D. E. Larsen, DVM

 Charlie’s horses were pretty well managed, and after the breeding season, there was not a lot to do around the farm. Betty managed to keep their account pretty active.

    “What brings you in today?” I asked Betty when she eased through the front door. Betty was a slightly built lady with black shoulder-length hair. She seemed a little shy most of the time when Charlie was around, but I suspect that she could hold her own in most situations.

    “This darn cat of mine is peeing everywhere,” she said with some concern in her voice.

 This darn cat was named Foster; he was an old guy. He was approaching the golden year for male cats in the 1970s. I seldom saw a male cat over 15, and if I remembered correctly, Foster was going to be 15 this summer. Betty had found him as a kitten under the dumpster at Glen’s Market in Foster. He pretty much had the run of the place now.

    “Peeing all over the place, small puddles or large puddles?” I asked.

    “Oh, they are large puddles when they are on the floor. He peed on the bed this morning. That is why I am here, it woke up Charlie, and he was none too happy,” Betty explained.

    “Well, let’s get him in an exam room and look at him and see if I can get some urine out of him.”

  Pulling him out of the carrier, I noticed that he was much thinner than he was in the past. There was urine in the kennel.

    “Oh my,” Betty exclaimed, “how could there be so much urine already?”

    “We will get a quick look at this urine first, then I will do an exam,” I said as I drew up some urine from the kennel.

    This urine would do fine for a dip stix, but we would need a better collection if we were going to have to do additional testing. I handed the syringe to Dixie and returned my attention to Foster. He was quite thin, ribs were showing through his hair coat. His eyes had early cataracts, sometimes these old guys just have trouble finding their way to the litter box. He was dehydrated also. My guess was either advanced kidney failure, the most common cause of death in an old cat, or possibly diabetes. I seldom saw diabetes in the cat, but it was definitely on the list.

 Dixie popped into the exam room and laid the results of the dip stix on the counter. A four-plus urine glucose and normal specific gravity just about confirmed a diabetes diagnosis.

   “Betty, Foster probably has diabetes. We need to do some blood tests to make sure and to check his liver and kidney function. Then we need to give him some fluids and get him on a stable insulin dose. He is probably going to have to stay with us a day or two.”

    “Doc, I can leave him for the day, but I don’t want to leave him overnight. If he is going to die, I want him to die at home,” Betty said in a stern voice. I had not heard that voice from her before.

    “We can probably work with that, but I will need to see him every morning for a week or so. We will start off with a pretty low dose of insulin and work it up slowly,” I explained.

 “The other thing we need to discuss is what we can expect with his treatment. He is almost 15, and I don’t see very many male cats older than 15. Diabetes is a difficult disease to live with for people. For people to manage the disease in pets is even more difficult. Top that off and cats are also difficult to treat when they have diabetes. A high percentage of pets with diabetes are euthanized within 6 months of diagnosis, just because of the difficulty of living with the disease.”

 “We will do whatever we need to do to keep Foster alive,” Betty said. “I know he is old, and I know he won’t last forever, but we won’t be the ones to give up on him.”

 With that, we kept Foster for the day. His blood glucose was well over 400, and other blood tests were normal. We gave him 300 ml of Ringers Lactate by SQ injection and started him on a low dose of insulin.

 Betty was waiting at the door every morning with Foster. My guess was the barn chores would wait until his treatment was done. Testing at the time was cumbersome. The first few days, we did both a blood test and urine glucose. Foster was obviously feeling much better, looking brighter, and Betty reported him to be much more active and peeing less. My goal was to get his glucose to somewhere around 200, just to a level he could live with and not have much in the way of a hypoglycemia risk.

 By the third day, we were there. “I think this is the dose we use for a couple of weeks,” I explained to Betty. We had been showing her how to do the injections all week. I want to see him still for a couple of days, just to check his urine glucose and give the dose in the morning, Then we will turn you loose at home.”

 Thursday morning, expecting a quick check, Foster’s urine showed no glucose. Great, so much for a simple case. We drew a little blood. Blood Glucose was 50, pretty low.

    “No insulin for Foster today,” I explained to Betty. “Sometimes, in the cat, we will see a remission or sometimes a fluctuation in insulin requirement. So no insulin today, and we will check him in the morning.”

 Friday morning, and there was still no glucose in his urine. We decided to go the weekend without insulin and recheck on Monday. This might prove to be a complicated case to manage.

 On Monday, Foster’s urine showed a 4+ glucose, and his blood glucose was over 300. So we started over where we left off.

