Get Off My Foot

Dr. Kim Brokaw DVM
Walkersville Veterinary Clinic

Dr. Kim Brokaw and her horse Bart

(July, 2011) One of the things I tell my students is that when working with dogs and cats, they should expect the occasional bite or scratch. When working with horses they should expect to get stepped on, kicked at and bitten. Sometimes this is intentional by the horse and other times it just happens. One of the rules of floating horse teeth is not to stick your fingers past the bars of the mouth if you do not have a speculum in. Numerous vets have failed to follow that rule and have lost fingers. One vet was following the rule, but unfortunately the speculum malfunctioned and the horse’s mouth closed, breaking her wrist and hand. While broken bones are on the severe side of the injuries, they happen less frequently. The usual is a few small bruises, with the occasional large one that you show off to all your colleagues like a battle scar.

I am not fond of bruises and try very hard to avoid getting them. I figure tranquilizers were invented to prevent injury to the vet and to create a positive experience for the horse. After all, my goal is for my patient to not be in pain and if a simple injection will alleviate the pain, and keep him from kicking me while I complete the procedure, then why not use it. Off course, tranquilizers are far from perfect.

Sometimes, the horse seems calm, but the tranquilizer has depressed his thought processes and inhibitions. He might normally think "I’d better not kick Mom and the vet. Mom will be angry at me." Under tranquilizer, the thought that kicking is not good may not occur. Therefore, he might kick out even though he is normally a horse who would never think of kicking a person. Sometimes it is hard to tranquilize a horse enough so he will tolerate a procedure, while keeping him alert enough that he can cooperate and obey his owner.

In some situations, owners prefer to sedate the horse themselves, rather than spending the money to call the vet. Sometimes this works well; sometimes it produces a dangerous situation. Owners often can get their veterinarians to prescribe one of a couple of sedative choices for them to use at home. Oral detomodine gel is a new choice for owners. This medication is effective, but has some significant risks.

If the horse moves and the owner gets the gel in his or her mouth or eyes, it can cause the owner to lose consciousness and stop breathing. The horse should then start CPR on his owner and call 911…you can see the problem. Detomidine gel is a great new product, but I do wonder how many owners will be harmed by it over the next few years. Horses do not always like taking medicine. It is hard to keep an uncooperative horse from spitting medicine all over the people next to him.

Some horses don’t sedate easily. I was recently called out to sedate an untrained horse so the owners could have the farrier trim her hooves. The owner, who takes care of sick humans for a living, had been unable to sedate the horse for the farrier. When I arrived, I realized that this horse was going to be a problem. Her feet were misshapen and badly overgrown. They needed the farrier work. She was clearly untrained and wild. After a couple of doses of sedative, the horse was dopey, confused, and uncooperative. The owner was desperate to have the feet trimmed as they were in such bad shape as to be unsafe for her health. I put the horse under general anesthesia for the farrier work.

General anesthesia carries a number of risks, and this horse seemed to be destined to experience many of those risks. Midway through the farrier work, she had a seizure. I stopped the seizure with seizure medication. After the seizure, she developed severe muscle pain and tying up and then an hour later proceeded to develop abdominal pain and colic. After more medications, she recovered, and walked off as if she had an uneventful day. The owner and I were mentally and physically exhausted but un-injured. Her feet looked great.

Not all of my bruises can be blamed on horses. One day when cooking dinner, I was asked by a friend if I had been kicked by a horse as I had a moderate sized bruise on the back of my leg. My response of "no I was trying to get blood out of an alpaca to test his thyroid level," elicited the next question of "oh so you got kicked by the alpaca?" No. This was actually a very nice alpaca. He did not kick, bite, or spit. He was just very wiggly and jumped about while his owners and I tried to hold him for the blood draw. I hadn’t even taken the cap off the needle yet as he was jumping so much.

In the chaos I had backed into some farm equipment while trying to get out of the way of the alpaca and had bruised myself that way. One bonus to being a large animal vet is that I can always explain away any bruise as a kick from a large animal rather than having to admit the truth that I am uncoordinated and that the bruises down my leg are from walking into a tractor or where I slipped on the rocks while white water rafting.

Proper footwear is key when working with large animals. They will step on you. I had been treating a large Clydesdale, Gamble, for about a week before he stepped on his caretaker’s foot. He was at a well run facility with multiple well trained individuals helping to provide his intensive care. A few new horses had been rescued from slaughter. The usual procedure is to isolate them from the main barn and keep them at a satellite facility for quarantine. Unfortunately this could not be done as one of the new horses had a large 4 inch framing nail imbedded in her foot. She needed care at the main barn.

While she not only survived but returned to almost full soundness, she did bring a respiratory infection that spread throughout the barn. A respiratory panel was performed and it was determined to be equine influenza. Most of the horses at the facility got snotty noses and a cough but otherwise recovered uneventfully. Gamble was not as lucky. His case of the flu took a turn for the worse as he had uncontrolled fevers and secondary bacterial infection leading to pleural pneumonia and colitis. I placed an IV catheter and set up fluids for him.

His caretakers were instructed on medication administration and proper monitoring. While referral was offered, it was not a financially feasible option for his owner. Gamble would have to remain at the farm for treatment. After multiple days of round the clock care, he started showing dramatic improvement. His lungs cleared and his diarrhea resolved. As a show of his appreciation for the care he had received, Gamble stepped on one of his caretaker’s foot. Massive bruising and a fracture now had his caretaker laid up for the next few weeks.

Working with animals has many joys. It also has risks and annoyances. When you notice that your vet has a few bruises, it probably isn’t that he or she has been going out to the bar and fighting with the other drunks. The bruises are probably from that horse who wouldn’t listen when the vet was shouting "Get off my foot!"

Read other articles by Dr. Kim Brokaw