A Yorkshire Vet Through the Seasons

by Julian Norton

  Once we got to the field, surrounded by its sparce hedge of hawthorn and oak trees, Gary was like a terrier, rummaging into rabbit holes and peering into the water troughs, looking for clues.

  I scuttled along behind him, not really sure what he was looking for. His fervour reminded me of the French police inspector in one of my kids’ favourite films, Madagascar 3: Europe’s Most Wanted, as she searched for the missing zoo animals. He wasn’t exactly sniffing on all fours, but very nearly, such was his enthusiasm for the task in hand.

  His trail led us to the edge of the field and over a ditch, thick with brambles and wild roses, but the spikes did not impede the ministry vet. He caught sight of something in the distance, at the edge of a field about a quarter of a mile away, and nearly broke into a run.

  ‘Look, Julian! It’s a mound of poultry manure! Follow me!’ he exclaimed.

  As we rustled along, me in my waterproof trousers and Gary in his white ministry-issue protective suit, he explained his theory.

  ‘You see, this is what happens – that pile of poultry manure is from the bottom of a broiler shed, where chickens are reared for Sunday roasts. The manure is a brilliant fertilizer and farmers get it to dress their land. The problem is, if any chickens die, they get trampled into the manure and their dead bodies partially decompose.’

  His manner was so matter-of-fact.

  ‘Since these birds hardly ever receive antibiotics in their food, the dead chickens decompose quickly and botulinum bacteria grow within them. The toxin builds up to quite high levels,’ he explained.

  This still didn’t explain why the field of heifers, about a quarter of a mile away and separated by a hedge, might have been contaminated by the toxin. I was sure none of the heifers would have escaped the field to have a quick chicken snack.

  ‘Then it’s the foxes, you see,’ Gary continued. ‘They come along and dig in the manure, looking for bits of chicken.’

  I still could not understand how this affected my heifers, but he went on: ‘They grab the chicken bits and pull them back to their den to feed their young. Foxes being foxes, they usually take more than they can carry, so they will drop bits of chicken carcass en route. Cattle do not usually eat this sort of thing but – and this is the key – if the grass is very short like it is now they might be tempted to sniff or nibble on a bit of dead chicken. They are so sensitive to botulinum toxin, even a tiny bit can cause illness.’

  It sounded like the way a disease would be spread in the drought-affected savannahs of Africa, but now, it seemed, it was happening in North Yorkshire!

  By this time, we had arrived at the brown mound of smelly, flaky poultry poo and Gary was already standing on top. Within just a few moments he had discovered several little holes where something – we presumed a fox – had been scrabbling, digging for food. With imagination it was even possible to see tiny fox footprints extending from the hole that had been dug.

  Gary didn’t shout out the words ‘ta dah!’ as he stood at the top of his mound, where he was doing a great impression of being the king of the castle, but he might as well have done. We could not prove his theory, but it sounded plausible and he seemed certain he was correct.

  As he leapt from foot to foot in his enthusiasm, Gary went on to explain: ‘We see this all the time now. It’s ever since poultry farmers stopped using antibiotics to promote the growth of their chickens. It’s good for chickens and people but bad for cattle if they accidentally eat the bones. The dead chickens are just full of botulism, you see. We’ve seen half a dozen cases this year, over the whole of the north of England.’

  The mystery appeared to have been solved. We explained it to an astonished Robert, and suggested moving the cattle to another field, well away from the offending pile of poultry muck. There was no effective treatment for the animals which were suffering – all my visits and injections were for nothing – but at least we had a diagnosis, could remove the cause and prevent sorry episodes like this happening again.

  Once the move had taken place, no more cases developed. The statistics for the outbreak were bad, though – eight out of forty-one animals died, eight affected animals recovered, twenty-five were, thankfully, unaffected. The muck was spread and Robert and I, despite having many more wrinkles than we did before the episode, swore that neither of us would ever visit a beauty salon for a botox injection as long as we lived!

