When lameness exams multiply, attention to details dwindles
Working up lameness in a horse is sometimes a tricky job. It's a task best accomplished with full concentration and focus. That never happens. Most of the time we have two or three things going at the same time and take phone calls while we watch them trot. Sometimes that multitasking menu can bring a bitter dish.
The horse was lame in the right hind leg. It wasn't going to be an easy one; two veterinarians had already tried and given up, so they sent it to us. That's OK with me—the harder, the better. But as fate would have it, we had four lamenesses going at the same time when this slow-talking, 60-something cowboy showed up with "Fred," the chronic right hind lame horse.
My associate Dr. Emily Berryhill began the process of working up ol' Fred with me as we shuffled through the now five lameness exams at the same time. We watched Fred move and just as slow-talking cowboy dude had said, the horse was lame in the right hind leg. So, here we go: flexion tests, hoof testers, trot uphill, trot downhill, palpate the leg, palpate the back, etc., etc. etc. It's the same thing we've done a thousand times and part of the way we work up a lame horse.
Dr. Emily started the process of diagnostic blocks. She finally hit with the tibial nerve block, and the horse was much better. Even the slow-talking cowboy dude noticed how much better the horse was. Only problem was, it was on the left leg. Oh yes, the left leg.
My technician Shelly had scrubbed the wrong leg for the tibial block. And being busy and going in five different directions, Dr. Emily just blocked the one she had scrubbed without even noticing it was the wrong leg.
The cowboy dude noticed it right off the bat, but he didn't say a word. He just figured we knew what we were doing. Even worse, we didn't even notice it when we watched the horse trot. All I thought was, "There ya' go. That block fixed him, so we know about where it is now."
The slow-talking cowboy dude now had his hat in his hand and was scratching his head: "Damndest thing I have ever seen in my life. You guys are the smartest people I have ever seen. Who woulda' thought you could block a nerve on the left hind leg and make the right hind leg get better? I guess that's why you guys are the vets and I'm just a cowboy."
Good thing he was looking down at the hat in his hand when he said that or he would have seen the same expression on all our faces. You know the one I'm talking about. It's when your eyebrows go up so high you no longer have a forehead, your eyes get so that the white part is visible all the way around your cornea, and your lips form a shape that is almost like you're trying to whistle.
Don't ask me what happened. You can't block a left tibial nerve and fix a right leg lameness. But this guy was really impressed.
"No wonder none of them other vets could figure it out. Wasn't a one of 'em ever did nothing with the left leg. You guys are great."
What do you do now? If you tell the guy it was an accident, then all those great compliments turn into "You guys are dummies." And how in the heck are you gonna' explain how the thing got better?
After saying this, the cowboy made a phone call and I heard him explaining to the person on the phone how we blocked the left leg and the right leg got better. As soon as he was around the corner, we all looked at each other for a long moment. I think it was Emily who started giggling first. This led to Shelly and then me and then eventually to the kind of laughter where no noise even comes out.
We must have laughed like that for five minutes. We eventually talked the guy into leaving the horse for more diagnostics the next day, and we finally did figure out why he blocked this way. And hopefully Fred and the slow-talking cowboy dude will live happily ever after still thinking we're brilliant.
Dr. Brock owns the Brock Veterinary Clinic in Lamesa, Texas.