Winter in upstate New York can be long, cold, and endless.
The call came early on the last day of the year. A Trotting-bred owner called me saying his two-week-old foal wasn’t right.
The Trotting-bred is a pony breed that race like Standardbreds with trotters and pacers. Many of them lived in a concentrated area north of my home. Really good-hearted people cared for them. These hard-working people spent most of their day working at jobs and then worked the horses at night and raced on the weekend. Their operating budget was thin so most of them performed the vet work themselves. When a vet was needed, it was often the last resort. I had been lucky enough to be accepted into their clan and often, I was the vet they called in when nothing else worked.
Ed was the owner that called me that morning. It was the first time he had reached out for help and it occurred to me that this probably wasn’t going to end well.
“Something’s not right with my new colt.” It wasn’t much, but it was enough to head my truck north. The sky was overcast and the air struggled at the freezing point. The traffic was sparse and in a short time, I was parked at the top of the hill overlooking his barn. I grabbed what I needed and carefully made my way down the slope.
Like most of the people in this area, Ed had made do with what he had. There was no barn as we know it, but rather a converted garage. His shop, filled with tools and equipment, occupied about half of the small building. The remaining side had a small stall plus an area with a few bales of hay, some bedding, and a garbage can filled with grain. In the stall stood the bay, 14-hand mare and standing next to her, half asleep, was her foal that looked just like her. I asked Ed to fill in the details.
“She had him about two weeks ago and all went well. A few days ago I started to notice something wasn’t right. I’ve been giving him some of this tonic.” He showed me a glass medicine bottle with faded writing on it from another vet in the area. I could not read it all, but I was able to make out the words “Tonic.” “Some of the guys have come to look at him but they’re stumped too. None of us can figure out what’s wrong, so I called you.”
I went into the stall and had my diagnosis within 10 seconds. Though I had never had a case, the signs were classic for tetanus. As the foal jerked from his sleepy state, the tonic spasms took over the small muscle behind each eyeball. This caused his pink third eyelids to partially come across the eye and stay there.
Horsemen have seen this normal movement of the eye and third eyelid when a horse yawns. The eyeball is drawn back into the socket and the third eyelid passively sweeps across the clear part of the eye, cleaning it. The pink tissue easily seen in the inside corner of both eyes told this foal’s story.
I started my investigation with a question, “Did this foal have a cut?”
“No,” Ed replied.
I then asked, “Did you vaccinate the mare a month before foaling for tetanus?” This is standard procedure for pregnant mares. This very effective vaccine can then boost the mare’s immune system and through the passive transfer of protection from the mare to the foal through the mare’s first milk, the foal can be protected from this ever-present and deadly disease.
“No,” he said.
I looked for any cut on the foal’s body. The bacteria that causes tetanus lives in the soil. When I was in college, I cut some blades of grass from outside the lab building and cultured them. It was an experiment for students to learn what was growing around us. The culture grew the bacteria that causes tetanus. It is everywhere but loves to grow in deep wounds where it can avoid air.
As the bacteria die, it creates a toxin that paralyzes the body in a full contraction. The lung diaphragm can no longer move and the animal dies of suffocation.
I continued to look for a puncture wound but I couldn’t find anything. Then Ed asked me what I thought was going on. I answered that it looked like tetanus toxin.
“That’s impossible,” he exclaimed. His confident answer was meant to say that he had wasted his money calling me.
“Why?” I asked.
“Because,” Ed replied slowly as if to prove he was right, “I gave him his tetanus shot just 3 days ago.”
My heart sank. He didn’t realize two important things about vaccinations. First was that vaccines take 30 or more days to work. Second, foals as young as his are unable to respond to vaccines. That is why it is so important for foals to get their mother’s milk. It has the protection needed until the foal becomes older and can respond to diseases on their own.
There was another important fact Ed didn’t know about. The mother needed to be vaccinated before birth to have that protection available in her milk.
I kept all of this information to myself as I continued to look for the infected cut. I noticed that the foal became stiffer as I continued my investigation. The toxin of the bacteria caused the muscles to contract which appeared as stiffness, especially when walking. I noticed though that he was favoring the left hind leg. Then it became clear.
“Ed,” I asked. “Where did you vaccinate this foal?”
“The left hind leg,” he replied.
“What needle did you use?”
Ed walked over to his shop counter and grabbed an old tin can. It was a common tin seen at many farms that had been filled with ointment for chapped hands. He picked it up, turned to me, and opened the lid.
My stomach churned as I gazed at the contents of about a dozen used needles of various sizes. They lay bare and unprotected with the familiar plastic covering gone. Ed said, “I think I used one of these bigger ones,” as he pointed to an 18 gauge 1 ½ inch needle with dried blood on it. It was obvious that to save money, he reused the needles but did not sterilize them.
Veterinarians have a tough life when all goes well. When it doesn’t go well, the metal of a vet becomes tested. I went into rescue mode and avoided the explanation and the assignment of guilt. All I said was, “I found the cause of this foal’s infection.” Now my voice of authority caused Ed’s face to contort. He went from disbelief to denial and was bordering on guilt. I stepped in with a plan to help him focus on what needed to be done, though I knew it was too late.
I filled the foal with antitoxin and Penicillin then went off to find more antitoxin at the university hospital. I returned an hour later and injected what I had found. Ed had followed my directions of cleaning the stall, bedding it deeply, and shutting the barn up to conserve any heat and prevent drafts. Then I told Ed that I would return tomorrow.
New Year’s Eve celebration occurred at my house. My mother was still there from the Christmas holiday and there was food and warmth that night as the temperature dropped into the 20s. My thoughts were only with the foal as my zest for celebrating was gone. Ed had no money to send the foal to the heated hospital for the round-the-clock, intensive care he needed. From what I knew, the tetanus toxin had taken over his body and it was a losing battle. All I could do was wait for the morning.
No one was awake and the roads were empty that early New Year’s day. A feeling of dread came over me as I drove back to Ed’s farm. I prayed for a miracle, but as I entered the barn, I glanced at the foal and knew that my first call of the year would be euthanasia.
In an effort to make things better, through the magic of science, the owner thought he had done the right thing. Veterinarians’ lives are filled with these stories of good intentions gone bad.
I drove home in silence. It was the end of one year and the beginning of another for me. I decided to let this one stay behind and looked forward to a better year ahead.