Sunday, May 15, 2005
Friday, May 13, 2005
A study in contrasts
We then left to do some farm calls. Nikki and I stopped first at a place with a down horse--never a good prospect. When we got there, she thought the horse was probably colicking, but as we got closer, we could smell the thrush in his feet and saw how long his hooves were. Nikki gave "Tension" some painkillers, and we got the horse on his feet. His back end was so wobbly that at first I thought maybe it was some kind of neurological problem, but then he steadied himself. His breathing was labored (generally, horses can't lay down for long without some respiratory distress), and he was clearly painful on four feet. Nikki diagnosed founder, Rx'd nitroglycerine, bute paste, acepromazine. The prognosis for this old guy did not look good, and the owners seemed pretty clueless about what they had on their hands: a serious, probably preventable problem that would keep this horse in agony for a while and likely end in putting him down. Again, I was wondering, "At what point do you stop being the nice guy and tell people off?" Nikki was thinking that it was better to get the horse treated, relieve his suffering as much as possible, and then attempt to educate the owners later. I don't know if I'd have the patience, but I can see the wisdom in her position.
We left there and headed out to a GORGEOUS place where they keep about 70 horses in both turnout and in stalls. It's a western-style operation with a legit cowboy and several different ways of training and riding going on. We vaccinated several horses and drew blood, ultrasounded (1 definite and 1 possible pregnancy, plus rechecked a fellow who had a vertebral fracture that was healing nicely), and did a pre-purchase exam on a really cute 4-year-old Appaloosa gelding. He had wonderful ground manners and passed his flexion tests (which check for lameness) with flying colors. He was sweet and dead quiet under saddle as the daughter of the owners rode him with just a halter. Tell you what: I'd buy him. :-)
I've posted a picture of the place on this blog. That's it for this Friday.
Oh, incidentally, I didn't write about the last Friday when I volunteered, which was a really l-o-n-g day (I got home around 9:30), mainly because we spent close to five hours with a draft horse, "Jill," who had mysterious edema all along her underside. To make a long story short, the owners had declined to refer her earlier in her illness, but when Nikki told them that the horse was suffering and it was probably time to let her go--in addition to even greater swelling than she had ever shown before, now she had labored breathing and an elevated heart rate, was sweaty and pawing, and even the painkillers weren't lessening her distress--THEN they decided to refer her. So Nikki made the arrangements, and we left them with the plan of trailering the mare to the specialist. I learned today that Jill died in the trailer. Good Lord, what a way to go. This was an intensely frustrating case. Could she have been helped by seeing a specialist sooner? Wouldn't she have had a more peaceful death if she'd been euthanized in her own stall? Couldn't they have saved her a lot of pain? It's becoming increasingly clear that one of the most challenging parts of being a vet for me would be the owners.
Monday, April 25, 2005
This gives you a good look at the filly we visited on 4/22/05, and a clear view of how tiny she is. For the vet to examine her, I cradled her in my arms, one arm around her chest, and the other around her back end, and I'd say she was at most four feet from chest to tail. The photo was taken a day after she was foaled.
Friday, April 22, 2005
"Gee, We Didn't Know She Was in Foal"
Our first visit was to see a horse with a swollen eyelid. A big bay TB not long off the track, "Derby" isn't fond of having humans touch his head under the best of circumstances, much less when he's in pain. So C. J. brought out the sedation and painkiller/anti-inflammatory, some Rompun (Xylozene) and Banamine, injected IV. It took all three of us (owner, vet and me) to restrain him so C. J. could put some dye in his eye and examine him. It turned out he had an ulcerated cornea, basically a puncture wound in his eyeball. C. J. recommended he be admitted to Westwood, where we could treat him further. The owner was visibly upset about the possibility of this horse losing its eye and concerned about cost, but agreed to get Derby over to the clinic for treatment.
We went from there to a farm for routine innoculations. Nothing terribly exciting to report about that, except that there was this funny little cat who, when I reached down to scratch him on the head, ran up my arm onto my back. :-)
Next we visited a farm for more vaccines and some dental work. This would have been equally routine, except that C. J. needed to extract some wolf teeth from a 2-year-old mare. Last week, I'd seen them pulled while a horse was out of it--anaesthetized for castration--but for this young mare (who obviously wasn't being castrated, too), C. J. sedated her and got to work. The teeth were exceptionally small, maybe the same height as this H, but had deep roots. It took about 45 minutes to extract just one. After the mare was done, a couple of other horses needed floating (rasping the teeth to take sharp points off them, which are created because the horse chews side to side, as well as up and down).
