An Unscheduled Lesson

Poppy and I set out tonight just before sunset.  We took our normal route running along the dirt road next to the alfalfa fields, headed towards our orchard.  Did you know that Poppy and I have an orchard?  We do.  We run around it 3 or 4 times a week.  As we set out tonight it was hot.  Still really hot considering that the sun had almost left the sky.  Everything was starting to turn the amazing shades of pinks and purples that you always get in the farmland.  Along the levee there were scads of dragonflies swooping down and barely touching the surface of the water.  Poppy, who has been quite pent up the last few days, was straining for a chance to chase them.  So I let her off the leash.  

You never know what's going to happen when you let Poppy off the leash.  I know my dog likes water, but she had never been in the levees, so I was curious what she would do.  My wondering was cut short by the excited splash that came a split second after I un-clipped the leash.  Another question answered.


It seems to me that I spend a vast majority of my time asking questions.  I think that is why teaching can be such a relief, for once you're answering questions instead of asking them.  In fact, maybe that is what I appreciate so much about interactive learning and the Socratic method.  When you answer someone's question, you feel empowered.  When your question is answered you feel informed.  The two are very different.


We are reaching a really fascinating part of vet school.  So much of what we are beginning to learn has a very sharp learning curve and can't really be taught.  For example, in the last few weeks we have begun the laboratory portion of equine reproduction.  One of the most important aspects of equine reproduction is rectal palpation.  


Now many people don't understand how important this is.  It is sort of a gross concept, sticking one's entire arm inside the rectum of a horse.  However, it is one of the most important diagnostic tools an equine veterinarian has and not merely for reproduction.  If a vet is called out on emergency because a horse generally isn't doing well, it is one of the first things that vet will likely do.  From that position, you can gain a lot of information including, the position of kidney, spleen, bowel, cecum,  and reproductive organs.  You can get a good read on how dehydrated the animal is or if there's an impaction in their colon or cramping.  Furthermore, it is very dangerous because it isn't that difficult to rupture the rectum.  If you do that, the horse is dead.


So while we were all excited about rectalling horses, we understood the consequences of making a mistake.  But when you're inside a horse, no one but you can figure out what you're feeling.  They can help you by suggesting what you might be feeling but ultimately, you have to figure out what an ovary feels like, a kidney, gas distension, a uterus in estrus versus diestrus.  Let me tell you, at the beginning it all just feels like mush.  Then suddenly you feel something and you picture a uterus in your mind and you realize that through the wall of the rectum, there you are, holding the bifurcation.  Its totally a rush.


These labs have been exciting because I'm having to make decisions.  I have to decide that what I just felt was an ovary.  Then I have to lock that feeling away and search for it on the next horse.  Its a different type of learning and its great.


During our last lab we brought in a mare that seemed fine.  The day was hot, reaching over one hundred and rectalling horses is warm to begin with.  We did a TPR (temperature, pulse and respiration) and gave her the normal amount of sedation.  We placed her in the stocks and began palpation.  I remember watching her and thinking she didn't look very sedated.  I wondered if we would have to "top her up."  I had been the first one inside and had noticed that to the right, there seemed to be a large beach ball like structure obstructing my palpation.  My classmate Cody agreed after his palpation.  It wasn't until we were preparing her for vaginal cytology that I noticed she was really trying to sit down on the back gate.  Then I realized how sweaty she was.


Now lots of mares sit on the back gate.  Lots of mares get antsy in the stocks.  But suddenly, this mare was trying to sit all the way down.  We got the attention of one of the instructors and pulled her out of the stocks.  It became immediately apparent that she was colicking.  Thoughts began streaming through my mind.  "What if we perforated her?"  "What if I just killed this horse?"  A field service vet was at the CEH (Center for Equine Health) so we began working her up.


Banamine (Non-steroidal Anti-inflammatory) and more sedation was given.  We brought her into another pair of stocks and a fourth year student passed the naso-gastric tube.  There was a lot of gas in her stomach.  At the same time, the veterinarian began her rectal palpation.


To make a long story short, it looked like a gas colic.  The cecum, situated on the right side on rectal palpation, was distended.  Cody and I were lucky that we had felt it earlier.  Its another feeling for the files.  Something to recognize in the future.  The mare is doing just fine.  Who knows if it was just the heat, dehydration or what.  Unfortunately, we often don't know why a horse colics.


Its just one of those lessons that vet school throws your way unexpectedly.  I thought about that tonight as Poppy and I ran around our orchard.  In my opinion, its the unscheduled lessons that stick with you and remind you why you bother with all the scheduled lessons to begin with.