did was throw some blankets and coolers over all of us to keep us warm. She didn’t even start an IV.
THis sort of injury is serious trauma, and just like an average hospital ER can’t do shock trauma, the average vet can’t care for this type of injury.
Best of luck to you, and I will keep a good thought for your boy.