We went on to visit a day-old filly and her 21-year-old mama. (See pictures posted Monday, 4/25.) The mare had been living away from home for a number of months, where she'd been bred. But then the fellow who was caring for her decided that she wasn't pregnant (based on what, I don't know) and stopped giving her grain and put her in poor pasture. The mare got incredibly skinny, even by non-pregnant standards. But a few days after she came home (the owners were shocked at her appearance), suddenly there was a foal on the ground, weak and struggling because the mare had no milk and had been so malnourished. Luckily, the foal was found right away and the vet was called. We were there the day after to check and see how both of them were doing. All looked good. The mare had been given Domperidone (a milk stimulant), and was starting to produce, plus she was very interested in the foal, so they weren't going to have any problems with rejection. The filly was nursing and taking a bottle. C. J. left them with instructions for continued feeding of the filly and care of the mare.
Next: more vaccinations at a farm where the owner was toying with the idea of leaving a young colt intact because his neighbor had said that he was looking for a cheap stud fee to breed some grade horses. C. J. was diplomatic but reminded the fellow that stallions are a handful and can be dangerous, and did he really want to have one on his property when he's got kids? He had been talking about selling the colt's dam because she is mouthy. Hello!
We went back to the hospital to check on Derby and treat his eye. When we arrived, I did a double-take because I couldn't believe it was the same horse. The banamine had really done its job, and the swelling was almost gone in the upper eyelid and Derby was holding his eye open fairly normally. C. J. got some ointments and was able to get them in the eye without too much hassle--much less of a challenge than we would have expected because the horse had been so difficult even under sedation earlier. (Amazing what dramatic difference you get when you relieve the pain.) C. J. was hopeful that she wouldn't have to put in a sub-palpebral lavage (a tubing system that seats under the eyelid with a little "foot" so that the eye can be washed without actually touching the eye with your hands)--a useful device for horses that are head-shy, but probably complicated with this guy, whose ulcer was at the top of the cornea and would necessitate the "foot" sitting under the lower lid. Meanwhile, we found out that the horse's owner had called several times to find out how he was doing, so I'm sure it was a relief to her when C. J. called to tell her about his progress.
We finished up visiting a halter-class champion Chestnut QH--such a handsome fellow with a big white blaze and beautiful coppery coat--who had come up lame. When C. J. pressed the hoof with her testers, a little liquid oozed: definitive sign of an abscess. So she soaked the hoof in warm water to draw out the infection, then applied an ichthamol bandage to both the bottom of the hoof, where she'd found the break, as well as one at the coronary band, where there was some inflamation and she expected the abscess to break, as well. That done, we were on our way home.
Incidentally, I have been toying with the idea of doing a correspondence course in veterinary technology so that I can be more helpful during volunteer work, plus dip my toe into the waters of science study. I had received some info from PCHI (Professional Career Development Institute) and asked C. J. if she had an opinion about this type of school. I don't want to waste my time or money on something that won't actually result in useful knowledge. She was unsure ... she said a colleague of hers doesn't think much of this type of set-up, but I'm going to do some checking around.
Friday, April 15, 2005
Right after that, I watched Dr. Wise and Jason (student vet) do a castration on a yearling colt. They put the horse under with a sedative plus anaesthetic (Ketamine). You know the sedative is taking hold when the horse drops his penis and start hanging his head low with a loose lower lip. Then the Ketamine starts doing the trick, and the horse gets wobbly and starts to buckle. Sometimes they drop hard, and sometimes they just fold down to the ground. After the horse is down, you protect his head with a towel under it and cover the exposed eye. A rope goes around the top leg (the horse is on his side), and you pull the bottom of the horse onto his back so that he's spread-eagle, kind of like a woman getting a gyno exam. (Alternately, that top leg is brought straight up toward his head, but neither of the castrations I saw was done that way.) The vet extrudes the testicle so that the skin is taut, then makes a verticle incision through the skin, then another through the scrotum and the testicle is exposed. The testicle is pulled straight up, the surrounding tissue pushed down, and the "stalk" is exposed. The vet applies a clamp close to the body then cuts to remove the whole package. (Dr. Nikki leaves the clamp on for three minutes and applies another grabber on the underside so she can check for bleeding after the top clamp is removed. Then she stretches the skin to help ensure that the incision doesn't close up too quickly.) The incision is left open so that the site can drain as needed. That's it! (Different operation than with cows, who get no sedative or anesthesia, stand for the job, and the vet grabs the testicles from behind and just cuts straight through everything at once in one or two slices.) While the colt is down, often the wolf teeth are pulled. These are two little teeth that get in the way of bitting, and not every horse has them, but if they can come out during castration they'll do it then.
