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Re: [RC] More Regional Differences? - John Teeter

> Question for the vets:
>
> a} How much fluids do you bring to a ride?
> b) How much fluids do you usually use?
==
a) is pretty much answered in the AERC Vet Handbook. It doesn't take long to read it and it provides a good insight into many of the issues involved.


b) would be interesting to know and should be included in the post ride vet report (aka the old post ride statistical report info merged into the final report the head vet sends in.) Is it?

Possibly truman's antidote occurred prior to the information being published by AERC?

johnt

]======================
http://www.aerc.org/Vets_Handbook.asp
This is not new territory:

From the AERC Vet handbook:

"...1. IV fluids: 40 - 100 liters, non-alkalizing (ie Ringers preferably or Physiological Saline), and more if a large number of horses are expected. Rule of thumb is to have on hand about 200-300 liters of non-alkalinizing intravenous fluids for 60 horses. More may be needed at high caliber championship events. (Sodium bicarbonate solutions are almost uniformly contraindicated for the metabolic problems of endurance horses). ....

Part of:

"...Suggested List of Medications
1. IV fluids: 40 - 100 liters, non-alkalizing (ie Ringers preferably or Physiological Saline), and more if a large number of horses are expected. Rule of thumb is to have on hand about 200-300 liters of non-alkalinizing intravenous fluids for 60 horses. More may be needed at high caliber championship events. (Sodium bicarbonate solutions are almost uniformly contraindicated for the metabolic problems of endurance horses).
2. Oral electrolytes
3. CMPK or calcium gluconate (dairy milk fever preparation)
4. Potassium chloride (individual vials containing 20- 40 mEq/ml)
5. 50% Dextrose solutions for IV and/or oral use
6. DMSO liquid for IV and/or oral use
7. Magnalax powder for oral supplementation
8. NSAIDS (Phenylbutazone, Banamine, etc)
9. Sedatives and Tranquilizers - Xylazine, Detomidine, Butorphanol, Acepromazine
10. Dopamine
11. Dantrolene capsules
12. Ophthalmic medications
13. Wound supplies - Antibiotic ointment, bandaging materials, local anesthetic
14. Euthanasia solution
...."


With table of contents:

"Table Of Contents

INTRODUCTION

AERC RULES

VETERINARY GUIDELINES
I. Qualifications
II. Equipment
Ill. Duties

VETERINARY JUDGING AND SAFETY
A. Control
B. Treatment
C. "Judge and Jury"
D. Special Awards
IV. Agreements
A. Head Veterinary Judge
B. Associate Veterinary Judge
C. Treatment Veterinarian
D. Combined Service as Judge or Treatment
V. Preparation
VI. Pre-Ride Veterinary Examination

LAMENESS
VII. Rider Briefing
VIll. Records and Recording
IX. Control
A. Entering the veterinary check:
B. Spot checks:
C. Principles:
D. Criteria
E. Completion Examination:
F. Best Condition Examination
G. Post-Ride Courtesy and Safety Check
H. Ride De-Briefing, Critique and Reports
I. Post-Ride Veterinarian Report

AERC DRUG RULE POLICY

SUGGESTED EQUIPMENT AND MEDICATIONS
Suggested List of Veterinary Equipment
Suggested List of Medications

TREATMENT PRINCIPLES FOR METABOLIC CONDITIONS IN DISTANCE HORSES
Recognition of the Exhausted Horse
Assessment of Hydration
Intravenous Fluid Therapy
Intravenous Electrolyte and Energy Supplementation
Diuretics
Oral Fluid Supplementation
Intestinal Stimulants
Medications for Pain Relief
Rhabdomyolysis and Myositis
Development of Hyperthermia
Laminitis Prevention

APPENDIXES
A. AERC Head Veterinarian's Post-Ride Statistical Report
B. Best Condition Judging Form
C. Rider Card
D. Sample Veterinarian Flow Chart
"

=======================


At 10:22 AM 9/23/2003, you wrote: Truman said:

> Several years ago at one of my rides I used my own vet
> as the treatment vet. She was a good vet and had vetted
> one endurance ride prior but had little experience in what
> to expect at a ride. Of course she didn't bring enough
> fluids...

I must confess to being startled by this statement,
especially the "of course" part.  Since for me, there is no
"of course" about it.  Certainly, if I were managing an
endurance ride and were using a treatment vet that didn't
already have experience with the sport and they asked me if
there were anythings that they ought to bring, I would tell
them that they ought to bring more than their stock supply
of IV fluids "just in case."

However, I would be very surprised if, even if I hadn't done
so, that the vet would use up his normal supply.  I just
don't see all that many horses being treated with IV fluids
at the rides I go to, so unless they are a bunch of horses
hiding behind trailers that are being given fluids that I
don't know about, the chances of running out of fluids in
these parts is about as rare as hens teeth.

So, am I living in a fantasy land and am just unaware of the
horses being treated at the endurance rides I go to; or this
another one of those "regional differences" in which horses
in the SE (and the other regions that I don't ride in) are
being treated with way more fluids than those out here?

Question for the vets:

a) How much fluids do you bring to a ride?
b) How much fluids do you usually use?

and

c) How much fluids do you give to the horse before you say
"this is enough for the horse to recover on its own?" or
alternatively "This horse needs way more but I have given it
enough for the horse to be sufficiently stable to transport
to a facility that is better equiped to deal with such a
compromised horse?"

It seems to me that if the UF is close enough to go pick up
more fluids, that it is also close enough to take horses
that need that much fluids (a place, I might add, that they
are more likely to have all the facilities needed to best
determine exactly what the horse needs, which may not be
just fluids).

Maybe it is the trained EMT in me ("stablize and transport")
that says that treatment vets at endurance rides are not
supposed to "fix" the problems that horses might encounter
at a ride, they just need to be able to stabilize them well
enough so that they can be taken off-site (which may be
home, but is probably the hospital if the condition is
serious enough) where they can be treated properly in order
to properly recover.

Am I missing something here?  The last thing in the world
that I would expect a treatment vet to run out of at an
endurance ride is IV fluids, my home vet carries enough
fluids around with him on a regular basis (just for the
things that he might encounter in the field treating horses
that never leave home) that he would have enough with him to
have treated every horse that I have ever seen treated with
IV fluids at an endurance ride.

And yet Truman says "Of course, she didn't bring enough
fluids."

kat
Orange County, Calif.



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Replies
[RC] More Regional Differences?, k s swigart