So Much Work, So Much Hope, From the Archives

D. E. Larsen, DVM

It was a perfect spring afternoon when I pulled onto the Hansen place. Mrs. Hansen was watching Leah finish up a workout with Bella. Leah and Bella were quite a barrel racing dual. Just out of high school, but Leah and Bella were one of the top barrel racers in the area.

Huh”Oh, I am glad that you come on such short notice,” Elsie said. “Leah just found out that Bella needed a Coggins test to compete at a big event in Idaho.”

“It was no problem, this is just a stop on my way back to the clinic,” I said. “This is just a simple test, I just need to draw a blood sample. Besides, it is sort of fun watching them work.”

“I am so glad Leah has Bella,” Elsie said. “Things have been really tough since her father died last fall. There has not been a lot of joy in the house with just Leah and I. I don’t know what we would do without Bella.”

“Thank you, Dr. Larsen,” Leah said as she dismounted Bella. “I had already paid the entrance fee, and then I found out I needed a Coggins test. And we have to leave the middle of next week.”

“Simple test, I draw the blood, and I should be able to get it in the mail this evening,” I said. “We will have the results on Monday. Tuesday at the latest, it does go to a state lab.”

“I am so excited, if we do well at this race, I will be ranked high enough to get into some of the sanctioned events,” Leah said. “That means we could make some money and help out around here a little. Things are really tight, even with both Mom and I working.”

Bella was a good horse, and drawing a tube of blood was a snap, it only took a moment. I never saw a positive Coggins test, a test for Equine Infectious Anemia. It was one of those regulatory tests that obviously served its purpose of keeping the disease from spreading.

Leah did well in Idaho and went on to compete professionally in local rodeos. Time passed, I think I looked at Bella once more for some swelling after Leah had given her some vaccines. Then an early morning call came from a tearful Elsie.

“Dr. Larsen, can you come quickly,” Elsie cried into the phone. “Bella got her leg hung up in the fence. She was fighting with the neighbor horse through the fence. There is a terrible wound. Leah is at the barn with her.”

Horse wounds were sort of like eye wounds or porcupine quills, you could never rely on a client’s interpretation of the severity. One or two quills elicited the same response as 200.

In Bella’s case, I could see before I got out of the truck; this was a significant wound. She had torn the skin off the face of her left hock. This was probably the worse area on the horse’s leg for a laceration. There was so much movement here, and it was difficult to keep a good wrap in place, even small wounds were a challenge.

This was no small wound. There was a patch of skin that was gone, probably hanging on the fence rail somewhere. The wound was about 3 inches wide and 4 inches long. There was no skin to close. It would heal, but it was going to be a long process.

“It’s bad, isn’t it?” Leah asked as I approached her and Bella. She obviously could read the expression on my face.

I knelt and examined the wound without touching it. Bella was shying from my presence without me adding a touch.

“It could be worse,” I said, not sure how blunt to be with Leah right now. “It could be worse, but this is bad. This wound is going to take months to heal. There is no skin, and this is a large area. A skin graft might speed up the process a little.”

“Dr. Larsen, we can’t afford a lot. If you’re going to need to make a bunch of farm calls, we might not be able to afford even that.” Leah said. “Mom does without, just for Bella and me, there is no extra money right now.”

“If you can learn some basics of wound care, we can get this healed, it is just going to take several months. It will heal by granulation if we do nothing. We can speed the process up if we take care of wound and protect the new cells that will be migrating across the wound. I know it doesn’t mean anything right now, but you will be amazed at how well this wound will heal. Bella will be her old self, I promise.”

“She will be able to race again?” Leah asked.

“Yes, I don’t see why not,” I said. “But for right now, we need to get a wrap on this wound and get Bella in a stall. The more we can limit her movement, the quicker this will heal.”

“She will go nuts in a stall,” Leah said.

“She will adjust, it might take a few days or a week,” I said. “Now, if you are going to take care of this wound, you need to watch everything I do. It will take me about 3 visits at 3 day intervals, and then I will turn things over to you. Our goal will be to have most of this wound covered with new skin in 3 months. After that you can probably give Bella a little more freedom. I would guess you could start working her in 4 months, she should be competitive in 5 to 6 months.”

With that, I cleaned the wound and carefully shaved the wound edge. One more scrub and I applied Furacin ointment and non-adherent gauze pad to the wound and secured it with a figure 8 gauze wrap around the hock. Then a pressure wrap with roll cotton and VetWrap that went down to the hoof.

