Externship Day II

I learned more things today!
Callie taught me how to examine a horse and some of the silly acronyms. I determined heart rates, listened to gut sounds, and watched respiration.

I got to watch a tooth removal on a 15-year-old horse and met the large animal dentist, Dr. Lowder. He's a very friendly fellow and he was very inviting and open to my watching the surgery. Apparently he's one of the best veterinary dentists in the country (if not the world...) and he's going to Florida next week to treat rhinos and zebras at a wildlife refuge (I think it was named White Oak...?). He has all these tools that he had someone make for him for very specialized jobs, like pliers for pulling rhino molars or a headrest-ring for keeping the horse's head up so you're not straining to see inside his mouth. We got to see X-Rays of the horse's teeth and Dr. Lowder taught us how to age a horse based on its X-Ray.

Sarah, one of the students I follow around, performed her first rectal today. Large animal vets have to do a lot of rectals because you can't really palpate a horse's (or a cow's) abdomen like you can a dog's or a cat's. A horse's colon and rectum is more fragile than a cow's, so you have to be a little more gentle when you're shoving your arm down there.... How does the horse stand for that, you ask? Sometimes they don't. You're standing directly behind the horse, and if he gets angry, you're in danger of getting a serious kick. So they like to give the horse a sedative before they do a rectal (this has the double effect of calming the horse and preventing it from straining too much against the vet's arm and thus damaging its colon). Oh, and of course they have special long disposable gloves for your hand/arm and you put lots of lubricant on your glove before you go in. What else?

I learned the many compounds that can be used as laxatives. These include: water, mineral oil, magnesium sulfate (epsom salts), DSS (which is soapy to break down impactions but also tends to damage the wall of the intestine), and cilium (which lubricates the ingesta and is somtimes used to treat colitis, but has the unusual side effect of causing the body to decrease its own breakdown).

Some anti-ulcer medications include: gastroguard (proton pump inhibitor/stomach acid reducer), sucralafate (binds to compromised mucosa like a bandaid and increases blood supply along with prostoglandins and mucous with no side effects), and histmine blockers.

Case Studies?

Coke, 14-year-old Appaloosa Gelding
This guy's prepuce was re-sutured yesterday. He has been drinking and urinating fine and his stallion catheter proves that no urine has been pooling in the sutured area. His complete blood count was good, so he is unlikely to have any sort of an infection, therefore he will be taken off antibiotics. His sutures will be left in for up to 48 hours and his swelling will be monitored. Callie plans to flush his prepuce with a stallion catheter twice each day. He is improving. He is a very friendly horse. :)

Petey, 7-year-old Clydesdale Mare
This is the mare who had to have her foal cut out of her uterus. She's under a lot of stress right now, and actually foundered last night. Founder is the verb/noun they use for laminitis, which describes a disorder in which the leg bone sinks into the sole of the horse's hoof. Dr. Pellegrini pointed out that even when a horse is feeling better, it may still be at risk for laminitis. A horse that has laminitis should be allowed to lie down, though it's difficult to convince a horse to lie down. Digital X-Rays were taken of the horse's hooves. One foot is club-footed. Some signs of laminitis in the horse include: sinking of the coronary band (the band around the top of the hoof) and an unwillingness to walk. They don't really know all of the causes of laminitis or a sure-fire way to treat it yet, but Petey will be given anti-inflammatory medicine and antibiotics.

Ralee, 5-year-old American Warmblood Gelding?
There are many ways of telling where an impaction is in a horse's GI tract, the details of which I will not bore you with. Dr. Pellegrini discussed with us exactly what causes colic in stressed-out horses and what can be done to attempt to prevent it. Ralee is doing better, his colon impaction is mostly resovled, and he was very excited to finally be able to eat today. The biggest thing that's stressing him out about bing in the hospital is that he is used to being exercised heavily on a daily basis, and it doesn't help that he seems to have a nervous, untrusting personality.

I'm getting very sleepy, so I think I'll stop here. Night!