10 minute read
Technician Update
Stuck in the Mud: The Importance of a Team
By Tammy Treitline, CVT
June 18, 2018 started out the same as any other workday in our northeastern North Dakota hospital: routine equine health care appointments consisting of dental floats, vaccinations and sheath cleaning. I made the mistake of thinking to myself “pretty light day, might even get a lunch break, and—best of all— appointments are inside the clinic and out of the cloudy, cold, potentially rainy weather outside.”
Appointments were showing up on time until about 10:30 am and that is when the day started to change. The 11:00 am-scheduled appointment was an equine dental float in the clinic, but the owner called at 10:30 and asked if we could make a farm visit for lacerations instead of a clinic appointment. Apparently, the horse reared up while loading in the trailer, fell over, and now had blood coming from the nostril and lacerations on the head and legs. The owner was extremely concerned, so we canceled the in-clinic appointment, moved the remaining appointments to another veterinarian and headed out on the road. Luckily, the horse was okay, just minor lacerations and swelling from the fall. While we were at that farm, the clinic called asking if we could go to another emergency call. We agreed and had them move the afternoon appointments to the other available veterinarian.
The second emergency was described as, “a horse stuck in mud by a river bank, with water up to his belly and he could not lift up enough to get onto a 2 foot bank to get to dry land.”
The owner of the horse called the clinic looking for a horse sling. They wanted some type of sling/ harness to assist the horse forward or to lift the entire horse out of the mud. Unfortunately, our clinic did not have that piece of equipment, but the clinic thought we might be able to assist the horse and owner in the situation.
Keep in mind that this is North Dakota so the distance between places is far. It was going to take us close to an hour and 15 minutes to get to there. We finished up at the first farm then headed in the direction of the horse stuck in the mud. We left about 12:45 p.m., just as it started to rain with temperatures in mid-to-upper 60s. I called the cell phone of the owner of the horse to let them know we were en route with the estimated time of arrival, and I wanted to get more details on the situation.
On the left: The horse was unable to climb onto the side. On the right, rescue personnel put the horse on a small John boat so he would not drown.
Images courtesy of Dr. Kingsley
The owner explained that they found their 24-year-old Arabian gelding in the river around midmorning.
They were able to row a small, low-sided (John) boat to the gelding, place a halter on and swim him back to the lowest portion of the river bank in the hope that he could climb out. Unfortunately, he was unable to climb out on the 2-foot embankment, and the river was at midbelly on the horse. The owners did have access to a telehandler and larger equipment to aid in removing the horse from the river. This is the reason the owner was looking for a sling/harness to lift the horse up and out of the river.
They also had called the local fire department for assistance and equipment, which were already on the scene. The owner wanted to know if we had any ideas the crew could try while we are on our way to them. Some ideas suggested were to try to knock down a portion of the 2 foot embankment, or try to create a lower shelf for the gelding to step on, or to try to get wide straps or ropes around his chest and front legs to assist him forward.
We cautioned them not to force the gelding too much because he might have a leg stuck underneath or was just too exhausted. In a water rescue, the strong underwater currents and debris are always a concern. It is hard to instruct a person how to fix a problem when you can’t exactly see the problem. Although in hindsight cell phone cameras can help with this.
Hannah Kingsley, DVM sedated the horse to make it easier to maneuver the gelding. Once on shore, they had to figure out how to get the horse out of the water.
We just turned off the highway—almost to the their farm driveway when the owner called. She wanted to meet us in the driveway because it had rained so much our truck would get stuck in the pasture. So we had to use a 4-wheeler to carry supplies to the scene. The scene had changed, the gelding was getting exhausted, his head was going down, and the river was rising. They had placed the small rowboat partially under him so he didn’t drown.
We gathered supplies like clippers, an IV catheter, male ports, sedation drugs, anesthetic drugs, an IV extension set and saline for flush—basically the bare essentials that would fit with us on the 4-wheeler.
At the scene, we had to help figure out the quickest, safest and most logical way to remove at least a 1,000 lbs of horse from a river with slippery mud and grass. The best option we had was to anesthetize the horse and pull him out in the John boat. This option would allow us to move the horse without him struggling and injuring himself or any of the emergency personnel— which seemed to be the safest scenario.
This would be the fastest way to get the horse out of the water, although it did come with risks. Those risks included:
• the small boat not being able to support the horse once anesthetized,
• the horse’s legs getting caught with debris under the water,
• the support cable to the boat breaking,
• the horse waking up in mid transport, and
Dr. Kingsley had sedated the horse and stayed with him as they used a wench on the firetruck to pull the entire boat ashore. Tammy Treitline in the barn with horse, who required fluids and medication to reduce inflammation. He was exhausted, and showed some facial nerve damage, but improved steadily.
Even with all these risks, this method was still our best option in this scenario.
