Rural veterinary practice
Delivery of a foal
Sleepy foal disease
22. Head wound
A call comes in concerning a horse with a wound. In tears, the girl explains that she found her horse in the stable with its head covered in blood. She has no idea what happened: ‘Duco is always so sweet’. She also knows the animal’s father: Pretendent. That is a renowned dressage horse known to pass on his talent. But he also has a touchy character. And that too is a dominant feature in his offspring.
The studhorses of the KWPN (Royal Warmblood Studbook of the Netherlands) are all registered in an eight-volume reference book. Pretendent is a breeding stallion with around 600 off-spring. He was bred in the Netherlands, but his sire, Le Faquin, was imported in 1967 from France. Concerning Pretendent’s character, the studbook reads: “troublesome, difficult to ride; demonstrates much resistance at times; is somewhat unfriendly when mounted; needs a good rider”. His character received a mark of 4 (out of 10) for the performance assessment. His offspring includes various top performance horses in the dressage sports. But many are sometimes difficult to manage.
Blood is visible on the bars of the box, along with a streak of blood on one of the walls. The damage to the head is not that bad: the animal has a loose flap of skin on its forehead. It costs the girl effort to put the horse’s halter on. She puts Duco in the washing area. He jerks his head up when I extend my hand towards him. When I persist, his response is a quick kick with his front leg. It just barely misses the girl who is standing in front of him with a handful of sugar cubes. She is astonished: he has never behaved like that before. Equipping him with a twitch is not an option. And in all her innocence, this young horsewoman is a danger to her-self. I propose that we wait and let the wound heal by itself. Worst case scenario: a few white hairs will eventually grow on his forehead. Many horses naturally have white hairs on the forehead: it is called a star. No other negative consequences are to be expected.
My soothing words backfire, however: she starts to cry. ‘She did not call me for that. The wound must be sutured! Duco is in pain; she can tell just by looking at him. That is why he lashed out at her. He has never done that before!’ There is no point to discussing the matter. There is no doubt that suturing the head wound of this animal will be extremely difficult without adequate assistance. However, I have enough sedatives in my car to knock out five horses like this one. I place him back in his box and tie him to the bars with a short rope. I spot a sturdy collar further down in the stable. He will not be able to pull it to pieces. He lashes out wildly with his front leg when I put the collar on. In doing so, he hits the wall of the box. The girl is standing just outside the box. She is startled and retreats to a safe distance from the horse. The collar is now around his neck and I also fasten the collar to the bars using a second nylon rope. I fetch a syringe with a sedative from the car. I estimate him to weigh around 600 kg, but I start off with a generous dose. It will calm him down and will also act as a painkiller. When I take hold of his neck and attempt to press the vein, he again rams against the wall of the box and pulls violently at the ropes. But the collar holds and he has little room to move around. I manage to give him an injection.
There is an empty garage next to the stables. In my line of work, I am always pleased to have plenty of room to work in, particularly when dealing with horses that are difficult to manage. I lay out the items that I will need later on. When I return to the stable, Duco has a drowsy look on his face and his head is down. But as soon as I touch him: Bam! The strike is as fast and even harder, if possible, than the one before. His head jerks forcefully in my direction. Back to the car: enough medication is always a sure win. He is administered a second injection shortly after. Fifteen minutes later, he is docile: he does not respond to my touch and when I loosen the ropes that are tied to the bars of the box, he drops his head far downward. He is staggering and collides with the door left and right. Inside the garage, I lead him in a wide curve so that his head is positioned towards the door where sunlight shines on his forehead. That is where the horse requires sutures. But that curve is almost too much to ask: his rear legs become crossed and he forgets to correct them. He very nearly falls down. He is sweating all over his body and his head drops to the floor when I release his halter. His front legs are positioned far apart. I put the twitch on the horse and stick the wooden handle between the halter. I will have to sit right in front of him on my knees when suturing his forehead. And I want to prevent him from kicking me between the legs with his front leg, no matter what the cost.
I then disinfect the wound and apply a local anaesthetic. I examine the skull while wearing sterile gloves. I find no fractures or splinters, just the flesh wound. The floor has become wet with the horse’s sweat. He does not move during the suturing. The flap of skin is put back neatly in place with a gauze drain beneath it to prevent the accumulation of wound discharge. The small gauze can be removed the next day. Then a bit of wound disinfectant spray and it is done. Duco is found to have had his tetanus shots every year, so a booster-injection is not necessary. He stumbles back to the stable and into his box. There, he is offered sugar cubes in a loving fashion, but he has no interest at all. The girl is relieved that his head looks virtually intact once again. But it was quite a bit of work for a minor, cosmetic surgical procedure and not without risk. For both the patient as well as the doctor. But what to do in such a case?
At the time, I had not yet heard of Monty Roberts and his revolutionary way of handling horses. His book ‘The man who listens to horses’ was not released in this country until 1997. His approach to horses made him a living legend. In 2005, he was also in the Netherlands where he gave a demonstration of his approach to unpredictable horses. Some of the animals were dangerous. I saw him at work and I developed deep respect for the man and his approach. He didn't use sedatives. Without hitting the horses, or using some other form of aggression, he got them to do what he wanted: he requested their cooperation, as it were, and accepted the horses as they were. Meanwhile, he was certainly at risk. It cannot get much more noble-minded than that.
That demonstration changed the way I approached horses. Still, it leaves me with questions: How would Monty Roberts have sutured a head wound on a horse such as Duco? Would he have done so without using a sedative? And would he have also lived past the age of seventy?
© Leo Rogier Verberne