Fiddler the Running Horse: A case report

It happens over and over again at Montana Equine.  While every patient is special, sometimes one case in particular can tear at our heartstrings, and provide inspiration.  Sometimes horses seem so fragile, and othertimes, extraordinarily resilient.  This year, a colt named Fiddler with a HUGE will to live captured our imagination, and captured our hearts. 

During the first half of every year, we see lots of our youngest patients, and of course  we fall in love with all of them to a certain degree.  Some foals are just accompanying the mare while she visits the clinic to be bred.  Some foals arrive to have medical, or even surgical care to help straighten crooked limbs.   And they are all amazing and adorable.  But sometimes the foal arrives as a very sick patient, needing serious intensive care.   Of course, foals can be more fragile than our adult patients, so early intervention can really stave-off more severe illness.  

Fortunately, Fiddler arrived within just a few hours of birth.  But he was already really really sick.  Bred as a racing thoroughbred, Fiddler was born only 10 days early, but even such mild pre-maturity can present a very

 severe combination of problems in foals.   He had been delivered at the same time as his placenta, strongly suggesting separation of the placenta from the lining of the uterus prior to delivery, a so-called "red bag" delivery.  There had been little warning of any problem prior to his early arrival, as is often the case.  Very often, uterine infections can go undetected and result in problems.  Sometimes the only clue is milk running from the mare's udder - this is definitely abnormal and warrants a call to your vet! 

Likely secondary to this type of smoldering uterine infection in the latter stages of pregnancy, Fiddler had signs of septicemia (blood-borne infection),low blood oxygen concentration due to pneumonia, and decreased mental status secondary to his low oxygen levels.  His prematurity also meant that the small bones in his knees were not fully mineralized or "calcified", so he needed special care to minimize risk of damage to his legs.  On top of all this, we soon discovered that his pancreas was not working properly - a blood sugar measurment of 475 (over 3 times the normal concentration!!) was checked and rechecked.  We soon determined that Fiddler had juvenile diabetes.

Diabetes is extremely rare in foals, but can be due to a variety of causes.  In Fiddler's case, it seemed most likely that his pancreas, which like the brain,

kidneys, and heart can be very sensitive to low blood oxygen levels, had suffered from low oxygen levels around the time of delivery.  His subsequent pneumonia wasn't helping anything!

Fiddler was treated with intravenous antibiotics, specialized fluid therapy and hyperimmune plama, as well as continuous oxygen, and began to make spectacular progress.   And just like a person with diabetes, his bloodsugar was closely monitored so we could provide just the right amount of insulin for him around the clock. 

Just before going home from the clinic in Late March, 2013

April, 2013.

Foals in particular have such an amazing ability to heal, and over a couple weeks of hospitalization Fiddler made amazing progress.  He was weaned off of the oxygen therapy as his lungs improved, and he was switched to oral antibiotics as his infection subsided.   More importantly, his pancreas began to heal!  After all, its one thing to supply insulin around the clock for a little while during foal-hood, but obviously not practical to do that throughout a horse's lifetime!  Soon, Fiddler didn't need ANY supplemental insulin and he went home mostly cured.  Over the following weeks and months, Fiddler has done amazingly well.  He is growing fast, and his family has high hopes for his racing career. 

With his goat buddy, June, 2013. He is growing up fast!

Every year, we treat many foals with varying problems, most of which are much less severe than Fiddler's.  With a little help, fragile youngsters can get back onto the right track with just a little veterinary care.  

Too often, sick foals arrive after their problems begin to compound upon themselves.  There is SO much we can do to stabilize and treat sick foals, from basic care to fancier treatments like oxygen therapy, blood pressure medications, or continuous infusions...cases that arrive sooner tend to GO HOME sooner, and often with a better prognosis and a lower vet bill!   With our special expertise in equine internal medicine, we are often called upon to offer second opinions or other input on some of these cases.  So call us or your local veterinarian right away if you have concerns about your youngster.