You Can Lead A Horse to Water…

One of my more memorable experiences as a fourth year veterinary student involved a 400lb stud pony and a mission. The pony was admitted to the clinic for a suspected pathologic condition involving the urinary system (i.e. condition involving the kidneys, ureters, bladder, urethra, or other associated structures). The pony had no historical report of failure to urinate; but was reported to seem as though he was straining to urinated on occasion and had a dark urine that was suspect for myoglobinuria (myoglobin in urine) or hemoglobinuria (hemoglobin in urine). The pony had blood work performed, a transabdominal ultrasound to attempt to look at the bladder, and a urinary catheter was passed in attempts to collect urine. Blood work was not supportive of a myoglobinuria at the time of admission. Also, no urine was able to be collected via the catheter. At the time it was unsure if this was because the catheter was unable to be passed to the point where it was in the bladder or if the bladder was empty or did not have enough urine to collect. The decision was made to try and collect a free-catch urine for basic urinalysis and go from there. However, as the saying goes “You can stand and watch a horse all day but you can’t make him urinate” (that’s my variation on the phrase for the purposes of this blog). That stud was determined to not be subjected to urinating in front of an audience. You could stand outside his stall for hours (or inside his stall, or around the corner), but no urine would be voided. The second you left to go to the bathroom or do rounds you would hear the sound of your sample hitting the floor. He was always done in the time it took you to run back and open the door, cup in hand. Long story short, this patient’s scenario led to the development of a new invention. The use of a rectal sleeve, a smooth round, thick wire (i.e. wire coat hanger) bent into a circle with no sharp edges, and brown gauze allowed us to successfully collect or sample in no time flat (envision a bucking strap with the open end of the rectal sleeve taped around the wire circle and placed over the prepuce so the horse urinates into the sleeve). So take home message, you may not be able to make the horse urinate, but if you have a horse that doesn’t mind a makeshift diaper around the prepuce (as I have found, most of them don’t) you can have your sample in the blink of an eye (without the horse being concerned with the audience).

On the road again

As an avid reader of those books about traversing across the country with no real agenda I have always enjoyed the freedom of being on the road. I love to get in the big diesel truck packed with all the meds and equipment and leave for the day – never knowing exactly what I will encounter. Often, usually when the very shy Chicago sun is out, I think to myself ‘What a great day to be an Equine Veterinarian!”.

I did not always feel this way. When I left my ambulatory job in the early 90’s, I swore that I would never ever, ever, ever practice ambulatory medicine again. I would only work at the racetrack or in a hospital. Ambulatory work can be exceedingly frustrating and difficult if you happen to find yourself in the wrong circumstances. One particular case always comes to mind – I had been working at the racetrack and on the farm and also covering the small animal clinic that my boss owned – he was out of town and left me in the middle of springtime colic season to cover everything. A client that we rarely saw kept calling me to tell me that their horse was colicking and wanted me to come out. I told them I could not get there and luckily it did not sound too urgent – they called two days in row and finally my boss got back and I told them I would go see the horse on my day off – they assured me this was necessary. When I got to the farm there were two horses eating grass in a field. Being out of school only a year I assumed I must be too stupid to figure out which horse was colicking. Somewhat embarrassed, I asked the client and she pointed to one of the horses that was calmly grazing about an acre away – OK I said figuring maybe this horse had not pooped – has the horse made any manure I asked – well the client did not know as they had been in the field. So I decided that this horse would get treated and we walked out and caught it. We brought it to a pen as there was no stall just a sort of pen with a roof – we decided to oil the horse and had it sort of backed into a corner and proceeded to do so – well about halfway through the oiling procedure the horse who had been struggling broke his ancient leather halter and proceeded to race into the field with a tube full of oil up his nose and no halter on. Now we were having some fun!

I think that was about the time when I made the commitment to never do this again.

I am happy to say that not all ambulatory experiences are so frustrating. I am glad I got a chance to revisit this part of my career as being ‘on the road’ is one of the things I enjoy the most.