    “That would be great if you could check his urine every morning, but I am not sure that you could get urine out him,” I said. “We will have you check his glucose every morning, give insulin if it is positive, and don’t give insulin if he doesn’t have glucose in his urine. That is not perfect, but we will see how that works. You just call in the mornings and let Dixie know how things are going so she can keep his record up to date.”

    So that was the program, Betty was happy, Foster was delighted, I was hopeful that we would not have a wreck. I could not believe that Betty could get urine every day.

 Two weeks later, when Betty was in for a recheck, I noticed that the daily record was complete. There was a two-day stretch where she did not give insulin. Foster had gained almost 2 pounds and starting to look like his old self.

 “Things look like they are going well,” I said. “But it looks like you are going have to check his urine every day, his insulin demands are just going to fluctuate enough that we have to have a daily check. My concern is, how are you going to get urine out of him every day?”

 “That is no problem, I just have him pee in a coffee cup,” Betty said with no expression, just like that was something everybody would do. 

 Betty was able to manage Foster for another 3 years with this simple program of monitoring. Consistently during those years, Foster would have several days each month where he would have no need for insulin. We could have managed him closer and done away with those days, but I am not sure that his quality of life and the quality of life for Charlie and Betty would have been improved.

Photo by Ave Calvar on Unsplash

D. E. Larsen, DVM

 “I have a hot tip on a horse running in the third race at the State Fair Friday night,” Charlie said into the phone. “I would like to take you and Sandy up there with Betty and me if you can get free. This is a solid tip, we can make some money. Sort of like insider trading.”

 “I think we can get a baby sitter, we would be happy to go with you, thanks for the invite,” I replied.

    Charlie and Betty were right on time to pick us up Friday night. Charlie seemed excited to be on the way to the horse races, almost jovial.

“This is a solid tip I have on this horse,” He said as we sped through Sweet Home. “You probably knew that betting the horses is filled with pitfalls. You have to have good information from the trainers to make any money at it. Occasionally, a race comes along where the trainers stick a horse in the race to get track experience. Rarely, one of these races ends up with one good horse, and all the others are just there for the experience. This race is a sure bet, I hope you brought enough money to make a good bet.”

     “I brought some money,” I said, “but I probably have a different experience at the track than you have Charlie. My experience has been based on luck, and I have suffered from overconfidence at times.”

    “I’m telling you, and you can take this to the bank, this is not overconfidence, this is the closest thing to a sure thing at the track you will ever see,” Charlie said in a stern voice, seeming to be irritated that I might question this tip.

   Friday night and the State Fairgrounds were packed. We did find a parking spot. Charlie walked at a fast pace, I think he was excited. I could keep up with him, but Sandy and Betty lagged far behind. They did not catch up with us until we were standing in line to buy admission tickets to the races.

    “This is a good thing,” Charlie said. “A large crowd means a bigger payout.”

    We picked up hot dogs and a beer at the concession stands and found our way to set of seats about a third of the way up the grandstands. The good thing was it was close to the breezeway to the betting windows. After downing the hot dogs, Sandy and I set about picking a horse for the first race.

   “I’m telling you Doc, don’t waste your money on two-dollar bets. You need to take all your money and put it on the #6 horse in the 3rd race,” Charlie said in a hushed voice, not wanting to give away any information to somebody who might overhear the conversation.

    “I’m pretty conservative at betting, I try to pick the best horse and bet him to show,” I explained.

   “You won’t win enough to pay for the gas getting here,” Charlie snorted.

   Sandy and I went along with Charlie and watched the first 2 races. As the third race was announced, Charlie sprang to his seat.

“Give me your money, and I will buy the tickets, I don’t want any mistakes of this one,” Charlie said with his hand outstretched.

   I handed him a $10.00 bill, and shuddered a little, remembering the horserace in Boston where I was overconfident and lost $10.00 on a horse which I bet to win.

    Charlie must have been first in line because it was not long, and he was back. He handed me our ticket, and we stood to watch the race, not really looking at the ticket. Charlie was all smiles and a little agitated. I was guessing that he was starting to question his tip.

  Horse races don’t take long to run. They spend a lot of time getting the horses out on the track and parade up and back to allow adequate time for the betting to take place. Once in the starting gate, they are off in short order. The #6 horse had a good start and was in the lead by a full length at the first corner. There was never any question after that point, and he won with a solid lead. Charlie almost threw Betty in the air. We were happy also. This horse had pretty favorable odds, something like 6 to 1. Charlie and I headed to pay windows. I started to get in line for the $10.00 window, and Charlie grabbed my arm and pulled me over to the high stakes window. Now I looked at my ticket, it was a ticket for #6 horse to win in the 3rd race, but it was a $100.00 ticket.

