An Apple a Day Keeps the Doctor Away

Remi reached five weeks of age in the end of August. Each day we would head out to the barn to handle and groom the horses, then feed them. Some days they got more attention than others, as Remi's unexpected arrival had caused us to put off quite a few other responsibilities and we were trying to catch up.
This particular day was a Friday. It was the day Berto was graduating from school, and his family was coming to Tucson to sit in on the ceremony. Teri and I were meeting at the graduation, since she was coming from work and I would be coming from the barn.
I walked up to Rose and Remi's stall and saw that they already had their evening hay, but it wasn't all eaten yet. Remi was just starting to eat grain and some hay, but his teeth were still very small, so that couldn't have been an easy task. Rose was standing in the run with her head down. I peered over the half door and called to her,
"Rose! Do you want some dinner, mama?"
Her ears pricked but she didn't move. Typically she's got her head over the door and she's whinnying at me as soon as I enter the barn. I'm a little concerned at how listless she seems. Remi came running into the stall to greet me. I reached my hand out and rubbed his forehead and neck. I decided to go ahead and put the grain in the bucket and see if that got her attention. Rose heard me opening the storage stall and scooping grain out, then opening the window into their stall so I could dump the grain into their bucket without having to actually enter. She ambled in and put her nose in the bucket, took a few mouthfuls of grain and chewed slowly.
I stood in the aisle, arms draped over the door. Remi was his regular pesky self, darting under Rose's neck, pushing her nose out of the bucket so he could get a mouthful, and biting at her. Rose looked uncomfortable and uneasy. She circled the stall and pawed at the ground, and snorted. She stood in front of the hay feeder and pawed at the rubber floor mat repeatedly. Every once in awhile she took another mouthful of grain but it was as if she kept hoping it would taste better or ... something, I'm not sure.
Rose walked back out into the run and just walked the perimeter. Slow, large circles, with occasional pauses to paw the sand. She stopped by one of the walls and buckled her legs underneath and lay down. I followed her into the run and stood still in the doorway, just watching her. I flattened myself against one side so Remi would have room to get by me. Rose sighed and rolled onto her side. Remi thought this was great fun to have his dam on the ground, surely she was doing this to better play with him! He trotted right up to her and sniffed at her belly. He went around behind her and kept poking at her with his nose, biting at her mane and ears and cheeks. She rolled further onto her back and thrust her legs into the air, grinding her back and head into the sand. Usually she rolls because it feels good to scratch her back in the dirt, and it's fun. Today she wasn't being herself and everything I was witnessing told me that Rose was in pain.
Abruptly, she stood up and shook the sand off herself. She resumed her large circles of the outside pen, Remi dancing alongside as if this was some new and wonderful game.
I was definitely concerned. I pulled out my phone and called Teri.
"Yes, dear?" she answered.
"Hi, so I'm out here at the barn and something's wrong with Rose. I'm not sure what to do." I said, sounding concerned.
"What's wrong?" Now Teri was concerned too.
"She's pacing the stall, pawing the ground, and rolling. I think she's colicking. She hasn't eaten all her hay and she's not interested in her grain. I want to give her time to work through it if it's not a big deal but I can't tell if she's just uncomfortable or if it's really serious. I don't want to call the vet but I also don't want to have to nurse an orphan foal..." I trailed off, not wanting to say 'in case she dies'.
"You know her better than anyone, it's totally your call. I don't want to call the vet either but if we have to, we have to." she replied.
"Okay well I'm going to stay here a while longer and watch her, I don't feel comfortable leaving her. I'll text Berto and explain what's going on, could you tell him I'm so sorry I missed his graduation?" I asked.
"Sure. Keep me in the loop, okay?" her voice was worried.
"Yeah, I will. Love you."
"I love you too. Bye." she hung up the phone.
Colic can be a very serious issue in horses. It is a generalized term for intestinal pain, and can be as minor as gas bubbles trapped in the intestines that cause the intestinal walls to stretch slightly and make the animal uncomfortable. But in the most serious cases, colic can be caused by sections of the intestine that actually roll and twist inside the body like a Tootsie Roll, and prevent natural digestive processing. A twisted gut requires a $10,000 surgery and there is no vet in Tucson who performs that procedure - the closest facility is in Gilbert. Some colics start as mild and increase in severity, which is why treating a colic early on is imperative. Some horses will simply work through the colics on their own in time and be completely fine, but some horses colic in the night and are dead by the time they're fed in the morning. Some horses with minor pain act as if they are dying, they fling themselves violently onto the ground and seem to have a very serious problem, while other horses who are very stoic won't show signs of even an extremely bad colic until they pass away unexpectedly. It appears that horses, just like people, have varying pain thresholds and aptitudes for the dramatics. The key is finding out which kind of horse you have, or in this situation, which kind of horse I have.
