Take Me Home Country Roads

            Well this week was a different kind of adventure… I went down to West Virginia for a full day of racetrack medicine and made several trips out to Amish country.  Each week, Dr. Berthold and Dr. Allison each spend one day servicing trainers at and near the Mountaineer Thoroughbred Racetrack in West Virginia. I tagged along with Dr. Allison for his weekly visit this week. Everyone joked and warned me about how West Virginia is a whole different world, but it provided a great learning experience. Due to the nature of racetrack medicine, very little diagnostic work is performed. The vets have to diagnose lamenesses solely based on abnormalities detected on palpation and analysis of motion. This “jog and inject” style was a perfect way to hone my palpation and flexion skills. It was very satisfying each time Dr. Allison asked me what I thought and concurred with my tentative observations. Next, we would “tap” or inject the joint in question with a steroid or a combination of steroid and hyaluronic acid. For a couple trainers, we looked at almost every horse just to make sure they were sound before their next race. We did radiograph a horse that came up non-weight-bearing during a gallop due to suspicions of a slab fracture in his knee. Unfortunately, this is a common and detrimental injury in racehorses. Fortunately for this horse, the slab fracture was sagittal instead of frontal and non-displaced instead of displaced. Dr. Allison bandaged the knee and recommended strict stall rest until the fracture is healed. Although the horse will never race again, he may retain function of that knee.

            Working in Amish country is actually not all that different from working on the racetrack. Partially due to economic restraints and partially due to unreliable electric sources for the fancy toys, most of the diagnostic work is done with eyes, ears, and hands. The Standardbred buggy horses are tough animals that are somehow able to handle a variety of lamenesses, wounds, and illnesses while continuing to work. This stoic demeanor, along with the fact that many of the Amish know as much about their horses as I know about my car, means that the cases we see tend to be more chronic and severe. Although these Amish clients don’t always know a lot about horse medicine, they are very interested in being educated: from learning the anatomy of different joints to learning how to administer IV shots. When finances allow, we take radiographs and perform ultrasounds, which provides even more opportunities for client education. My favorite Amish case has been a buggy horse that somehow got himself tangled in the shafts while his owner was at a horse sale. He gave himself a couple lacerations on his hind gaskin and cannon bone. The own said someone came over the loudspeaker saying that a horse was down, but he never thought it was his horse. All I could think of was the feeling when someone announces that a car has its lights on in the parking lot. Anyway, he had the horse trailered home and called us out on emergency. Dr. Hill evaluate the wounds as well as the rest of the horse (he had some traumatic uveitis as well.) Luckily no major structures were injured and there was limited muscle damage. To cut down on cost for the client, he agreed to let me suture up the wounds. Under the careful supervision of Dr. Hill, I placed a drain and closed the wound with tension-relieving sutures. Both the client and I were impressed by how well it turned out. Now we just hope it heals well!