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.

D. E. Larsen, DVM

I glanced out in the waiting area and could see Emma waiting to talk with me. Emma was an attractive young girl with light brown shoulder-length hair that she wore in a ponytail. I think she was still in high school, probably a junior or senior.

Emma had a young mare, Lilly, due to foal most any time now. Emma was doing everything in her power to provide the perfect setting for the delivery. In doing so, she has been talking my leg off. She had been talking with me a couple of times a week for the last month. Most of the time, that was okay, I did a lot of work for her father.

When I stepped out to the front counter, she bounced up.

“My father says I have been bothering you too much and not paying you a fair fee,” she said. “So I want you to make a farm call and check out the birthing facility I have set up. I have moved a bed into the barn, and I will be sleeping there until Lilly foals.”

“You tell your father I am always willing to provide whatever instruction I am capable of to our clients and their families,” I said.

“I know that, and so does he. We just thought maybe you should check over what I have set up, just to make sure I am not missing something. I want this to be perfect.”

“That sounds fine. You can schedule a time with Sandy. It is probably a good thing, we have covered a lot of topics over the last month or so.”

“I have a checklist from those discussions and from reading in Horse and Rider magazines.”

“You know, Emma, a lot of mares will be reluctant to foal if they are being watched,” I said.

“But she is so ready, all the signs are there,” Emma said. “She is leaking milk, and her privates are really swollen and flabby. And her due date is tomorrow. I am taking off school tomorrow, and Thursday, and Friday if she hasn’t foaled by then.”

“They have their own clock, and don’t be surprised if you don’t go to the house for dinner or something and come back to a foal standing in the stall,” I said. “But, you schedule a time, and I can get out there this afternoon and see what you have set up.”

The Pedersen farm was anything but neat. The barn was a large old barn, once painted red, that set a hundred yards behind the house. With all the work on the farm, Mr. Pedersen didn’t have a lot of extra time to worry about mowing the lawn. Emma was the oldest of 5 girls, and I don’t think any of them helped around the barn much unless it was with Emma’s horse.

I drove past the house and parked the truck by the barn. Emma came out of a small attached shed on the house side of the barn. Her younger sister was by her side, Sara was 7 years old, and she was often around when we were working with the cows. Both girls were all smiles, and you could tell that the pending birth was going to be an exciting event for them.

I was literally blown away when Emma and Sara led me into the shed with the horse stall. It was immaculate. There was not a cobweb in the tallest rafter. She had a well-made cot in the corner with a desk and bookcase nearby. Then she had a small refrigerator on a shelf for medication and supplies.

Lilly was in a sizable stall that was bedded entirely with straw. There was a pitchfork by the stall gate and not a trace of soiled straw in the stall.

“Do you think the straw is clean enough?” Emma asked. “I have worried about that, but I don’t know what else there is that I could use.”

“The straw is fine,” I said. “It is far better than most foals get.”

“Emma thinks that it is going to be born tonight,” Sara said. “I want to bring a sleeping bag out here, but Mom won’t let me.”

“Your mother is probably right,” I said, “it is a school night. When mares have their babies, it is usually a pretty fast event. You would probably sleep right through it.”

“I just worry about all the little things,” Emma said. “The magazines talk about all sorts of problems. Things like navel infections I can feel confident that I have under control by dipping the navel with iodine. They talk about foals suffocating in their membranes. Stuff like that where you have to there to help, or you lose a foal.

“You have things just about as perfect as they can be, Emma,” I said. “Those stories like the foal suffocating in the membranes are just stories. Most of those foals were probably stillbirths. Things happen fast when mares foal and most of the foals are not going to allow any membranes to hang around on their heads. Horses have been doing this a long time before people got involved in the process. Being here to watch is okay, but you don’t want to do anything unless there is a problem. And then you should call me first if you can.”

“Okay, I will relax a little,” Emma said. “At least you have made me feel a little less concerned. It is just that I want everything to be perfect with this delivery.”

“And Emma, don’t worry if she doesn’t foal tonight,” I said. “Mares will often hold off their labor if there is too much observation. The big horse ranches usually monitor their mares in labor with remote cameras.”

“Okay, but you know I am going to call you if anything looks unusual.”

With that, I returned to the office, and Emma sort of faded into the background for a time. Wednesday came and went with no call.

By Friday afternoon, I had just about forgotten about Emma and her mare. Then the phone rang.

Sandy answered the phone and quickly handed it to me. There was a very frantic Emma on the other end of the line.

“Dr. Larsen, you have to come quick!” she said. 

Then the phone was silent for a moment before little Sara picked it up.

“Lilly had her baby out in the shit pile,” Sara said. “Emma is pretty upset. Can you come?”

“You tell Emma that I am on my way and that things are going to be alright,” I said.

The entire family was out in the barnyard when I arrived. The mare and the foal were both up and looked like they were doing okay. Emma had a halter and a lead rope on Lilly.

“It is all my fault,” Emma said with tears streaming down her face. “I was cleaning the stall and left the gate ajar. Lilly ran past me and out the gate. She picked the dirtiest place in the barnyard, right on the pile of straw and manure from the last 2 weeks of stall cleaning. She laid down and popped that foal out before I could do anything.”

Lilly was stepping sideways with her hind feet, bothered by the membranes still hanging out of her. About that time, the membranes came out with one big flop, and she stepped away.

I picked up the membranes and spread them out on the ground to show Emma how to check that the entire afterbirth came out.

