Finishing last week marked my half way point here at Cleveland Equine. It's amazing to think abut how much I've learned, and how much more comfortable I am with performing a lot of tasks.
Beanie, the mare with a corneal ulcer, is still in the hospital. I've been giving her nighttime and weekend treatments through her subpalbepral lavage. We've adjusted her treatment plain to include fluconazole because the culture from her eye came back showing a fungal component. we also replaced the acetylcysteine with EDTA in hopes of better control the melting of the ulcer.
A barn I've been to a few times now is part of a case a couple of the doctors have been discussing. Originally, one out of three horses in the barn had a swollen eye. The vet determined the symptoms to be allergy related and dispensed some dexamethasone and suggested getting generic Zyrtec (cetirizine). We went back a second time because another horse in the barn developed the same symptoms, and then the last horse did as well. We looked for an environmental factor (they had used a new chemical in the pond that spring to kill algae, a raccoon had been hanging around the barn and there were lots of geese just outside the barn) but couldn't come up with a definitive answer. We flushed the tear ducts for all three of the horses and all are doing better on aspirin and the cetirizine.
We did another castration this week and this time I got to use the emasculators! After the vet separated the muscle from the cord and ductus deferens I first crushed/cut the muscle and then then the cord. It took more force than I thought it would! As usual, the horse was sedated with dormosedan and torb, blocked with carbocaine, and given banamine and the antibiotic genacin IV.
I also got to see two umbilical hernia surgeries this week. The first one I just watched, but for the second they allowed me to complete some of the skin sutures to close the incision! We used simple interrupted to close. The doctors commented that, while simple continuous is faster, it's riskier because if one area comes undone the entire suture line can pull out. I also learned about the vest over pants suture used during the surgery and got to practice it afterward.
The last case I'll mention here is a respiratory workup that we originally saw on the barn. The owner complained that her horse seemed slow and lazy and was having a hard time breathing during exercise. She opted to come in to the hospital a few days later for thoracic radiographs, a thoracic ultrasound and a bronchioalveolar lavage (BAL). The radiographs and ultrasound appeared normal, and we did the BAL last. This consisted of placing a tube down the trachea into the horses lungs and then flushing sterile saline into the tube and immediately pulling it back. The first sample was surprisingly clear, but the second was much cloudier and had some debris. We've sent these to be analyzed for respiratory diseases like EHV-5. I will keep you updated on what is found!
Lastly, Annie, the pony with hemothorax, has gone home! The coagulants she was given helped to stabilize her, and while she is not cured from whatever caused the bleeding into her chest, she was stable enough after about a week to return home and spend some time with her family.
I am excited for the second half of my time at CEC :)
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