Vet school was full of some of my most memorable patients. Surprisingly, two of these patients were horses.  During large animal medicine rotation, I’d become highly skilled at avoiding equine patients, preferring instead the cows, goats, sheep, and even a few pigs.  My technique of securing my preferred patients relied on my height.  At 5 feet 1.5″ I ‘d casually slip behind taller, more horse-eager students when the professors gathered us up each morning to go through the process of assigning patients.  The trouble is, while my method worked for the duration of large animal medicine, when we switched to surgery it didn’t take long before one of the large animal surgeons picked up on my avoidance of horse patients.  He even called me out on it and assigned me my very first horse patient named “Emma.”  The surgeon described her as ‘perfect for you small animal types.’  Yes, that was indeed me–a small animal vet-to-be thrust into an overwhelming world of very valuable, easily excitable, oversized patients.  Then I met Emma. There was no question about it, she was the perfect horse to teach me how to become comfortable around horses.  Emma was a draft horse and while she was supremely large, she was equally as gentle.  Emma had come with a friend to the hospital–a goat who shared her stall to keep her company.  The two of them put me at complete ease whenever I’d care for Emma.  I could absolutely understand why Emma’s family adored her, as I quickly came to feel the same way.  Emma lowered her head for me to put her halter on, she lifted her gigantic feet for me to examine them, and she’d stand patiently while I took her vital signs.  Everything Emma did was with grace and attention to where I was in her stall and how she could help me care for her.  Meanwhile, her goat friend munched away on hay or would come visit me for a scratch on the head.  The surgeon was absolutely right about assigning me as Emma’s student and when Emma was well enough for her and her goat friend to return home, I was overjoyed knowing I’d played a role in this beautiful, peaceful animal’s recovery.

While my confidence in caring for horses had grown with Emma, I wasn’t ready to take on any of the high-strung Thoroughbreds by myself.  Again, it seemed our professors easily figured this out and assigned me a patient matched to my abilities.  This horse patient was named ‘Cappy.’  Cappy had fractured a leg and was hospitalized in a sling for his recovery.  His stall had a system of overhead ropes and pulleys so that he could slide himself around on his good three legs while taking enough weight/stress off so that his injured leg had a chance to heal.  The sling was a hammock of sorts, supporting his underbelly in a way that left his head and legs accessible.  The sling then connected to the overhead system so that Cappy could move by more or less sliding about in the stall.  Cappy was a valuable horse with a complex condition and associated treatment plan.  We started spending a lot of time together because of the intensity of his treatments and his condition.  While Cappy surely would have fallen into the category of excitable racehorse, the sling translated what would have been happy prances into eager slides in my direction when I entered his stall.  Because of the sling, I knew where he was headed and could get out of his way as needed.  One of my greatest horse fears was getting trampled, a deeply held belief from my childhood where I only ever saw police horses at parades.  The advice my mother had given to me then was to be careful around horses as they can kick you and kill you.  While I brought that advice into my large animal surgery rotation, Cappy and I could develop a trusting relationship because although he was a spirited stallion, the sling limited him physically.

Cappy and I saw each other many times throughout the day so that I could give him the different medications he required and keep a close watch on his progress.  Every morning, Cappy was the first patient I’d care for and at the end of the day, he was the last.  One morning I walked up to check the paper that listed out his treatments and noted something new.  It stated, “apply preputial balm.” The surgeon in charge of his progress walked by and I stopped him to ask, “Cappy’s treatments say I’m to apply preputial balm, what exactly does that mean?”  If this surgeon never thought he had a really stupid student, he for sure did now.  He looked at me completely frustrated and said, “do you see this ointment here…that’s the balm.”  Oh, okay I nodded my head.  “And do you KNOW what a PREPUCE is,” he asked while raising his voice.  Um, yup, pretty sure sure we covered that back in first year anatomy class I thought to myself.  So I nodded again.  “Well, you rub this balm onto his prepuce.”  With that, the surgeon walked away for me to figure out the logistics of this by myself.  To be clear, the prepuce is the covering of the male anatomy (equivalent to foreskin) and Cappy was getting chafed from the sling.  The balm was meant to protect this area.

There are many moments where veterinarians must examine and get up close and personal with every last bit of an animal’s anatomy.  The prepuce was certainly no exception.  I started by putting some gloves on as one should when having to get into the nitty gritty of parts that may be unclean.  Then I headed over to Cappy with my gloved hands that held a reasonable amount of the balm.  He was less than thrilled that I was having to crawl up under his belly to have a good look at the chafing and to assess what parts should receive the balm.  Cappy kept sliding away from me and we had multiple starts and stops of my examination.  That was until the actual application of the balm began.  Cappy’s attitude then changed completely from ‘what exactly are you doing there’ to ‘I must stand completely still as this is enjoyable.’  Somehow in the back of my mind, I wondered if this treatment plan of applying balm was less about helping Cappy and more about humiliating a small animal vet student.  Either way, I was determined to help this horse get better even if it meant shimmying around his stall in a crouched position while applying balm to his private parts.

Though I approached the balm application from a strictly clinical, let’s get you healed perspective, that was not the case for my patient. Over the next few days, any time I walked by his stall Cappy would nicker loudly, quickly slide himself over to the stall door, and anxiously await the application of his balm even if it wasn’t time for his treatments.  Cappy’s recognition of me and the associated excitement was so obvious that the staff and other students joked that I’d become Cappy’s girlfriend.  Yes, I do think you could say that was his assessment of the situation, too.  Cappy would even slide himself about in the stall to keep his eye on me as I cared for other animals in the barn.  I certainly had an admirer, tending towards a stalker.  There was no doubt that this balm application drastically improved Cappy’s quality of life.  As for me, while I’d wanted to ‘connect’ more with my horse patients, hand delivering equine pleasure several times a day was quite a bit more than I’d bargained for.  Ultimately there was no choice other than to laugh about the situation.  Laugh, and in order to keep it clinical, avoid eye contact with Cappy during balm application.

Unlike my patient Emma, Cappy never returned home.  Cappy succumbed to his injury in spite of the heroic efforts on everyone’s part to save his life, especially the efforts of his surgical team.  I like to think that although Cappy was cared for by a  ‘small animal’ student’ in his final days, we were put together for a reason.  Cappy made me and many others laugh during an extremely stressful rotation.  He showed me how much personality a horse could have by learning exactly who I was and shamelessly displaying great enthusiasm for the ‘services’ I was there to provide.  Cappy’s joy while dealing with such an intense injury and life in a sling made him a patient I will never forget. Wherever he is now, I hope Cappy’s receiving regular applications of preputial balm.