Hold the Horse Down

D. E. Larsen, DVM 

Mike was sitting behind the desk in the large animal hospital, his standard position during every one of our weeks of night duty at Colorado State University.

“Mike, you seem to like the desk job,” I said.

“Naw, not so much. I just need the experience of talking to people on the phone,” Mike said.

This was Thursday evening, nearing the end of our week of night duty. Seniors were assigned night duty every couple of months. Ten of us ran the hospital from closing at five until ten o’clock. We were managed by two interns, one on the small animal side and one on the large animal side of the hospital. We got to go home at night. The interns slept over at the hospital. But they had our telephone numbers if the need arose.

“Larsen, you need to get the whole group together for a quick conference here,” Doctor Reese, the intern on duty, said. “We are going to have an issue tonight.”

I headed out to the small animal side of the hospital and started gathering everyone for this conference.

“Conference?” Rod asked. “What is going on?”

“I have no idea what’s up,” I said. “Doctor Reese needs us all together to discuss the night.”

“Is he going to keep us here all night?” Rod asked.

“I say again, Rod,” I said. “I have no idea what’s going on. I’m just the go-for out getting everyone over to the large animal office.”

“It looks like we are missing a couple of guys,” Doctor Reese said.

“Chuck and Rod are finishing up doing the evening treatments over on the small animal side. They should be here shortly,” I said.

“I’ll wait till they get here. I don’t want to have to repeat everything twice,” Doctor Reese said.

The two latecomers came through the door just as Doctor Reese made that statement.

Chuck sat on the corner of the desk. “What’s up, Doc,” Chuck said.

“Okay, for those of you who don’t know it,” Doctor Reese started. “Doctor Adams had an emergency surgery today. He had the American champion endurance horse come in with a fractured humerus.”

“That is almost an automatic euthanasia, isn’t it?” Jim asked.

“In most cases, yes. But this horse has an exceptional value. So it was decided to give the repair a try,” Doctor Reese said. “It was a complicated surgery, even for Doctor Adams. Repairing a fractured humerus in the horse is almost an unheard of surgery.”

“So, how does that affect us?” Chuck asked. 

“It was a seven-hour surgery,” Doctor Reese said. “Seven hours lying on its left leg, and on recovery, there is radial nerve paralysis in the left leg.”

The radial nerve controls all the muscles that extend the front leg. Without radial nerve function, the animal cannot stand on that leg. I had never heard of it in a horse. In the dog, the leg drags along, wearing the skin off the top of the paw in short order.

“That’s another automatic euthanasia in the horse,” Jim said.

“So the surgery team has been holding the horse down in the recovery stall all evening,” Doctor Reese said. “The plan is to let them go home at ten tonight. We will be responsible for holding the horse down tonight. We will pull two-hour shifts with two of you on each shift.”

“I’m not sure I understand the plan,” I said. “I mean, if we had radial nerve paralysis with the horse on its side during surgery for seven hours, can we expect anything different if we hold the horse down on the other side for ten or twelve hours?”

“It is the only option we have,” Doctor Reese said. “They gave the horse a big dose of dexamethasone. The hope is to see some return to function by morning so they can get the horse in a sling. I will agree, the odds are not good for the horse. But, Larsen, if you want to discuss the plan with Doctor Adams, you can just march right down there and talk with him.”

Doctor Adams was almost a god in the world of lameness and orthopedics in the horse, and he had a massive influence in the veterinary school. He could kick a person out of school in a heartbeat, and there were rumors of him doing just that in the past. True or not, the potential threat made students conduct themselves with an extra measure of decorum. 

“I think Jim and I will volunteer for the first shift,” I said.

“Okay,” Doctor Reese said. “We need to get everyone signed up for a shift. You guys take a phone into the recovery stall with you. There is a phone plug-in there. You give the next shift a phone call a half hour before they are due to be here. Everybody needs to take the responsibility to make it here for your shift. That way, all of us can get some sleep tonight.”

“I need to call Sandy and let her know I am going to be late tonight,” I said.

“You other guys go ahead and head home now,” Doctor Reese said. “Jim and Dave, gather the clipboard with the list and bring a phone. We can go down to the recovery stall and get instructions for the night.”

The recovery stall was a large room, maybe twenty feet square. It was padded with thick rubber mats, like a wrestling mat, on the floor and all sides. Once you were in the room and the door was closed, it was just you and the horse, and do place to duck for cover if the horse was flopping around.

