Super Moon

Folks in the medical profession and emergency care attribute weird, whacky, and high volume to the full moon. The super moon was last night and it brought me a gift. I was the veterinarian on call. A man called with a percheron mare having difficulty delivering her foal – we call this dystocia. If you’re not a horse person, the Percheron is one of the larger draft breeds – they pull carriages, farm equipment, logs. They’re big like the Budweiser Clydesdales. The 11yr old maiden mare had been trying to deliver the foal for several hours before she was noticed. It was a 45 minute drive from the time I got his call, and I arrived at 8pm – already dark on this first Monday of daylight savings.

I filled my stainless steel bucket with the typical tools of choice – warm water and chlorhexidine disinfectant, three stainless chains, and obstetrical chain handles. With an arm-length examination sleeve on each arm and a generous amount of lubricant, I did an internal exam. One front hoof was showing at the vulva, the other just inside the vagina about 10 inches deep. Each hoof was about the size of my fist – a large draft mare with a very large draft colt. The foal’s head was ducked down under the pelvis and the nose turned to the mare’s right. I pressed into the foal’s mouth and eyes, pressed hard on the bones of his legs and there was no response. The hoof wall was starting to separate from the foot – common in a deceased fetus. Unfortunately the foal has expired from the stress and separation of the placenta – losing its source of oxygen. The foal was very much in a bind trying to enter the birth canal. Yes, it is sad, but our attention must shift to this beautiful, distressed mare. She’s our new priority.

The mare was pushing relentlessly, doing exactly what Mother Nature was telling her, and exactly the opposite of what I needed while trying to repel the mammoth child into a deliverable position. If only she understood. Her rectum was prolapsing in and out from the pressure of each forceful contraction. I went back to the truck for some sedation and a head snare to help the cause. This was going to be a freaking monster to wallow out of there.

The sedation calmed the mare and alleviated some of her discomfort. I was able to insert the cable head snare up to the top of the foal’s poll and over the right ear. To get it over the left ear, I had to squeeze my arm under the left side of the foal’s head, smashing my arm between its head and the boney floor of the mare’s pelvis. Her contractions felt like a vice around my forearm. I inched the snare in my hand forward a little at a time between each contraction. Just as the sensation was leaving my fingertips, one final thrust forward landed the cable over the foal’s left ear, snuggly over his poll. I slid the coupler into the foal’s mouth and had a secure snare to help manipulate the head.

I pumped a healthy amount of lubrication into the vagina and affixed a obstetrical handle to the head snare. With some steady traction on the head, I slowly let my entire body weight lean back, adding more tension on the head. I laid on it for about 10 seconds, then took a break. After about 8 long attempts, the reproductive Gods granted mercy, and the head slid upright and into the birth canal. The head was out to the level of the foal’s ears. Sweet, sweet mercy.

With a chain secured around each of the foal’s fetlocks and a snare on the head, all now out of the mare, the stage was set. Sweat rolling, lungs pumping, heart racing – I started to walk this foal out, alternating tension on the left chain, then right chain. We do it this way to allow one shoulder to pop through the canal at a time, preventing the foal from getting stuck with two broad shoulders in the pelvic canal. We continue it similarly to allow one hip to pass through at a time, to prevent “hip-lock”.

The client jumped in before I knew what had happened. We’ll call him Doug. Doug is an amputee, his right arm is amputated at the elbow and he wears a hook prosthesis. I hooked a chain and obstetrical handle to the left leg, a handle on the cable head snare around the foals head, and Doug snapped his prosthesis directly into the right leg chain. I’ll admit I was internally going through all the possible things that might go wrong and hoping to God he didn’t get hurt or have an embarrassing moment. But I was tired and grateful for any help. The only other person there was a man in his early eighties who had the lead rope in his hand, and looped around a corner post in the old shed.

Boy did ever underestimate Doug. I was blown away at how much force he put on that prosthesis. He legitimately was doing better than what I was doing. Left leg, right leg, left leg, right leg – we alternated pulling on the foal. The shoulders were out- another milestone. We were both now sitting on our butts in the straw and muck, no where to lock our feet to gain traction. I would stick a leg up one the mare’s rump every so often, but honestly I’m just not that coordinated and weigh 160 lbs soak and wet. I braced against her back hooves, but she was shifting left and right. I begged the mare to just lay down. Not a chance. With two hands on chain, and Doug’s hook and left hand on the other, at the count of three we gave one last long tug, timed with a contraction. It was a dramatic and glorious expulsion of fluid and elephant-colt. The foal’s hips passed through the canal and the entire thing shot out with the placenta adhered to his hips and hind limbs right into our laps there on the stall floor. Sweet, sweet relief for mare and man. I put on a fresh glove and did an exam of the mare’s pelvis and uterus – no tears, and thankfully no twin. She was still standing and two grown men were there in the stall floor feeling like we had just given birth.

As I was back at the truck cleaning up, Doug was standing there and I had to say something. “Doug, I just have to ask how on earth does that prosthesis hold up to all that force?” It felt odd to ask, but I was genuinely impressed. He was delighted to show me the silicone sock over the stump and the harness that attached over both of his shoulders. It allowed him to pull with his entire body weight without the fatigue of gripping. Absolutely incredible. “Yeah, it has its perks”, he said.

I got some pain medication in the mare, although she looked at me as if she thought Doug and I needed it more. The other gentlemen who was leading her around lead her over to the water trough and she took her fill. She walked as if nothing had happened. As fragile as these giants can be walking around on their fingernails with abdominal viscera that is suspended and susceptible to all matter of trouble, they really are tough critters and remarkable healers. She started picking grass. Just another day for her. She’ll be fine. I would also be fine, after a shower, ibuprofen, and sneaking into bed without waking my warm, sleeping wife.