The immediate implementation of systemic medical treatment in a horse with an injury to the CNS is critical for a favorable outcome, especially in a recumbent patient. Prolonged periods of recumbency are a significant sign for a poor prognosis. A recumbent patient is lifted, preferably with a rescue sling designed for this purpose. However, if the horse is unable to support its own weight, it is placed back in lateral recumbency. Shock therapy is aimed at hemostasis and stabilization of respiration and the circulatory system. Intravenous fluids prevent a drop in blood pressure. Recumbent patients are placed on soft bedding and rolled to the other side every 4 to 6 hours to prevent muscle necrosis and damage to peripheral nerves. A protective headgear is applied to prevent soft tissue injuries. The patient’s respiratory, cardiovascular and intestinal function and the passing of manure and urine is monitored continuously.
The primary goal of drug therapy is the prevention and treatment of cerebral edema and the associated increased intracranial pressure. Dexamethasone, Mannitol, DMSO, intravenous fluids and Nonsteroidal anti-inflammatory drugs may be used. Broad-spectrum antibiotics are indicated in confirmed or suspected (hemorrhage from ears or nares) open fractures.