So, See, as everyone who works as a vet know, you never quite know what each day is going to bring, and, the unexpected may happen usually when you're least expecting it. So fortunately for me, it's an area that I'm interested in, and I've been involved in a lot of teaching, and I've been on, courses with regards to equine rescues and helping, barter, provide some teaching material. But, I'm actually the person with the riding hat in the middle of this picture.

This was just outside my house when I wasn't at work. Didn't have any of my work stuff with me, but it just goes to show that, you never quite know what's around the corner and just how your skills, even when you have minimal, equipment with you, can be very beneficial. So it's all about being prepared, because, if you're scared and you just bury your head in the sand, you, you're just gonna find yourself in a, in a very unknown, situation when that potential worst does happen.

Before I start, I would like to acknowledge a few, a few people and organisations, particularly to Jim Green, who, is based at Hampshire Fire and Rescue Service and he's working for SAA, who I'll come on to at the end of the talk. He's provided me with a number of photos, but he's someone that I've also, had a lot of conversations with over the years, shared a lot of experiences and skills with me. And to Professor Mark Seniors, one of my colleagues at Liverpool, who's head of equine anaesthesia, for allowing me to use some of his sedation and anaesthesia slides.

And I'm not going to run through all of these, but these are the learning outcomes and I hope we we achieve this during this talk. So as a starter, when that phone call comes in, or when you're alerted and to the need to attend an emergency, a rescue emergency involving a horse or horses, you'll need some basic information. So you'll need to know what type of incident it is, whether you're going to be dealing with human casualties.

And, horses and other animals and what sort of injuries or suspected injuries, these horse or horses have, and getting a rough idea of numbers and, you know, whether you're potentially dealing with catastrophic injuries can be very helpful with just making sure that you've got, enough equipment and medications with you. It's useful to know if an owner is present, because if not, trying to find that owner whilst you're on your way there is very helpful. And knowing that other emergency services have been informed.

And in many parts of the UK we are lucky enough to have foreign rescue services who have more specialist animal units, and so asking whether they have been informed because some of these units may take a little while to actually get to the scene. The location of the incident, it's a bit, a bit like going on any, any large animal call, and particularly places where you're not familiar, is trying to make sure you've got a precise location so you don't waste time trying to find where you need to be. And it's received a little bit of publicity on the BBC recently, but what Free Words is an app that's fairly recently been launched, and is what the UK rescue services are using to precisely locate any casualties, and I'll demo that in a minute.

It's really clever. Apparently they use it now in Mongolia for the postal service, . And it's useful to have a contact phone number of somebody on site in case you need to contact them if you're having difficulties finding them.

And also know if you can actually get to the site, for example, a horse that's got stuck in a bog, or is the horse in or near water. And this is just an example of what 3 words, it's very easily downloadable onto your phone. And so, you can see, it forms a grid, and each grid has a unique three words.

So my office is grudge newspaper smiling. So there you go. So just coming on to a few principles, and I'm sure there might be quite a mixed audience watching this presentation.

So some of you may be very au fait with rescues, maybe some of you are, new graduates who've never yet had to deal with one. So I thought it was important to make sure that we start from the basics, and apologies to some of those of you who may already have attended and have a fairly good idea of of what an emergency situation. Necessitates from the veterinary surgeon.

The most critical aspect is to appreciate that human safety is paramount, and certainly when other rescue services are in attendance, that will be their priority. Certainly in the UK and in those areas where there are large animal rescue teams, but usually globally, the fire and rescue services have an interest in attending these services to try and prevent. Of these emergencies to try and prevent people risking their lives.

So for example, dogs trapped on ice, or cats stuck up trees, because invariably members of the general public will attempt their own rescues with potentially catastrophic implications. So they're there to really ensure that human life is saved, but also to try and save the life of any animals that are there. And you may be under pressure from quite upset and distraught owners to risk your own safety, which is not acceptable.

