Wednesday, July 31, 2013

Farewell to Somerset

Well, it has finally sunk in that my time with the MSU Equine Summer Fellowship Program and Brown Equine Hospital has come to an end. I could not have imagined a better experience and I would do it all over again in a heartbeat. The vets and techs at Brown Equine Hospital taught me so much and were so supportive, I could not ask for a better group of people to work with. I was very sad to say goodbye, but I left with many fond memories. So here it is, my final blog post:
Something must have been in the air this week, because we received four emergency colic cases in less than three days. The first to be brought in was a draft horse that had been off feed since the night before. From the abdominal ultrasound and rectal exam, Dr. Brown diagnosed him with anterior enteritis, or inflammation of the duodenum and/or jejunum. Since anesthetizing draft horses carries an even higher risk than other horses, Dr. Brown wanted to keep this gelding off the table at all costs. We started by passing a nasogastric tube to reflux every few hours and administering IV fluids with a lidocaine drip. The draft horse took a turn for the worst a couple days into treatment, refluxing up to 30 liters and going into acute renal failure. We increased the frequency of refluxing and started to bolus the IV fluids. Remarkably, the gelding pulled through and is now recovering well. We stopped refluxing completely and have started weaning him back onto solid food.
The second colic that came in was a part-Standardbred that had been acting uncomfortable for a couple days. As it turned out, this gelding also had anterior enteritis and we started him on the same treatment regimen as the draft horse. Unfortunately, our refluxing did not keep pace with the fluid backing up into his stomach. About 48 hours after being admitted, we passed a tube, but we got negative net reflux. Suspicious, Dr. Brown performed another ultrasound and belly tap. The results showed excessive fluid (reflux) surrounding the intestines, revealing that the gelding’s stomach had ruptured. Sadly, we had to put the horse down. It is surprising how such similar cases, treated the same, can end so differently.
The last two cases were also treated medically. An impaction and a right dorsal displacement were resolved with IV fluids and fasting. Both horses were slowly reintroduced to solid food and were sent home within two days of being admitted. I had always thought that all colic cases that were referred went to surgery. Much to my surprise, however, the vast majority of the colic cases we saw this summer were treated and resolved medically. Another surprise was how many of the horses that came in for colic went home healthy; it was nice to discover that colic is not a death sentence.
To end, here are a few photos of some of my favorite moments working at Brown Equine Hospital:
Repro work with Dr. Jen Brown

Surgery with Dr. Keith Brown

Scoping with Dr. Travis Tull

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