“You guys have had a long day,” Doctor Reese said as we squeezed through the large door that was opened only a crack for our entry. “We are set up with two-man shifts at two-hour intervals. We just need some instructions.”

“All you need to do is have somebody sitting on his neck all the time,” Doctor Adams said. “He is fully recovered and will try to jump up if he gets a chance. His left leg has no radial nerve function, and bone plates on his right humerus will not hold his weight. His only hope is to get enough return to function so we can get him in a sling tomorrow.”

Jim placed his knee on the horse’s neck as Steve stood up, and then Jim swirled around and sat down on his neck. It looked like an easy maneuver, but the horse did try to raise his head during the change of position.

“I’m about beat,” Steve said as he pushed past me. “I don’t think I will be going into Equine Orthopedics after today. We have been working on this horse since ten o’clock this morning. You should have been in on that surgery. I will never complain about the surgical approach of the humerus on a dog again.”

“Retracting the muscles must have been a chore,” I said. 

“I don’t think most people could have done the surgery,” Steve said. “Doctor Adams is so strong, and he made some of it look easy. But, a seven-hour surgery is almost too much for this kid.”

The surgical team filed out of the recovery stall. 

“Call me if you need anything. I will try to get some shut-eye,” Doctor Reese said as he left the stall and shut the door.

I plugged in the phone and laid the clipboard down in the corner, and set the phone on the clipboard.

“I guess if we hold the horse down, the phone will be safe in the corner,” I said.

“I hate being closed in this room with a horse,” Jim said. “There is no way to be safe if the horse is really flopping around.”

“Well, it’s one thing if you are recovering a normal horse,” I said. “This horse has almost zero chance of recovery, and here we are, stuck in this recovery stall with it.”

“The thing that I don’t understand is how are they going to get this horse in a sling anyway?” Jim asked.

“I don’t know. I would guess they will have to sedate him to lift him into it,” I said. “I don’t know why they didn’t do that this evening. By morning, the nerve on the repaired leg will be shot too.”

“I think Adams just wants to be able to write up this repair,” Jim said. “I doubt if it has been done before.”

“I don’t think so,” I said. “If it has, it hasn’t been done very often.”

“Have you heard of a radial nerve paralysis ever returning to function?” Jim asked.

“I haven’t heard of it occurring in the horse before, but in the dog, the leg gets ruined before there is any return to function,” I said. “At least that is the impression that I get from Doctor Creed.”

“It’s probably about time we switch positions,” Jim said. “My butt is getting tired.”

I moved around the horse and knelt with my knee on his neck. Jim stood up and stretched, and I tried to turn on my knee and sit down on the horse’s neck. The horse swung his head up at the same time, knocking me off his neck, and suddenly I am lying on my back beside his front legs. I scrambled away from his legs, and he was immediately was up on his sternum. In an instant, he tried to stand.

His left leg hung uselessly, and he placed his repaired right leg out to stand. It held together for a brief moment, and then the leg collapsed as the repair broke apart.

I looked at Jim and shrugged my shoulders.

“I wonder what Adams is going to say about this?” I said.

“We better call Doctor Reese,” Jim said as he picked up the phone and dialed the intern quarters.

Doctor Reese was there in a flash.

“Oh, boy,” he said. “Not much to do now. I will go call Doctor Adams.”

It didn’t take Doctor Adams long to get to the hospital. I have no idea where he lived, but I would guess he drove fast.

He entered the recovery stall with a frown and knelt down to examine the horse’s leg.

Jim and I stood aside, not saying a word but waiting for Adams to explode.

“I have to go call the owner,” Doctor Adams said. “Then we will put him to sleep.”

That was all that he said. I could hear Jim take a deep breath when Doctor Adams left the room. Doctor Reese looked relieved also.

It was maybe five minutes later when Doctor Adams returned with a bottle of euthanasia solution.

“It was a long shot anyway,” Doctor Adams said as he drew up the solution into a couple of large syringes. “I have never seen radial nerve paralysis in a horse before. Too bad, I really wanted this repair to work.”

With that, he gave the injections and patted the horse on his head.

“We can move him back to necropsy in the morning,” Doctor Adams said as he left the room.

We stood there a couple of minutes, nobody said a word.

“I will call the others,” Doctor Reese finally said. “You guys can go home.”

