The subject of bandaging technique and ettiquette can spark some fiery debates among equine enthusiasts.
The potential dangers behind “bad” bandages
Bandage bows are injuries to the tendons/ligaments on the leg that result from improper bandaging. The tendons at risk are critical structures required for flexing joints, and are located on the back of the leg. Damage to these tendons can be serious and cause long-lasting effects on performance. I’ve seen my fair share of bandage bows resulting from the use of poor quality materials, insufficient materials or benign negligence. Most times, it has resulted from a novice horse owner applying pressure wraps or standing wraps improperly.
90% material, 10% technique
When wrapping around a leg, if the tension as maximized back-to-front, it can result in excessive tension on the back of the leg..right where those critical structures are. If the tension (effort to remove slack from the bandage) is maximized from front-to-back, then the maximum tension rests across the front of the cannonbone where less “susceptible” structures are.
The common pressure bandage or standing wrap provides structured support and even pressure on the leg.
And what is the key material?
It’s all in the fluff.
Gamgee, combi-rolls and cotton are all materials that serve as “fluff.” They serve as a buffer, a way of preventing particulr area from too much compression. The material that wraps around the “fluff” are materials that create the pressure around the leg. The fluffy layer is insurance, ensuring that no matter how much tension you create in either direction, you won’t be able to put the constricting layer on too tight.
In other words, since there is no absolute “right” direction, you can rest easy in either direction so long as you have the protection of the fluff.
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The list of causes for colic is endless. Sometimes I say it could be due to a cloud moving across the sky in a particular way…meaning it could be anything.
The most common type of colic I see is gas (spasmodic) colic. These tend to resolve quickly, especially with the help Banamine (anti-inflammatory). Most of the time, to the frustration of many clients and equine effianados, the cause of a particular episode remains a mystery. While spasmodic colics can strike at any moment, I see more cases during the changes in seasons and during drastic weather/temperature fluctuations. Hottest days and coldest nights.
Colic, simply defined, is abdominal pain. Pain associated with the gastrointestinal tract (the gut) can be due to gas (we all know what gas cramps feel like!), shifting of part of the tract into an abnormal position and therefore displaced, imbalance of natural GI bugs, diarrhea, impactions, twists in the gut or due to other diseases in the abdomen (tumors, infection). While 90% of the colics I see are simple gas colics…the past 2 weeks have really thrown a statistical curve ball.
Last year, I had 3 cases of colic that were due to impactions in the gut. Impactions can be complete (nothing is passing through the clogged pipe) or partial (mostly just liquid passing through, sometime small amount of manure). In the past 2 weeks, I have diagnosed 7 impactions. Usually, I see impactions in the fall. This year, the transition to spring definitely brought in the new.
Impactions (basically something in the colon or small intestines that impedes flow, like poorly digested/broken down feed material) can occur anywhere in the GI tract, but particular parts of the horse’s anatomy predispose certain areas to become blocked. These are areas where a large diameter is going to a small diameter, or where the gut suddenly takes a hairpin turn.
The most common location is called the pelvic flexure, and accounts for 5 of my 7 recent cases. I think one of the most astounding and stressful aspects of impactions is that they can go either way…as in, some can be managed fairly easily in the field, some may be fatal without surgical intervention. Sometimes, even surgical intervention is not enough.
Working the Cases
Of my 7 cases, 3 were referred to our local hospital for surgical or intensive management. For the two cases that did not have a referral option (finances, owner choice etc), one made a full recovery over the course of a week. Unfortunately, the other one had to be euthanized within 12 the following 12 hours.
All of the impactions were diagnosed by performing a rectal palpation. After identifying the impaction, I assessed how impressionable it is. Some impactions are so firm that I cannot make an impression or indent (feels like a baseball). Others, I can almost mold with my hand (like dough). The more impressionable the impaction, the more likely we will be able to resolve the issue in the field…which becomes a labor-intensive endeavor for vets and owners alike!
After identifying where the impaction is, how impressionable it is and how large it is, the next assessment is comfort. If pain cannot be managed, referral becomes the next avenue. Otherwise, the mainstays of treatment in the field is tubing (passing tube from nostril to stomach) in order to administer fluids/laxatives/electrolytes…sometimes requiring 3-4 return farm visits a day for 2-3 days. Discomfort is managed with NSAIDs, and horses are held off feed until they are passing manure and recheck rectal palpation confirms that impaction is gone. In some cases, IV fluids are necessary.