    “You must have got your tickets mixed up,” I said to Charlie.

    “No, that is your ticket, I assumed the risk, you can pay me back out of the winnings,” He said, handing me my $10.00 bill back.

    I collected the $600.00 and handed Charlie his $100.00. I am not sure how much Charlie had bet on the race, but he had a lot of money in his hands.

    “Now we have enough money to bet a few Quinellas or Trifectas. I will teach you how to win a little money at the track. But remember, you have to have an in with the trainers, and you have to trust their tips. If you don’t know Randy, I will introduce you one of these days.”

    Sandy and Betty were awaiting our return, Sandy was feeling pretty frisky thinking we had won $50.00 or $60.00. She was a little surprised when I handed her a couple hundred dollar bills. 

“Charlie insured our bet at a little higher value than my $10.00,” I told her.

Photo by Mathew Schwartz on Unsplash

D. E. Larsen, DVM

 I pulled the fingers off a plastic OB sleeve and pulled it on my left arm. After the fingerless sleeve on my left arm was in place, I pulled on a latex exam glove. Then I pulled on a second OB sleeve, also with the fingers removed. This would allow excellent protection from the ‘elements’ and still all for excellent sensitivity at my fingertips. I applied a good squeeze of KY to my hand and arm. I struggled to maintain a safe position behind this large quarter horse mare. She moved from side to side as I eased my gloved hand into her rectum. Standing at her right hip, I held her tail with my right hand and lean hard on my elbow firmly planted on her rump. It was apparent who had the most muscle as we danced from side to side in the stall.

 “How many times have you bred this mare?” I asked Charlie as I advanced my arm into her rear end.

 “This is the third visit for her this year. I had problems with her last year and didn’t get her pregnant. The owner really wants to get her in foul with Carbine,” Charlie answered.

 Charlie had related the problem when he stopped by our house on Ames Creek yesterday. I was out front with the kids, picking some corn in the garden, when Charlie pulled into the driveway in his old blue Chevy pickup. He was on his way home from work when he saw us out front.

 “Hi, I’m Charlie Land, I have a little horse ranch up the creek. I just wanted to introduce myself and ask if you had time to look at a mare for me this weekend,” Charlie said as he walked across the lawn with his hand outstretched.

 “Dave Larsen,” I replied as we shook hands. “We are going to be home on Saturday, I could run up and look at her in the morning. Not terribly early, I am not much of a morning person and like to sleep in when I get a chance.”

     “This is a mare that I have been trying to get pregnant for a couple of years,” Charlie explained. “I lease this big quarter horse stud, Carbine. He is a pretty valuable horse and has a great record on the quarter horse track. I generally have mares lined up all spring. This mare didn’t get pregnant last year, and I only get paid for a pregnant mare.”

 My hand reached the brim of the pelvis, and I swept from side to side to find the uterus. I carefully ran my hand along the length of the uterus, starting at the tip of the right horn and continuing to the tip of the left horn. 

 “Not pregnant, and the uterus feels pretty normal,” I said, almost to myself as I reached the left ovary. “Normal left ovary,” I said, returning to the right ovary. “The right ovary is normal, and a large follicle is present, this mare should be in heat very soon,” I said as I pulled my arm out and peeled the OB sleeve and gloves off.

 I breathed a sigh of relief as I pushed myself away from the mare. I was always told the only way to be safe around a horse was to be in the right place at the right time. To be in the right place at the right time, you have to be in the right place all the time. Doing a rectal exam on a poorly restrained horse was one of the most dangerous positions to be in, both for the horse and for the examiner. It is easy to receive a kick, and ruptured colons are also possible for the mare.

 “If she doesn’t get pregnant with this breeding, she goes home,” Charlie said. “What do you think we can do to get her pregnant?”

 “Well, Charlie, I will be honest with you. I am much more of a cow doctor than I am a horse doctor,” I said as I pondered the problem in my mind. “The horse guys like to culture a mare and treat any infection according to the culture results. That procedure takes almost a week to complete if we start today. She is going to be in heat in the next day or two.”

    “This heat is her last chance this year,” Charlie said. “She goes home after her next cycle.”

