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.
Issue link: https://thehorse.epubxp.com/i/636486
24 TheHorse.com THE HORSE February 2016 requiring surgery. Four weeks post- surgery we're dealing with laminitis in the opposite, supporting front limb because he has been bearing most of his weight on it. ■ A horse with eye pain and consequent squinting due to inflammation and swelling that needs four different medi- cations in each of her eyes—and isn't very excited about us delivering them. ■ My Warmblood case from equine medicine; he needs hourly checks for comfort and oral medication administration. ■ The Welsh mare from equine medicine, who also needs hourly checks and hand-walking to reduce swelling at the surgical site. ■ A few postop horses being examined for any complications. ■ A horse in isolation with diarrhea—the typical protocol for horses present- ing with diarrhea and fever or a low white blood cell count is to put them in isolation until we have identified the cause as noninfectious. If there is an infectious cause (such as Salmonella, Clostridium, rotavirus, or coronavirus), they will remain in isolation during their stay at the hospital to prevent infection in all other patients. ■ And, the Ag animals. Bascially, this includes any large animal that's not a horse. This week we have a few neat cases that even an horse-obsessed student might find exciting: a sick baby camel, a pet yak with bladder stones and a ruptured bladder, a fawn with a broken leg, and a few cows with presentations such as mastitis, lethargy, and anorexia. By the time we finish all the treat- ments, it's 7:50 p.m. Ten minutes until we start the next set of treatments. Throughout the next few hours, I perform wellness checks, re-evaluate fluid rates, deliver medications, walk horses, and make sure all the patients left in my care are doing well. Midnight — We get a call that a colic is coming in from an hour and a half away. At this time, I need to set up a "colic cart" with everything the clinician and I might need to evaluate the patient quickly and effectively: ultrasound ma- chine, buckets, tubes, rectal sleeves, lubri- cant, fluids, intravenous catheter, and a few other imperative items. My rotation- mates agree to let me take this case. 2:00 a.m. — The colic case arrives, a 1 ½-year-old Thoroughbred colt. Dur- ing travel he sustained a few lacerations in the trailer. We record his weight and bring him into the treatment area to be- gin evaluation. While I perform a physical exam, my rotation-mates help by getting a history and writing down my findings. The horse is dehydrated with an elevated heart rate and decreased gut sounds. He is quiet but alert and doesn't seem to be as uncomfortable as reported earlier in the evening. We conclude that he is, indeed, colicking, but we needed to run further diagnostics to determine the exact cause of his abdominal pain. The clinician asks for my evaluation, problem list, and diagnostic plan. I want to perform an abdominocentesis (get a sample of his abdominal fluid); abdomi- nal ultrasound to look for small intestine dilation, increased stomach size, and possible left or right colon displacement; rectal palpation to feel for any abnormal structures, dilation of bowel or blood ves- sels, etc.; nasogastric intubation to check for reflux (which might occur if there is a blockage within the stomach or small intestine) and deliver mineral oil/fluids; blood work; and urinalysis. The clinician agrees. 3:00 a.m. — We've finished diagnostics and colic evaluation. It appears our little Thoroughbred most likely had a severe gas colic that resolved during the trailer ride. His diagnostics revealed moderate dehydration and increased free fluid in the abdomen (meaning it was unlikely the bowel had ruptured or that he had any abdominal infection). He has a mild right-side displacement of his colon, but his small intestine is functional and there are no other pertinent abnormalities. I had noticed dirt in his eyes and epiphora (excess tearing), so I asked the clinician if we should consider an ocular exam. He approved. We flushed and stained his eyes with fluoroscein dye but saw no uptake (a corneal ulcer holds onto the stain)—no corneal ulcers for our patient. We're now left with a few lacerations that need to be debrided, flushed, and Part of monitoring a horse involves checking and adjusting IV fuids as needed. For colic cases, students set up colic carts with everything needed to evaluate the patient. A Day in the Life of an Equine Veterinary Student One of Hayley's patients was a Welsh mare that underwent a unilateral mastectomy.