Horses are part of an ever growing industry, with over 600,000 horses in the UK, 1.4 million riders and 5 million people with an active interest in the equine industry*. Most people acquire a horse out of choice, so if you make this decision you should think carefully before going ahead. A horse needs lots of love and care, including regular worming, vaccinations and dental care. Owning a horse is time consuming and can be costly; not only will you will need to consider where you will keep your horse, you must also consider the ongoing costs of owning a horse which include accommodation, bedding, feed and healthcare.

In the unlikely event that your horse goes missing it is going to be very difficult for anyone to know who it belongs to, unless your horse carries some form of permanent identification. It is wise to get your horse microchipped or freezemarked, this will avoid heartache in the long run, should your horse go missing or is stolen.

Horses are herd animals, and thrive on being together with other horses. Don’t forget that your horse will need somewhere to graze, a stable for warmth in the winter time, a constant supply of water, feeding daily and regular exercise. It can cost hundreds of pounds a month to care for a horse, including accommodation, food, veterinary care and insurance; there will be other costs, including buying tack and rugs and extra livery charges when you go on holiday.

Horses can live into their thirties, over this time your horse will need lots of care and attention. Being able to provide all of this will ensure you and your horse make the most of your time together.

* Research conducted in 2004 by the Henley Centre for DEFRA and the British Horse Industry Confederation.

Chest trauma

Luckily, thoracic injuries are relatively uncommon in horses, however, if untreated these injuries can be life threatening. If your horse experiences blunt trauma to the chest such as in a road traffic accident, is kicked or falls at a fence, or has a penetrating chest wound or laceration to the pectoral or axillary region (by the elbow), then this should be classed as an emergency and you should seek veterinary attention as soon as possible. 

Why should chest trauma be deemed as an emergency?

Depending on the type of trauma and the location in which the trauma occurred the following complications should be considered:

If there is a wound… 

  • How deep is the wound? Could the wound have penetrated the chest cavity causing pneumothorax (air within the chest outside of the lungs), or has it perforated any important arteries or veins causing haemothorax (bleeding within the chest)?
  • Deep open wounds can cause air to be sucked in resulting in subcutaneous emphysema, an accumulation of air under the skin.
  • Are there any unseen draining tracts?
  • Could there be foreign material present?
  • If there has been a penetration could there be a secondary infection within the chest?

If there is no visible wound… 

  • If the chest has been crushed and there are several fractured ribs in one area, the multiple fractures may cause a condition known as Flail Chest. This condition makes it difficult for the horse to breath.
  • Displaced fractured ribs can lacerate the pulmonary lining or perforate the heart or larger veins or arteries found in the chest cavity leading to a haemothorax.
  • Haemothorax may develop which is bleeding within the pleural cavity (the area between the chest wall and the lungs). This can compress the lungs making it difficult to breath as well as reducing the amount of blood available to circulate oxygen.
  • Pneumothorax may develop, an accumulation of air in the pleural cavity. This can also compress the lungs as often there will be a one-way leak of air into the chest cavity.
  • A diaphragmatic hernia may occur (a tear in the diaphragm) allowing abdominal structures such as the intestine to enter the chest cavity.

What clinical signs are common?

Common clinical signs include signs of shock and respiratory distress. 

Flared nostrils, difficulty breathing, increased respiratory rate and accentuated respiratory excursions (movement of the ribs) are all signs of respiratory distress. Pale, blue or grey mucous membranes may suggest a circulatory problem and a horse with a diaphragmatic hernia will develop colic.

What type of diagnostics and treatment should I expect?

The veterinary surgeon will need to take a full history and perform a full clinical exam of the horse. During the initial examination the vet will auscultate (listen) to the chest as both haemothorax and pneumothorax will alter the respiratory sounds. They will also palpate the ribs for any evidence of a fracture. Radiography and ultrasound may be suggested. Radiography helps detect pneumothorax, fractured ribs and foreign objects within a wound, and ultrasound helps detect the accumulation of abnormal fluid within the pleural cavity. If the trauma was close to the throat, endoscopy may be suggested to rule out any damage to the trachea or oesophagus.

Treatment depends on the location and specific complications displayed by the horse. Tension pneumothorax is an emergency and requires immediate care to relieve the pressure in the chest. Haemothorax patients may require intravenous fluids or a blood transfusion. Rib fractures and diaphragmatic hernias may require surgery. General wound management will be necessary for the treatment of any lacerations or penetrating wounds and many require surgery, lavage and drains placed. Box rest will be necessary to prevent subcutaneous emphysema.

What is the prognosis?

Most chest trauma that does not develop severe complications have a favourable outcome, even though large wounds sometimes form unpleasant scar tissue. If complications occur the prognosis is more guarded, and it is therefore advised to seek veterinary assistance immediately if chest trauma is suspected.