Always at least some minimum form of restraint required.

Minimum restraint required: halter and lead rope

A PE should never be attempted without a halter and lead rope in place with someone holding the horse. Never wrap lead around your hand, arm or any other body part Never tie a horse unless you know it is accustomed to being tied.

The general examination should start with the observation of the horse from a distance in order to detect abnormalities that might be obscured by handling and restraint. Horses' stance and general behavior in the stall will reflect their general mentation, which is frequently affected by systemic illness, neurologic disease, and pain in various organs (P). The respiratory rate and effort should be noted prior to handling, as well as a general evaluation of body condition (P).

Examining the horse from nose to tail along the left side and then tail to nose along the right side is one way of ensuring a complete general examination.

Again, there are no strict rules regarding the proper physical examination procedures. It is recommended that a consistent approach be adopted. The mucous membranes are first examined by raising the upper lip as shown.

Mucous membranes are examined for moistness, icterus, hyperemia, cyanosis, pallor, ulceration, and petechia. Capillary refill time is also evaluated at this time by blanching the mucous membranes.

The retropharyngeal lymph nodes are not readily palpated in the normal animal but may be if enlarged. The facial artery is palpated at the ventral aspect of the mandible.

The thyroid gland is frequently palpable in older horses and should not be confused for a lymph node . The left jugular vein is then occluded and palpated to evaluate jugular fill and to examine for thrombophlebitis.

The heart is then ausculted in three locations on the left cranial ventral thorax: over the pulmonic, aortic, and mitral valves. The normal resting heart rate of the horse is 28-42 BPM. The hand is then run down the forelimb to evaluate temperature of the distal extremities if cardiovascular shock is a concern and also to palpate temperature of the hoof and evaluate digital pulses if laminitis is a concern.

A discussion of auscultation of the thorax and abdomen is included in the focused examination of the respiratory and gastrointestinal tracts respectively. The inguinal area is then carefully palpated to evaluate testicles in stallions, scrotal remnants in geldings, and the mammary gland in mares. The distal hind limbs are visually inspected for joint effusion or distal limb edema. If edema is present, it should be determined if it is warm or painful to palpation. The tail is then carefully raised from the side and a thermometer is inserted in the rectum, noticing tail tone and anal reflexes.

temperature

Sign Temperature Heart rate Respiratory rate Mucous membranes Capillary refill time

Normal 99.5 F to 101.5 F 30-45 bpm 8-20 breaths per minute Pink 1-2 seconds
o o

Temp. - Pyrexia Anorexia Dehydration Behavior Change Tears Diarrhea, constipation

Most resting horses have rectal temperatures of 98.0-101.5 F.

Examination is then continued on the left side for visual inspection of the integument and auscultation of the abdomen and thorax, as noted in the focused physical examination.
In the general examination, the right side of the heart is then ausculted, the right jugular vein is occluded, and the right side of the head and neck are visually examined. As one can see, this general physical examination can be easily performed in just a few minutes, yet it can provide important information that would otherwise be easily missed.

Collect blood

Although blood of horses is usually collected from a jugular vein, alternate veins for collecting blood include the transverse facial vein, cephalic vein, and the lateral thoracic vein

Some horses have prominent lateral thoracic veins, especially draft horses , but for many horses this vein is difficult to find. Blood can be safely collected from the saphenous vein in recumbent foals or anesthetized horses.

Indications To collect blood from horses with thrombosis of one or both jugular veins To avoid excessive venipuncture of the jugular veins of horses prone to venous thrombosis (e.g., horses with colitis)

Materials Alcohol and cotton for site preparation When only a packed cell volume (PCV) is needed, materials include a 25-ga, 5/8- in (0.5 x 16 mm) needle, sealing clay, and a heparinized microhematocrit tube.

When larger quantities of blood are needed, materials include a 20-ga x 1.5-in (0.9- x 38mm) needle, a 10- or 20-mL syringe, and EDTA and plain glass tubes. Blood can also be collected directly into blood collection tubes using a blood collection needle.

Procedure A needle is inserted through skin, below the facial crest, on or rostral to a line perpendicular to the facial crest drawn from the medial canthus of the eye. To obtain only enough blood for a PCV, a small gauge needle such as a 25-ga, 5/8-in (0.5- x 16-mm) needle is inserted until the hub fills with blood. Then, the end of a microhematocrit tube is placed into the needle hub and allowed to fill by capillary action (Fig. 5.4). Or:

A 20-ga needle with a syringe attached is inserted below the facial crest near a line perpendicular to the facial crest drawn from the medial canthus of the eye until the point of the needle strikes bone, the plunger of the syringe is gently retracted, as the needle is slowly withdrawn, until the syringe begins to fill with blood

Complications Some horses become head shy after the procedure has been performed numerous times. Hair loss over the site of venipuncture may occur, possibly from skin irritation from repeated application of alcohol. A transient hematoma at the venipuncture site (rare) Facial nerve paresis has been reported, but placement of the needle distal to the recommended site of venipuncture was the suspected cause. The facial nerve lies about 2-cm below the recommended site of venipuncture.

Clinical Pathology - Normal Values Clinical Chemistry Normal Values for Horses ALB2.5 - 4.2 g/dLALKP109 - 315 U/LALT3 - 25 U/LAMYL< 30 U/LAST205 - 555 U/LBUN8 -27 mg/dLCa10.7 - 13.4 mg/dLIonized Ca 50 - 60 % of total CaCHOL51 - 109 mg/dLCk90 565 U / LCl 94 - 102 mmol/LCO2 24 - 31 mmol/LCREA0.6 -1.8 mg/dLGGT12 - 45 U/LGLU72 -114 mg/dLK 2.7 - 4.9 mmol/LLDH520 - 1480 U/LLIPA460 - 870 U/LMg1.6 - 2.5 mg/dLNa132 -141 mmol/LPHOS1.9 - 5.4 mg/dLTBIL0.1 - 1.9 mg/dLTP 4.6 - 6.9 g/dLTRIG11 - 59 mg/dLURIC< 0.5 mg/dL

Hematology Normal Values for Horses WBC5,500- 12,500 /cubic mmPlatelets100,000-600,000 /cubic mmSegmented Neutrophil 2700 - 6700/cubic mm or 30 - 65%RBC6,500,000-12,500,000 /cubic mmBands0-100 /cubic mm or 0-2%MCV34-58 flLymphocyte1500-5500 / cubic mm or 25-70%Hemoglobin11 -19 g/dLMonocyte0 - 800 /cubic mm or 0.5 -7%PCV32 - 52 %Eosinophil0- 925 / cubic mm or 0 -11%ACL Fibrinogen 150 - 375 mg/ dLBasophil0-170 / cubic mm or 0-3%Fibrinogen (Miller) 200 - 450 mg/dL