After that first castration at the clinic, Dr. Nikki and I went and did another on a farm immediately after. That was great because it immediately reinforced what I had seen, plus I got to see how two docs do it, what the similarities and differences were. While I was holding "Davis" before he was put under, the rascal struck me. Lucky day! Two minor horse injuries in one morning. That was kind of interesting, though. Normally, I would correct a horse for that behavior (it's seriously naughty), and I was taught that when a horse kicks you, you kick back. However, this not being my horse, I was reluctant to do that and just backed him a few steps. I talked to Nikki about this later, and she confirmed that you really can't administer any kind of physical reprimand for bad behavior--no punching or kicking back. After all, we're not out there to train the animal, just to help him medically. She thought it odd that the owner didn't take over herself to correct the horse, but then the owner mentioned that the horse had done it before. Hello! That would have been good to know beforehand.
Next, we visited a gentle giant of a horse, a brown and white draft Shire named "Gulliver" who must have been 18 or 19 hands, with a dental problem. He'd cracked an incisor and bled some. Nikki decided it didn't need to be extracted and asked the owner to keep a watch on it, though it should just heal itself. The horse needed to gain weight, so they discussed a gradual increase of turn-out/grazing time plus supplement with the pelleted feed, Strategy, as well as Biotin because the hooves were in pretty bad shape. She then floated the horse's teeth--an interesting experiment! He's so big that the file wouldn't reach all the way to the back of his mouth, and when the horse lifted his head even a little, I was reaching as far over my head as I could. He was so big ... I swear his hooves were at least a foot in diameter. She used a different kind of device to keep the horse's mouth open than I'd seen before. Instead of a full speculum, she had a J-shaped dealie with a round coil on the end. The side with the coil goes in the mouth so that the coil can sit between the molars to keep the horse's mouth open. Usually, you tie the other side off to the halter, but in this case I had to hold it (along with the tongue) because the horse's mouth was too big.
We moved on to look at "Cody," a sorrel appaloosa who had gotten into the feed room and eaten a serious amount of grain a couple of days prior, including one nutrient-dense Weight Builder formula. Unfortunately, the owner had waited until today to call for vet assistance--much better to do it right away to prevent predictable problems from this sort of thing: colic and founder being most likely. The horse had been acting grumpy and uncomfortable, bucking the owner off when she tried to ride him and not wanting to move forward. Nikki sedated him, twitched him, tubed him (a long plastic tube is inserted nasally to deliver something directly to the stomach), and administered oil to help lube the stomach and gut. She also left the client with Nitroglycerine gel to apply (you have to wear gloves) to the vessels in the front pastern to help ensure blood flow to the hooves. Hard to say whether the horse will founder or not at this point, but we'll see. The horse was already pretty fat with a ridge down his back. I suggested a grazing muzzle, which I've used with some success with my own horse.
We returned to the clinic, where we got an update on the horses there--that's when I found out that foot-stomper had a broken leg, there was another with kidney failure, another ophthalmic case, and another one ready to go home.
Incidentally, the calf I wrote about last time, which we'd tucked up in straw for the night, had recovered nicely. In fact, when I dropped by the clinic the next day and went to see him, he'd gotten up right away, all bright eyed and beautiful, mooed at me, and tried to suckle my fist. A success!
Tuesday, March 29, 2005
Babies Are the Best
Meanwhile, we had a three-day old calf come in with the same situation, except that his cow had died of a prolapsed uterus. The calf was severely dehydrated with sunken eyes and a glazed expression. Just as with the foal, we brought him in and started an IV drip with various nutrients and drugs added to the saline solution. (I wasn't in the office to find out what all went in, except for some B Complex, which I drew and injected into the saline pack.)
During the day, I bottle fed the three-day-old, as well as a three-week-old calf who was in with scours (diarrhea). Unfortunately, we couldn't put the real little guy in the calf room, because the doc was concerned he'd get infected with whatever was causing the scours. So we tucked lots of straw around him to keep him warm. By the time I left (about 6 p.m.), he was sitting up and alert. I'll be curious to hear if he bounced back or if this will be another sad case. These calves are sooooo adorable. I know I sound like such a girl, but their long eyelashes, big brown eyes, and round black noses are too cute.
Dr. Wise had a 35-year-old pony come in with choke (esophageal impaction)--a nasty case with necrotic tissue around the impaction (you can tell because it stinks). They sedated him, tubed him, used carbomine (not sure that's the right name--I was working on cleaning the pony's stall of blood at that point), and cleared the obstruction without a hitch. The pony went home later in the day.
