Greetings, sorry for the lack of posts lately, things have been busy. It is very weird coming to the end of this summer, I'm sure it's a mutual feeling all around, but it's been a pretty incredible few months!
Things have been very busy here, I guess June was a record-breaking month for them here. My weeks have been fairly consistent as well, with some fun surgery days, ICU going from a full barn to a bit of a slow down, and being able to go ambulatory as well as to the Horse Park for the shows. With the busyness has brought some diversity, so I've been able to see a handful of really cool cases.
This was one case I went to with Dr. Senn, one of the former interns from last year. The owner noticed this in the morning, and was rightfully a little concerned..! Upon arrival, he, Hot Shot, was fairly calm and alert, but clearly this was very painful. It was a long process of trying to diagnose, clean, and prep just to even get a feeling for just what the damage was. We were obviously worried about any brain damage or communication into the local sinuses. The same side nostril had some blood coming from it, so that led to a little more caution as well. Once Dr. Senn was able to get a probe in there and feel around, trying to see just how deep it was. He wasn't the biggest fan of all of this, and to add insult to injury, upon normal administration of PPG IM, he had a pretty severe reaction. Thankfully no one was injured, including Hot Shot. We finally got him settled down, and were able to take some radiographs of the area. A big concern is not just the depth, but the interaction with the eye itself. He didn't have much of a menace response, and his globe was already starting to get cloudy. After all that, we eventually got him stitched up, leaving a slight opening at the bottom to allow for any drainage.
Two weeks later, we returned for his recheck, and the wound itself looked really great. I forgot to grab a picture of the after, but the site was clean, and healed beautifully. That was a relief, however, we were still concerned with the eye. Again, no menace was elicited, and he wanted to keep it closed constantly. Dr, Mullen, the Internist, came to the appointment as well, and was able to stain the eye, which had no uptake; take an IOP, which was surprisingly within normal limits; as well as ultrasound, which found some slight retinal detachment. Unfortunately, this doesn't bode extremely well, however if they do choose to remove his eye, they think that he could do just fine, seeing as it wasn't causing him too much pain anymore. Dr. Mullen said she would discuss it with an ophthalmologist and go from there on any further options.
There's also been the multitude of arthroscopes, athrodeses, and more than enough colic surgeries. The Summer Show Series out at the Colorado Horse Park ended 2 weekends ago, and they were all a steady stream of lameness exams, pre-purchases, radiographs, joint injections, and miscellaneous patients.
This was an interesting case, the horse had been having some soreness and pain up around his head and poll, thinking maybe something was out of place potentially. He had chiropractic work done, and some rest, but nothing was seeming to work. This rad taken shows some interesting mineralization or metal potentially up near his pole, caudal to his ears. It was quite the mystery, and I'm not even entirely sure how he's been doing since then.
There were a handful that did have to come in to the hospital for colic surgeries, I think week 6 out there had 3 over the weekend. I was asked to forego my final weekend out at the shows to stay here and help with ICU, as it was getting a little packed..! Thankfully since then, it has calmed down a bit.
This horse came in for a recurring dental issue as well as some concern about the sinuses. This horse has previously had 108 removed I believe, and there was a bit of infection, and it apparently kept draining from the site for over a month. Dr, Dunbar, the tooth expert, as well as Dr. Devine, our surgeon both tackled this case together. Dr. Dunbar went in orally through her mouth and removed 109, which was the primary reason for the procedure. Yet, when the sinus flap was opened, it showed that the entire right side of this horse's face/sinuses was filled with a caseuous exudate. Very pleasant smelling too.. Thus began a massive lavage and cleared it all out. A film was shot, and there revealed some cyst-like structure in the same region as well. It was quite perplexing just because there was no localized swelling and when Dr. Dunbar probed from within the mouth, there was really no opening to go through. It was decided to just totally flush it, take care of the tooth, close her up and see how it heals, coming back to rads later down the road. She recovered great, and as far as I know, there have been no further problems.
Two weeks ago, we had another interesting case. A broodmare was in to be re-bred, however she came into surgery for a urethral extension. The mare was so sunken back cranially, that her uterus would just fill with urine. A rubber catheter was used as the temporary line, and it was an intricate process of making sure it would stay in as well as not doing too much damage to the structures involved. This mare was about 22 years old, and was a little bit of a poor doer, so the topic of even breeding her in the first place came up. It was a good learning experience to understand that even though we as a veterinarian may not think it's best to breed this mare or that stallion, and can convey that to a client, but at the end of the day, unless truly critical, that decision isn't ours to make.
Last week also brought in a 4 year old TB with a rough history of some hock effusion and intermittent lameness.
He had an arthoscopy to basically get a diagnostic game plan for the future, and even Dr. Devine mentioned that this might possibly be the largest hock he's ever seen..! Once he was in there, it was a mess. A lot of shredded cartilage, and even removed a couple of these bone chips. The prognosis was not great for this horse to return/aim for a full athletic career, and it is really unfortunate just given he's so young. Hopefully he is now much more comfortable though.
Another fun case was a horse that I have previously mentioned on this blog post. Russel, a horse that presented as a choke, stayed at the hospital for a while, with a temporary trach, and an eventual diagnosis of DDSP. They went in and lasered it, but after he went home, apparently he was not improving like we wanted. So, he arrived back for another visit, this time for a permanent trach.
Everything went smoothly and he was now equipped with a much improved breathing capacity. He recovered really well, and apart from the expected swelling around the site, everything looked great for him and he was able to go home. The only true concern for the owner was his lack of vocalization anymore! He was an incredibly sweet horse.
This past week/weekend also brought Colorado the National Junior and Young Riders Championship. I partook on the festivities on Saturday, the major cross country day. Being an FEI regulated event, the security and rules were much more strongly enforced. It was exciting to see just exactly how this ran, being extremely interested in that level of competition and veterinary care. I helped out with the One Star horses in the morning to start, in the holding box after they ran. It was very similar to the rush that happens at Richland, if anyone has been there. I helped Dr. Toll, who has been at this event since 1998, with the TPR's and rechecks of these horses. Then, we proceeded back up to the main area where I helped Dr. Christakos administer some IV fluids for a few horses. Most teams brought their own vets, so we had less to administer than expected, which was very welcomed. The trouble with FEI events is the lack of ability to use any drugs, sedation, blocks, etc. so placing a catheter is made a lot more interesting. There was only one horse that fell on the cross country course and it was only a slight abrasion, road rash basically, so everything and everyone stayed very safe. We had a chance to watch the stadium jumping at the end of the day, and again thankfully no injuries, just an exciting run!
I can't believe I'm coming to the end of this awesome experience, but here's to a great final week and finishing out my time here in Littleton! Hope you all are having wonderful summers from here on out as well!
-Taylor Alton
No comments:
Post a Comment