Case Description: A 5 year-old Thoroughbred racehorse presented for collapse during a race and subsequent respiratory distress and hypovolemic shock. Clinical Findings: The patient was in respiratory distress upon arrival, with severe tachypnea, nasal flair, and abdominal breathing. Lung sounds were absent dorsally and cardiac sounds were muffled. The patient's mucous membranes were purple and capillary refill time was prolonged. Radiographs revealed 4 rib fractures and a bilateral pneumothorax which was confirmed by ultrasound and revealed a bilateral hemothorax. Treatment and Outcome: Emergency bilateral thoracostomy tubes were placed to relieve pneumothorax, fluid resuscitation with colloids and crystalloids, and intranasal oxygen were instituted. The patient was hospitalized for 10 days with supportive care and serial monitoring. Six months later he was re-evaluated and deemed suitable to resume race training. Clinical Relevance: Respiratory emergencies are one of the most life threatening emergencies clinicians face. Knowing what tools to use to evaluate a patient in respiratory distress and what can be done to stabilize a hypoxemic patient is of utmost importance. Additionally, this case Case Description: A 5 year-old Thoroughbred racehorse presented for collapse during a race and subsequent respiratory distress and hypovolemic shock. Clinical Findings: The patient was in respiratory distress upon anival, with severe tachypnea, nasal flair, and abdominal breathing. Lung sounds were absent dorsally and cardiac sounds were muffled. The patient's mucous membranes were plll'ple and capillary refill time was prolonged. Radiographs revealed 4 rib fractures and a bilateral pneumothorax which was confitmed by ultrasound and revealed a bilateral hemothorax. Treatment and Outcome: Emergency bilateral thoracostomy tubes were placed to relieve pneumothorax, fluid resuscitation with colloids and crystalloids, and intranasal oxygen were instituted. The patient was hospitalized for 10 days with supp01iive care and serial monitoring. Six months later he was re-evaluated and deemed suitable to resume race training. Clinical Relevance: Respiratory emergencies are one of the most life threatening emergencies clinicians face. Knowing what tools to use to evaluate a patient in respiratory distress and what can be done to stabilize a hypoxemic patient is of utmost importance. Additionally, this case report discusses key stall side blood values that can be used to monitor hospitalized patients. discusses key stall side blood values that can be used to monitor hospitalized patients.