The Horse

SEP 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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TheHorse.com THE HORSE September 2018 58 This opinion column is for topics of importance to the horse industry. If there is a topic you want covered, or if you'd like to submit an article for possible inclusion, contact Stephanie L. Church, Editor-in-Chief, The Horse Media Group LLC, Beaumont Centre Circle, Suite 100, Lexington, KY 40513; schurch@TheHorse.com. Articles contained therein are not representative of opinions held by either The Horse or the American Association of Equine Practitioners. ACROSStheFENCE TRACY E. NORMAN, VMD, DIPL. ACVIM TheHorse.com/Across-The-Fence S ometimes being a horse vet is a struggle. Long hours, tough condi- tions, and the occasional require- ment for clairvoyance are only some of the challenges. There are horses, how- ever, that more than serve to remind me why I have dedicated my life to equine veterinary medicine. Wizard is one of those horses. It had been a long, hot day on the cross-country course at the Virginia Horse Trials in October 2016, where I was working as an on-course vet. I had already called to cancel dinner plans be- cause the day was reaching so far into the evening. At last, the final horse galloped by my station on the top of the hill. I was packing up my stuff when my colleague Dr. Julia Hecking asked me to report to the stable area to help out with a horse that had been loose on the grounds. The horse was Wizard, a 2008 Thor- oughbred gelding who was competing in the CCI** with owner Sally Cousins. He had completed the challenging cross- country phase without jumping faults and returned to his stall. While he was being groomed, he spooked and broke free, bolting down the road toward the high- way and back onto the grounds again. He sustained severe injuries from colliding with a trailer on the show grounds. I found Wizard in his stall with Sally and multiple members of our veterinary team. Drs. Hecking and Brent Hall (FEI treating vet) had started intravenous (IV) fluids on the stressed, panting horse, and Dr. Marcos Santos was assessing Wizard's face for fractures. The horse was bleeding from his nose and taking rapid, shallow breaths. His gums were pale, and he had a high heart rate and a swollen, painful right front leg. We could tell Wizard was in pain, and we were anxious about whether he'd be able to breathe through his ever-swelling nose. Equally worrisome, as I ultra- sounded his chest, it became clear that broken ribs had lacerated his left lung, which was leaking air into the left side of his chest and bleeding into both sides. If the damaged lung didn't seal itself, air and blood could continue to accumu- late, smothering the horse if the pres- sure wasn't relieved. Dr. Santos placed a tracheostomy to ensure Wizard's airway, and Cousins drove him to the Blue Ridge Equine Clinic, in Earlysville, for further evaluation and treatment. Dr. Santos and I also traveled to the clinic to continue his stabilization. We were genuinely concerned about the horse's chances for survival. At the clinic, Dr. Santos and I re- evaluated Wizard with a physical exam and ultrasound to see how he handled transport. The news was good: The bleed- ing in his chest had stopped, and he was breathing well through his tracheostomy. Fortunately, the lung had sealed, so there was no immediate need to insert chest tubes. We put a plan in place to address Wizard's medical and surgical problems, and we all worked together, along with Dr. Steve Trostle, to treat and monitor Wizard over the next two weeks, while he recovered enough to return home to Pennsylvania. Wizard's treatment plan included pain management, broad-spectrum antibiotics, IV fluids, aminocaproic acid (to decrease the risk of bleeding), bandaging the leg, and intense monitoring to determine if chest tubes or other procedures were needed. We pulled the tracheostomy tube five days later, once he could move enough air through his nose. He was kept quiet in a stall to allow the rib fractures to stabilize and prevent further injury to the lungs. All told, it took the work of five veteri- narians (including two surgeons and an internist) from three practices and one very dedicated owner but, to our delight, Wizard more than did his share—setting aside his usual energetic and opinionated demeanor to be a perfect patient—and recovered beyond our expectations. Wizard continued excellent progress at home, and Sally started him back to work slowly in the spring. Apparently, Wizard missed the memo that he had been injured, finishing in the top 10 of five outings at Intermediate and finishing two CCI** events before moving up to Ad- vanced this spring. There's nothing more rewarding than working hard alongside dedicated colleagues and wonderful own- ers and prevailing with a tough, healthy horse at the end of the process. h Why I Do This Thanks to his dedicated care team, Wizard survived severe injuries after colliding with a trailer and has returned to eventing, rising to the Advanced level with Sally Cousins (pictured). CALLIE HEROUX PHOTOGRAPHY, COURTESY OF SALLY COUSINS

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