Auggie Gets an Ultrasound

Fearing the worst, I opted for more tests.

I started to worry that the change in Auggie's diet
may have caused kidney or bladder stones.

   Amy texted me around 9:30 that Wednesday morning to say that the vet would be at the farm in about half an hour to see Auggie. The rain was beginning to clear out slowly and the sun started to pierce through the cloud cover a little at a time. There was new vet at the practice, and Auggie would be her first on-call patient at the farm. I wasn't sure if I would get along with this new vet, but I knew Auggie couldn't wait for another day to be examined. 

    I left the jobsite where we had been installing Belgian blocks around the front entrance of a law office. It was the first day that week that we had been able to get anything done outside due to the monsoon that had taken over our region. As much as I hated to miss valuable time at work, I wasn't about to skip this doctor's visit for my horse. I still felt the melancholy of Julie's passing, but now the added stress of the unknown concerning Auggie's health had my mind spinning.

    As I pulled up to the stone parking lot of the farm with the pickup truck, I began to wonder how much it would cost to have this visit. It was an emergency call, so right off the bat it was going to be something like $100, now add in the exam, labs, and possible diagnostic imaging; the tab could go up fairly quickly from there. As I turned and walked to the barn, I shrugged and resolved to deal with the cost when it came, there was nothing I could do about it at the moment except pray that the problem wasn't as severe as I was imagining. 

    I found Auggie in his stall, looking confused about why he was still in the barn without his pasture mates and shuffling through the bedding with his lips in search of grain scraps and hay bits. He seemed relaxed and comfortable, so I immediately started questioning my judgement on calling the vet out emergently. Just as I was beginning to think that I must be a horse hypochondriac, Amy walked briskly around the corner and into aisle of the barn where Auggie was waiting patiently. A small, blond woman was trailing in her wake carrying a black duffle bag of sorts over her shoulder. This was the new vet, and she didn't know her way around the farm yet. 

    "Hey! There you are! I saw your truck, I figured you might be done here already," Amy said as she saw me peering out from behind Auggie's huge rump. 

    "Yeah, I got here as soon as I could. I thought this was kind of weird, so I started to get worried, " I replied.

    Amy still had her hardhat and riding clothes on, as she had just rushed from training one horse to get the vet down to the barn. I was rarely at the farm during the morning hours, so I almost never saw Amy riding, but today she was concerned enough about my horse's health to take a time out of her training schedule to check on him. Maybe I wasn't so crazy to be worried about him. 

    "This is Doctor Bye, she's on call today, " Amy said indicating to the woman behind her.

    "Hi! So what's been going on with this guy?" the vet piped up as we all squeezed into the stall with Auggie.

    "Well, he started doing this thing where seems to be struggling to pee, " I responded. "He stretches out and then kicks at himself or the wall and he might drip a little bit, but he won't empty his bladder. It looks painful, but he seems totally fine right now so I don't know what is going on with him. Amy saw him do it this morning too."

    "Hmm yeah maybe he just needs his sheath cleaned?" Amy mused.

     "I hope that's all it is, I haven't really looked there. I'm pretty sure he'd knock me out if I tried though," I said. 

    The vet began rummaging through her bag in the dim light of the barn. Amy grabbed a lead shank from the door and clipped it to Auggie's halter, preparing for an examination. The vet motioned towards Auggie's sheath, and I felt a wave of terror pass through me with the thought of my horse stomping this lady to death as soon as she tried to grab his manhood.

    "I wouldn't do that. He needs sedation for that."

    "Right. Yeah. Let me get something for that. It will help him relax and maybe he'll drop for us to see a little better," she said, as if she had simply forgotten that most horses don't readily present themselves for examination like that. I sighed, thinking of what the bill was going to be for all this. 