“I think this was the best outcome for the horse,” Jim said. “But somehow, I feel like we dodged a bullet tonight.”

“Doctor Adams likes to look mean,” Doctor Reese said. “But he is really a nice man, down deep.”

Photo by Missi Köpf from Pexels

There is Gold in Them Hills, From the Archives

D. E. Larsen, DVM

It was 11:10, and Bob should be coming through the door any minute. He was sort of the highlight of our morning in the office. Bob had been our Postman ever since the office opened. He was older, probably getting close to retirement, but he was a joy to talk with.

I think he must have us as a scheduled break on his route. He always seemed to have several minutes to talk. Bob was a Sweet Home native or as close as one could be to a native. He knew everyone in town. If we wanted to know about someone, Bob could give a pretty good synopsis. 

Bob could talk gold. He knew where to look in every stream, and he shares that information only to a trusted few. I liked to think I was one of those entrusted few. Bob had lost a son who was my age, a Lieutenant in the Army. In those years of the Vietnam War, Bob was probably preparing himself for his son serving in the war. Instead, he was driving home from the East Coast, and died in an auto accident.

The reality of the thing was he knew I was too busy to chase any of his stories.

We bumped into Bob one afternoon when he was panning gold with a friend. Bob took the time to give the kids and me a lesson on how to work the pan. We came up with a lot of black sand but no color. Bob truly enjoyed teaching his hobby to the kids, including myself. Hobby was probably the wrong word. I think gold was Bob’s true vocation. His postal job and any other work in his life only allowed him to pursue his real life’s work.

Bob told me a story one day about one of his trips to the California goldfields. He and a group of friends would make an annual trip to the areas out of Sacramento, California to pan for gold. This was a working trip for this group of guys. They would rework some of the same streams that were the site of the 1849 gold rush.  

Bob said that on one of these trips, they had a new guy along. He was always underfoot and trying to learn every little thing he could from these old guys. Bob finally tired of putting up with this guy. Bob pointed to a distant sandbar up the creek.

“Why don’t you go up there and work that sandbar,” Bob said.

The guy took his shovel and pan and headed up to the sandbar that Bob had pointed out. Bob and the rest of the crew continued to work with the dredge where they had been all morning.

“That was the biggest damn mistake that I ever made,” Bob said to me. “Just before quitting time that afternoon, this guy comes down the creek with a gold nugget the size of the end of your finger. I was so mad at myself after that, I almost couldn’t eat dinner.”

One August afternoon, we had a new client, Rob, came in with his dog, Yoda, a pit bull cross. Yoda had a pretty severe laceration on his large pad on his right front foot. Yoda was camping with his owner way up the Calapoolia River at the mouth of State Creek.

“Yoda spends most of the day in the river with me,” Rob said. “If he is not in the river, he is chasing a squirrel somewhere up the creek. I don’t know when this happened, I noticed him licking his foot last night, and then this morning he was limping on that foot quite a bit.”

Yoda was an excellent dog, and he didn’t flinch while I examined his foot. This was a deep laceration that extended halfway across the carpal pad, front to back. It was deep also. This was going to be challenging to get healed. Especially in a dog who was used to spending a lot of the day in the river.

“Pad lacerations are difficult to manage, in the best of circumstances,” I said to Rob. “In a dog who is spending a lot of his time in the river, it might be impossible.”

“I can keep him out of the water for a couple of weeks,” Rob said. “I am not on any schedule, I am just spending the summer up there panning for gold.”

“I suture most of these,” I said. “By suturing them and keeping them wrapped for a couple of weeks, most of them will heal. If we can’t keep a dry wrap on the foot, there is little chance that the sutures will hold.”

“When can you do this?” Rob asked. “Keep in mind, I am a long way from camp.”

“I can probably do it shortly,” I said. “But it is going to take a little time from Yoda to wake up.”

“This dog is the toughest dog I have ever owned,” Rob said. “You could probably sew this up with giving him anything. Is there any chance you could do it with local anesthesia?”

“We can try,” I said. “Yoda will let us know if that is an option or not.”

We moved Yoda into the surgery room. Laid him down on his side. He did not react as we started scrubbing the wound. Rob stood on the opposite side of the table from me and scratched Yoda’s ears. 

I drew up a syringe of Lidocaine and looked at Rob.

