Almost exactly a year ago, I wrote A Hole in Her Head, a blog about how our gelding kicked our new mare in the head. We sutured up the skin, but obviously, it was up to Mother Nature to deal with the rest.
For the most part, Mother Nature did a great job. However, for the past few months, Sadie has periodically blown mucus out of that right nostril. There have never been signs of infection, just mucus that indicates inflammation. She might go days or weeks with no evidence of discharge, and then one day there’s a lot! She has never missed a meal and has never shown any indications of a serious problem.
Additionally, our rescued Black German Shepherd, Mica, has had an ongoing lameness for about the same time frame. As my husband and I have been dodging wildfires or on the road, it has been challenging to figure out if, when, and how to work them up. It finally occurred to me that we would be fairly close to my Alma Mater, Purdue University. (I wrote a series of blogs about my time at Purdue… Vet School Vignettes.) We made appointments for both Sadie and Mica on October 19th.
Dr. Adams, 40 years later!
When I called several weeks in advance to make the appointment, I spoke with one of the equine clinicians on staff. He was very helpful, and we agreed upon a date and time. He then informed me that he was going to be gone that day, but perhaps I knew the clinician who was covering for him? It was none other than Steve Adams, one of my professors from decades ago! COVID masks made it somewhat difficult to converse truly face-to-face, but what a hoot to bring him my horse all those years later!
Because of COVID restrictions, my husband and I were not allowed to be present for Sadie’s and Mica’s exam and work-up. We had to turn them over to students and wait inside our LQ trailer parked right outside the Large Animal Clinic. That was really, really disappointing for me…
Sadie was sedated and placed in the stocks. They took radiographs and used an endoscope to check her guttural pouch. They thoroughly evaluated her teeth, making sure to rule out all “normal” things before looking for the less likely explanation. However, in this case, the most likely cause of Sadie’s mucus discharge was her kick in the head last year. Medical and veterinary schools have a saying… “If you hear hoofbeats in the woods, think horses, not zebras.” This means that a clinician should rule out the most likely things first and then look for the less common causes of disease.
All of the normal causes of nasal discharge were eliminated, and the radiographs provided concrete proof of what was going on. It appears that a piece of bone has adhered to the wall of the maxillary sinus. It is attached, so not able to be easily retrieved by an endoscope. In order to remove it now, it would require major surgery.
The decision to proceed with a major intervention can be made at any time. Should I have had her scoped within a month or two of the injury? Maybe… hindsight is 20/20. My equine vet friend that treated my horses in Kansas felt that we should suture the outside and see what happens. Many horses have no negative consequences at all. There is still the opportunity to intervene in the future if necessary. For now, she blows snot occasionally!
Mica is an awesome, human-friendly dog, even though he scares the bejeebers out of most folks. He’s not so nice to other dogs… so when a human sees Mica sporting a muzzle, it only heightens their fear. But the reality is… Mica is a wuss! He’s got the lowest pain threshold of any dog I have ever owned. When he developed a right front leg lameness a few months ago, I poked and prodded his leg. He never made a sound. I placed him on NSAIDs and rest. Over the ensuing weeks and months, we saw little or no improvement.
When the students and clinicians evaluated Mica, they were able to be a little more aggressive than I am willing to be on my own dog. When they hyperextended his elbow, he hollered. But it was only at the very end of the range of motion. He also had radiographs taken. They showed an absolutely normal elbow. At this point, further workup has the potential to create more problems than answers. Their suggestion was to keep on keepin’ on with NSAIDs and rest. This is why it is called the practice of medicine. We are still all practicing getting all the answers!
Mica’s lameness has persisted with little change. He is no longer walking with me and the other dogs. He never yelps, but he’s on 3 1/2 legs… it is very sad. I understand better than most that one can spend a significant amount of money and not get an absolute answer. Still, we have confirmed there are no fractures or lesions that demand therapy. So no information is still information. But it is frustrating…
We had an enjoyable few days at Midwest Horse Camp. I will write about that next week.