    Doctor Bye stepped back into the stall with a syringe and quickly administered the sedation into Auggie's neck. And as she withdrew the needle, Amy excused herself from the stall to return to training some of the other horses in the barn. Within minutes the medication was beginning to take affect and his eyes began to get heavy and sleepy. As the tension left his body, the vet stepped back into the stall to begin the physical examination at Auggie's back end. 

    The exam of the sheath produced no abnormal findings, much to my dismay, as I had hoped that a simple cleaning was all that would be needed to solve the problem. With my sort of luck, it couldn't possibly something that easy; nothing was ever that easy as far as I was concerned. I started to sweat thinking about the other possibilities that could be lurking in the background. If there happened to be a kidney or bladder stone present, that could be a life-threatening issue to deal with; but then again it could be some sort of bladder infection, which would simply require antibiotics. My mind was all over the place.

    "OK so his sheath looks completely normal," she said as she stood up by his flank, "next I'm going to palpate rectally to see if I can feel any abnormalities inside."

    "Ok, sounds good," I said as I held Auggie's drowsy head in my hands. I felt terrible putting him through all the prodding, but I didn't see any other way. As the vet reached her arm into Auggie's butt, I could only hope that he would forget this experience once the medication wore off. A few minutes of awkward silence with the vet up to her armpit in my horse's butthole produced no abnormal findings as she searched around his internal anatomy for anything out of the ordinary. 

    "Well, I certainly can't feel any stones in there and everything seems to be normal," she remarked as she withdrew her arm from under his tail. "Next thing to do would be to get a urine sample and possibly an ultrasound to see if there are any tiny stones in there that I couldn't feel."

    "Ok what about maybe checking his blood to see if there are any imbalances? Like his calcium levels and all that?" I asked.

     "Right, yeah. We should do that too," she agreed as she peeled the glove off her arm and threw it in the trash can in the barn aisle. 

        "I was just thinking maybe the changes in diet could messing with him since he had a completely different lifestyle at the rescue than here. I'm sure the minerals in the grass and water might be different."

      "Yes, that definitely a possibility," the vet said as she rummaged through her medical kit for blood sample tubes.

 "I'm going to wait for a little bit to see if he will pee so we can get a sample," she said producing a little plastic cup with a screw on lid.

    "Um you don't have a catheter to collect a sample?" I asked, failing to hide my shock. How could you get a good sample from a horse in this sort of situation without a catheter? I could tell the vet was having a rough first day. 

    "No, I didn't bring one, so I'll wait a little to see if he pees but if he doesn't, I'll leave this with you to see if he will go for you."

     "Ugh ok," I shrugged. I was feeling a little irritated at the thought of having to stand watch for the horse to pee in front of me. She collected a few tubes of his blood and sat down on the trunk outside of his stall to wait for the big horse to pee.

    I walked to the indoor arena where I found Amy riding one of the boarded horses with Rich sitting in the middle observing. I let her know that the vet had not found anything unusual so far, but the blood and urine tests would need to come back before scheduling the ultrasound to rule out any possibility of an obstruction. 

 "That's so weird," Amy remarked from atop the palomino mare she was riding.

"I know, I wouldn't think there could be any congenital abnormalities present or else he would not have made it this long, so maybe it's just a little bit of an infection or something like that. She is going to wait a few minutes to see if she can get a urine sample from him while he's in his stall, but if not, I'll have to try to collect it from him later."

    I returned to work that day with more questions than answers, and of course the vet was unable to collect the necessary urine sample from my horse, which meant that I would need to return to the farm after work to attempt collection myself. I grumbled to myself at the prospect of staring at the horse for hours until he needed to pee, but I wasn't left with much of a choice at that point. 

    Later in the afternoon, Cheyenne and I returned to the farm to find the little plastic cup outside Auggie's stall with instructions attached on how to collect and store the sample. Auggie innocently stared back at us through the bars of his stall, patiently waiting for his dinner to arrive. Cheyenne grabbed the wire stall door eagerly and gazed into the horse's big, saucer eyes.