Additional Info for the Curious at Heart
Vetstream has a great client hand-out about colic that I have included below…for those who want to learn more or brush up on the colic basics.
Reproductive work makes up less than 5% of our cases. Foals have always been a special area of interest to me, largely because my first veterinary-related job was with a university and USDA breeding herd. For 3 years during my undergraduate studies, I spent the summers orchestrating and managing a breeding program consisting of 30 mares and 3 stallions. It was during these summers that I thought to myself for the first time
‘I can’t believe I’m getting paid to do something I thoroughly love and enjoy.’
I felt like this every day. Although the actual cycling and breeding (AI and livecover) was interesting, without-a-doubt my favorite part was the foals. Foals were the heart and soul of the job. From their first day to their last day, they were both the most challenging and rewarding aspects of my job.
In the present…
Since there is definitely a professional void that foals used to fill, I jump at any opportunity to work with them. Last year, I inherited a big client with a small breeding program. We delivered 6 foals last year, and with the exception of one FPT, they were all healthy. This client also became one of my favorites, and I was filled with mixed feelings when she shared the news she was moving out of state. Part of me was sad at the thought of never working with her and her horses again, while the other part was excited for her new opportunity. The odds of working with mares and foals drastically dropped.
However, another client happened to have a pregnant mare that was rescued off a reservation last summer, She was pregnant, feral and has been a ticking time-bomb for the last 4 months. Since it was impossible to ultrasound or examine her, her due date was a complete mystery. As a 2 year old, she was facing a heightened risk of foaling complications (specifically, dystocia),
The client placed cameras in the stall for constant monitoring, and we all spent many evenings obsessively glued to these cameras. I even found myself checking the cameras while driving between appointments, grocery shopping and every night before bed. Over the past 2 weeks, curiosity turned to obsession as the rescue thought labor was underway any time she laid down, swished her tail, took a break from her feeder or circled her stall.
After the long wait…
It was on a Wednesday, which happens to be one of the weekdays I am not on call for emergencies. When my work phone rang, I didn’t have to look at the caller ID to know that it was the owner of the rescue.
“We’ve got wax!”
I actually squeel-yelled into the phone with excitement and then apologized for blasting her eardrum. Waxing, in 95% of cases, means impending parturition (birthing process) in the next 6-48 hours. From my previous experience a breeding program, I guessed she would deliver her foal in the middle of the night, between 12am and 3am.
At 11:30pm, I was already out the door before I knew who was calling. This time there was a panicked tone on the other end of the line.
“The foal is coming and there’s something wrong! Come quick!”
I live 8 minutes away from the rescue. I was there in exactly 7 minutes. During that handful of time, the foal was born. He lay sprawled on the ground, soaking wet. His dam, while curious about the new arrival, was equally suspcious and reluctant to approach. After passing a physical exam without a single abnormality, I spent a little time soaking up the moments. The adrenaline rush was replaced with heavy exhaustion. My colleague, the official doctor on call, was due to arrive any moment (she lived 30 minutes away). The foal was now in her care until 6 the next morning.
A note on exhaustion, fatigue and sleep deprivation
While I treasure foals, and welcome the surge of emotions that come with the entrance of a new horse life, I was also entering zombie mode. I had spent the previous two nights handling emergencies and then worked two full days with no sleep.
During vet school and the internship, mental/emotional/physical exhaustion is a very real problem. Going without sleep for 36+ hours takes sleep deprivation to a dangerous level. It wasn’t uncommon to wake-up in the driver’s seat, engine still idling and suddenly realizing you don’t remember the drive home.
In the middle of my fourth year of vet school, I remember jolting awake to the sound of someone knocking on my window. My neighbor’s worried expression was followed by
“I wanted to make sure you were okay. My husband said you’ve been idling here for 4 hours. Are you okay?”
It was 4:30 am. I assured her I was okay, just tired.
And during the internship, I even fell asleep standing up. After 42 hours without sleep, I was watching our clinician perform an abdominal ultrasound on a very sick patient. Before I knew what was happening, I felt myself suddenly fall forward…stumbling into the ultrasound and doctor trying to perform it!
Nothing will make you treasure and value sleep like an internship, vet school or any other inordinately demanding job. Looking back now, I shake my head in disbelief that any employer, program or profession would even consider asking or expecting someone to reach this extreme level of fatigue. It’s not only dangerous to the individual, but the patients as well!
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