So you have to be aware of your own life and your own risks that you're taking, and those of other people around you, including the emergency services. It's really important to be wearing appropriate personal protective equipment, and I said, as in my picture, that I showed earlier, I wasn't armed with my usual equipment, but, you know, basic things like making sure that you've got, protective headgear, and, many fire and rescue, service teams will have headgear that, you can use, especially if you're dealing with water-based rescues, protective equipment, suitable waterproofs, for, for going into water situations. Now, many of you may have heard of the safer working zone, so no area around a fairly large animal that is trying to get away from all these people who are suddenly crowding around it is going to be safe, but there are areas that are a definite no no.

So you should always try and position yourself on the spine side of the horse and keep a, a distance away from areas that may strike out at you, particularly the limbs and the head and stay, you know, with regards to the head again, staying on that, sort of neck side, spine side, not getting into, these sort of zones here. And discuss the plan and your thoughts and any concerns with the rescue personnel. And I think sometimes as vets, we are quite used to, particularly in large animal situations, it's quite a solitary job where we're working and making decisions on our own.

But in these situations, it is very much a team effort, and the rescue personnel are there to help you, to, you know, share the burden, because some of these situations may be, you know, pretty tricky and quite, quite difficult to deal with. And as you'll be aware, you know, horses are fight or flight to animals, so they may be, they may appear quite calm, but be ready to shoot off as soon as they get the opportunity, whereas other horses may be visibly quite distressed. And in those situations, trying to keep them calm while you get a plan and try to rescue them safely is important.

So practical things, and these are things that you can advise people on the way out to an emergency is offer feed, for example, some hay, probably rather than hard feed, especially if you're going to have to anaesthetize them, or keeping a companion nearby their herd animals. So obviously, a horse that's entrapped and its mates and go walking away is going to become potentially more distressed. And during a rescue situation when there may be quite a lot of visual or audible stimuli to the horse, trying to reduce that stimulation.

So for example, putting cotton wool in their ears or covering the horse's eyes. And when on site, you may be the first person there, or you may be joining a team of rescue personnel who are already on the scene. And in those situations, it's really important that rather than just going straight to the casualty, that you introduce yourself to the rescue service personnel as as the veterinary surgeon in attendance, and find out who is the senior person overseeing the rescue situation to try and get a plan that your safety will be one of their concerns as well.

I'm aware that obviously, some of you may not be based in the UK and, you know, in certain regions and certain countries, fire and rescue service assistance may be quite variable. And for those who don't have those facilities, then it is potentially something that as local veterinary surgeons that you can maybe Try to work together, with people with the necessary skills to try and get, animal rescue teams set up. There are certainly lots of fairly horrific examples of fairly poorly, conducted rescues, if you look on YouTube.

When a rescue is conducted properly, you know, it's a really, nice thing to see that, you know, human and animal life has really been, properly taken into account. And there are some really highly trained personnel who work worldwide and they're very good at sharing their experience and expertise with others. You're also going to be dealing, potentially with a horse owner if they're present, and members of the general public who may or may not be used to, horses.

So, you may be faced with any range of situations and very different emotions. And as you'll be aware, owners. And members of the general public can occasionally be quite difficult to deal with, but fortunately, most times are very helpful.

So it's trying to make that decision as to who you keep on the scene and really trying to minimise the number of people that are, distracted, causing a distraction and and complicating things further. People may have a range of emotions through to being overtly distressed, wanting you to jump straight in to save their horse, right through to those who may be very angry and may have, other emotions. And it can be difficult at times, but as the veterinary surgeon in attendance, just trying to remain calm and professional is, is really important.

And during the rescue, particularly when you've got an owner present, just taking a little bit of time, either yourself or getting somebody to update the owner during different stages of the rescue, is often very helpful. So being prepared is one of the critical things, and I said, you know, as a veterinary surgeon on duty, then hopefully you will have the necessary, equipment and medications with you. If you're off duty and come across an emergency situations, that, that's a little bit more challenging.

But even without an awful lot of equipment, you can still do a lot to help the situation until a colleague, or somebody from a a neighbouring practise arrives to provide the medications and equipment equipment needed. The most important thing is to be prepared for the key eventualities. There's always going to be some situation where you may maybe do need something, that potentially can be brought along by somebody else from the practise or a neighbouring practise.