  Lady Anne and the Colt with Colic

  The small village of Sutton-under-Whitestonecliffe takes its name from the imposing limestone escarpment that dominates the skyline to the east of Thirsk. The cliff marks the beginning of the North York Moors National Park and it always gives me a thrill when I have the chance to negotiate the steep hairpin bend near its summit. On the edge of this village was where Lady Anne kept her young stallions.

  Lady Anne was a frail, elderly lady who lived alone in a small, messy, 1970s bungalow that looked very out of place in the picturesque village. A visit to her stables always sounded like an idyllic way to spend a sunny morning. Nothing was further from the truth though, because Lady Anne owned a couple of brood mares and a collection of very unruly yearlings, all bred out of these ageing mares. Whilst Lady Anne had obviously been a force to be reckoned with in her youth – the photographs around her living room were testament to her formidable equine background – she was, when I knew her during my first few years at Skeldale, finding it a challenge to manage her animals.

  So, the call to see a yearling with colic at Sutton Stables on this misty summer morning was always going to be one for the junior vet. As I packed up all the extra bits of equipment that I might need – a bottle of liquid paraffin, a selection of sedatives and painkillers and a stomach tube – some additional instructions from the senior partner issued forth from the vets’ office: ‘Make sure you get a cheque from her. She owes us a fortune! It’s like pulling teeth trying to get money from her! She’s not paid anything off her account for over six months.’

  ‘Great!’ I thought. As if the clinical part of this morning’s job wasn’t going to be hard enough, I had the job of debt collecting, too. That was not something for which vet school had prepared me!

  I had one final check of my car boot, just to make sure everything was there, and took a deep breath before embarking on the ten-minute journey towards Sutton Bank. Mist was clinging stubbornly to the fields despite the increasing intensity of the midsummer sun. It would soon evaporate and the haze would give way to the strong June heat. Whilst it was a glorious day, I was not looking forward to the job ahead of me.

  Lady Anne usually packaged her mares off to stud in the spring then, once they were pregnant, she would have them back for the summer to graze, quietly gestating their foals. Just before the foals were due to be born, the mares would return to the stud, where they would get expert and constant supervision by specialized staff and veterinary surgeons, who dealt with nothing else. So specialist is the job of an equine stud vet, that once the UK stud season is over, they often travel to New Zealand, where the stud season is in the opposite half of the year, so that they are dealing with breeding animals all year round. Soon after Lady Anne’s mares gave birth, they would be mated again and return to Sutton, pregnant once more with a foal at foot. It was Lady Anne’s job to nurture and rear these foals and supervise their progression into sensible, well-handled and well-mannered youngsters before they were sent to a racehorse trainer, to be honed for glorious success at Cheltenham or Aintree.

  The system worked well, except for the fact that Lady Anne was now in her eighties. Judging by the slowness of her movement, her permanent reliance on a walking stick and her general frailty, she had enough of a challenge looking after herself, let alone half a dozen young horses.

  I parked my car by the stables and, as I waited for her to arrive from her bungalow, I peered into each box, looking for my patient, but all were empty. It was several minutes before she tottered out of the side door, terribly stooped and very precarious on her legs.

  ‘O
h, it’s you, is it?’ was the terse greeting from the old lady, when she finally made it to the stables. She did not look delighted to see me.

  ‘Hello, Lady Anne. How are you?’ I replied.

  ‘Not very good. My knees are knackered and my back is bloody awful. And this yearling is bad, too. He’s been like it since first thing this morning. I could see him from my bedroom window, you see?’

  ‘How is he to handle, Lady Anne?’ I asked, suspecting I already knew the answer.

  ‘He’s not really very good to handle at all,’ she confirmed.

  My heart began to sink.

  ‘He’s quite a strong yearling, you know. Well, he’s actually a two-year-old, but I still think of him as a yearling. I haven’t really had much chance to handle him – not as much as I would have liked. It’s my knees, you see. He’s out here, in the paddock next to the house, I’ll show you.’

