Monday, July 20, 2020

At Huachipa They Lost the Bets by Carolina Yepes

At Huachipa They Lost the Bets

Almost 10 years ago, I was invited to work as a foreign veterinarian at an equestrian club near to Lima-Peru, after the loss of several horses because of lack of appropriate medical attention, especially in urgency cases, and after facing the toughest challenge, both personal and professional till that moment, and still being a newcomer, I wrote the following storytelling: 

Last Tuesday, after a long working day at Club Ecuestre Huachipa, near to Lima, and after being for a while inside a traffic jam, I got to an internet cafe to communicate with my family, and as soon as I sat down, I had a call to attend a colicking horse: The first horse colic in Peruvian territory. Then I grabbed a taxi, which took me to La Molina neighborhood in Lima, to meet the owner of  Mozo de Caba (the sick horse) and, together, go back to Huachipa. We arrived at the club at 9:15 pm, and I went to my office to get ready all the basic stuff to attend Mozo de Caba, and suddenly its owner shows up pretty upset, almost crying and she says Carolina: The horse is pretty bad. I went to see the horse and in fact, it was sweating, barely standing, and its vital signs were not good at all.

Capturahua ~ Photo by Carolina Yepe (c)

Capturasalto - Photo by CArolina Yepes (c)

I got everything ready and some club members in solidarity showed up to help. To be honest, I must say that I was in front of the worst colic I ever attended until that day. Mild analgesics were not working at all, so I needed something stronger, so I could keep working with the horse. The "fun" thing was that I was surrounded by people wanting to help, but no one had any idea of what to do and that was complicating things a little, and I was not sure where to start, because I had some things to do at the same time. As a treasure, I had with me 2 endovenous catheters, which I took from Colombia (because in the time I was in Lima, I couldn't find them in the market), and these would be the tools which were going to allow me to keep giving fluids to the horse for a long time, and although I explained this to my helpers, and that it would be important to keep the catheter in place while fixing it, they let both catheters out of the vein: both were lost.  This meant the beginning of long endovenous hydration using regular needles, and I was thinking that if they let the catheters go out of the vein, the needles had no future.   

On the other hand, as soon as I got in the club for the very first time, I was asking for ringer lactate for fluid therapy, but in Lima, I learned something new about this matter: They used 5 lt of sodium chloride and they thought it was enough, so given the circumstances, anything was better than nothing, so getting together all the fluids they had, I gathered a total of 13lts: still not enough. I moved on with the protocol and I remember to hear them talking about what I was doing and saying: We never sought someone doing what you're doing. After about 2 hours, or so, everything I knew that could help the horse was done, and the horse was getting worse, not better. If there was a horse clinic around (an around I mean in Peru), I would have derived the horse immediately, but I hadn't that option, so I was alone with this horse and the club members who wanted to help. At that point, I asked them to call my mentor, who brought me there and who was in Bogotá-Colombia, and he told me: Keep the horse hydrated and you will have a patient. It was like midnight, and I was managing needles and losing the veins to work because once I put my attention in another issue, and the horse moved, the needles went out and the person who was holding the horse didn't care much. I felt that water was getting into my ship, but as it was, I should keep giving fluids to this horse. It was 4 am, and the horse stabilized, so I decided to stop hydration, we let the horse rest for a while, and I fell asleep inside the box with him, and after half an hour I went to sleep at my home's couch (my house was not ready yet) for another hour. Suddenly: knock knock in my door, it was Mozo de Caba's owner saying: Carolina, the horse is not well. And I thought: No way, but these things are like that. Let´s begin once again: needle, fluids, analgesics, nasogastric tube. I spoke to my mentor once again, and he made them understand the urgency of finding ringer lactate, and I don't know how they got it, or where, but they brought a bunch of ringer lactate bags by 9 am.  By noon, I was reaching 6 hours beside the horse and holding the needle by myself, and at this point, I barely had 5cm of the vein to work, and now my ship was sinking: The horse was getting worse.  All the bets of the club members were going that the horse would die: just before I arrived, they lost 3 horses, so statistics and experience dictated that Mozo de Caba should die too. The owner was crying besides me, and she was even offered "the injection" to put him down. But my mentor from Bogota encouraged me to continue with other medical treatment options. 

At any point I was able to eat and drink something, and desperately I needed to go to the bathroom and I let the groom taking care of the needle and as it was expected, he let it out: Believe it or not. Then I asked my mentor: How long do you think this is going to take? I did not want to leave the horse alone, but I was starting to feel tired. He said: Caro, be patient and get ready for another long sleepless night; it was like 2 pm. As the vein was lost, again, I took the horse out of the stall to try to empty his stomach anew, this time successfully accomplished. They took him for a hand walk and when he came back, I left him stable in the stall. I went to visit my other patients in the club, and when I came back to Mozo de Caba's stall, my dog who was my faithful co-worker and adventurer was pulling me through the horse's box, and what do I see? The horse which 2 hours earlier had the muzzle on the floor and barely stood was now standing very well, calmed, stable and with his eye, he told me: I'm feeling fine. Yes, it was shocking to see. We kept watching and treating him till 10 pm, and again I fell asleep in his box, with the horse and my dog, who joined us all this time, and since Mozo de Caba seemed to be fine, was resting and looking good and calm, I went back to my couch for half an hour... Half an hour? The owner waked me up at 5 am. The horse spent the night so calm, that he was sleeping soundly, stretched over his shavings bed, and his owner thought he died and we didn't realize, but it was a new dawn and Mozo de Caba was still alive. We took him for a hand walk and to eat some grass and the club members who followed the step by step of this journey were telling me: How is he? -Fine, I answered excitedly and surprised they confirmed: Fine? Is he alive? And I said: Yes, he is alive and stable for 12 hours now: no analgesics, no fluids. I think in Huachipa they lost the bets and in what way. They were as thrilled as they were amazed that Mozo de Caba went to the other world and came back and now he was grazing in the club fields, and well let me tell you that this was the best presentation letter. My mentor congratulated me, also people did, the owner was more than excited, the other club members were confident and Mozo the Caba was alive. Now ringer lactate was a trend in Huachipa and they were bringing not bags, but boxes. After a few days, Mozo de Caba got a fever, we carried out some laboratory analysis and it turned out he had his immune system kind of weakened, so we treated him and at the time I wrote this, he was sound and jumping again.

Carolina Yepes
Bogota-Colombia-South America

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