Things I've done to a horse so far this week

This week's rotation is Large Animal Procedures lab, which is basically structured to teach us serious small animal people how to not be total fools around horses, cattle, etc. (Unfortunately for the equine-experienced students among us, everybody has to take the lab whether they want to or not.)

Yesterday we focused on basic "horsemanship" - nothing to do with medicine, just how not to get kicked in the head (well, not as often or not as hard, I gather). We worked on two of the VTH's teaching horses, who live on site and are pretty hilarious. They are quite cooperative for most of the things we need to practice on them, but they are also pretty experienced with manipulating students who don't know what they're doing or aren't comfortable with horses. They know when you're about to do something they aren't going to like, and they know how to keep you from being able to do said unpleasant procedure.

Yesterday's student-equine interactions included: picking up their feet (not as easy as it looks or sounds), taking rectal temperatures (heckuva lot easier than with a cat), lifting up lips to look at gums, and reaching your hand into the horse's mouth(!), grabbing its tongue(!), and wrestling the tongue out of the mouth so you can do a thorough dental exam and the horse won't bite you (since obviously it would then be biting down on its own tongue.

Well, that was about enough for me. Yesterday, however, was only Day 1!

Today, Day 2, we focused on general physical exam skills, again using three teaching horses. Since a lot of what we were learning involved using a stethoscope to listen to heart, lung, and GI sounds, we worked with the horses indoors, in standing stocks. (It was really windy out, which adds plenty of extra background noise to your ears as you listen through your stethoscope, and isn't terribly conducive to hearing sounds that are difficult to hear anyway in a horse in a quiet environment.)

I felt a lot more comfortable with the horses situated in the stocks. Yes, you can still get kicked or stepped on or bitten (and apparently people who are accustomed to working around horses sometimes forget that stocks aren't totally "safe"), but it was a lot easier for me to learn how to do things just knowing that the horse couldn't walk away.

We started with TPR -- temperature, pulse, and respiration -- gauging the respiratory rate by watching the horse's breathing from a distance, palpating the pulse using 3 different arteries (one under the jaw, one near the eye, and the digital pulses on the back of the feet), and taking rectal temperatures.

(Side note: Horses seem to tolerate rectal temperatures really, really well. Now, granted, these are teaching horses, so they are used to being poked and prodded and having all manner of rude things done to them. But it sure is nice to have that [if you'll excuse me] relatively huge opening to aim for rather than a cat or toy poodle anus.)

I was excited that I actually found the facial artery pulses on both sides on my first try, while some of the horse "pros" in the class had trouble.

We assessed circulatory status and hydration by doing capillary refill times on the gums. We palpated distal limbs to feel for effusion, heat, or pain. We held the horse's mouth open and percussed the frontal and maxillary sinuses. We palpated the trachea, larynx, thyroid, and lymph nodes. We listened to lung sounds, with and without rebreathing bags. We ausculted the heart and pretended to actually hear the 3 valve sounds on the left side and 1 on the right. We listened to GI sounds (rumbly!). As the horses kept pooping all over the place, we assessed the quality of their feces (all very normal).

At the end we watched the instructor pass a nasogastric tube on one of the horses. Yikes! Horse no like!

(Side note: Horses have a unique anatomical configuration in their stomach that makes them physically unable to vomit. As the stomach gets fuller and fuller, the sphincter between the esophagus and stomach basically begins to act like a one-way valve. If the horse continues to eat and drink, the material can pass from the esophagus into the stomach, but the pressure of the stomach contents stretches the stomach wall and pushes it so that the opening back into the esophagus is kept closed so no contents can reflux back into the esophagus. This can be life-threatening, because if the horse has an obstruction in its intestines that is preventing stomach contents from leaving the stomach, the stomach can rupture [i.e. burst open] if it gets too full. So if a horse presents with colic, you usually want to pass a tube into the stomach to see if the horse needs "help" emptying out its stomach contents before the stomach bursts and the horse dies.)

Here's something else sort of off topic: When there were a few minutes of downtime (since 22 students were trying to work on 3 horses), I overheard one of my (sort of annoying) classmates complaining to the instructor about how the junior students don't get to actually do anything on orientation (i.e. how we just got to watch the stomach tube being passed instead of doing it ourselves). He was going on and on about his friends in other vet schools and how they have been in the clinics since their first or second year, get to do all sorts of hands-on stuff, etc. I really just wanted to go up and point out that it's not like my vet school is all secretive and deceptive about how the program works -- he knew coming into vet school (or at least, he should have known, or should have asked questions if anything was unclear) that our program is structured this way. And hey, some vet schools don't even have any clinics until senior year -- imagine having 3 years of sitting on your butt in a classroom and only 1 instead of 1.5 years of clinics! Okay, mini-rant over. :-)