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Archive for March, 2010

“Non-client”

I got two calls yesterday at around 7pm, one about 2 minutes after the other.  Luckily one was a laceration on a hip that could wait until after I handled the first one (colic).  The colic was a nephrosplenic that I treated with phenylephrine, and while the phenylephrine seemed to help and he may have gotten better from there without further treatment, we all opted to send him into the hospital to be monitored overnight.  With just a bit more fluids to rehydrate him, he is doing very well today.  Yay!

The laceration was right on the point of the h ip, and there was a round flap of skin about 4cm in diameter and 1/2cm thick that was attached by only a narrow piece of skin at the bottom.  The flap was already cold and when I trimmed the edges it didn’t bleed, so it will most likely die over the next few days.  “If it’s skin, leave it in”, sometimes it surprises you and stays alive.  So cleaned it up and sutured it.  It’s funny how hard on myself I am about making lacerations look perfect when I’m sewing them up.  Being round, it was a bit awkward to sew anyway, but considering that  I am 100% that the flap will die and it will fall apart anyway, I thought it was amusing that I still wanted to make it look beautiful.  The horse’ll be fine — it’s far from the heart.

Both of these clients were very kind and we’ve seen them both before, but they only call us for emergencies when their regular vet can’t make it.  We have three tiers of emergency fees – A daytime fee, a weekend fee for regular clients, and a weekend fee for non-clients.  So, when we get these calls on Saturday night from people who don’t use us as their regular vet, we are perfectly justified to use the non-client emergency fee (though depending on the situation we sometimes cut them some slack).  For me to pull up to your barn, before I even look at the horse, costs about $190 for a non-client ($160 for a client).  Rest assured that I don’t see a dime of that.  But, that’s the life of an equine intern.  The hours can be long, and the pay is always laughably low, and you’ve gotta keep smiling.  Livin’ the dream!

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If I were to pick two of my favorite topics in regard to veterinary medicine, it would be reproductive medicine and toxic plants.  And hey, there are some plants that affect repro, like mustards or fescue — the best of both worlds!

The breeding season is off to a slow start this year, but we’ve got some healthy foals on the ground, a few mares bred, and several others on our schedule to watch and breed over the next few months.  Enough to keep me happy.  We worked up a “problem mare” a couple weeks ago.  She had been either not getting in foal or losing her pregnancy early.  Luckily, the problem (or at least one of them) was self-evident when we drove up and looked at her and saw that she was a good 8/9 on the body condition scoring scale, and had all the classic signs of a horse with Equine Metabolic Syndrome (cresty neck, regional adiposity behind the shoulder and around the tailhead, divergent growths rings on her hooves reflecting chronic sub-clinical laminitis).  Glucose and insulin testing confirmed that she is insulin resistant.  On uterine biopsy she had mild age-related changes that may be adding to the difficulty, but the first step toward getting that mare pregnant is certainly a diet.

On the opposite end of the spectrum, I checked a mare yesterday that belongs to an employee of the vet school, and the mare was winking at me with her vulva before I even entered the stall.  Sure enough, 40mm follicle on the left and moderate uterine edema.  Ordered the semen, shot her with deslorelin, and bred her today.  Took a sample of the “boyfriend in a box” back to the hospital, and they were certainly swimmers.  This mare has had some pregnancy difficulties in the past, but she looks clean now (without any extensive testing), so we’ll do the pregnancy dance, check her tomorrow to make sure she ovulated, and schedule that fateful exam in 2 weeks when we’ll know if she caught.

Regarding my other favorite topic, toxic plants, I have become painfully aware in the past few months that the vet school curriculum here does not have a strong emphasis on toxic plants.  Shame!  So, I’m putting together a power-point for students to use to learn and review toxic plants, and thinking about giving a 1hr informal evening talk to the AAEP club on plant toxicities in horses.  Could be fun.

My current approach : Enjoy today.  Try not to worry too much about tomorrow.

It’s better than the alternative.

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