Saturday, June 9, 2012

Hold Your Fire

“Like most veterinary students, Doreen breezes through chapter 9.”
Life was a simpler time back when many things weren’t treatable.
Like Most Veterinary Students,
Doreen Breezes Through Chapter Nine.
(Courtesy of The Far Side)
Conventional wisdom holds that horses with broken legs don’t survive. However, veterinary medicine has advanced enough in the last 30 years that many equine fractures are in fact reparable. That’s the good news. The bad news is "reparable" doesn’t mean the horse will be able to return to full function and in many cases a decision to euthanize is made based on utility or for humane considerations. Unlike dogs, cats, and even people, horses really do need all their legs just for support. Even if a fracture can be stabilized, the remaining legs must bear additional weight during the healing process which puts the horse at risk for developing laminitis. Laminitis is the excruciatingly painful hoof condition that led to the loss of 2006 Kentucky Derby winner Barbaro after the Preakness.

Looking at Bea’s x-rays, (see previous post), my boss and I simultaneously gasped  and  winced. The pastern bone was unrecognizable, two joints were affected and there was no way she’d ever race again. I knew from the stricken look on his face he was already preparing himself to put her down and that my own expression confirmed the wisdom of that course of action.

Then I noticed something on the x-rays. Though shattered and displaced, the bone fragments were all relatively close together and none seemed to extend beyond the skin margins. I hadn’t seen her myself yet and asked if the fracture was compound, meaning skin was open and bone exposed. Given the degree of trauma needed to cause such a fracture, followed by a trailer ride, it should have been open, severely contaminated and on the way to a fatal sepsis.

He looked at me incredulously, probably wondering why it even mattered, and said he didn’t know. In my inexperienced opinion, it mattered. Bea was young and strong, lean but well-muscled in racing form, and perhaps most importantly, she was sensible. (Even an uncomplicated fracture would take 8-12 weeks to heal, that’s a long time for anything, much less a young horse to spend in a 12 x 12 box without going bonkers. In veterinary medicine temperament can be a matter of life or death.)  What if the fracture were closed and we could stabilize it? Her breeding was good, and she had heart. Even if she didn’t have a racing career, perhaps she’d make a good broodmare?

Another incredulous look, a glimmer of hope and we were on our way to the farm loaded with enough casting supplies and anesthetic for, well, a horse.  It was in fact a closed fracture, but there was still the problem of protecting the injury as well as the other legs. A simple cast wasn’t going to be enough, we had to get the weight completely off her lower leg. I had an idea and it just so happened that her trainer had welding skills and my boss’s brother-in-law worked with concrete. Using hastily “borrowed” rebar I had her trainer fashion a modified U-shaped support. I placed the cast on her lower leg, immobilizing the joints above and below the fracture as required. Then I continued the fiberglass cast up her leg, incorporating the rebar and effectively transferring the weight bearing higher up the leg which allowed her to stand on the rebar with the injured lower leg suspended above it.

It wasn’t easy. Bea needed to be under general anesthesia to place the cast, and then safely recovered. We did this three times for cast changes.  She lost weight, she fretted about the confinement, she had some rub sores under the cast. But she was the filly that lived.

(Courtesy of icanhascheezburger)
She was bred the following spring and a year later gave birth to a race horse. And another after that, and another after that. All told, Bea was an excellent mom to 10 foals, each of whom went on to a racing career.  (One had almost $200,000 in winnings.) That leg was never “pretty” but she seemed sound enough to enjoy trotting around her pasture in between accepting treats over the fence. And I’m still a fan of improvising with whatever’s at hand.  

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