All Hell Broke Loose

D. E. Larsen, DVM

“I have been looking at Sophie’s horse for a couple of days now,” Don says as we were lining out our morning calls. “I would like you to come along this morning and get your opinion. This is low-grade colic. I think it must be an obstruction, but I have not been able to confirm it.”

The three of us in the practice in Enumclaw were cow doctors. We did fine with the small animals, but horses were a different story. We had a few horse doctors around, and we tried to send most of the horses their way, but a few of the dairies would have a horse, and we were usually stuck with taking care of them.

“I didn’t know they had a horse,” I say. 

“She bought it a few months ago,” Don says. “Harold says he isn’t going to spend any money on it, but you know how that goes.”

We pulled into the barnyard in Don’s truck. The horse was in an open shed across from the milking parlor. She was standing, head down, and kicking at her belly every minute or two. 

“Have you done a rectal exam?” I ask Don. 

“Yes, but I didn’t find anything,” Don says. “But I am not sure about the horse’s gut. That’s why I wanted you to get a look. Your schooling is a lot more recent than mine.”

I started a full exam just so I wouldn’t miss anything. All her vitals were normal, except her pulse was a little elevated. Then listening to her abdomen, there are virtually no gut sounds.

“I guess I should do a rectal exam. I hate doing one on an unrestrained horse, but I don’t think we are going find a stocks around here.”

“She was pretty good for me,” Don says. “I will hold her for you.”

“Maybe we should put a twitch on her,” I say. 

“Don’t let Sophie know about that,” Don says. “She was pretty protective of her when I did the first exam.”

“If she says anything, just explain that a rectal exam on an unrestrained horse is dangerous to the vet, but also dangerous to the horse,” I say. “If she jumps or kicks, she could end up with a ruptured colon. That is probably fatal.”

I wrapped the tail to keep the hair out of the way and lubed my OB sleeve with a large amount of J-Lube. Standing on her right side, I held the tail to the side with my right and slid my left hand and arm into her rectum. She stood still. 

The colon was utterly empty. Don was probably correct in this being an obstruction colic. Pushing my arm in deeper, I explored the gut that was within reach. I found nothing in this initial exploration.

I reached deep and down on the left side of her abdomen, searching for the pelvic flexure, that spot where the large colon of the horse does a u-turn. It is a small portion of the colon and it is often the site of obstructions.

Finally, the pelvic flexure almost jumped into my hand. There was a firm impaction in the flexure. I massaged this mass, and the mare danced from side to side. This impaction was not large. I was surprised that the earlier treatments with mineral oil had not moved it. I slowly removed my arm and rinsed her rectum.

“You are right about this being an obstruction,” I say to Don as I unwrapped the tail. “There is firm impaction at the pelvic flexure, and it was painful for her for me to try to massage it.”

“I figured you had found it when she started acting up,” Don says.

“I know the experts say not to mix mineral oil and DSS,” I say. “But if you have treated her with oil a couple of times over the last 3 days, I think we should give her a big dose of DSS. If that doesn’t do it, and Harold doesn’t want to send her over the mountain to Washington State, I think we should talk to them about doing surgery.”

“That’s a big step,” Don says. “Are you sure about that? I have always been told never to touch the gut of the horse.”

“When I was home a couple of years ago, I went on a call with Dr. Haug to look at a horse he had done a flank surgery on for an impaction at the pelvic flexure,” I say. “That surgery went well. He just made a left flank approach, pulled out the pelvic flexure, and massaged the impaction to break it down. Worked like a charm.”

“I guess we could give it a try,” Don says. “I know Harold will go for it. He is sure this horse is going to cost more than they paid for it in the first place.”

“When I went back to school after visiting with Dr. Haug, I asked Dr. Adams about that procedure,” I say. “He said, if you have no other option, get in and get out as quickly as possible, and you will be fine.”

We gave the mare a full dose of DSS and some Dipyrone for pain. As we were finishing up, Harold came out of the house to talk with us.

“What do you two think?”

“We definitely have an impaction at the pelvic flexure,” I say. “We gave her some more medication. If she hasn’t passed anything by morning, we think we should do some surgery. Either that or send her over to Washington State.”

“We are not going to send her anywhere,” Harold says. “I’m not sure about you guys doing surgery either. But you know, Sophie will say we have to do what you say.” 

“Okay,” Don says. “No food, just like before. We will be here, ready to do surgery the first thing the morning.”

“I guess we should hit the books tonight,” Don says as we were driving back to the clinic. “I am not sure I can find the pelvic flexure. In fact, I have never done a flank incision on a horse.”

“Believe it or not, we did several while I was in school,” I say. “The incision is a piece of cake. In fact, the whole surgery is a piece of cake. It is just getting it done and not ending up with an infection following surgery.”

“We will plan for you to do the surgery. I will just be there to learn,” Don says.

The next morning we spent a lot of time packing and repacking our supplies for the surgery. 

“I don’t want to be out there and find out we forgot something,” Don says.

Finally, all packed up, we made the drive out to Harold’s place. When we pulled into the driveway, we could see the shed where the horse was being kept. As we got closer, we could see several boards were missing on the side of the shed. They were lying out on the pasture.

“That doesn’t look good,” Don says. “I hope the horse is still alive.”

When we pulled up to the shed, the mare was standing head up and eating some alfalfa. The inside of the shed was plastered with horse manure. And there were 3 boards kicked out on the side of the shed.

Harold came out of the barn when we arrived.

“About 3:00 this morning, it sounded like all hell was breaking loose.”

Sophie came up behind Harold. “We got up and came out here, and she was acting like everything was fine. She had kicked out the side of the barn, and there was horse shit everywhere. We figured that everything was okay, so I gave her just a little hay. She loved it.”

“This is the best thing that has happened to me in a long time,” Don says. “I have worried about this surgery all night.”

“What do we do now?” Harold asks.

“Let’s just go easy on the feed for a few days,” I say. “Maybe plan to be back on a full diet this time next week. Until then, just small amounts of hay and grain and plenty of water.”

We got back in the truck, and Don let out an audible sigh. “I am so relieved that we didn’t have to do any surgery this morning.”

“Makes the rest of the day easy,” I say. “Maybe we should stop off for a beer on the way home tonight.”

“That sounds good,” Don says. “I’ll buy.”

Photo by T.J. Checketts from Pexels