Field Surgery
Equine ambulatory practice
The majority of horses are treated on the farm by a veterinarian. This means the vet brings supplies with them and that animals are basically treated on an outpatient basis in their “homes” (aka stalls, pastures, fields, pens). A few will be treated in a local “haul-in” clinic after being taken to a clinic by the owner. Even fewer will be trailered to a referral center such as the UMN or a private practice referral equine clinic.
Horse facilities range from paddock only (potentially without running water or electricity) to heated barns with living quarters for humans included. Veterinary work areas may be pastures/lots, stalls, arenas, front yards or other open spaces. Other horses are often in or near the space (and are quite frequently talkative while you are trying to sedate or anesthetize their buddy.) Some barns may not have the wiring to support high powered radiograph machines. Internet access is typically spotty. Clients (and their friends and relations) are often in attendance.
This leads to a quite different environment than a small animal practice in which pets are typically removed from the client’s view for simple procedures such as blood and urine collection, not to mention surgery. While a few small animal vets do house calls, many use a mobile truck that can be the site of procedures and can get animals out of the home and the owner’s arms. The closest model in the small animal world is probably in home visits for euthanasia.
Most barns are equipped with halters, lead ropes, and basic bandaging supplies. The veterinarian is expected to bring the rest of the necessary equipment and drugs to the farm in the practice vehicle. The vehicle is often a truck with an insert that holds bottles and equipment. The insert generally has a small refrigerated compartment and a lock box for controlled drugs. Alternatives include various SUVs or large cars with similar inserts. Regardless, space is limited, particularly since large patients need larger volumes of drugs, fluids, and bigger supplies in general. Equipment such as ultrasounds and radiograph units may also be shared among trucks and vets in the practice. Having a good history or best guess can make packing the truck most effective.
Horse owners are often involved in the calming of their horses and even the cleaning and bandaging of wounds while waiting for the veterinarian to arrive. Legally, it is best to not rely on the horse owner for handling; however, it is often necessary, particularly with emergency calls. Not all clients are able to handle the gore and excitement that can be associated with equine practice; the equine veterinarian also has to manage the safety and expectations of owners and bystanders. The lucky veterinarian brings an experienced technician or veterinary student along as an assistant.
Veterinarians will typically visit a barn or stable twice yearly at a minimum for spring and fall vaccines, dental care, and other preventive medicine steps. Many barns are visited monthly for various treatments (particularly for lameness conditions). However, with horses being horses and accident prone, visits tend to be fairly regular and frequent.
Farriers are often on the premises at least as frequently and often have a closer relationship with the horse owners. Lay specialists may be involved in dental care, chiropractic and massage therapy. Legislation varies by state; most states require these practitioners to work closely with a veterinarian.