Around 11 a.m., Dr. Nikki and I went out to check on a mare with ringworm. Bad case! On went the gloves, though I never touched the mare. Rx: Topical administration of miconazole (OTC), an anti-fungal powder on the feed plus antibiotic dosing for systemic support. The owner also had a "silver" ointment (need to check and find out what that was; it's something commonly used on human burn patients) that Dr. Nikki thought would be an excellent addition to the treatment.
One of the best parts of the day, from the standpoint of my ongoing debate with myself about whether to pursue veterinary medicine as a career, was talking at some length with Nikki about some of my goals and concerns. She assured me that the intense physical strain comes mostly with a mixed practice rather than an equine one. (She reminded me that you can't win a battle of strength with a horse, anyway, which is absolutely true--so she doesn't ever start that kind of fight. "I bring out the drugs," she said.) She also says that being in a group practice, rather than a sole one, makes it possible to call for help/relief, too. Another bit of excellent advice: Since vet schools in the states are so few and far between, and because there are exceedingly high admissions requirements, and because there is no saturation of vets, and because my application might be a bit unorthodox, I might consider going to a vet school outside the U.S. She attended one in St. Kit's, a Caribbean Island. Something to think about. She also liked my idea of doing some biology and chemistry coursework in the fall.
When we got back from lunch, I tangled with the power washer, trying to get a bunch of cow manure out of the chute. The hose kept blowing, though, so it was tedious. I did get it cleaned up, though, thank God, because the place stank to high heaven.
We did some clean-up in the office and ended the day by tubing the three-day-old to ensure that he got enough to eat. He was suckling, but he kept getting too tired to finish. We fluffed up his straw, and I left for the night.
Tuesday, March 22, 2005
Back in the Saddle
Okay, on to today: Arrived at 8 and not much to do, so I went along on farm calls again with Dr. Wise. Found out that the prize winner had indeed broken his leg just above the ankle, and the doc had applied a cast. Also, Mysty (the inflamed hock case--which I remember now we booted and gave hydro-therapy to last Monday) was moved over to a surgical clinic because the docs had done an ultrasound and discovered some foreign body in her leg. Also found out that the little calf I'd bottle fed died after he went home that night. Sigh. This is a lot of death to contend with, and I understand it gets a little worse as we come into spring with more cows calving.
At any rate, our farm calls today were diverse, to say the least--though all equine today. We started out at a lovely farm with a pasture pet who had never loaded onto a trailer before, and we were there to help because he needed to be hauled to the hospital for attention. They'd tried unsuccessfully for 3.5 hours the day previous, so we showed up with drugs and Dr. Wise, who applied "brute-esthesia" (brute force--he actually picked up this horse's back end after we got his first two feet on the trailer). A dose of banamine and torp, plus several people pulling and pushing got "Chief" on the trailer and on the way to the hospital for x-rays and treatment for an extended case of founder.
The rest of the day was a curious mix of very nice barns and well-cared-for animals along with some pretty scary conditions. One barn had manure piled up about a foot deep and horses who have foundered, injured themselves on farm machinery, and other miscellaneous other "ignorant" mistakes. (I'm finding it's a real challenge not to get irritated with some owners who have obvious poor undertanding of what these animals need and aren't educating themselves. Or maybe they just don't give a damn. Grrrr.) It's a good lesson in diplomacy, watching these vets interact with owners.
There were no particularly interesting cases today--we did a lot of vaccinations ... oh, but there was one paint horse who, it turns out, had two tear ducts in his left nostril (one is usual). Dr. Wise found this because he was checking a tear duct by putting dye in the eye, then waiting to see if it would drain through the duct and out the nostril. When it wasn't happening, he went to flush the duct--and discovered two. Curious!
I found myself enjoying sketching the horse's markings for the Coggins tests (you draw in identifying marks as part of the documentation accompanying this blood test required for horses that travel). I'm a poor artist, but it kind of made me feel important. (grin)
We returned from farm calls in time to meet the farrier, who was to work on Chief's feet. The x-rays showed that the angles were way off (the relationship between the bone angle and the hoof angle), so he was going to do some serious reshaping to help correct that problem. It was clear that the horse's discomfort was also due to the sole of his feet having descended well below the hoof wall, something I had seen earlier that day in another founder case. I can't say I'll soon forget what that looks like.
All in all, an enjoyable day, and much less tiring than the ones I've spent in the hospital on my feet the whole time. I still fell asleep by 9 that night--a pattern now firmly established after each of my vet volunteer days.