Greetings again from the MSU Large Animal Hospital! I am sorry for the delay in creating this post, things have gotten busy the last few weeks. Since returning from AAEP Summer Focus, I have been on the day shift at the hospital. In addition to helping out with hourly treatments on in-patients, I have been able to assist with some out-patient procedures and observe surgeries. We have had a few weeks of very hot weather (often in the 90s), and have seen many horses with colic.
An interesting case that presented for evaluation was a 20 year old Morgan gelding with prominent swelling of a hind limb and accompanying lameness. He was non-weight bearing on the limb and had pitting edema, pain on palpation and the limb was very warm. Differentials included dermatitis and cellulitis, and joint infections and fracture. An ultrasound was conducted to check the subcutaneous tissue. Radiographs were performed to rule out fracture, and blood work was submitted to check fibrinogen elevation and white blood cell changes. The results of testing indicated that the horse had cellulitis in the limb. Broad spectrum antibiotics (SMZs) were started, and Banamine was given to control inflammation. A sweat of nitrofurazone and DMSO was also applied to the limb to draw out the fluid, and a bandage was applied. The gelding was walked several times per day as his comfort level allowed, and the sweat bandage was changed daily. He steadily progressed and became more sound, and the swelling continued to resolve. This was a great case with a great outcome!
Another interesting case was a Holstein cow that presented for dystocia. During the exam, it was determined that the calf was likely still viable, but was too large for the cow to deliver on her own. After a short time of trying to pull the calf manually, we proceeded to the operating room for a Cesarean section. The surgery was uneventful, and a large bull calf was delivered. Often calves delivered via C-section require some resuscitation, but this guy was lively.
Unfortunately, the Belgian foal that I wrote about in my last post returned to the hospital. She had been doing well at home, when the owner found her lateral and obtunded. The owner thought she may have been kicked in the head by another horse in the pasture. There were abrasions on her head, but they were more consistent with damage due to seizure activity than due to trauma like a kick. Skull radiographs were unremarkable. She was started on IV fluids, and a nasogastric tube was placed for feeding purposes, and IV antibiotics were started. The foal soon developed seizure activity, and was placed on a Midazolam CRI. Despite this, she continued to have breakthrough seizures and required IV diazepam to control those. When her seizures did not resolve and became more difficult to control, and the prognosis for the foal's recovery was poor, the owners elected for humane euthanasia. Due to the seizure activity, the doctors suspect that the foal may have had Tyzzer's disease. Liver biopsies and a necropsy were performed. I actually got to take a few liver biopsies myself. On gross necropsy, a subdural bleed was found, consistent with head trauma. However, it is not known if that is due to truly being kicked in the head, or if the bleed was due to head trauma from seizures. Lesions on the liver were also found during the necropsy, and were submitted to histopathology. Those results are not yet available, but will confirm or rule out Tyzzer's disease.
Another foal came in last week. The owner's indicated that it was an embryo transfer foal, and that it was 30 days premature. The foal was surprisingly bright and feisty for being so premature. Luckily, the foal's lungs and joints were mature, which are the biggest concerns with premature foals. However, because the foal was premature, the mare had not yet begun to produce colostrum, and therefore the foal did not receive antibiodies via nursing. This leaves the foal at a very high risk for infection, because foals get their early immune system from colostrum. Therefore, the foal was given a plasma transfusion which contains the necessary antibodies to protect the foal from infection until they begin to produce their own. I was tasked with monitoring the foal during the transfusion. I had done plasma transfusions on dogs before when I worked at an emergency clinic, but this was my first transfusion on a horse. Vitals have to be monitored every 5 minutes during a transfusion, to watch for signs of a hypersensitivity reaction. However, the foal did great, and went home a few days later.
This summer has flew by! I can't believe that July is half over, and I will be back in class in a little over a month.
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