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What is Traumatic Brain Injury?

A traumatic brain injury, also known as a TBI, can occur at any life stage of a horse and from many different causes.  Whether it is from running into a tree or getting kicked by another horse, you will need to consult with your veterinarian.  Diagnostic images will be taken in order to properly diagnose the TBI and will determine the course of treatment.  If your horse remains upright and standing, prognosis of a recovery is good.  However, if your horse is in lateral recumbency and remains that way for four days or longer, his prognosis is very guarded to poor.

A traumatic brain injury can be some type of skull fracture or soft tissue damage to the brain.  You should contact your veterinarian if you believe your horse has suffered an injury so treatment can be started immediately.

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Symptoms of Traumatic Brain Injury in Horses

Symptoms can vary depending on the severity of the trauma.  Symptoms may include:

  • Depression
  • Altered gait
  • Ataxia
  • Nystagmus
  • Abnormal pupil size
  • Abnormal pupillary light reflex
  • Abnormal mentation
  • Head tilt
  • Lateral recumbency 
  • Epistaxis 
  • Dysphagia
  • Facial-nerve paralysis
  • Blindness
  • Seizures
  • Unconsciousness 

Types

A traumatic brain injury can be an actual fracture type injury or it can be a soft tissue injury.  Obviously if the skull is fractured in some way or form, the injury would be considered obvious and treatment would be focused on it.  When in cases of soft tissue injury, you may not notice the symptoms at first.  Some TBIs can cause subtle symptoms of only depression or a slightly altered gait causing it to be misdiagnosed or completely missed entirely.  In this case, the main thing you can do for your horse is offer him supportive therapies and keep him quiet while his body heals.

Causes of Traumatic Brain Injury in Horses

Traumatic brain injuries can occur in many ways.  This condition is seen most commonly in younger horses during halter training.  It is common for them to rear and fall over during this training causing injury to the poll.  Another cause could be if he struggles while in an entrapment of stall.  

While it may be more common to see in young horses, it can occur at any age.  More frequent causes of TBI in older horses include running into something, such as a tree, struggling during recovery from anesthesia, or being kicked by another horse.  For racehorses, falls or accidents can also lead to a TBI.

Diagnosis of Traumatic Brain Injury in Horses

Diagnosing a brain injury in your horse is all about imaging.  The veterinarian will perform her physical exam, check him out entirely and may suspect a fracture, but she may not be able to give a definite diagnosis without imaging confirmation.  Radiographs are typically the first type of imaging to be utilized.  In many cases, it can clearly show the break or fracture.  However, depending on the location of the injury, a different type of imaging may be needed.  Computed tomography, also known as a CT, is another form of imaging that can give a more thorough description of the injury.  In some cases, the veterinarian can even use rhinoscopy as a form of imaging.  She would put the scope up your horse’s nasal cavity to check for injury. 

She may also use an MRI image to check for soft tissue injury to the brain.  Many people do not realize a traumatic brain injury can occur with or without the presence of a skull fracture.

The veterinarian will also want to run blood work and collect cerebrospinal fluid for diagnostics.  The spinal fluid can be tested to evaluate for nerve damage.  The blood work will consist of a chemistry panel, complete blood count, and packed cell volume.  The results will indicate if there is anemia from blood loss, if there is an ongoing infection, and just how the body is handling the trauma overall. 

The veterinarian may also conduct other neurological tests to check for nerve damage.  Depending on her findings of all the diagnostic tests, she may perform other tests as she sees fit.

Treatment of Traumatic Brain Injury in Horses

Treatment of a TBI is mainly supportive.  Ensuring your horse continues to eat and drink is very important.  Also, the veterinarian will offer medications to combat inflammation and control seizures, anti-microbial medications to fight infection, and possible surgical decompression.  

Horses that are in lateral recumbency may need more supportive therapies than those who are able to remain standing.  They require more labor intensive care that can be challenging and oftentimes unsuccessful.  When the horse is in lateral recumbency, he isn’t able to eat as much, drink as much, and is at risk for developing a decubital ulcer, pneumonia, cystitis, GI-tract dysfunction and more.

Recovery of Traumatic Brain Injury in Horses

There are many factors that play a role in the recovery of your horse after suffering a TBI.  The severity of the fracture and how he responds to treatment are important factors.  However, the main factor affecting prognosis of recovery is how long he stays in lateral recumbency.  The longer he is down, the more guarded his prognosis becomes.  Even if your horse has experienced an intense fracture, if he is still standing, his prognosis is still considered good.