But the key thing if you're on call and attending an emergency is to have personal protective equipment, certainly, boots and headgear. And ideally, that shows that you are a veterinary surgeon in attendance, particularly for major incidents, having analgesics and antimicrobials, all the routine equipment that you would have for dealing with an emergency situation, including bandaging materials, catheters, sedatives. And it's, again, being prepared, especially if you're not used to having to do different types of station, carrying with you protocols that you're used to using, and that you don't need to go rushing to a textbook in the practise to look at that you've actually got there with you.

And having a good idea of anaesthetic protocols and having those drugs either available or that somebody can bring to you if the situation arises that you would need to anaesthetize the horse. So, on arrival, having sort of dealt with all the personnel, you want to get some sort of idea of the background leading up to this situation and said these two pictures show that, you know, anything, anything goes. So the key things are really to find out whether you're dealing with a, a, a, an animal that was known to be healthy before an observed incident, or how long or how long it is since the animal was last seen to be normal.

How long, a horse or other equid, has been, trapped, and whether they've got any concurrence conditions or other, known and suspected problems going on. And I said, an owner may or may not be present. So for example, in situations where there's been a road accident, you may Have to deal with an owner that's actually been one of the casualties or agents and may not be able to assist you.

But where an owner is present, it's helpful in being able to get consent and, obviously the, more challenging situation of discussing payments and bills, etc. Especially when it's not a client lon to you, is also important. So, initial triage will be something that all of you are used to dealing with.

I thought I'd just put in the actual definitions of, of, of this. And really just to highlight that, particularly in these rescue situations that we may not be dealing with the more usual single horse that needs attention. You may be dealing with a number of horses, .

That have varying degrees of injuries or maybe completely uninjured, and trying to determine which needs to be dealt with first, and potentially, if you've got multiple casualties, you know, electing to get another colleague or colleagues, to actually, assist with, dealing with those, multiple other casualties. And again, as with any sort of situation that you're used to dealing with in the field, it's making sure that you've got the ABC's covered. This is this pony that's managed to get into the back compartments of a small horse box.

So as you can see, it's going to be pretty difficult for this pony to breathe. So trying to ensure that this pony has some form of airway and to check that it's actually breathing is important, and trying to assess how much blood has been lost and whether there's any ongoing haemorrhage and any degree of circulatory compromise is important. And you know, there are a number of emergency situations when you first arrive on the scene and you see limbs sticking out of trailer windows and on the ground where you think, oh my goodness me, you know, this must be catastrophic, maybe we ought to just euthanize now.

But, it's a very final decision to make, and it is important to make sure that you've done a full appraisal and not be pressured into making a hasty decision, and particularly, where members of the public are present and are just calling for you to put the animal out of its misery. Those situations are not always what they seem like, and sometimes fairly innocuous situations, as you'll be fully aware, can sometimes be much more serious. So initial assessment is really gonna depend on the access that you safely have to get to the casualty, and ideally should be performed, before you, administer any sedative or anaesthetic agents.

And primarily, the key aim is to determine how compromised that horse is, whether it's a just a horse that actually once you start freeing it is going to disappear quite rapidly down the fields, or that horse that may have been entrapped for a number of hours and is genuinely exhausted and potentially may be quite close to death. So during that time that you're doing your assessment, and again, depending on what access you have, you'll be wanting to assess the horse's reaction, to people around it and to any handling. But, you know, there are some situations where it just may be too dangerous or impossible to perform a full assessment and .

If the other alternative is that you just have to euthanize the horse, then, you just have to go with what you can do to try and assist getting that horse out alive. Initial assessment's going to be no different to dealing with any casualty that you may be dealing with in other situations. So doing what you can to get an idea of the horse's vital parameters which are listed on the screen.

And again, as you'll be used to doing, but maybe more so for potentially new graduates, it's sort of getting used to that as you're getting those vital parameters. Start making a plan in your head and you know, sort of discussing with rescue teams, because it may be that if it becomes very obvious from your discussion with them, and that it's very clear that it's not going to be an option to do anything with the horse, unless it's, for example, anaesthetized, then you may need somebody to start bringing additional drugs or equipment, or it may be very helpful to have another colleague, either from your practise or from a neighbouring practise, to assist you. And obviously, it will take time for them to be able to get to you.

