We started the week off with our normal cases of joint injections, lameness exams, pregnancy checks, and various other procedures. Although I have not yet discussed it, seemingly every week at least one overweight horse comes in lame with some degree of laminitis and rotation. Equine Metabolic Syndrome is something that I had vaguely heard of before, but I have gained a much better understanding of the prevalence of the problem here. EMS is developed insulin resistance comparable to Type II diabetes in humans. For some reason, changes in the sugar composition in the grass during spring and fall cause insulin resistant horses to experience bouts of laminitis. These horses also become very overweight, depositing fat around their tail-heads and developing a “cresty” neck appearance. We have seen so many cases now that I can tell by looking at these horses that they will have coffin bone rotation on a radiograph. Just like with diabetes, the solution to the problem is diet and exercise. Dr. Brown and Dr. Tull recommend switching to a low-starch grain, severely limiting access to grass, and soaking the hay before feeding to leach out the sugars. EMS is an interesting condition and I am sure I will be seeing it quite often, even after I leave Somerset.
On Tuesday, we had the surprise of not one, but two horse with P1 fractures come in. Both cases were lateral condylar factures that were repaired using two lag screws. As always, I got to scrub in! It was a long day in the operating room, but Dr. Brown set both fractures with relative easy. I finally got the hang of assisting for these fracture repairs (at first all of the hardware and new instruments intimidated me) and could anticipate what Dr. Brown would need next. In the end, he let me practice my vertical mattress suture pattern to close over the screws. We were all pretty excited over how well the surgeries went. Both horses recovered well and were sent home a few days later.
The post-op radiographs. You can't even see the fracture line!
Drilling Flushing Sewing
The twist of the week came on Wednesday, when I started experiencing severe abdominal pain and my Brown Equine family decided I needed to go to the ER. After every diagnostic test under the sun, the human doctors admitted me to the hospital for several days on fluids and pain meds. The final diagnosis was a viral infection and they released me after I had no pain or fever for 24 hours. While the nurses and staff were very nice, I am more than excited to be back at work and I am looking forward to another great week.
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