by Lauren Levy
Long hours, lots of paperwork, few breaks, and squeezing in bites of lunch between meeting with clients is what I would have expected from a day in the life of a Wall Street Journal reporter or a big-time lawyer. However, after spending a day with the professionals at the La Mesa Equine Lameness Facility in Pilot Point, Texas, I quickly realized that these vets work just as passionately and diligently around the clock to ensure the well-being of our equine athletes.
Alan Donnell, the world-renowned vet of twenty-nine years and owner of the La Mesa facility, works with a team of eight professionals who specialize in “performance horses, sports medicine, and the treatment and diagnosis of lameness issues.” Alan’s business is respected as being one of the most knowledgeable lameness facilities in the country and uses state-of-the-art technology like digital radiography, shockwave therapy, digital ultrasound, acupuncture, and electromagnetic pulse (P-3) therapy to improve the lives of its equine patients. When they aren’t working at the facility, Alan and his team can be found at some of the most prestigious equine competitions in the country, working out of Alan’s purple and blue Equine Sports Medicine trailers. At shows they aid injured, sick, and lame horses as well as carry out pre-purchase exams and other routine veterinary tasks. After spending an entire day with Alan and his team, it was clear that there is never a dull moment in the life of an equine vet. The account that follows is a play-by-play description of a random workday at the La Mesa Equine Lameness Facility. However, Alan assures us that no two days are alike in his profession.
I showed up at the facility, which had opened an hour earlier for employees like Amanda Ramseyer, a veterinarian who received her doctorate in veterinary medicine from Washington State University in 2011, and Katie Knight, a veterinary technician. When I arrived, Amanda was vigorously filling out unfinished paperwork from the day before in the back x-ray room while Katie was preparing Alan’s tools for a trip he was taking later that day to Minnesota to work on a group of show horses. I could hear Glenna, the secretary, answering phone calls in the front room.
Shortly after I arrived, Alan came in, coffee cup in hand, and invited me into his office. While we waited for the first patient of the day to arrive, Alan listed what he had already accomplished that morning. “I woke up at four o’clock this morning, worked on the computer, took a nap from 5:30 am to 6:30 am, got up, organized some things for my trip, made breakfast, and then came to work at 8:30. I did not even get home until nine o’clock last night because I was working on horses all evening.”
When asked if he ever gets any breaks, Alan said, “You can sit at home and tell yourself you have to work seven days a week, but you have to take breaks.” His last one was in August when he went fishing for a week in Colorado. Just as we were finishing our discussion, Katie popped in and told us that the first patient of the day had arrived. Alan and I headed out to the x-ray room to meet him.
We went to find a large bay gelding, who consistently had lameness problems in both of his front feet and needed x-rays so the farrier could make adjustments to his shoeing and make him more comfortable. Amanda and Katie were already propping the gelding’s front feet up onto wooden blocks and putting on radiation protection jackets. Then, they began taking x-rays of his feet. Alan reviewed the results, which showed that the horse’s hooves were normal. However, Alan says he has been working with the horse for four years and to help with his lameness issues, they were going to inject his joints with hyaluronic acid, a liquid with anti-inflammatory properties, to make him more comfortable.
As Amanda and Katie prepped the gelding for this procedure by scrubbing the injection sites with betadine and alcohol-soaked gauze pads, they explained that this is a very typical procedure in their practice. Amanda says, “Typically, we do ten or more injections a day, because we specialize in lameness.” Sure enough, I would see this same procedure performed six or more times throughout the day. After the procedure was complete, Alan filled out a “ticket” for the client that listed what he had seen and done with the horse that day.
It was time to see the second patient of the day. Patient number two was a stallion Alan had recently vetted but who was now having lameness issues on his hind right leg and having trouble turning to the right. This time, I got to observe a typical lameness examination, which is another routine procedure that was carried out multiple times throughout the day. During the exam, Katie put the lame horse on a longe line and made it trot and lope in each direction while Alan assessed its movement. “You shouldn’t really verbally diagnose a horse’s lameness until you have seen it go both ways. You have to compare both directions first.”
Next, he carried out a standard flexion test on the stallion, wherein Amanda individually flexed each of the horse’s legs and he had Katie trot it off immediately afterward. “This test stresses the horse’s joints,” he said. “A horse with a sore joint will definitely trot off lamer after this test. It is just a tool that we use to help us with the lameness assessment.”
After performing these tests on this stallion, Alan said he was getting mixed messages regarding the origin of the horse’s pain. He wanted to do a diagnostic block of his lower hock joint to see if it alleviated the horse’s lameness. This procedure started out the same as the hyaluronic acid injections the first horse received, but instead of injecting acid into the joints, they inject a type of anesthetic into the joint, similar to “the way a dentist would to numb a tooth,” Amanda said. She said they only block out one part of the horse’s leg at a time before taking it back out to start the lameness examination from scratch to see if the horse is still showing pain. This particular stallion had to be blocked and re-examined in two different spots before he was sound. Alan determined that his lower hock joints and carpal joints were bothering him and needed to be injected with hyaluronic acid like the first patient to reduce his inflammation in those areas. He was then given bute (Phenylbutazone) to help with any aches after the injections, and he was sent home, hopefully more comfortable than before. In the meantime, Alan filled out his routine paperwork, and the next set of patients was beginning to arrive.