And so by getting those plans in place, I think it's always better to err on the safe side, rather than delay a rescue for a significant period of time, which can be quite stressful for everybody involved. And particularly for rescue services who, for example, may be under quite a lot of pressure to get, for example, a major road route back open again. So gonna consider all the usual sort of body systems, and some of these, you know, you can do from a little bit of a distance and just to look at at the respiratory system and the thorax, the abdomen, and then, of course, the limbs for any obvious wounds.

Or other suspicions that maybe you're dealing with something a little bit more serious, that may make a rescue futile, and also attempting to try not to worsen any, injury that you've noted during the rescue procedure itself. So coming on to some key rescue principles, and these are ones that certainly the UK Fire and Rescue Services sort of very much adhered to and expect attending veterinary surgeons to adhere to. So there's no point in attempting to rescue a horse if that horse disappears off into the sunset and to be hit by a car.

So the most number one, is to have control of the horse's head and get a head collar on and take off any bridles, leather can snap. So getting something that's secure on, that you've got control over the horse's head and the horse itself. As I said to you in the earlier slides, being prepared to sedate or anaesthetize the horse because it may be completely impossible for rescue personnel to work safely, for example, around horse's limbs without having a horse either very heavily sedated or completely anaesthetized.

Key mantra is never release the horse unless it's got somewhere safe to go. So for example, you know, you wouldn't be releasing a horse onto a busy road, where the horse can potentially be hit by, traffic. So that will be where the pre-planning, before you actually start the rescue is really important.

And then finally, for you and for other personnel working around the horse or horses, being in a, enclosed space, with a 600 kg horse that has, absolutely, no idea of what it's doing. And certainly, you're not going to get in its way, to avoid serious injury, it's really important that you make sure that you and personnel around you can get out safely and very quickly. So make sure you have your exit routes, well planned.

In terms of rescue techniques, I'll give you some organisations where you can get, further details of how to actually perform these. Unfortunately, in the UK, the, the animal rescue teams will have all this equipment to hand and they're very well trained in using it. But in countries or areas where you may be having to deal with, you and a farmer and some other members of the general public, it's critical to make sure that you don't use the head, legs, and tail routinely as attachment points, and ideally not using rope, because that can cause quite a lot of trauma and to the tissues and to the skin.

So what's most frequently utilised, and this is a fortunately, this is not a live horse as you can see, but this is an example of one of the mannequins, the rescue horses being extracted from a bog, and but demonstrating these . These, webbed, strops, these wide bits of webbing material, that are routinely used to, encircle the horse's thorax and hindquarters to get them out through a variety of different manoeuvres. And I said, the key mantra, as you can see, these people here is staying in that safer working zone and avoid the kicking zones and the headbutt zone.

So thinking about sedation or anaesthesia, if this is requested of you, what you need to know from the fire and rescue personnel is how long they think it's going to take, for them to do the preparation work, to extract a horse is that every situation is going to be different. Also knowing how awake the horse needs to be. So you may go from a situation where a horse may actually be able to get itself out if they're given a little bit of a helping hand, for example, a horse stuck in a canal, if they can find some way.

And for the horse to get itself high enough to then get itself onto the bank. So you wouldn't want a horse to sedated, but it can't help itself. But in other situations, it may be that having the horse completely anaesthetized is the only way.

And in many situations, your interests, in keeping the horse alive and reducing the, injuries or problems that you have to deal with afterwards is not having a horse that is anaesthetized for prolonged periods. So it may be that you keep the horse sedated until the key rescue points takes place, and then you perform a short general anaesthetic at that stage. It's useful to know how much stimulation the horse is going to have in terms of noise and movement around it.