Long Lateral Collateral

Spring is here; geese flying north, horses shedding, a few sunny days. Winter can be a long season in Chicago. It’s great working in the clinic in the winter but I always look forward to ‘going on the road’ in the spring and summer. There are some things we can only do in the hospital but farm calls in the spring are refreshing. The sense of renewal associated with the green grass and sunshine is always something I look forward to.

We did have a memorable case in clinic this winter. A young horse injured his long lateral collateral ligament of the hock. I had never seen this particular injury before and like most medical problems it will probably heal with time. The alliteration of the ligament’s is what stuck me; the long lateral collateral. It sounds like the lyric of a rap song. Like: “If you’re a believer in cabin fever, the lateral collateral is compatible…etc.”
Ah, the things we do on long winter night to amuse ourselves.

Trial by fire

During college, I took a class called Equine Management Practicum, a requirement for Equestrian Studies and equine Administration students. We were responsible for all daily care of the horses and even most of their vet care, due to the fact that our nearest vet was almost 30 minutes away. Toward the end of my senior year, we had a situation that no one could ever think would happen.

In the beginning of February of my senior year the Equestrian Department was getting ready for our spring horse show, but we never got a chance to hold our show that year. The night before the horse show, two of our dressage horses started to show signs of laminitis. Our dressage instructor thought that she recognized a faint smell coming from the shavings. She also thought the situation was strange because dressage horses don’t receive the same concussion that jumping horses do, so she thought the shavings might be the problem, and started stripping stalls. By the next day with 110 horses on campus over half were showing signs of laminitis. The culprit was black walnut shavings.

With over half of the 110 horses on the facility in danger, all equestrian students quickly became vet techs. We ran fluids, DMSO, iced feet, administered medications and wrapped feet. Our little campus became a hospital for more than two months. Luckily, by the end of March and the start of spring break, all horses were starting their slow recovery. Our little campus slowly began to return to normal, except for the faint smell of DMSO.

I was one of a hundred students that helped nurse 110 horses through months of medications and rehabilitation. I learned a lot about veterinary medicine in those few months and was able to add that to my equine education. Now that I am a vet tech, it also makes me appreciate those few months of education even more and the veterinarians and vet techs that helped us through a very difficult situation.

Pigs?

One of the most unique and rewarding clinical rotations at Texas A&M College of Veterinary Medicine is TDCJ. The TDCJ (Texas Department of Criminal Justice) has the second largest cattle herd in the state of Texas, 2,000 head of horses, guard dogs and tracking hounds, 25,000 swine and 300,000 poultry.

4th year veterinary students, along with a veterinary clinician, work closely with “non-violent” offenders on numerous prison unit farms throughout the State of Texas. There is never a shortage of cattle to work, colts to castrate, pigs to bleed or mares to palpate.

During one of my visits, two other 4th year students and I were asked to look at a yearling pig that was non-weight bearing lame on the left hind. His stifle was very swollen, hot and painful. He did not appear to have any orthopedic injuries. His stifle was about the size of a basketball, leading to a diagnosis of an abscess. Scalpel in hand, I carefully made a small 2 cm incision and a small amount of caseous (think cottage cheese) material oozed from the incision. One of my good friends James, who is a true Texas Good Ole Boy, drawled, “Katie, I don’t think that is gonna do” and proceeded to lengthen the incision with an accurate and nonchalant swipe of the blade. Within seconds all of the prisoners scattered to escape the deluge of cascading pus and the putrid odor that infiltrated the immediate 10 foot radius. While the prisoners were dry heaving outside the pen, we milked the last ounce of pus out of the abscess. I don’t think I will ever see such a rewarding abscess again. It was at that moment that I realized it takes a very special (and strong stomached!) person to see the beauty in a 5 pound mound of pus. Such a sense of accomplishment! While I probably will never work on swine again, this was the pivotal moment that I realized how much I love to work on animals.