Fantastic Voyage

Thursday night, I was helping my trainer by feeding the horses at her barn. She has been suffering from a bad cold, so I had done quite a few of her chores for her that day.

Her oldest horse, Havoc, had been having problems since Sunday. Although he didn’t show other signs of colic, he had become very reluctant to eat. My trainer had the vet out to see him Monday morning, who diagnosed a possible case of choke. (This happens when the horse gets something stuck in his esophagus. Even after the blockage passes, it can leave the area bruised and inflamed.)

So my trainer had been treating Havoc for choke all week, mainly by wetting his hay and giving him beet pulp and bute, a pain killer. She had discontinued the pain killers Thursday morning. Havoc, by Thursday evening once again looked very reluctant to eat, even refusing his favorite treats of oats and pieces of carrots.

A horse that can’t eat without painkillers is a pretty sorry creature. Havoc had already had normal blood work drawn earlier in the week, and we knew that endoscopy was the next diagnostic step.

I told my trainer I would haul him to CSU if she wanted him endoscoped there. CSU has a veterinary college in Fort Collins, two or three hours to the north of us. However, my trainer had been talking to the vet, and the practice for which she worked had the same equipment as CSU, so we decided to see how soon we could get him there.

It was after office hours by then, but my trainer called the vet who had treated him Monday. After a few calls back and forth, we arranged that we would bring Havoc to the clinic at 8:30 the next morning, where the principal of the practice would do the endoscopy. I told my trainer I would be at the barn with my truck and trailer at 7:45. Although my trainer has a half-ton truck and small trailer, I prefer using my three-quarter ton truck and stock trailer. Most horses seem to prefer my stock trailer as well.

After being given more bute, Havoc had been able to eat the hay that the vet said he could be given. When I arrived the next morning, he looked more interested than concerned when we covered him with his blanket and loaded him into my stock trailer. His air of alert interest continued after we got him to the clinic. It was comforting seeing Havoc act so normal, since I had been imagining grisly little pictures of a tumor strangling his trachea and esophagus since the previous night.

We had to wait quite a while because a horse who was at the clinic for an impaction colic had another episode of colic, and horses with colic trump everything else, except maybe major arterial bleeding. Finally, about 9:30, the two vets and their assistants started with Havoc.

The vets thought that Havoc most likely had a gutteral pouch infection. The first step was to take radiographs of the area of the head that contains the gutteral pouches and sinuses. Havoc, despite sedation, did not want to cooperate with having the plates held next to his head. It took two more injections before Havoc was sedated enough so that they could hold his head at the proper angle for the films. I started feeling very sorry for the associate vet and the assistant who kept putting the heavy lead aprons and guantlets on and off while they tried to get Havoc to keep his head at the correct angle.

Finally, they got sufficiently good films that they could proceed with the endoscope. At first, I flinched a little when the vet’s assistant put the tube of the endoscope in Havoc’s nostril. After a while, I became used to it, fascinated by the color images on the monitor. My trainer and I stayed out of the way, against the wall the huge examining room, but had a clear view of the screen.

When the endoscope went into a new area, the vet would announce what it was. We looked the esophagus and trachea, and the left gutteral pouch. Everything looked reasonable for a 23 year old horse, except for some foam found in the esophagus. I suppose I expected the images to be similar to the mysterious images I have seen on an ultrasound monitor, but instead they were crisp and clear, and even made sense to someone with little anatomical knowledge.

As I watched, I felt a sense of familiarily, and finally realized that the images reminded me of the long ago, almost forgotten TV show, Fantastic Voyage, which I watched as a kid. One really did have the feeling of walking around the structures of Havoc’s head and neck. Although I kept feeling braced against them finding Something Awful, I also kept a little mental checklist of the gross structures they were examining, and feeling a little relieved each time we moved onto a new one without finding a problem. I knew a little about the things that could go wrong in that region of a horse since a horse at my trainer’s barn was successfully treated for gutteral pouch mycosis a few years ago.

The vet was unable to get the endoscope into the right gutteral pouch, but flushed it with solution and found no signs of infection. Finally, he examined the sinuses, and they looked clean and healthy as well.

The sedation was wearing off as the vets finished. The vet went in to stare at the radiographs again, and then came out to confer with my trainer.

Aside from the foam in the esophagus, the endoscope didn’t show anything that would lead to a reluctance to eat. Therefore, he wanted to treat Havoc for ulcers, which have been recently found to be not uncommon in horses. He also wanted Havoc to be given IM penicillin for a week, in case there was an infection that he hadn’t found.

The treatment for ulcers in horses is similar to treatment of ulcers in people. Havoc is now on a complicated medication schedule which includes Tagamet and another drug to coat his stomach.

While my trainer, who had followed in her car, settled up the bill and got the details on his medication schedule, I took Havoc home. I gave him a little hay when we got to the barn, which he lipped up enthusiastically. However, he indicated that what he really needed was a good roll, so I took off his blanket and turned him loose in the sandy arena. By then, my trainer was there, so I held him while he received the first of his medications, and then turned him loose in the gelding field.