  She pointed in the direction I needed to head, as if suggesting that I go first. She knew I could walk quicker than her. When I rounded the corner, my already sinking heart sank as far as it would go. The horse was rolling around in the middle of the paddock, obviously in a great deal of pain. It was clearly a very bad case of colic and was going to be every bit as difficult to manage as I had expected.

  Colic is the term used to describe abdominal pain in any animal. Horses are particularly prone to colic, because they have such an enormously long intestine. A cow uses its rumen to digest the cellulose in grass and therefore bovine intestines are not as long. Horses, like rabbits, rely on their huge hindgut to do the same job as a cow’s rumen. The great length that is required for this purpose means that the bowel can easily get twisted or pulled into the wrong place, a bit like an unravelled ball of string. This leads to stretching or distension, which is very painful and in some cases can be very serious. A horse with colic will kick at its belly and roll around on the floor, writhing in agony. Sometimes this rolling can make things much worse as the mass of guts can twist further.

  The cause of the pain can be relatively simple. Spasmodic colic, for example, where the intestines contract vigorously often for no obvious reason or cause, can be very painful but is easy to treat with the correct drugs. An impacted colic can be equally painful and is caused by a partial blockage of the large intestines, by hard faeces, soil, sand or matted-together grass. This usually occurs at a sharp bend in the colon called the pelvic flexure, and needs to be treated with large volumes of laxative, administered by nasogastric tube. It works well, but requires a rectal examination to make the diagnosis, followed by the successful passing of a stomach tube up the horse’s nose, which then needs to be held in place for about ten minutes whilst a couple of litres of mineral oil are funnelled down. As we both peered at the writhing youngster in the middle of the paddock, I sincerely hoped this was not what we were dealing with today. I didn’t relish the prospect of inserting my arm into one end of the horse or a pipe into the other.

  The most serious type of colic occurs when part of the bowel twists and becomes entrapped. These cases are very dangerous for the horse and can only be treated by surgical correction by an equine surgeon. Add in conditions like grass sickness, which causes colic by virtue of the intestines becoming paralysed, and conditions that masquerade as colic, such as ‘choke’, and you can see that working out exactly what is happening inside the abdomen of an affected horse can be a diagnostic challenge. It is difficult enough in a calm, quiet patient, but in an unhandled colt, rolling around on the grass in the middle of a field, it was going to be ten times more challenging.

  ‘At least he’ll be easy to catch,’ I thought.

  Often horses turned out in summer fields are not keen on being caught, especially by a stranger smelling of surgical spirit and other animals. There was no way Lady Anne could do it, though, so between rolls, and whilst avoiding the flailing legs of the youngster, I managed to loop the lead rope round his neck and steady him down. Before long, with some gentle coercion, I had the front part of the head collar over his nose and then the strap behind his ears so I could buckle it up. It was clear, however, that I could not progress further without giving him a hefty dose of sedative and I kicked myself for not bringing it with me in my pocket. I would have to leave Lady Anne in charge while I went back to the car.

  ‘I’ll take him now,’ said the old lady, without hesitation. She was very confident with horses and this colt obviously had a little more respect for his owner than I gave him credit for. They were used to each other’s company, after all.

  ‘That’s a good boy, Trevor,’ she reassured her horse. It seemed an incongruous name for such a handsome and headstrong beast. He seemed to relax as Lady Anne spoke and snorted loudly, between groans, as if in conversation with his owner.

  My heart rate dropped by about twenty beats per minute through sheer relief once I had successfully injected sedative into Trevor’s jugular vein. It would take a few minutes before it started to work, which gave me time to quiz Lady Anne about any changes that might have faced Trevor recently – dietary differences, worming procedures, anything that might have brought on this episode. As is often the case with a colicking horse, nothing useful was revealed by my history taking, so there was nothing for it – I would have to start my examination.