“We are going to find out right now, this stuff stings a little, I hate it myself,” I said.

Avoiding the laceration, I slid the needle through the skin at the front edge of the pad. Injecting a little at a time as I advanced the needle under the pad. I injected half the syringe here and then repeated the process from the back edge of the pad.

After a few minutes, I parted the edges of the laceration. There was no response from Yoda. Spreading the wound wide, I scraped the deep crevice of the wound. I applied some Neosporin to the in the wound and wiped it out with a sterile sponge. Then I draped the wound.

Taking a deep breath, I stabbed the pad with a suture needle. There was no response from Yoda. I glanced and Rob and smiled as I continued to close the wound. In this type of deep pad lacerations, I would use a deep vertical mattress suture using stints, made from IV tubing, on each side to spread the tension across the wound edges so the stitches would not tear the tissues.

Closure only took a few minutes. And then I applied a wrap that extended halfway up the leg. 

“The key to healing this wound is the wrap,” I said. “If it gets wet, it needs to be changed. Otherwise, we will change it every 3rd day. Is that a schedule that will work for you?”

“I can work with that schedule,” Rob said as he let Yoda stand up on the table.

“I will put him on some antibiotics just to make sure we keep the infection down as much as possible,” I said.

With that, Rob and Yoda headed back to camp. We started on their schedule of regular visits. Rob did a great job of keeping the wrap dry, and the wound looked better with each wrap change. After two weeks, we had a decision to make.

“We could go without the wrap starting now,” I said. “This wound looks good, but I really would like to go one more week.”

“The squirrels are going to love you, Doc,” Rob said.

The following week we removed the wrap and the sutures. This wound healed as well as any pad laceration that I had managed. I patted Yoda on the head when I set him down on the floor. 

“It has been fun working with Yoda,” I said as I shook hands with Rob. “It has been good working for you too. How long are you going to be around these parts?”

“I will probably break camp in a couple of weeks,” Rob said. “You never know about a guy like me, I might back next year, or I might be in Colorado.”

As the days passed, Rob and Yoda sort of slipped to the back of my mind. I was a little surprised when Rob was in the reception room one afternoon. He motioned to me, indicating he had something to show me. I invited him back into the exam area, and he looked at an empty exam room and stepped into it.

“I have to show this, Doc,” Rob said. “I saw this under a large boulder, and it took me three days to get to it.”

Rob had something wrapped in a square of rawhide in his left hand. He held his hand out as he peeled back the folds of rawhide. There, in the palm of his left hand, was the largest gold nugget that I had ever seen. I didn’t have words.

“Wow!” I said.

“This is what keeps us guys with gold fever going,” Rob said.

It was a few days later when I had time to meet Bob when he came through the door with the mail.

“Bob, I have a story to tell you,” I said.

“Will now, that is a switch,” Bob said, “you telling a story.”

“Bob, I just spent a few weeks working on a dog for a guy who was camped up the Calapoolia River at the mouth of State Creek,” I started.

“I know the area,” Bob said.

“He came into the clinic the other day with a nugget wrapped in a piece of rawhide,” I said. “This nugget covered the palm of his hand and was over an inch thick.” 

I motioned on my hand the size of the nugget. Bob grabbed my forearm, his eyes wide open, and his pupils expanded as wide as possible. 

“No!” Bob said, “I have been all over that river and that area. There is gold there, quite a bit of the stuff. But it is all small, tiny stuff really. I have never seen a nugget come out of the Calapoolia.”

“Well, I don’t know,” I said. “That was the biggest nugget I have ever seen.”

“That is a $20,000 nugget, maybe $30,000,” Bob said. “But, I can’t believe it came out of the Calapoolia.”

“I guess, when I think about it, he never specifically said it came out of the Calapoolia, I just assumed it,” I said. “He has been camped up there most of the summer.”

“Now you have done it,” Bob said. “I am not going to be able to sleep until I can get up there and start looking through the place myself.”

Photo by Csaba Nagy from Pixabay

New Job, New Equipment

New Job, New Equipment 

D. E. Larsen, DVM

I stood at the corral fence and pondered my dilemma. I had just tried to uncoil my new lariat, and it was so stiff it was all but unusable.

“Doc, it looks like you need to drag that behind your truck for a couple laps around the pasture,” Jim said. “That will take that newness out of it and make it so you can throw a loop with it. You’re lucky today. This old girl is so tame you can just walk up to her and drop a loop over her head.”

