XL Equine vet Dr Imogen Burrows BVetMed CertAVP(EM) MRCVS reveals what it's like during a hectic day as she juggles appointments and multitasks like a pro!
Today I’m working on our zone visit scheme. These days are great for our clients, giving them an opportunity to book hugely discounted visits on a set day each week for routine work, such as vaccinations, dental work, scheduled re-examinations, bandage changes etc. Generally, my zone days are very busy and I see an average of 20-25 horses per day.
Days like this bring their own challenge of ambulatory work - fighting with traffic as well as the unpredictable nature of equine veterinary work - meaning efficiency is paramount. After leaving each visit I make sure I check my phone to see if the office needs me. Typically for an ambulatory vet I use my driving time to return messages, deliver lab results or catch up with owners of ongoing cases, and consequently the phone never seems to stop ringing! All was going well today until my I finished my penultimate appointment.
I’ve been in the car around 90 seconds when the phone rings. “How are you getting on?” the chipper, but tentative voice says on the other end. “Why?” I reply with suspicion. It’s a permanent game between office and vets - how do you ask someone who’s already fully booked to ‘squeeze’ an extra visit an hours drive in the wrong direction into their day and get them to say yes! ‘How are you getting on?’ is the staple opener at our clinic, so I know they’ve got more calls for me - I just don’t know what and where yet.
“There’s a colic in Bexhill - would you be able to go please? We’ll try and find someone else to cover your last call.” I smile at the sweetener of the thought of someone else helping me out, take the directions and head off to the new destination.
Now for the most part I am very grateful that our clients are hugely understanding when it comes to having to move their routine appointments for such an issue. I think most owners are well aware of the potential seriousness of a colic and the worry is causes, so have the attitude that ‘I’d like the vet to drop and run for my horse too if it was needed’.
Even though this is far from my first colic examination, I still find myself running through a mental check list. Have I got everything I need? Stethoscope, thermometer, rectal gloves, lubricant, stomach tube, stomach pump, electrolytes, liquid paraffin, appropriate pain medications, blood and faecal sample pots…the list goes on.
I mull over the age and breed of the horse, the yard he’s at, his likely management and work level. I wonder if he’s been dewormed recently, and if so, what with. I’m pretty sure the yard has a worming programme, but how good is it and are they all up to date? I’m not trying to guess what’s wrong before I get there, rather think of the most common causes of colic for this particular patient.
He’s a mature chap being 25 years young, but in great body condition and full of beans as a rule. His owner keeps him in light, regular work to avoid him from stiffening up, and he still acts like a bit of a ladies’ man, the horse not the owner! He’s up to date with worming, and has had a recent tapeworm test due to a mild colic episode last month. Fortunately, the result was low - suggesting that tapeworm is unlikely to be at fault.
The owner reports he’d been trying to roll and kicking up at his belly before I arrived, but the hour of walking has settled him right down. I check him over and find all his vital signs are normal, save for his gut sounds which are gurgling like a Glastonbury portaloo!
Once he’s had some pain relief and a spasmolytic injection to settle his gut spasms, the old boy’s world seemed to become rosier by the second, and he even whinnies at the lady of his fancy over the door! I advise the owner to take away his feed and hay for the next few hours and gradually reintroduce them later on if he still seems perky. Of course the question every owner wants to know is why did he colic in the first place? Knowing how far to investigate into the cause of colic episodes is never easy, and there is no single right approach either. The weather is pretty changeable today, being a lot more windy - that could be enough to have set him off. A bit more stress than normal from flirting with his ladies; would that be enough? Maybe.
My advice at the end of today? Keep everything a constant as you can. Keep on top of your worming programme, with regular worm egg counts and occasional tapeworm tests. If he has another bout in the next few weeks, give some thought to checking him for gastric ulcers. But for now, go and give him a cuddle and keep an eye on him. Ring me if you need me.
And with that I gave my last patient of the day a pat, and he gave me a great big lick and then tried to get in pockets for treats. I think he’ll be ok today.
To find out more about XL Equine visit www.xlequine.co.uk