Rose was on the ground again, being tormented by her colt. She was laying on her side, quietly groaning while he jumped and pounced on her neck and her side. I walked over to him and shooed him off of her, but I also must have scared Rose because she jumped to her feet and looked a little alarmed. I rubbed her face and stood back into the doorway again. She kept laying down and breathing heavily and slowly rolling back and forth. Each time she paused, Remi would prance right up to her and try to stand on top of her. Once he threaded his little hooves inside the crook of her legs and leaned all his weight over her neck, then began biting her. She shook her head and stood up, which pulled his legs out from underneath him and caused him to fall down comically. I chuckled as he scrambled back up to his feet. He did look a little upset by this, but it didn't stop him for long.
Rose walked another few strides, and lay down again. Remi carefully walked up close to her belly and decided he was hungry. He pushed his muzzle up between her hind legs and tried vainly to nurse, but Rose wasn't having it. She straightened her hind legs and again, swept his feet out from under him. His face hit the ground first, then his body weight came up in the air behind him and he somersaulted over Rose's hind legs. Remi ended up splayed on the ground just behind Rose's hindquarters. He looked a little dazed from all the acrobatics. At first I was worried he'd hurt himself but then he jumped up to his feet and decided that it was a better idea to attack Rose from the side of her body that her legs were not on. Apparently, he was fine.
It was just after 5 o'clock, which meant that all the vet offices were now closed and I would have to call as an emergency. I had been watching Rose for about twenty minutes and she still was uncomfortable and rolling around. I didn't want her to get any worse, so I called the clinic I used to work for. I knew one of their large animal vets actually boarded her horse at the same property that we were on, and hoped that vet was available. I left a message on her emergency cell and waited.
I received a phone call only a few minutes later, from the vet who kept her horse at the same stables as us. She was finishing up at the clinic and would head right over, probably only half an hour before she'd be there.
I decided to walk the horses for a few minutes while waiting for the vet. I'm sure Rose was tired of being assaulted by Remi and he obviously needed to get out. I haltered them both and led them from the stall. We walked all around the property, Rose stopping to paw at the ground a few times. After twenty minutes of walking, I had enough. I put them back into their stall but left the halters on and simply unclipped the lead ropes. It would be faster to catch them when the vet arrived.
Fifteen minutes later, the silver vet truck pulled up outside the barn. The vet got out and introduced herself as Dr. H (I won't mention her name because I would hate for her to come across this blog if she ever "googles" herself - you'll see why.) and asked about Rose. I explained the situation.
Dr. H began assessing Rose's condition, starting with heart and respiration rates, and a temperature. So far, all normal, which is a good thing. Horses in bad colics have increased heart and respiration rates as well as a fever sometimes. She used her stethoscope to listen to Rose's belly, trying to see if she still had movement in the four gut quadrants. Dr. H told me that there was still some movement but that it was pretty quiet. She asked me if Rose had been drinking and pooping, which I couldn't give her the answer to because they had a five gallon automatic waterer and the stall had just been cleaned so I didn't know if she'd been pooping or not.
The next step was that Dr. H wanted to perform a routine rectal palpation. This is the only exam that can identify a twisted intestine. We needed more room than the stall could afford and it was starting to rain, so we took both mare and foal into the barn aisle. I stood Rose in the middle and just held onto Remi's lead rope. Dr. H asked if we could tie the baby up somewhere and I must have had an incredulous look on my face as I told her that he was only five weeks old, because she hastily said that he would be just fine there in the aisle. She gloved up and added lube to her whole arm and said,
"Well since she's a broodmare she's probably used to these! I don't think I need to sedate her."
Famous last words.
"Actually," I answered, "she's not a broodmare, this pregnancy was an accident and she's never had any other foals."
"Oh, well we'll just try it and see." Dr. H called back to me from her truck.
As soon as she attempted to push her way in, Rose's head came up and she got agitated. Rose was dancing back and forth, trying to get away from the vet. I was doing my best to hold her still, but she wasn't sedated and she wasn't a broodmare! As far as I knew, she'd never had a rectal palp before in her life. I wouldn't be thrilled either.
Suddenly, Rose pitched her weight onto her forelegs and kicked out with both hind hooves, high and hard. Luckily for Dr. H, she was standing to one side of Rose with just her arm behind the horse. Also luckily, she was not successful in pushing her hand and arm into Rose's rectum because if she'd gotten very far her arm would have been broken as Rose kicked out.
"I'm so sorry! Are you okay?" I was both surprised and unsurprised at what Rose had done, since I never saw her kick out at anything or anyone ever before, but the vet didn't think she needed to sedate an uncomfortable 7 year old Thoroughbred mare that was a new mommy - what did she expect?
"Yeah, I'm okay." she sighed.
Remi was surprised by this as well, but he took it in stride. He was behaving pretty well, considering that I was asking a lot. I was slightly taxed in my duties, as I was trying to hold Rose still and keep track of Remi simultaneously. He was biting Rose's lead rope and sniffing around at anything within reach. He knocked down a manure fork and scared everybody, then kept tying me up by walking around and around. He got more bored as the evening wore on but he never threw a tantrum and for that I was very proud of him.
Dr. H decided that she was going to sedate Rose after all. (Really?) I warned her that since Rose had been on the track, she had a lot of experience with IV injections and didn't really like them. She was known to shake her head up and down somewhat forcefully when the needle was inserted and I thought this was something Dr. H should know.