Jim was right on both counts. The lariat needed some work, and the cow was a real pet. She nuzzled my arm as I fashioned a halter with the rope and tied her to a post.

“How long has she been in labor?” I asked.

“I found her almost three hours ago,” Jim said. “I had Dean come over and check her. He said her head was turned back. He tried to fix it, but he couldn’t get it. He is the one who said to call you. Otherwise, he said I would be waiting all day to get somebody out of Albany.”

 I tied her tail to a twine that I tied around her neck to keep her tail out of the way. After scrubbing her vulva, I ran my left arm into her birth canal.

The head was turned back to the calf’s right side. That always seemed to be the direction that a retained head took. I don’t know why, or even if that was a valid observation. There was not enough room for me to reach the head.

“Are you going to be able to get it?” Jim asked.

“Yes, I think so,” I said. “I am going to have to turn one leg back, so I have more room in the birth canal, but I should be able to reach the head then.”

I attached an OB strap to the right front leg of the calf and pushed it back and down out of the birth canal. With the extra room now, I pushed my left into the birth canal up to my shoulder. I grasped the calf’s head by its eye sockets and pulled it forward.

Then I cupped the calf’s muzzle and popped the head into the birth canal. As I pulled my arm out of the cow, I paused and stuck my finger into the calf’s mouth. The calf sucked on the finger. It was still alive. With a bit of traction on the OB strap, I quickly pulled the right front leg of the calf back to a delivery position.

“This is going to be a tight fit, Jim,” I said. “This is a big calf for this cow. That is probably why the head got turned back.”

“I’m still pretty stout. The two of us should be able to pull it out,” Jim said.

“The problem, Jim, is that once we start, that calf has to come quick,” I said. “When the calf is this large, there will be some significant compression on its chest. This calf has been being pushed on for several hours. If the chest compression lasts for any period of time, the calf will die.”

“So, what’s the plan, Doc?” Jim asked.

“I’ll grab my calf puller, and I will be able to pop this calf out in a short minute.”

I attached an OB strap to both front legs and then washed my arms before going to the truck to retrieve my calf puller.

This would be the first time I used this calf puller in Sweet Home. It is brand new and looked it. When I was in Enumclaw, all my equipment was hand-me-down stuff. I was always worried that it didn’t provide a favorable professional impression. But now, this equipment made me look like I had just come out of school.

I pulled all the pieces of the case and carried them back to the corral. I threw it all over the fence. Hoping it would get a little dirty and scratched up in the process.

“Doc, this thing looks brand new,” Jim said. “Are you sure you know how to use it?”

“Ha! I have to admit that this is the first time I have used this one,” I said. “But, I can assure you, I have used these things many times.”

“I guess everything you have is brand new if you are just getting started in a new practice,” Jim said.

“Yes, I sort of feel like a kid with a new shotgun,” I said. “Afraid to use it until I finally walk through the brush and put a scratch on it.”

“Sort like when your wife puts a dent in the new car,” Jim said. “You are just happy that she did it before you.”

I hooked up the OB straps on the calf to the calf puller, and with everything positioned correctly, I started jacking the calf out of the birth canal. 

When the calf’s chest and abdomen were pulled into the birth canal, a large volume of mucus came out of the nose and mouth. Most of this probably came from the stomach, but I quickened my pace.

The calf’s hips hung up on the cow’s pelvis briefly. I lowered the rod on the calf puller, changing the direction of the pull and elevating the hips higher in the cow’s pelvis.

The cow strained at the added pull. She stiffened and pulled against the rope tying her to the post. She fell, stiff-legged, in a flop onto her left side.

The calf plopped out on the ground. My brand new stainless steel bucket squirted away from the cow’s impact and laid, severely bent, in the straw some ten feet away.

The calf raised his head and shook some more mucus from his nose. I unhooked the OB strap and cleared some more mucus from his mouth.

Jim retrieved my bucket and pressed the edges of the bent top, sort of straightening it out a little.

“Sort of like that scratch on the shotgun,” Jim said with a broad smile as he handed me the bucket.

I wiped the mucus splatted from my forehead with the back of my hand and chuckled with Jim.

“It’s good steel. It will still serve its purpose,” I said.

Photo by D. E. Larsen, DVM. Same bucket, forty-some years later.