Vet Adventures: Gut Feeling

A frigid day brings a case of colic needing a very special palpation.

A black stallion lays on the snowy ground in discomfort in this edition of Vet Adventures
Vet Adventures is written by Dr. Courtney S. Diehl, DVM, an equine veterinarian of over 20 years. Photo by DragoNika/SHUTTERSTOCK

Cimarron, a stallion, lay quietly on his side in the snow as I walked up to his pen. He stretched out his neck and halfheartedly nibbled on a bit of hay, but soon abandoned the effort. There were a few tiny piles of manure around him, and he strained several times from his position on the ground.

“He’s been like this since he came home from the vet yesterday,” said Shirley. “They said he was OK because his gut sounded good. They tubed him with a gallon of oil and sent us home, but he’s not getting any better, and I’m worried about him.”

“What were his vitals and rectal exam like?” I asked, watching the stallion with concern. He groaned and rolled briefly onto his back, then returned to his side.

“I don’t think they did any of that,” said Shirley. “I’ll tell you, we was in and out fast, and they didn’t even say what was wrong with him.”

Also read- Vet Adventures: A Unique Equine Companion

Signs of Trouble

The temperature was 15 below zero that morning and I was bundled heavily in long underwear, coveralls, double socks and heavy boots. I sighed, unenthusiastic at the thought of stripping down in the bitter cold to perform a rectal exam and colic workup. The stallion was an unexpected addition to what was supposed to have been a quick call for some Coggins tests. Shirley was apologetic.

“They said he would get better Doc, but if anything, he’s worse.”

Poor Cimarron was trying to roll again, and I quickly went to the truck to get my equipment and drugs. The stallion did not need the vet pouting because it was cold out. He needed my help.

We got him up and moved him into the barn, which did little to improve the Arctic temperature. Despite his discomfort, Cimarron still managed to arch his neck and parade grandly past the mare in the adjoining pen. Shirley swatted him lightly.

“You’ve been colicked for two days, and you’re still showing off for the girls!”

She looked at me hopefully. “That’s a good sign, right?”

“I hope so,” I said.

Cimarron’s heart rate was in the mid 40s and his respiratory rate and temperature were normal. He did have some gut sounds, but they seemed sluggish. I didn’t like his gum color: dull pink with a blueish undertone of mottled vessels, and he strained frequently, hoisting his tail high but only passing a single manure ball here and there.

Also read – Vet Adventures: Balancing Mom Life

A Tingly Diagnosis

Cold or not, it was clearly time to do a rectal exam on Cimarron. I took a deep breath as I removed my coat and five heavy outer layers. Shivering in the icy air, I drew up the sedative, and the drug froze instantly in the syringe and in the bottle. I had to tuck syringe and bottle inside my shirt to thaw.

When the stallion’s head dropped and he swayed in place, I started the rectal exam, but I couldn’t advance past my wrist. Often a twisted intestine will be forced into the pelvic inlet, and initially I thought that was what I was feeling. But as I continued palpating, my heart sank as my fingers brushed past a structure that was not supposed to be there.

It was a dense tissue mass about the size of a melon adhered to the inside of his pelvis, and it felt lobulated and thick with sizable blood vessels, which told me it was there to stay, and that it meant business.

Sometimes I can feel a weird and unpleasant tingling in my arm when I touch an animal that has cancer, and my arm was definitely feeling the weird energy contained inside the invasive structure. It might sound a little nuts, but my arm is almost always right. I always recommend additional diagnostics, because writing, “I knew it was cancer because my arm tingled” in the medical record is probably not very professional. But this diagnosis was crystal clear.

Shirley watched me anxiously. There was no good way to tell her that her beloved horse most likely had cancer, and I took a deep breath.

“There’s a large mass growing inside his pelvis, Shirley. He’s straining like this because he can’t pass much manure around it and he’s got a big impaction built up in there. I can pass a tube and give him some medicine to help soften up his manure, and some rectal fluids may help break the impaction down as well.”

“That’s not gonna fix him, is it?” Shirley asked quietly.

I looked at her sadly. “There might be some better diagnostic and treatment options at a referral hospital. I’ll try to get him comfortable if you want to take him in.”

Zap to It

Shirley silently stroked Cimarron’s neck as I readied my stomach tube and pump, but she stopped me as I approached the stallion’s head. There were tears in her eyes, but her voice was steady.

“It’s not fair to him, Doc. He’s been through enough, and I want you to put him down.”

I nodded sadly and went to my truck to get the euthanasia solution. It was the right thing to do, but as I gave Cimarron his last injection and he sank to the ground, my heart ached for Shirley. She hunkered down next to the stallion and laid a hand on his head.

Dr. Diehl of Vet Adventures. Photo courtesy of Courtney S. Diehl, DVM

I patted her shoulder gently with my still-tingling palpation arm, meaning to offer comfort, but Shirley jumped as though she’d been zapped with a cattle prod.

“Ouch!” she exclaimed. “What was that?”

I stared at my arm. Had it truly absorbed the cancer energy, and had I inadvertently shocked Shirley with my amazing powers? But Shirley pulled a needle and syringe from her pants pocket and glared at it, rubbing her backside.

“Damn cap came off the needle.” Then she straightened up. “I don’t know about you, but I could sure use a cup of coffee. What do you say?”

I was in. Magical arm or not, coffee was always a good idea.

This edition of Vet Adventures appeared in the November/December 2021 issue of Horse Illustrated magazine. Vet Adventures appears in each issue. Click here to subscribe!


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