10:06 AM-1:17 PM
Amanda had managed to slip away on a farm call to a nearby ranch to see a horse that could not walk due to a locked stifle. She was just returning and preparing to see the next couple of patients of the day. Within the next three hours, we saw a highly accomplished 18-year-old Quarter Horse gelding whose farrier needed more information about how to level up the uneven growth of his feet due to old age. The horse ended up needing his hocks injected with hyaluronic acid for maintenance purposes. We did a lameness examination of a four-year-old bay stallion who had been sore for over a year and had to be diagnostically blocked four separate times and re-examined each time to find out where his lameness was coming from. It was determined that his fetlock, pastern joint, and distal flexor tendon sheath all needed to be injected before moving on to different types of therapies.
At about 11:40 am, while diagnosing the four-year-old, Katie finished preparing Alan’s supplies for his trip to Minnesota. Alan filled out tickets for each of the horses he had seen, emailed pre-purchase x-rays of a horse to the horse’s trainer, and managed to meet with a well-known AQHA exhibitor whose horse had just gotten new mechanics applied to its shoes in the last week to improve the horse’s blood flow and strengthen its foot. Around noon, while waiting for one of the last blocks to set in on the four-year-old stallion, Amanda met with some clients who had come to check on their horse that was staying at the facility to be treated for laminitis. After she finished consulting with that client, she went straight to the next one, a mare with stitches, who had just arrived to have her bandage changed. She had recently injured her suspensory ligament and needed surgery to correct the problem.
By the time all of this was done, and I finally had a chance to look at the clock, I realized it was an hour past lunchtime and no one had taken a single break. I asked Alan if they would be breaking soon to eat. He told me they would not, and that instead they would have to eat on the go. According to Alan, going without a lunch break is routine procedure at the clinic simply because they are so busy.
Through bites of her lunch, Amanda said she might have a second to show me some old x-rays. Then, Katie informed us that our next patient, who was having a hard time on the left lead due to soreness, had arrived and was being ridden in the arena by its owner. This owner had also brought what Amanda referred to as an “add-on” patient who was having lameness issues as well as excess urination problems. She said it is common for clients to ask the vets at the La Mesa facility to look at additional horses that were not scheduled when they show up for their appointments. When this happens, they try to accommodate “add-on” patients, but they do not always have time. After doing a lameness examination and flexion test on the horse that had originally been scheduled for an appointment, Amanda determined that it was sore in both hind feet. After pulling up her records, Amanda also found that this horse had arthritic changes in its lower hock joint, so she injected it as a first attempt at fixing the problem. She also had to inform the client that she did not have time to check on the lameness of the “add-on” horse because she was already late for a farm call at a nearby ranch. However, Amanda still managed to clean the horse’s sheath, take blood work, and collect a urine sample to send off to a lab to check for abnormalities in its urine before we packed the portable x-ray machine into the car and headed off to see our second-to-last patient of the day.
We arrived, twenty-five minutes late, to see a middle-aged Paint gelding that Amanda thought would only need a slight adjustment to the mechanics of its shoeing. However, she did a stifle check on the horse, and because there was excess fluid in the horse’s right stifle, she decided to inject it with hyaluronic acid to reduce the inflammation. Also, she felt that the horse’s flexor tendons were tight. She suggested that perhaps bringing the horse’s shoe out up past his heel a little more might help, but Amanda still suspected that there were bigger issues to address. She asked the horse’s trainer to ride it so she could see where the lameness was coming from. After doing a full lameness examination, she decided to block the horse’s two front feet. After completing three other blocks up the horse’s leg, the gelding was still lame. We resorted to taking x-rays of his carpus, or knee.
That’s when the x-ray machine broke. All of a sudden, the machine would only bring up a snowy static screen when Amanda pushed the x-ray button. After multiple attempts, she looked at her watch, and knowing she was already forty-five minutes late to see her last patient of the day back at the clinic, she had to tell the horse’s trainer that she would come back tomorrow to finish the examination.
We reloaded the x-ray machine into Amanda’s work truck, rushed back to the lameness facility, immediately set up a new x-ray machine (Alan owns three), and were ready to see the last patient of the day. Amanda started by doing a stifle test on the 18-year-old Quarter Horse gelding, and she determined that both of his stifles needed to be injected. She also carried out routine injections on his back legs. Lastly, the horse’s owner asked Amanda to get health papers together, because she was getting ready to take the gelding to a show. While Katie prepped the horse for his injections, Amanda took care of the health papers. Within the next couple of minutes she carried out the injections and discussed with the owner what the horse’s maintenance plan would be in upcoming months.
By this time, the final patient was being led back into his trailer to go home, and the final activities of the day were taking place. Amanda began restocking the vial draw, and Katie was cleaning up the facility. I thought the employees were setting up to go home, but Amanda said that she was going to be there for at least two more hours. After seeing her last patient of the day, she must stay after to do paperwork, fill out tickets, and return phone calls. Often, she is not done working until seven or eight at night. Leaving Amanda to finish her paperwork, Katie, Glenna, and I left to go home for the evening. My experience at the La Mesa Equine Lameness Facility came to an end.
Although I thoroughly enjoyed the opportunity to join Alan and his team during a full day of their work, I was exhausted, and I had only been observing! Even if Amanda, Alan, and Katie were just as tired, it did not slow them down at all. The very next morning, around 9:30 am, I went out to ride at my trainer’s ranch. I found Amanda and Katie hard at work once again, ready to start off the next episode of a day in the life of a La Mesa Equine Lameness Facility veterinarian. I left this experience with new insight into how much work it takes to be an equine vet, and I learned that a horse doctor’s work is never really done.
To learn more about the La Mesa Equine Lameness Facility or Equine Sports Medicine, please visit their website at: www.equine-sportsmedicine.com.
Click here to read the complete article from the Equine Chronicle November/December 2013 Issue, Vol. 16 Number 7.