    “In the cow, I do a post-breeding infusion,” I explained. “The day after breeding, I infuse the uterus with an antibiotic that is easily absorbed by the uterine lining. This clears any infection in the lining of the uterus and gets it ready for the fertilized egg, which reaches the uterus usually 3 days following breeding. My guess is if you call a horse vet, he will shudder at that strategy. I don’t know why it might be a money issue. Their procedure runs up quite an expense. Might just be that they listen to the experts more. In the cow, we are working a herd, not an individual.” 

    “You make sense to me,” Charlie answered. “I will breed her when she cycles and give you a call. Or just stop by your house. I thought, how lucky can a guy get when you came to town, then I thought I had died and went to heaven when you moved in down the road.”

    “Whatever works, you are more than welcome to stop by the house anytime. We haven’t been in town too long, people are just now learning I am around, so I am not too busy just now,” I said. “The clinic won’t be completed until this fall.”

   Charlie pulled into the driveway on his way home from work on Tuesday. I recognized the old blue Chevy pickup and stepped out of the garage, where I had been putting things away.

    “I bred that mare last night after work,” Charlie said as I walked up the driveway toward his pickup. “I was hoping you could come up this evening.”

    “It will take me a couple of minutes to get things ready,” I replied. “If you get home and get her in a small stall, I should be there by then.”

 It didn’t take long, I just needed to make sure everything was in the truck. I ran through a checklist in my mind as I looked through the back of the vet box. Plenty of water, a vial of IV Ampicillin, infusion pipettes, tail wrap, OB sleeves, bucket, boots, coveralls, Betadine scrub and solution, and plenty of lube. I ran into the house and told Sandy that I would back before dinner. Charlie’s place was only a couple of miles up the creek.

    Charlie was waiting in the stall with the mare haltered when I stepped through the open barn doors.

   “Push her over against the wall on her left side,” I instructed.

    I wrapped her tail, and the did a preliminary scrub of the rectum and vulva with Betadine surgical scrub. After mixing the 3-gram vial of Ampicillin, I did another scrub of her rear end and then flooded the area with Betadine solution. I drew up the Ampicillin in a 60 cc syringe and stuck it in the chest pocket of my coveralls. I held the infusion pipette in my teeth as I pulled on an OB sleeve and applied ample KY.

    Again, standing on her right hip, I eased my left hand into her vagina. She tensed a little but tolerated the intervention far better than the rectal exam the other day. I moved more behind her now, took the pipette in my right hand, and directed the tip into the palm of my left hand. I advanced my left hand and arm into the vagina until I encountered the cervix. Holding the pipette steady, I attached the syringe to the pipette with my right hand. With my index finger in the cervical orifice, I advanced the pipette into and through the cervix. Then I slowly infused the Ampicillin solution into the uterus.

   That accomplished, I withdrew my arm and pipette, moving out from directly behind her as I did this maneuver. I rinsed her off thoroughly and removed the tail wrap.

    “That’s all there is to it,” I said to Charlie. “Now we wait to see what the next couple of months give us. Since there is no rush to make a pregnancy diagnosis, I would wait at least 60 days before checking her. Obviously, if she continues to cycle, she is probably not pregnant.”

 “I doubt if the owner will be able to wait that long before a check for pregnancy. But that is his problem, she is going home this week. I will let you know when I get the news either way,” Charlie said.

    “Everybody is in a hurry for an answer, but if it doesn’t make any plans change, time will give you the same answer as an early pregnancy exam,” I said as I loaded things into the back of my truck. “I will be as anxious as everybody to hear the news, you let me know either way.”

     It was just short of 50 days later, and Charlie’s pickup skidded to a stop in our driveway. Charlie jumped out and ran to the door, getting there before I could navigate the way across through the toys scattered around the living room.

    “Good news,” Charlie said as soon as I opened the door. “You are my hero now, that mare is pregnant, and the owner is happy as can be. I think I like the way you treat cows.”

    Charlie pulled a wad of bills out of his front pocket and peeled two bills off the roll. He reached out his hand with two 100 dollar bills. “This is for your good work,” he said.

    “No, Charlie, I am no damn lawyer, I charge for what I do, I don’t take from your profits resulting from my efforts,” I said. “You just call me next time, that is rewarding enough.”

   “Call you next time!” Charlie said, “I am thinking that next year we should be infusing every mare. You will make me a lot of money if we can speed up the process and get more mares serviced and pregnant.”

    “That might be overdoing it a little, but we can work out the details next Spring,” I said.

 As time went by, my relationship with Charlie grew with every mare we treated. This was a simplified procedure but worked well. Mares were seldom bred more than one time, and the pregnancy rate was very high. Charlie remained a happy and loyal client.

Charlie and Betty Land continued tomorrow, #2 At the Track