“If this holds in place, we will change it in 3 days,” I said.

“I can tell, if I have to do that wrap every 3 days, I am not even going to be able to afford the materials.” Leah said with tears welling up in her eyes.

“This is probably the only big wrap we will need,” I said. “We will work with you on this, Leah. Your father was a good client for many years with Jack. After this wrap, you will only be doing the first part where I secured the gauze pad on wound.”

“I am going to give her a tetanus booster and some long-acting antibiotics today,” I said. “We are probably not going to need to keep her on antibiotics.”

With that began a multi-month process of wound healing on Bella. Leah proved to be a good nurse. She was in the office often, and anytime I was in the area, I would make a quick stop just to check on Bella. I probably came to know Elsie and Leah better than any of the other horse clients. Bella almost became a favorite patient.

There was little a celebration the day I stopped and had Leah remove the wrap on Bella’s leg. The wound was now a narrow strip of granulation tissue on the face of the hock.

“I think you can be done with the wraps, and you can start letting Bella out of the stall for some light exercise,” I said. 

“Oh, thank you, Dr. Larsen,” Leah said with a brief hug. “I thought today would never come.”

“Now, take it slow for the first week and call if you see any change in that wound,” I said. “I will stop next week and take a peek. If it is okay, I let you start getting Bella in shape.”

Things went well from that point. The wound was completely closed ahead of schedule, and Leah and Bella were running barrels, and Elsie was running the stop-watch. Leah had her sights on a local event in the early summer.

The last time I stopped, Elsie was standing at the fence of the arena. 

“How are they doing?” I asked.

“Their times are great, even better than their times before the injury,” Elsie said. “We can’t thank you enough. They have a competition next week. Leah is so happy again. After all that work, she deserves some good times.”

The following week, I was in the clinic for Saturday calls. I had come in a little early just to make sure things were in order. I did give a brief thought about Leah and Bella finally getting back into competition today.

Then the phone rang! It was early, that meant the organization for the morning just went out the window.

“Hello, this is Dr. Larsen,” I answered the call.

“Oh, Dr. Larsen, I am so glad it is you.”

I recognized the voice of Elsie. 

“We have been in a terrible accident on the highway,” Elsie continued. “Can you come quickly? It is bad.”

After telling Elsie I was on the way, I left a note for Mary and headed out to the highway.

There were police, wreckers and a lot of people standing around when I got there.

Leah ran up to me and buried her face in my chest. “We pulled out onto the highway on our way to the event in Puyallup. We were rear-ended almost immediately by this logging truck. Mom and I are fine but the trailer is a wreck. I am afraid to look at Bella.”

They had just finished pulling the truck off the horse trailer. It to several of us to wrench the trailer’s rear door open. Bella was down, very scared, and very painful. I could not see any leg fractures, but there was some blood coming from both her rectum and her vulva.

“She is so painful, maybe we should put her sleep,” Elsie said.

“Let me just check with a quick rectal exam,” I said.

I put on an OB sleeve and lubed it well, I could feel bone fragments immediately as I pushed through the rectum. As I sweep my hand around the pelvis, it was shattered in a dozen pieces. I pulled out. 

So much work, so much hope, and now we can only bring Bella’s suffering to an end.

Leah didn’t need me to say anything. She knew from the blood on the sleeve and expression on my face. She cried on my shoulder, and Elsie stood with tears streaming down her face. The people in the crowd could have no understanding of what these girls were going through right now.

“Leah, there is nothing that can be done,” I finally said, “not with a million dollars. The only thing we can do now is to make Bella’s pain go away.”

In school, Dr. Adams talked some about how to euthanize a horse in front of a crowd. If you didn’t have immediate access to euthanasia solution, you could carry a scalpel blade in rectally and lacerate the abdominal aorta. That was not something I wanted to do here, not with those bone fragments lacerating the pelvic structures. I had euthanasia solution. I just lacked easy access to a large vein. There was no way I could get up to the front of the trailer. I would have to use the tail vein.

There must have been some nerve damage also because Bella had no reaction with I elevated her tail and stuck the needle into the tail vein. The injection went smoothly, and Bella was gone before the injection was completed. I was just sorry I had nothing to relieve the pain for Leah and Elsie.