To Vet or Not to Vet? Or, Meltdown Imminent (Human, Not Horse)

This has been a week from hell, which means it’s time for a Horseblog Classic. We are celebrating the anniversary of this blog’s adventure with another vet adventure, a couple of severe colics. One horse got over it quickly and the other seems to have tipped over toward recovery, but since I’m still in the middle (and accordingly exhausted), here’s a blast from the past to hold us till I have working brain cells and an ending to the story (a good one, we hope; it’s looking that way, at least). Then I’ll blog the whole thing.

In the meantime, from October of 2011, here’s a bit of barn drama a la mode. The main character had some further adventures and a number of relapses, but made a full recovery.

It’s been a while since I did a writer-focused Horseblog, and last week was a Learning Opportunity (aka Veterinary Crisis), so here’s one for the writer looking for a horse-related crisis to spice up the plot.

The setting here is contemporary but the incident and the treatment were fairly timeless. In an earlier historical period or a fantasy or sfnal world, there would be alternatives to the drugs and substances used. And the process itself dates back to the dawn of the human/horse interaction.

It all starts harmlessly enough with the sleepy stablehand staggering out in the early(ish)  morning to feed the horses. Most of them are in stalls or corrals/paddocks where they belong, doing what they normally do in the morning: snoozing, basking in the first of the sunlight, pacing or banging on walls or feeders and demanding their breakfast.

Except for one. He’s usually out in the big horse turnout where, being a stallion, he rules alone. Instead of snorting and striding up to the gate so that I can take him in for his breakfast, he’s ‘way down toward the back, and he isn’t moving. There’s a pile of dirt in front of him, which is not normal.

I pause a nanosecond for the Horse-Owner’s Heart Attack(tm), that first OH HOLY CRAP moment when you know something is wrong but not, yet, what it is.

With horses, it does not hurt to always assume the worst.

I head toward him at a very carefully modulated, very fast walk. A run might panic him, horses being flight animals and all, but I need to get there muy pronto. As I come closer, I can see that the dirt has been piled up by a whole lot of pawing, which indicates he’s been there for some time.

Then I see why he hasn’t moved. His back leg is suspended a couple of feet up, tightly wound in fencing. Wire fencing in this case, but could be board, rope (in horselines), piled timber, stone, you name it.  Horses are geniuses at catching a foot in things you wouldn’t imagine they could get a foot into.

I knew immediately how he’d done it. He has this not so adorable thing he does when showing off for the mares who are stalled on that side of the property: he prances up to them, stops, paws, arches his neck, then squeals and kicks out fiercely. Usually he’s smart enough to kick away from the fence. This time he clearly was too distracted by his hormones to do that.

So there he was, still on his feet, fortunately–if he’d gone down, he’d have possibly taken the fence with him, probably ripped his leg up (the wire is heavy and well rounded, no barbs, but wire is still wire), and since he appeared to have been there at least an hour, damaged his internal organs. Horses are not built to lie down for long periods; too much weight in the innards. Here his exceptional temperament saved him–if he had panicked, if he had pulled with all of his considerable strength, if he had reared or flung himself around or done anything else that an animal does when trapped and unable to escape, he would have hurt himself badly  and I might have found him dead–either from shock or from loss of blood.

But the strength that let him stand on three legs for however long also meant that he might have damaged his back or his other legs. I could already see that that nice thick wire had only scraped the skin; very little blood, and no serious lacerations. The leg was swollen and the wire was tightly wrapped.

Wire-cutter time. I cut him out, ready for him to erupt, and he did bounce a bit, but he was extremely shaky. The “good” leg was bending in ways it shouldn’t. So, next panic attack on my part: how much damage had he done to his rear assembly? He was also covered with stress sweat, and his back was clearly strained; there were bulges in places where horses don’t bulge.

I determined that he could walk, led him to a safe enclosure and offered him water and a little hay–to help him de-stress through the endorphin release of chewing, to make sure he was hydrated (to prevent an impaction), and to determine how shocky he was. Horses won’t eat when they’re seriously traumatized.

He wasn’t all that interested in food or drink. The first thing he did was lie down for a few minutes. Logical: he was exhausted and he’d been on three legs for much too long. And that was good. But it could also mean he was colicking (bad, could kill him), and there was question of whether, with the as yet undetermined amount of damage to his legs and back, he could get up again.