  The first part of any examination of a horse with colic is to check the pulse and heart rate. We are supposed to feel the pulse under the lower jaw as well as listening to the heartbeat with a stethoscope. They are usually exactly the same, but occasionally the pulse and heart rates are different. Today though, I decided just to listen to his heart, to avoid doing anything around his head that might upset him. Gently, gently, because even in a horse with a very painful belly, the surprise of a cold, metal circular object on the side of its chest can cause alarm.

  Trevor’s mind, however, was on something else completely and the stethoscope on his side did not bother him one little bit. Now came the time to count. The simple rule is that the faster the heart rate, the more serious the colic. The normal heart rate of a horse is about thirty-two to forty beats per minute. Forty to fifty would fall into the ‘mildly elevated’ category, fifty to sixty would be ‘moderately severe’. Anything over about eighty is in the danger zone, usually signifying extreme pain and carrying a grave prognosis.

  I counted the beats up to fifteen seconds on my watch. I repeated it a second and then a third time, just to check, and to make sure the rate was not changing.

  ‘Bother,’ I thought.

  Trevor’s heart rate stubbornly refused to be anything other than fifteen beats in fifteen seconds, which made sixty beats in a minute. That was pretty high and it warranted further investigations, especially since I would have expected his heart rate to have reduced a bit with the sedation. In short, this meant I was going to have to try to palpate Trevor’s large intestine, per rectum, and run the risk of being kicked. It is a good idea to lift up one front leg of any horse when this procedure is being undertaken, as it makes it more difficult for them to kick if they have to balance on two legs. As I explained what I needed to do, I knew there was not a chance that Lady Anne could lift up the front leg of this horse.

  First, though, I needed to listen to his intestines, to hear what noises were being made. Upper and lower segments, both left and right. I listened patiently. There was a lot of noise, much louder and with much more gurgling than there should have been. Could this simply be a case of spasmodic colic? I really hoped so, because that could be simply treated with a single injection of a spasmolytic. But the horse was in so much pain and his heart rate was very high, especially considering that he was sedated. As much as I tried to convince myself that a rectal examination was not necessary, I knew that this was really the correct thing to do.

  I could not vacillate for much longer. I watched him intently as I returned from my car with long gloves and lubricant. He looked much more relaxed as a result of the sedative drugs, their painkilling effect and the soothing words of Lady Anne who, despite her dimin
utive appearance, was proving to be more help than I had expected. Trevor’s head hung low and I could see rhythmic breaths blowing from his nostrils against the dew on the short grass. Occasionally he would lift his head and stomp his feet, as another wave of pain gripped his intestines. His ears flicked and his head rose again as soon as he sensed my approach, although I was sure he had no idea of what I was about to inflict upon him.

  A rectal examination on a horse sounds like a deadly dangerous thing to perform, but surprisingly most horses tolerate the procedure quite well. The problem is that if something does go wrong, and the vet is kicked, it can be a complete disaster. A kick from one or both back legs at such close range would almost certainly leave the vet with at least one broken leg, and possibly a broken arm as well if it isn’t withdrawn in time. Being an equine vet is regarded as amongst the most dangerous of professions and recently it was ranked as the most dangerous outside the armed forces. The main cause of injury is from a kick from a hind leg. As Trevor danced around when I came close, I did not want to become another statistic.

  I explained my plan again to Lady Anne, as I donned the long, green, plastic glove and smothered my hand in lubricant. I slowly edged my way to the action end and lifted Trevor’s bushy tail, standing slightly to his left side. If he were to kick out, it would be better if I were standing to one side rather than immediately behind him. His head went up and he whinnied as I started my examination.

  ‘Phew!’ was my first thought, and I exhaled loudly. My hand was inside Trevor’s rectum and nothing bad had happened so far. Faeces were present and this was a good sign for Trevor. An absence of faeces in the rectum could indicate a blockage further up the bowel and this would be bad. For me, though, it was not so good, because it meant that I had to scoop it all out, one handful at a time, as if I was moving sand on a beach to make the moat around a sand castle. Every time I put my hand back in to remove more, there was the repeated risk of upsetting the colt.