“In cows, we don’t worry too much about retained membranes these days. As long as the cow is doing okay. But in the horse it is an entirely different story and it is important to check that both off these ends are intact. Otherwise, we need to go in and get the retained pieces.”

“Now, let’s clean this little gal up and take care of her naval and her E-Se injection,” I said. “Then, we can take care of Lilly.”

By the time we were done, and we had Lilly and the foal back in their stall, Emma had calmed down a little. 

“What should I watch for now?” Emma asked.

“You should watch for a normal baby,” I said. “Don’t worry unless there is something to worry about. You have a long way to go in this life, Emma, if this little hiccup today is the worst you have to deal with, you will be a lucky young lady.”

Photo by Helder Sato of Pexels

D. E. Larsen, DVM

It was almost comical to watch Tom struggle to get through the front door with both arms wrapped around a large white goose who had no intention of coming inside. The goose was squawking, and in trying to bite an ear, it had knocked his hat off. Finally, Mary rushed over and held the door open as Tom half fell through it into the waiting room.

“That was a struggle,” Tom said, almost out of breath.

“It is a little too early for Thanksgiving,” I said. “What’s up with the goose.”

“This is Samson, I ran over him with the tractor a few minutes ago,” Tom said. “His one leg is broken or something. He can’t stand on it.”

“Tom, I don’t do birds,” I said. “Maybe I can find some place to send him.”

“Now listen,” Tom said, “you are good enough for my cows, you are going to damn well be good enough for my goose. Samson makes me more money than any of my cows. He’s the top breeder in the area. The money from his stud fees sends the old lady and me to Reno every year.”

“Sounds like I better get a look at that leg,” I said. “Let’s get Samson in on the exam table.”

The exam table was an excellent thought unless you are a barnyard goose. Samson had no intention of being put on a table, much less holding still for an exam on a messed up leg.

“Tom, we are going to have to sedate Samson to get an exam,” I said. “It might take 20 minutes or so. Do you want to wait?”

“Doc, I have a bunch of heifers waiting for their morning feeding,” Tom said. “I want you to fix the leg. You give it your best shot. I have every confidence in you. If it turns out that it can’t be fixed, will so be it. I don’t want a bunch of phone calls. I will be back in the morning after my chores.”

Tom left us with Samson who could not stand, did not want to be here, and had no thought about being cooperative. 

“How do you want to handle this?” Mary asked. “You are supposed to be out to Elliot’s right after lunch. They will have their heifer calves caught for vaccinations.”

“You need to give them a call and let them know we have an emergency, and I may be late,” I said. “I don’t want to sedate Samson more than once. We will give him an injection, do the exam, probably will need to get an x-ray, and then go right to surgery, if that is required. That probably means we work through the lunch hour so I can get out to Elliot’s.

My experience working on birds was almost non-existent. We got an estimate of Samson’s weight by Mary holding him and standing on the scale, then subtracting her weight. I gave him a good dose of ketamine for anesthesia. It only took a few minutes, and we could lay him down on the exam table.

I was surprised that Samson was relatively free from any other injury except the left leg. The leg was a mess. It didn’t feel like any fractures were present, but the knee was totally ruined. There was a definite rupture of the anterior cruciate ligament and also the lateral collateral ligament. We took an x-ray to make sure there were no fractures.

With Samson still under anesthesia, we started plucking feathers and prepared the leg for surgery. I incised over the lateral stifle (or knee). It looked more like a turkey drumstick at Thanksgiving than anything I had looked at before. I carefully dissected to where I could reflect the knee cap to the inside of the leg and expose the knee joint.

It looked better than I was expecting. The lateral collateral ligament was torn, and that fact allowed me to examine the joint a little easier. I spread the joint open, the cartilages were intact, and the anterior cruciate was completely torn.

 “How do you repair this in a goose?” I said to myself.

Samson would put far less stress on this knee than a dog, so a repair should have a better prognosis. I decided to use a modified Paatsama procedure. I looked for a good strip of fascia to use to replace the cruciate ligament and found a suitable piece of lateral fascia that would work. I could leave one end attached near the knee. I drilled a hole with an IM pin through the lateral condyle of the femur, exiting at the location of the cruciate ligament and continued it through the tibia to come out on the medial side of the tibia tuberosity. I thread the strip of fascia through this hole and placed anchoring sutures on each end of the strip of the fascia. I was a little surprised at how stable the joint felt when I was done.

I repaired the lateral collateral ligament with stainless steel sutures. Then I returned the knee cap to normal position and closed the joint. I used Dexon sutures for all the closures and a subcuticular suture for the skin closure.

We placed Samson in a kennel for recovery. I was surprised when I returned from my farm call. Samson was up standing on the repaired leg like nothing happened. I glanced at the clock. With any luck, I could get Tom in here to take the goose home this evening.

“Tom, can you pick up Samson this afternoon,” I said into the phone when Tom answered.

“Is he okay?” Tom asked.

“We did surgery and repaired the leg,” I said. “He is fully recovered and walking well. He will probably be better off in his barn than here tonight.”

“I will be right there,” Tom said.

“I told you that you guys were good enough for my goose.” Tom beamed as he scooped up Samson and headed for the door. “Remember that when you fill out the bill.”

When the breeding season came, Samson was in shape and functional as ever. He paid for another trip to Reno for Tom and his wife.  

Samson had learned to avoid the tractor, and I had learned that I would be stuck working on farm birds for the rest of my life.

Photo by Eric Muhr on Unsplash