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The Snowball Story

T’was a cold and wintery night and I, a senior veterinary student and budding horse doctor at the University, was assigned all-night duty at the Teaching Hospital. Specifically, I was working C-Barn; a facility shared by the equine medicine and surgery services, where hospitalized horses lived during their stay at the University. Slave labor is a necessary and critical part of every veterinary student’s training, and tonight was my turn for the 6 PM to 6 AM shift.

Much of the night would be spent on busy work. Under the knowing supervision of an able Intern (who, having actually completed a DVM degree, was vastly higher up the veterinary hierarchy than a lowly student like myself), I would circulate through the barn, waking first one horse to administer eye ointment, then waking another horse to administer an injection, and so on. That real-world horses would seldom be awakened in the wee hours to receive eye drops was of no concern to the University. We had a schedule to keep.

One of the Intern’s tasks was to perform initial evaluation of equine emergency patients, should any arrive. After making an examination, the Intern would consult with the Resident On Call, who would return gloriously to the VMTH and take over any really fun cases. At that time, this was a relatively infrequent thing. Oh sure, there would be an occasional horse brought in at night, but most acute cases showed up in the morning.

Not so this night. We received a call that a horse was coming in with colic, and made the usual preparations. Colic is an extremely variable presentation in horses, ranging from a simple bellyache to a life-ending colonic torsion. Like a box of chocolates, you never know what you’re going to get.

The sun had just set when a station wagon pulled in to the equine clinic, and we wondered at the lack of a horse trailer. The mystery was soon cleared when the driver opened the rear hatch. There, curled in a ball and obviously uncomfortable, lay an American Miniature Horse.

His name was “Snowball,” for no reason we could discern. Snowball was a brown gelding, weighing about 150 pounds. He had some white patches, but nothing to explain the moniker. I suppose Snowball’s name really has no bearing on this story, except to justify my telling it for Christmas. Hope you had a merry one.

We lifted the little guy out of the car and examined him. He was bloated, to be sure, and showed clear evidence of belly pain, but his vital signs were OK and his gut sounds were relatively normal. The Intern performed a standard series of tests, grumbling all the while at our inability to perform a rectal examination, a critical diagnostic test, on such a diminutive horse. In a full-size horse, invaluable information could be gained by emptying the colon and reaching in with a well-gloved and lubricated arm to actually feel the colon and other abdominal organs. There was no possibility of doing this with Snowball, but we muddled through, administering pain relievers and a quart of mineral oil via nasal-gastric tube and starting IV fluids. Snowball felt a little better, but not a lot, and it soon became clear that the tiny horse might die without exploratory surgery.

The Intern telephoned the Resident On Call. It was nearly 10 PM by now, and no small task to pull together a crew able to perform the sensitive and delicate task of surgically exploring a horse’s abdomen. The Intern and I agreed that Snowball’s condition was deteriorating, and that surgery was his best hope for getting through this alive.

But the Resident On Call did not agree. He seemed to think that Snowball was stable enough, and did not require him to drive back to Davis from his home in Sacramento, and that the Intern was more than capable of managing Snowball’s problem until morning, thank you very much.

And so the night dragged on: Snowball continued receiving IV fluids and medications, and the Intern and I dutifully recorded his slowly worsening vital signs every 15 minutes, into the wee hours. The Intern was unhappy about all this, at a loss for something more that he might do to gain control of the situation, and lamented over and over, “If I could just do a rectal on this horse! Then we’d know what to do!” My kingdom for a rectal… I felt equally bad, and equally powerless, but as a senior veterinary student whose opinion was routinely dismissed, I was more accustomed to my condition. The Intern believed his career had progressed beyond that point. Oops.

The Intern and I stayed with Snowball all through the night, watching the little guy shift uncomfortably from one stance to another as his belly slowly swelled with accumulated gas. We had done everything within our power to help him, and now we could only wait for the morning when, we were certain, the Senior Resident would appear, would assess Snowball’s condition for himself and see the rightness of our thinking, and then whisk the tiny horse into surgery for a lifesaving operation - if Snowball lived that long. We sat on the cold floor of C-Barn; our backs against a concrete pony wall, watching and trying to make the hands of the clock spin more rapidly.

Around 4:30 AM, as the Intern moaned for the three-hundredth time about his inability to perform a rectal exam, I felt something pop inside my head. Truly, I do not think I have ever been the same since. I got to my feet, walked to where the little horse stood groaning in his little stall, and slipped my ungloved finger in his rear end, intending to scream out my frustration. “There! He’s had a rectal exam! Will you please just shut the f…”

But the words never left my mouth. I forgot to tell you: I was a mixed animal tract student. Mixed animal veterinarians take care of dogs and cats too. We are accustomed to preforming rectal exams WITHOUT shoving a whole arm in there (dogs and cats tend to frown on that), although we usually DO use a glove. Much to my surprise, I felt something. “He’s constipated!” I told the Intern, who scowled at my complete lack of both glove and veterinary decorum. “We need to give this guy an enema!”

The Intern was not pleased, but deigned to don a glove and perform a completely inadequate (from an equine standpoint) digital examination of Snowball’s rectum. Even the Intern had to agree: There was a rock-hard mass of stool impacted just inside Snowball’s booty. We argued (the cat was out of the bag, so to speak, so why not?). The big shots would arrive in a couple of hours. I could see that the Intern was reluctant to do anything unconventional, but as I have said, something really did snap. “You’re going to look like a real idiot,” I told him, “if they take this horse to surgery and he turns out to be just constipated.”

Reluctantly, the Intern agreed. We rounded up a tube and drench pump, and gently pumped a couple of liters of warm water into Snowball’s lower colon. The Intern wouldn’t allow me to use any lubricants or softening agents, but I was happy enough to be doing something, anything, that might help, and I really thought the enema would make a difference.

But nothing happened. We waited, first five minutes, then ten, while Snowball continued to grunt painfully in his stall. I felt like a complete horse’s… behind, as I slumped against the pony wall next to the Intern. “It’s just not that simple,” the Intern intoned, sounding for all the world as if he were repeating the Word of some higher power, words that had once been spoken to him, and relishing the opportunity. “You can’t expect that kind of simple treatment…”

And suddenly, there was a noise. It wasn’t a sonic boom, exactly, but more of a high volume thud, or perhaps it was more of a splat; a sonic splat. To this day, I swear that I felt the whole of C-Barn shake.

I looked at the Intern. The Intern looked at me… and a barrage of high-powered explosions echoed as horse muffins blasted out of Snowball’s rear end to spatter and bounce off the concrete pony wall behind him. We leapt to our feet, amazed at the staccato chatter of Snowball’s bowels firing on full-automatic to the sound of the most hellacious fart ever witnessed by human or equine-kind. I half expected to see the little horse fluttering through the beams of C-Barn like a child’s balloon gone rogue, and may owe my life to the fact that there was no open flame nearby. Had there been, Snowball might well have become the first horse in space.

It couldn’t have taken 10 minutes, though it seemed longer, for Snowball to visibly deflate and gradually stop blasting muffins across his stall, like a little equine bag of popcorn reaching the end of its cyle in the microwave. By 6 AM, when I went off shift, Snowball was happily munching hay. As it turned out, the miniature horse belonged to an eight-year-old girl, who must have forgotten to water him. I heard later that he went home that afternoon. The Intern never spoke to me again.

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