   "So, we need him to pee in that little cup, mommy? How are we going to do that?" 

   "That's a good question, Nugget. I guess we just have to wait!" I said slipping on a pair of nitrile gloves and preparing the container. 

    "Let's see if there are any of those relaxing YouTube videos with the rushing water sounds. Maybe he will pee if he feels relaxed," she asked, reaching for my phone.

    "Ok. I guess it can't hurt. See if there's one of those sleep videos with the waterfalls or whatever." I handed Cheyenne the phone as she proceeded to click on "Water Sounds for Sleep or Focus" to help speed the process along. The sound of a babbling brook filled the barn as we sat across from his stall. Auggie pricked his ears forward at the noises, but there was no sign of a bathroom break on the way. We waited and waited.

Auggie was groggy after his vet visit! 

    Diane walked down the aisle with several laps of hay in her arms and stopped at the spectacle that we had created in the barn as we camped out near his stall. She looked befuddled for a second as she approached, and before she could ask, I offered the explanation for my predicament.  

     "Maybe you could take him out to the wood shaving pile and see if he will pee out there? The geldings like to go on fresh bedding. Let's try that, it always works!" Diane offered as she threw hay into the neighboring stalls and grabbed a lead shank off the door. I was hoping that Diane would be correct in her assumption that Auggie would provide a sample as soon as he parked himself near the pile of shavings as I had no intention of staying the whole night. 

    Diane led my horse to the mountain of shavings outside the main barn and stopped him over a flat area outside the tarp where he could stand on some fresh, new bedding. Cheyenne and I stood anxiously watching, cup at the ready as people started gathering around. Diane started to whistle to him, thinking that maybe he had been taught to pee on command during his racing days, but to no avail. With a curious crowd gathering around, Auggie did nothing but stare back at his human handlers with confusion. 

    After some time of waiting with no results, we returned him to his stall slightly frustrated. In a final attempt to get a sample from him, I decided to tack him up and get on, noting that he often had to pee as soon as I was done riding. As I walked and trotted him around the arena, Cheyenne feverishly followed on the ground from a safe distance, continuing to play the sounds of rushing water with my phone. As I dismounted and took him back to the barn, it was clear that he needed to go imminently.

    I led him into the stall and as I loosened the girth, the floodgates opened, and Cheyenne scrambled to hand me the cup before we missed our opportunity. At the last second, I dove under the horse to catch the desired sample, barehanded and desperate to be finished with this task. At that point it was getting very late, and I no longer cared about the nasty horse pee running down my arm, I had gotten the required sample and I was ready to go home and hand it off to the vet. We double bagged the cup and I washed up before heading home. I had never been so happy to see a horse pee.

    The vet picked up the sample from our house and ran all the labs on it as well as the blood from earlier in the day. All bloodwork came back normal, and the urine sample was only positive for some slight crystallization, which was not very unusual. I scheduled the ultrasound for the end of that week, but it was looking more and more like nothing was seriously wrong with the horse other than he needed to drink more water to flush out his urinary tract.

    Doctor Bye performed the ultrasound that Friday and found nothing unusual in his pelvic region. I was relieved and confused at the same time, as I still did not have reasonable explanation for his strange behavior. As the vet was cleaning up from the procedure in the wash stalls, I asked her if this could just be some sort of peculiarity that he came with.

    "It could be entirely behavioral. I can't find anything in his urinary tract to explain it, although the next thing to consider could be gastric ulcers. If he has that, he could have some pain further up in his belly that might make it uncomfortable to stretch out. But he's certainly not in any danger right now, he can pee and poop just fine, no signs of stones or colic, so there's no emergency. Just make sure he's drinking enough water."

    "So should we check for ulcers next? I hate to put him through all this, it seems very stressful," I asked. 

    "We can hold off and see if he is feeling better with more water and a couple days of rest."

The emergency wasn't even an emergency, but now I had to figure out what exactly was bothering the horse, something physical or mental?