And obviously, having done your initial assessment, knowing how compromised the patient is and making sure that, you know, the owner if present, or the agent of the horse again, if present, is aware of those additional risks. But I suppose being pragmatic about it, if you can't get a horse out, then Your only other option may have to be to euthanize the horse, or it may be that if a horse struggles and panics during the rescue, you may have converted a situation that was potentially survivable into a situation where there's no option option but to euthanize the horse. So in terms of sedation, just some key principles, and sedatives can be given by any roots, but the speed of onset will of course vary with intravenous being the most rapids, followed by in sorry, intramuscular, subcutaneous, followed by oral, which is usually sublingual administration.

And in situations where you're not giving in by intravenous, but you're having to go down the intramuscular routes, and then you do need to use higher doses compared to the intravenous routes. So, your plan will involve not just what level of sedation is required, but also how you're going to give that sedative. And talking to foreign rescue personnel, who are dealing with equine rescues and are communicating with veterinary surgeons on a regular basis for these rescues.

One of the key bits that is fed back to me a lot of times is that a particularly less experienced vets are much more likely to underdose horses, which, as I'll show you, just makes everything just a little bit difficult. So a key route, a key take home message is do not underdose a horse, particularly those that are have been otherwise fit and healthy, because they may look quite calm until they actually think that they're about to be freed, and then that can cause havoc. Use drugs that you're familiar with, you'll have a good idea then whether you are a big fan of remiphidine ordomidine and butrophenol or other combinations, you're much more able to gauge the level of sedation.

And it, you're obviously dealing with horses where you may not be able to fully appreciate the size of the horse. So you may not actually know the true body weight. So you just have to, to bear that in mind.

If at all possible, try and get intravenous access, getting a catheter placed, does make life a little bit easier, particularly if you're having to give multiple top-ups, and usually via the jugular vein. But you may have to be very creative and think about other routes of, venous access, and it may only be safe to do those once you've got a horse very heavily sedated, for example, accessing, cephalic or venous veins. And as with any sedative, it's really important to give enough time for the full effect of drugs to, be allowed to take effect, before you give any more and before you start stimulating the horse.

And as I said, just remembering that flight, fight or flight instincts and that, your horse may actually look quite calm, whereas, their, adrenaline level levels are actually quite. High, and these very highly stimulated horses, to get the same degree of level of sedation as a normal unstressed horse, you have to give much higher doses. So, always, on the overdosing rather than underdosing side, even when you're worried that a horse might be, slightly compromised, as I'll come on to you, you can always give reversal agents.

I've already, mentioned about intravenous access, and just being a little bit creative, depending on, what veins that you can actually get access to. So as in the horse in the picture here, you may even have to get creative with things like tail veins, but obviously, you've got a rather large, intramuscular area that you've got access to, and that may be the only route that's safely available. And talking to our anaesthetists, certainly super maximal doses may be your only chance to achieve proper sedation, and you've always got the ability to antagonise them if necessary.

I thought of Also just mention about remote injection poles, and there are other sort of homemade sort of injection lines that you can use as well in these situations so that you've got intramuscular access to give drugs whilst not being completely in the, in the danger zone. If you have got a situation where prolonged sedation is needed, then it is well worth considering using a continuous rate infusion. And I think many more vets are used to using these for doing standing surgical procedures.

But for those of you who haven't used them, I would certainly recommend that you have a go with them. They are, they, they, produces the graphs show a much sort of more stable the . A concentration of the sedatives, staying within that, therapeutic range and avoiding the sort of the swings, when horses go into deep sedation and then come very light and that sort of seesawing effect that you tend to get and, accumulation of the, of the agents, within, in the bloodstream as well.

And having a recipe to hand that you're used to using and you can make up quite quickly, whether you're a zylazine ordomidine infusion fan is something that is very useful to have with you in these situations. If you are worried about potentially having a compromised horse that you're worried about it staying really sedated after and you want to try and get the horse to come around quicker, then remember that with Alpha 2 agents, you can antagonise their effects, with Apamazole, and the, dosages, are given there. And, we've used that, to effect in, rescue situations where, sedation's been administered for a long period of time to try and get them up, much quicker, and it's very effective.

General anaesthesia. So this is the horse that I showed you in the very first slides, that, was sedated, up until the point where, metal, sort of, grinding equipment had to be placed right next to the horse to be able to fully, extricate it, at which point, general anaesthesia was induced. So you will often have a period of time where The preparation work has been made to enable you, if you don't have, for example, ketamine, with you in the car that you can get a, a colleague or another practise, to, to get that to the site.