After five minutes, he got up. Good sign. But he was wobbling all over the place, and would eat, but only in brief snatches instead of his usual chowhound eat it all and look for more.

While this was going on, I was running the mental flow chart of the horse owner in crisis: Call the vet? Not call the vet? If yes, call now (emergency) or wait to see how he progresses (not emergency)? If no, let him be and see if he comes out of it himself, or scrounge up some anti-inflammatories and treat according to my judgment?

And let’s not forget the barnful of uninjured but hungry and rather impatient horses who would have to be fed and looked after in there somewhere. Feed now, wait and watch injured horse, both, neither, aaack?

As he wobbled around the pen and picked at his hay, I opted for Vet Yes, Call Now. I really didn’t like what his “good” leg was doing and was concerned about tendon or ligament damage (short-term or permanent). It was bending ‘way more than normal, and buckling at the pastern (the part of the leg directly above the hoof). That could mean overstretched tendon, though if it had been ruptured, he wouldn’t have been able or willing to put weight on it. He was holding it up as often as not, but when he wanted to move around, he was walking on it.

Also, he was shocky and low, which could indicate colic. So, vet (horse healer, horse doctor, wise old stablemaster–male or female; in this case, actually, a young woman). Colic connected with trauma is nothing to miss around with.

In the hour and a half it took the vet to get there, I soaked his hay in water, which forced him to drink while he ate, and he did eat more willingly as time went on. He used his leg a little more. He was still low and very shaky.

Hey, so was I. Horse owner can be very connected to horse, and when there’s a crisis, well.

Vet came. Vet examined him all over. Listened to heart and lungs–breathing rapid normal, heart rate elevated. Which was to be expected. Temperature, by then, normal. Capillary refill normal–this is a simple and totally non-techie but effective test of the horse’s circulatory system. Gut sounds normal–it should sound like a boiler room in there, gurgling away; if it’s very agitated that’s gas colic, and if it’s silent (which had been my concern), that’s impaction colic and it can be very serious. But he was percolating along as he should. And the best news: no sign to palpation of tearing or rupture of any of the relevant tendons. All the wobblies were muscle fatigue and soreness.

The vet verified this by having him walked and trotted straight toward her and straight away (looking for signs of lameness, crookedness, or any gait deficits), then on a circle around her in both directions. He was dragging the toe of his injured leg–the swelling made it difficult for him to bend the hock joint properly–and was clearly sore all over, but there were no indications of deep damage.

This being the future, if she had seen anything to concern her, she would have done x-rays or ultrasound. But he checked out as a straightforward case of horse-is-bigtime-sore.

Because he had a good old-fashioned problem, he got the old-school prescription: stall rest with gradual return to exercise and, eventually, riding; a sweat wrap for the injured leg to bring down the swelling; and a course of horse aspirin (phenylbutazone or bute) for the pain and inflammation. She also recommended he see his masseuse (yes, he has a masseuse, of course he does, doesn’t everyroyalbody?).

Stall rest is a standard deal for hurt horses: shut them inside and hope they stay quiet, in this case for two weeks. He lasted eight hours before he was literally climbing the walls. So I made a judgment call the horse owner often has to make: more space, just enough to keep him calm, which is what stall or box rest is really about, but not so much space that he could run around and reinjure himself. In this case that meant a small paddock in the day and a stall with a small outdoor run at night. No big turnout for him for a couple of weeks.

A sweat wrap is an old horseman’s trick for reducing leg swelling. Swipe the leg down with a poultice or ointment–we used nitrofurazone–and wrap in plastic (or in the old days, canvas or even paper–maybe leaves in the really really old days?) and then pad with cotton (or soft quilting or moss or…) and wrap in a bandage. The photo shows the result.

The yellow stain is furazone, the wrap is Vetrap (yes, it comes in prints now). In older days it would be cloth, of course, and instead of sticking to itself it would be pinned or tied.

Also note the other leg turning out. That was part of what had me calling the vet–too much twist in the “good” leg. Muscle fatigue, but could have been tendon or ligament damage. The little, soft and slightly squishy lumps up the side were signs of stress; they went down in a couple of days.

