MSU Large Animal Clinic Weeks 4-6

Hello again from here at MSU! I have had an enjoyable couple of weeks on first shift! I have been able to see an assortment of different cases on outpatient, inpatient, and surgery.

Outpatient has been filled with a variety of different cases from putting splints on crooked baby goat legs and bull breeding soundness exams to lameness and neurological exams on horses. My main duties with outpatient is helping the techs set up anything that is going to be needed for the patient coming in. Then once the patient arrives I help restrain or if its something like a lameness exam, I will help jog the horse. One of the first outpatient cases I got to help with was a breeding soundness exam (or a BSE) on a bull. This is basically to see if the bull will be fertile enough to adequately service the cows in his herd. The BSE starts with a physical exam to make sure the bull looks physically able to breed. This would include things like making sure he has an ideal body condition score. It is undesirable to have a bull that is underweight or overweight. The scrotum is also examined. The testicles are palpated to make sure there are no abnormal lumps or bumps. The circumference of the scrotum is also measured. The amount of sperm that is produced and the size of the scrotum are highly correlated. So as scrotal circumference goes up so does sperm production. The other main part of a BSE is to examine the bulls sperm under a microscope. The bull is normally then graded as a satisfactory or unsatisfactory breeder. Bulls with no sperm production, or too many sperm with abnormalities (for example, bent tails or no tails) are graded unsatisfactory and are not recommended for breeding.

Another cool outpatient case that I was able to be apart of was a lameness/neurological exam on a horse that shows in eventing competitions. The horse had previously fallen when going over a jump and has been on and off lame ever since. The horse had a history of going lame 15-20 minutes into exercising and then it would resolve itself shortly after. Because of the history, a neurologic and lameness exam were both done. When helping with this case, I was the one handling the horse. During the neurologic exam various test are done to try to exacerbate any neurologic abnormalities the patient may have. These tests include walking the horse in a serpentine pattern, walking the horse with its head lifted in the air, turning the horse in tight circles and then stopping abruptly, stretching the horses head from side to side, placing their legs in abnormal positions, pulling the tail while walking, and backing the horse. For the lameness evaluation the horse is trotted up and down a straight path. The doctor will also perform a flexion test on each of the joints in all four limbs. This is when a certain joint is held in flexion for 30-60 seconds. Then the horse is immediately trotted off to check for lameness. Here at MSU we also have access to The McPhail Center which has a big indoor arena where we can lunge the horses and the doctors can access the horses lameness while the horse is going in a circle.  This way the horse can also be observed at the canter and transitioning from one gait to another.

For inpatient during the day, it is similar to the duties I have when working nights. This includes hourly checks and treatments. During the day, the clinical student on that patient’s case will do their hourly checks and treatments so there is not as much to do for inpatient during the day compared to nights. One of the more interesting inpatient cases I got to see was a pony that came in on emergency with a giant wound in its semimembranosus and semitendinosus region. The referring veterinarian did a great job at debriding the wound. When the wound was unbandaged it looked pink and was starting to fill in with granulation tissue. They flushed the wound with sterile saline and betadine. The process seemed to be unpainful to the pony and this is because granulation tissue has no nerve endings. Once the wound was cleaned, it was rebandaged. It is unclear what caused the wound. First thought was maybe it was from getting an IM injection but she hadn’t recently received any injections in that area. It could also be from an abscess or tumor. It is still unclear where the wound came from but thankfully it is looking better and better each day.  

I also got to help with surgery and that was really fun! I helped the tech set up the surgery suite with whatever would be needed for that particular procedure. Once the horse was dropped we would help hoist them onto the table and get them positioned for surgery. Once the horse is positioned, the tech and I would clip and scrub the surgery site while the anesthesia team was intubating the patient. The first surgery I was able to observe was a tie-back. A tie-back is done in horses that have a history of roaring. Roaring is when a horse makes a load noise while breathing during exercise. This is normally due to a paralysis of the arytenoid cartilages in the larynx. This causes a partial blockage of air flow because the arytenoids close when they should be open. This is treated by surgically “tying back” the arytenoid cartilage with suture material. The goal of this surgery is to hopefully improve airflow to the lungs during exercise.

Well that is all for now! I’ll keep you all updated as more share-worthy cases come into the clinic!