Dr. H brought the syringes over (one of sedative and one of a painkiller) and occluded the blood flow in Rose's jugular vein. As soon as the vet applied pressure to the vein, Rose began to shake her head around. The vet was fumbling with the syringe cap and continuing to agitate Rose by keeping pressure on her jugular. As it looked like the vet was finally prepared to stick the needle in, I grabbed Rose's top lip in my fist. It is a restraint called a "twitch" and most people do it with a tool, but I prefer just to use my hand. Firmly taking hold on their upper lip just below the nostrils releases some calming endorphins into the bloodstream and also gives me better control of the head. Rose stood still but flinched and jerked a little bit as the vet took her sweet time pushing the sedatives and painkiller into Rose's vein.
After only about a minute, Rose's head drooped and her eyelids fluttered lazily at half-mast. Her ears stuck out to the sides of her head, unconcerned. After five minutes, Dr. H came back out from her truck and looked very happy at Rose's stoned state.
She put another glove on and added more lube and was successful in performing the rectal palpation this time around. The exam had good results, Rose had no gut twist and everything seemed fine.
Next was intubation. Basically, she stuck a big rubber tube up Rose's nostril, down her esophagus and into her stomach. Rose didn't love this idea either but she was still sedated, so she allowed it to happen. The first purpose of this tube is that it will let out anything in the stomach that is building up and causing pressure internally. If the horse is twisted somewhere really close to the stomach, even a rectal palp can't identify it. Horses are big one-way valves, they cannot vomit or belch so once something goes down it does not come back out. This is a problem when they get their guts twisted, because all the food and water they consume backs up in their stomach and even up into the esophagus since there isn't anywhere else for it to go. In order to get the material out of the stomach, the vet has to get a vacuum suction going so they usually suck on their end of the tube a little to get things started. Dr. H put her lips around the tube and sucked in, hard. A ton of greenish tinged water came rushing into her mouth from the tube and she started coughing and hacking and gagging. She spit a bunch of times and wiped her face on her shirtsleeve. It was all I could do to contain myself, I swear I must have had tears of laughter in the corners of my eyes. I'm sure I snorted but it must have gotten lost within all the coughing and retching. There was some water and chewed up hay material in Rose's stomach, but not a concerning amount. Next, Dr. H mixed some electrolytes into a big pail of water. She used a pump to push the electrolyte water through the tube and into Rose's stomach. A big concern with colics is dehydration, so she pumped five gallons of electrolyte water in. Then she pumped in some mineral oil to slick up Rose's insides and make it easier to pass stool. She pulled the tube out and took the bucket to her truck.
I stood with Rose, stroking her forehead and ears and talking to her quietly while Remi took this opportunity to nurse a little. Dr. H came back into the aisle to listen to her belly again and take her heartrate again.
"Everything looks good, I think she was just dehydrated and had a gaseous bubble, so she felt uncomfortable. She's going to be just fine." Dr. H smiled at me.
"Thank you for coming out so quickly to see us." I replied. I thought to myself that I was lucky Rose didn't have anything more serious going on because this vet didn't really seem very competent.
"Walk them up and down the barn aisle for a few minutes and then they can go back into the stall. I'm going to get your instructions and your bill ready, then I'll be back to check her one last time." she told me.
I heaved on Rose's lead rope to get her turned around - she was very sluggish and didn't really feel like walking. I kept pulling on her and she stumbled forward drunkenly. It took her a few steps but she got a little more alert and I stopped worrying about her falling over. We walked the length of the barn a few times and then I led them back into their stall. Since I used to work in the field, I knew to take away the hay and the grain. Rose was sedated so it was unsafe for her to try and eat anything for a few hours.
Dr. H came out of the truck and gave me a paper explaining what I should do over the next few days - all information I already knew, but that was okay. Then she handed me the bill.
Ouch!
I called after five, so it was an emergency and had an extra charge of $100. Then there was the farm call fee of $70, an exam fee, a rectal palp fee, painkiller, sedative, intubation, water, electrolyte, mineral oil... ugh. Over $400 total. Not something I could really afford spending but not something I had a choice on either. I cringed as I wrote out the check and signed the receipt.
Dr. H listened to Rose's gut sounds and heartrate/resp rate one last time, patted her on the hindquarters and left the stall. I watched her make her way through the rain over to her white Arabian's stall in a different shedrow. She dumped some grain in the mare's feeder and then got back in her truck and lit out. It was raining fairly heavily by this time and I was exhausted.
I leaned over Rose and Remi's stall door and watched them. Rose was pretty alert now and she was feeling better, so she was hungry. She nosed around the stall, catching any wisp of hay she could find in her lips. Remi followed her around, trying to nurse. Rose walked up to me and nudged me with her nose.
"I'm sorry sweetheart, I can't give you any food until tomorrow morning." I told her wistfully.
Rose was disgruntled with me. She walked to the back corner of the stall and contented herself with licking the salt block.
I drove home to tell Teri about the vet visit and the bill.