Any horse owner will tell you that horses are forever trying to kill themselves. Mine is no exception.
Last month Gem was slammed against the gate latch in a multi-horse attempt to escape to the back pasture. My son witnessed the kerfuffle and came running for help. He burst into the house and announced Gem was hurt really bad. I figured he was exaggerating but I dragged myself off my chair and down to the barn to take a look.
The sight of the wounds stopped me cold.
Gem had a gash the size of my arm over her shoulder and her skin was splayed open. Right next to that was a grapefruit-sized puncture wound over her lung area with muscle torn all the way to her ribs.
I am no equine vet, but I know a bad wound when I see one. And I worried she’d punctured a lung.
This dear horse is very old. And the hard reality is that when a terrible injury or illness befalls an old horse, there is a good chance the costs will exceed the benefit of veterinary intervention.
My heart started racing as I feared the worst.
My aunt is a large animal vet who unhappily lives hours away in a different state. She is easily the smartest and most practical doctor I know, human or otherwise. So I grabbed my phone to have her triage the situation.
She calmed me down (I was in tears) and instructed me to go fetch my stethoscope to listen for breath sounds and check her heart rate. My mind went blank and I reminded her I don’t know horse anatomy. She told me listen on the good side first then switch to the injured side. I marveled at her wisdom and got to work trying to ascertain what lung sounds and a heartbeat sounded like on a horse.
Incidentally, the heart and lungs sound like they do on humans except the heartbeat is so slow that at first I counted each lub-dub as two beats.
I texted Gem’s vitals along with lots of pictures to my aunt. She called back to reassure me that the horse’s vitals were normal, meaning she did not have a pneumothorax. Her assessment was that this was not a lethal wound and asked how the horse was acting. I noted that Gem wasn’t acting at all like she was in distress. In fact, she seemed quite bored with the whole situation.
My aunt suggested I just stitch her up.
I scoffed, pointing out that I had no idea how to suture a horse. I informed her that the more I stared at the humongous skin tear, the more I thought I should just call the local vet to come fix it.
She disagreed. And the conversation that ensued went something like this:
Kay: I think you can manage this.
Me: You are crazy. These wounds are huge.
Kay: But you are a PA. You know how to suture. You stitch up humans for a living.
Me: I’ve stitched up humans smaller than that shoulder gash. And besides, humans don’t have fur. (Which isn’t entirely true. Some humans are actually quite hirsute. But that’s not the point.)
Kay: Tam, you can do this. I know you can do this.
She repeated over and over again that she thought I could manage and pointed out that the vet bill would cost a fortune. She also gently reminded me this is an old horse so the exorbitant cost might not be justifiable.
I begged her to get in the car and drive up. I may have even offered her cash. I just could not picture myself sedating, cleaning out a wound that size and sewing up a horse.
We were losing daylight and I started to mentally calculate the emergency vet bill. I knew that if the quote was significantly high, my only choice would be to euthanize this dear old horse. In that case, I would be out the emergency vet fee and still lose my horse.
I slowly started to trust my aunt’s assessment that I could handle this wound. And I decided I really had nothing to lose by stitching her up myself. In fact, it was probably the best option.
A while ago my aunt gave me a huge vet care package containing pretty much anything I’d ever need in an animal emergency. Unfortunately there were no gloves in the tub because we used them all last summer when we neutered cats together in my garage. (The sort of stuff we do for fun when my aunt visits.) But I figured I would have to do without gloves and try to ignore how uncouth this was from a sterile standpoint. I figured my bare but clean hands were no worse than a nasty gate latch.
I followed my aunt’s careful instructions to sedate Gem and started directing my family to gather the supplies I would need. They ran for hot soapy water and brought clean towels. We set up a makeshift surgical table and set out the numbing agents, needles, saline solution, surgical cleaning agents and suture packages. And when everything was ready, I began.
My daughter stood at the ready to text questions to my aunt and my son sat on the fence and pet Gem’s face, whispering calming words to her the entire time. My husband was my surgical assistant – but he drew the line at actually touching the wound, which I decided was fair enough.
Stitch by stitch, inch by inch, with copious amounts of text questions and photos back and forth to my aunt who was standing by the entire time, I sewed that old mare back together.
I have a gnarly picture of the shoulder wound that my advisory board (hubby & friends) gave mixed reviews about including because it is … a bit much. The medically minded can click HERE to see it.
There were points that I had to get creative with my suture technique because I am not used to 1000 pound hairy patients who stand during the procedure and cause their wounds to flap open. As night fell, my kids ran to the neighbor’s for a flashlight and my husband pulled up his truck to provide lighting. And multiple times during the procedure I marveled, “I can’t believe I am doing this. Who am I?”
I used every package of suture in the tub and it took two and a half hours from sedation to the last stitch. But when I stepped back, I was stunned. I did it. And it looked really really good. My horse had stood like a perfect lamb the entire time in an almost sacred trust and she nuzzled me when it was all over.
I am not gonna lie, I felt a little bit like MacGyver in that moment.
Gem was started on the appropriate antibiotics and pain medicine. (A side note of interest for my medical friends – she was on 24 Bactrim DS per day!) She loved the addition of molasses to her grain to make medicine go down easy. And aside from needing to lance and drain a big seroma with a scalpel given to me by a doctor friend, she healed remarkably well.
The whole experience got me thinking about tackling situations in life that we don’t think we can manage. And I have a few takeaways I’d like to share.
1) Some people identify abilities in you that you don’t see in yourself. Listen to them.
I had zero confidence that I could manage this wound. But my aunt saw things differently. She knew what it would take to sew up this horse and she knew I had the skill to do it. Her relentless encouragement (read: bossiness) pushed me to tackle a problem I didn’t think I could manage. But I could and I did.
2) Start with what you know.
My aunt was correct – I know how to suture. I’ve done it hundreds of times. And she was right that the technique used to stitch up a horse isn’t any different from stitching up a human. I worked as a first assistant in surgery for five years and watched amazing surgeons tackle the unexpected by sticking with the basics. Sometimes scary things are actually simple when you boil the steps down to the fundamentals.
3) Don’t forget the big picture, but go one step at a time.
I had never sutured anything this large. Obviously. And the puncture wound scared me because you could see muscle and ribs. I wanted to run for the hills rather than tackle that wound. But I planned my overall approach then focused on just one stitch at a time. And once I got started, the next steps always became clear.
My Aunt just happened to be visiting exactly two weeks after the accident so Gemmy had the luxury of a real live vet to assess her progress and decide on a plan for the next phase of healing.
I’ve said it before and I will say it again – this horse is kinda like a cat with nine lives. She has put us through the paces during her tenure as our very first horse. But she is still our favorite and the favorite of the multiple kids who she’s taught to ride. And I am grateful she is ok.