And just having an extra pair of veterinary hands can be quite reassuring and and quite helpful, particularly if you're not used to doing field anaesthetics. Just make sure that you've got sufficient quantity of drugs. Obviously, the last thing that you want is a horse waking up, because, you know, they've only partially managed to do the job and then having a little bit of a problem on, on your hands.

So, having, having a backup there is really important. And if it's something that worries you, or you feel that you're not able to do, then certainly consider there's some, great anaesthesia courses out there, or just, getting out and doing some field general anesthesias as preparation. Once you've done a few, a few field anaesthetics, you will, in these.

Be confident enough to do it. And as I said, with some of these situations, it's either you give it a go, or the horse ends up having to be euthanized because it's just impractical to do anything else. So I think in a lot of these situations, you, you might not have anything to lose, but ideally, not the first general anaesthetic that you will have ever done.

So after the horse is freed, what do you do? And it may, become evident either during the rescue or, once the horse has completely been freed, that you may be dealing with something catastrophic. And that's where you have to keep up the communication with the rescue services and with the owner, when you identify these and explaining what your worries are, because obviously it may change the ongoing plan.

So once the horse is freed, it's trying to work out where's the safest place to perform ongoing assessments, and again, to make sure that you're performing assessments in a safe place, most areas of the horse are are accessible working, from, the safer working zone. So for some cases, after entrapment, no further treatment is required, and just dealing with minor injuries is, is just as you would, do for, for any other situation where an owner has called you out to look at a horse that they're worried about. Remembering that horses that may have been recumbent, or, may have been trapped in water, where, for example, there may be pieces of metal buried, just making sure, particularly if they're very hairy and covered in mud, that you don't miss subtle injuries, so making sure that you check them.

Eyes, checking for any lameness and any puncture wounds over synovial structures, and certainly making sure that people looking after that horse or pony or donkey, know what to be looking for, over the following few days and when to seek veterinary attention. And remember that, for example, horses that have been found stuck in a ditch, it may be that there's some underlying condition, for example, a horse that's been collicking violently, and that's the reason that they've become entrapped. So just being aware and ruling in or out something underlying that may actually have been the predisposing cause, cause for the horse, getting stuck somewhere.

So, some of the common problems that you might be dealing with are listed below. And I've put a little bit more information on the slides. I'm not going to talk you through in lots of detail through each of these slides because you can, you can see all the various medications that you need to give.

So instead, I'm just going to pick up the key features of each of these situations, to remember. Wounds will be dealing, you know, as for any horse that you're asked to attend to look at a wound that's been found by an owner, obviously in emergency situations, and this might even be something that you have to do before the rescue is undertaken, getting any haemorrhage under control. And then once the horse is freed, and doing your usual routine of fully assess.

Wounds with the prime aim to try and determine whether these wounds are superficial or whether you've got something more serious going on, and obviously then deciding how these wounds are best going to be managed. And knowledge of the local anatomy is absolutely critical, and, assessing each wound by wound, to determine whether, there's been any penetration into any body cavities, any, injuries to bones or tendons, synovial structures, or, any injuries, in the periocular region or to the eye themselves. And sometimes it's the larger wounds that sort of draw everyone's eyes and to them, but it may be the smaller wounds that's actually the more potentially life threatening.

Fractures, certainly where horses have been, stuck in, different positions and may have been involved in, you know, some form of impact. It's always a concern as to whether they have sustained a fracture to the limb. But as for making the decision, in general, to euthanize, it's making sure that you don't jump to any immediate conclusions, unless it's very obvious, for example, there's an obvious long bone fracture with a portion of bone sticking out of a limb, in which case, euthanasia may be the most appropriate immediate action to take.

But in other situations, it's often only once you've got the horse fully freed that you can assess whether it's weight bearing or not and have a really thorough assessment of that limb. And if you decide that the horse needs to be moved, for example, radiographs to be taken, and that you stabilise that limb to avoid, making a potentially savable, limb injury, and turn into something catastrophic, that requires euthanasia. So again, having bandaging material and, and splinting material as well.