So there he was. And is. Wrapped, medicated, and in jail. He had his massage the following day, and got his muscles soothed and smoothed, which helped considerably. After three days the wrap (renewed daily) came off. There’s still some swelling, but it’s going down more each day. After six days, the painkillers stopped–he’s on his own with that now.  He’s in and we try to keep him quiet for two weeks, and will need another two weeks to get back to normal, maybe more, maybe less. In the meantime he can do a little gentle work on the ground, soft bending and slow walking. It will be a month or so before he’s ridden again. But he’ll recover, they tell me, 100%.

So that’s the saga. Often they go on much longer and have much less positive prognoses. Sometimes they turn out to be nothing. With horses, you never know. We’re lucky here that we don’t have more crises–we don’t get much turnover, the horses belong to an exceptionally sturdy and healthy breed, and for the most part they’re exceptionally smart as well.

Meanwhile he is about as cranky as you would expect, and about as disinclined to admit that he pulled a Stupid Pony Trick. But we’ll all live–though in those first few horrified moments, none of that was a sure thing.

 

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To Vet or Not to Vet? Or, Meltdown Imminent (Human, Not Horse) — 9 Comments

  1. The other writerish thing to keep in mind is that you not only have access to futuristic modern vet practices, you can -afford- the treatment. Horses were and are expensive to treat and keep. If your hero is not well-heeled, he may have to resort to treating his horse with tincture of time.
    And the number of fraudulent horse doctors must be a constant; I am sure your odds of finding a quack are good whenever your book is set. So you can spend all your ducats or royales or guineas on a treatment that does the horse no good. Many charming pitfalls here.

  2. Well written and educational. I completely understand that “Oh Crap” moment: the heart skipping beats before you know just how bad something is. (And making sure the trailer is hooked up just in case. Just when it isn’t hooked up is when you will need it.)

    Other questions for your characters to consider are chances of a horse’s recovery, quality of life post-treatment, and whether the treatment is affordable.

    i hope the Fat White Pony recovers quickly.

  3. One other thing… It’s possible to have equine insurance. Any call from the vet means notifying the insurance company (although equine insurers tend to be a lot better than human insurance companies). Once a claim is placed against a particular injury / event, chances are the policy next year will have a rider stating that the previous injury is no longer covered. It can provide interesting options, depending upon the story.

  4. Wonderful comments, thank you!

    Chaz, they use their hands. Some may have things like “electrostim” for stimulation of the muscles, but the basic-issue horse masseuse is a hands-on kind of practitioner. For my guy, there weren’t any extras at all. Just massage and manipulation.

    Brenda, oh yes there is horse acupuncture. My first experience of acupuncture of any kind was a barnmate’s horse getting treated for an injury. It’s used for pain management in colic surgery, among other things.

    One of our local DVMs went away for a while and came back with acupuncture certification. He’s supposed to be very good. I remember him when he was more of a standard vet–he sewed up Pooka’s face after the Goat-Goring Incident (three layers of stitches immediately above the eye, at midnight, by miner’s lamp–I lost count of the stitches at 50. There is, these days, a small and barely visible scar). Clearly his superpower is Needles.

  5. The difference is that Crumble would have been three-legged lame… (and nobody understood why I was so blase about that. I could *never* measure injuries by his response. OTOH, being such a whimp possibly saved his life because I caught the laminitis when it was in its infancy. Swings and roundabouts.)

    I’ve stayed in the 19th century with treatment for swelling.

    Take cold water, pour a some vinegar into it. Take a dishtowel and cotton bandage, soak them, slap towel on, and fix with bandage. Half an hour later, take bandage off, soak, repeat.

    It’s labour-intensive. You need to change the bandage every half hour, otherwise it will heat up too much, but it works if you have the time. (I also wrap legs in pairs; another cavallery instruction.)

    (The other old-timey thing that I’ve never needed is to use sauerkraut on hoof abcesses. It’s a stinking mess, but it helps to draw out gunk.)

    The ‘call vet or not’ (particularly with my horse who used to have some sort of injury or owie once a month at least) is always a tough call. I’ve found that sometimes just getting on the phone and talking it through with them helps – if things *do* get worse, at least the vet is in the picture.

    Ultimately, I’d rather call the vet out and have him say ‘oh, he’ll be fine’ than have one go ‘why didn’t the stupid cow call me’. Then again, I’ve always lived reasonably close to my vets; I suspect that distance makes a difference.

    Anyway, I’m glad that he seems to have managed to do only minor damage. Phew.

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