The firefighters attached the front cable of the fire truck to the front of the boat with a carabiner clip a firefighter had in his pocket. The cable would pull the boat up the embankment. The firefighters also placed a board in the water next to the boat to help maneuver the front of the boat onto the embankment once it was being pulled by the cable. We also needed to secure the horse with a strap once anesthetized and in the John boat. We did use the life jackets in the boat to support the horse's head when anesthetized, to try to prevent possible facial nerve damage.
Again—in hindsight—we probably should have worn life jackets ourselves on the river. One of the most important rules in large-animal rescue is safety, and to make sure you never become the focus of the rescue.
Once we anesthetized the horse it was “GO TIME” to pull the boat up the embankment, which worked really well until the cable on the fire truck got entangled. The cable was caught enough so it would not release and reset nor would it continue to pull. The boat with the horse was up on the embankment but not in a location far enough away from the river to recover an anesthetized horse.
A simple solution was to back up the fire truck and continue to pull the boat with the horse farther onto land. However, it had rained so much that the fire truck had no traction on the mud and wet grass. So the next solution was to use the telehandler to pull the fire truck and the boat with the horse farther away from river. The reason we needed the anesthesized horse farther on land was to avoid a recovery of the horse on slippery mud and wet grass, and to limit the possibility of the horse having a rough recovery. There was also the likelihood of him falling back into the river. This solution worked and the emergency personnel were able to pull the horse far enough onto land for the recovery phase.
The next phase of the rescue was recovering the anesthestized horse. The team was able to tip the John boat and gently slide the horse out onto the grass. The concerns with recovery of the horse were:
• The area was slippery, increasing the possibility of the horse not being able to stand up well.
• The horse was exhausted, which would affect the cardiovascular and muscular systems.
• We were concerned about potential hypothermia.
The temperature of the horse was 97.8o F, the heart rate was 40 beats per minute, respiration was 8 breaths per minute, and the capillary refill time was less than 2 seconds.
The firefighters had a large blanket with a wool liner to cover the horse to increase his temperature. We used portable forced-air heaters to create a warm air flow under the blanket to increase the body temperature. We discussed placing an IV catheter at this time and starting lactated Ringers solution to help support the cardiovascular and muscular systems.
Before we could place the catheter, the horse stood up and started to the barn.
The recovery phase took 28 minutes from removal from the boat to standing.
Once the horse was in the barn, a 14-guage, overthe-needle IV catheter was placed and lactated Ringers fluid started. The fluid therapy helped support the kidney and cardiovascular systems from the exhaustion symptoms observed. The horse did show slight facial nerve damage on the right side. The horse was also given flunixin meglumine to reduce inflammation of the facial nerves and muscles.
The horse continued to improve so we instructed the owners to monitor him throughout the night and call if they had any concerns. Once we had packed up the supplies in the truck, we headed home soaking wet. On the way home, we had to call Lisa and let her know about our exciting water rescue.
I did a follow-up call the next day with the owners. The horse was showing some muscle soreness but was eating and drinking well. The facial nerve paralysis on the right side had improved.
The water rescue was an amazing situation, which could have had many different outcomes. Through this experience, I realized how important teamwork is—especially working with other emergency departments and personnel.
A career in veterinary medicine can be a very exciting profession with rapidly changing situations. Being as prepared as you can and learning from colleagues will help you grow in this profession.
Teaching Points
In my 20 years as a veterinary technician, I can look back on different cases and wonder how incredible it was that the patient survived against all odds.
Some situations start out as emergencies bordering on disasters. I have come to appreciate the extent of the teamwork and effort it takes to improve a bad situation. I have learned to appreciate the colleagues who you work and collaborate with every day. They push you to strive to be better and learn new things.
Lisa Trader, CVT, is one of those colleagues. I have worked with her for many years. When the horse rescue occurred, she challenged me to learn more about large animal rescue and help her with a presentation for our annual state veterinary technician meeting. So thank you, Lisa, for being interested in large animal rescue, pushing me to learn more.
Another inspiring person is Hannah Kingsley, DVM the veterinarian that I had the pleasure of working with on the day of the rescue. Dr. Kingsley is an incredible veterinarian who strives to improve patients care, quality of life, and is determined to find the best solution to any problem she faces.
Dr. Kingsley is always willing to discuss the different cases, treatment, or diagnostic options. She has allowed me to view things from a different point of view and become more knowledgeable in different areas—another person pushing me to be better.
A few months prior to the water rescue, Lisa found a local seminar held by the state on large animal rescue and emergencies that all 3 of us attended. The seminar discussed different scenarios, dangers posed and different rescue options.
A couple of things I learned directly from handling this rescue:
• Getting camera phone videos ahead of time might have been helpful in guiding the rescue operations until we arrived.
• We were lucky, but we probably should have worn life jackets.
• Looking back, I probably should ask more questions before agreeing to help.
About the Author
Tammy Treitline, CVT works for Kingsley Equine and loves being outdoors hiking, riding, enjoying each and every day.