You may be dealing with a horse that's been stuck for a while, maybe have been in there for a number of hours or potentially days, and, you know, you may be dealing with a horse that's very weak or exhausted, but it can be a little bit difficult to differentiate those sometimes with horses that have neurological deficits. So again, looking, see how shots, the animal, the horses and the vital parameters, if it's something pain related and getting analgesics and intravenous fluids on board. Hypothermia will be variable depending on location and the ambient temperatures, certainly in the UK apart from in the winter months, we probably wouldn't be dealing with many hypothermic, patients apart from those that may have been stuck in water for a period of time.

But obviously, people are working in other parts of the world where the ambient conditions may be much more extreme, may be dealing with these more frequently. So if the horse has just been freed from water, get it dry, try and get it somewhere warm out of a cold wind. If the horse, if you can't get it up and if it's recumbent, getting it off the ground to avoid losing heat from the horse into the cold ground and getting it covered with some blankets to stop ongoing heat loss.

And, in theory, you can administer warmed intravenous fluids, but that can be very impractical in field situations. So really just trying to get the horse warmed and somewhere, where you can provide a little bit of heat or at least stop, the cold, ambient conditions, sap even more heat from the patient's importance, and then trying to investigate, you know, what's actually going on with the horse and why it's still recumbent. Horses who've been freed in water may have had their heads submerged for variable periods of time and may have been potentially close to drowning.

So these horses, considering, you know, they're going to be dehydrated potentially, they may have aspirated pneumonia, and the effects of that may not be immediate. They would certainly be horses to consider broad spectrum antimicrobials to try and stop pneumonia or pluuritus developing. Remembering traumatic injuries, you know, frequently bits of wire hidden in, water, and it may be that once you've got the horse rescued, that you realise that some horse has got a nasty lower limb laceration.

And other things to consider, wounds and the fact that you the horse may have actually been in some quite contaminated water as well. And so you may need to take some steps to try and remove any contaminants in the water and protect yourself from these too. Hypothermia again, it depends on the ambient weather conditions, but, for example, on a hot day where a horse is trapped within a metal horse box, certainly the temperatures within can rise quickly.

So trying to keep these horses cool and then administering other medications is listed there, and certainly looking at reassessing their mentation, they'll often become brighter as their temperature, core temperature starts coming down. And repeatedly assessing their basic parameters is important. If the horse remains recumbent after you've freed it, then obviously you have to start running through some of the key differentials, more common differentials, and considering the nature of the injury, or possible underlying causes as to why the horse has been found recumbent.

And it is sometimes quite useful if there's nothing really obvious, just rolling the horse onto the other side, just to fully assess the previously downside, and in some cases, horses may then have enough power to actually get themselves back up and onto their feet. Myopathy, obviously where horses have been stuck for a period of several hours, would be common, and you'll all be fully aware of diagnosis of these and the common therapies as well. CNS trauma may be something that you're worried about.

If the horses had, you know, an impact or depending on the regions, of the world that you're in and potentially, other, sort of conditions that may cause horses to be recumbent. But just making sure that you've, done a full neurological assessment and, seeing how the horse responds to various therapies while you're attempting to get some more diagnostics, performed. Fire-related rescues may be something that you're called to, and again, some key principles there, getting rugs off that retain any heat, and being aware, try not to pull off material that may actually be physically stuck.

And most important thing that you can do is get cool. It shouldn't be ice cold. It should be around about 10 degrees C for at least 10 minutes, to try and reduce the, burn effects.

And remembering that actually it's not just the physical burns, but smoke, is smoke inhalation can cause major problems. So here is a list of all the medications and things that you might want to consider. Fire and rescue crews do carry oxygen, and they are, frequently, certainly in the UK, able to provide some oxygen that might be useful to supply to, horses and other animals that have inhaled smoke.

And just being aware that, you know, these could be anything from very minor superficial burns, that require just topical therapy and some of the things that you can treat these with are listed, certainly one of the critical. Things to remember is not to use any oil-based substances because they just continue the burning process. Analgesia is really important in being hygienic, and as to any bacterial loads developing at those sites.

But for horses that have sustained more severe burns that are either really deep or really extensive, or those horses that go into burn shock as a result of, for example, smoke inhalation. They are often ones that do need hospitalisation and it may take a long time to heal and that's where euthanasia may be indicated either on welfare or economic grounds. And I think one of the critical things for a number of equine rescues is really just determining at the onset or during rescue or following it is whether you're dealing with a viable horse or not, and whether euthanasia may be the only viable situation.

But as I said, sometimes those horses that you think are going to be non-viable may actually be less severely affected once you can completely get them freed. In the UK there are British Equi Veterinary Association guidelines for these, where horses are insured, and the non-insured cases, they at least give you some guidance. And I said, don't make any hasty decisions because euthanasia is something very final.

So if you're not sure, getting a second opinion, even if it's advice over the telephone is certainly better than nothing at all. And ideally getting written consent from the owner or agents is advised. if not then getting a suitable other person such as an attending police officer to authorise that.

And if there's any dispute as to whether that was appropriate, then certainly having photos or videos of the situation is often very helpful because sometimes when people actually see what you were dealing with, it's quite clear that euthanasia was really the only practical thing to do. You need to make an ongoing plan for the horse, and it's often a situation, particularly for horses in transit, that the horse may be away from its usual, premises, away from its usual veterinary practise. So trying to decide where you're going to assess and treat the horse, if There's any further tests that need to be done, and sending to a clinic with suitable facilities, depending on what level of ongoing assessment you think or hospitalisation is needed.

There's no point sending it to a clinic where the horse then needs to be sent on to another referral centre. And, discussing, what the plan is and what they should be looking for. And I think it's quite helpful to find out the horse's usual veterinary practise and veterinary surgeon, and to be able to communicate with them what you've done and provide a little bit of consistency.

Referral may be something that may be appropriate. So, again, getting a plan in place for how you're going to get the horse there, contacting the referral centre, you know, if you've got any questions or you're unsure, they will be more than happy to provide advice, and getting an idea of costs and prognosis as well, together with making sure that accurate directions are given and, and that the clinic and the person transporting the horse have got each other's contact numbers. So, that's a bit of a rattle through some of the principles of equine rescues, and they can be challenging, but they can be very rewarding when they go well.

They can also be quite difficult and you may be dealing with some fairly horrendous situations. So it's just a reminder and to, to sort of say to you, you know, don't be afraid to debrief with the rescue teams. They do that routinely after dealing with some, after any incidents, but, you know, particularly incidents where there may have been some quite traumatic, casualties to deal with both human and animals.

And making sure that you do speak to somebody if you found a a rescue situation upsetting, it can have quite an effect on, on the attending veterinary situation, veterinary surgeon. So, so don't, don't suffer in silence and seek help. Being prepared and knowing some basic principles is, is absolutely key in, in doing a good job, staying calm and professional and working alongside the other teams who are there to help you, and just remembering, you know, it's, it's never a bad thing if you're stuck or need some extra helping hands to make sure that you get some extra help there.

As I said, work with the rescue agencies, they're there to help you and get that common goal of getting the situation resolved, and communication is absolutely key. And just make sure you don't compromise your own safety or those of other people around you, and that euthanasia isn't always a failure. It may be the only humane and kindest option in some situations.

I just thought I'd, give a mention to Barta, the British Animal Rescue Trauma Care Association, who I've done some work with, an absolutely fantastic organisation, who run courses, and provide ongoing training. So if you haven't been one of the courses, I'd highly recommend it. For those of you in other parts of the world, for example, Australia and the USA, there's some fantastic organisations that are very active there.

And textbooks, there is a rescue little section in the equine emergencies handbook that I wrote, particularly to help people, for example, new graduates. And some multiple veterinary anaesthesia textbooks that give some really fairly practical, very basic, but very useful recipes for sedation, general anaesthesia, and continuous rate infusions that, if you're not sure, are well worth consulting. And thank you very, very much for listening to me, and I hope you found that helpful.