Wait For The Jump: Pictures Are Worth 1,000 Words

We had a really busy weekend at work and by Monday my back was bothering me quite a bit. On Sunday it seemed like every large, unruly dog and his brother had eaten something they shouldn't, and all of them needed x-rays. Every single one of them was naughty on the x-ray table, and even though I know how to lift with proper technique (abs and legs), sometimes it is inevitable to use your back when you have an 80 lb wiggling and kicking patient that you're trying to pin down on a table that is wider than your upper body is long, while reaching over with a foot to hit the pedal that will take the view. If you work in veterinary medicine, you will know that that pedal will always, 100% of the time, manage to be out of reach of your foot no matter where you are standing!

A brief description of how radiographs are taken in veterinary medicine, since most of you will not know:
We use a human radiology table. Same size and dimension. Most veterinary hospitals nowadays are equipped with digital x-ray capabilities, which is a godsend. This means that a computer with a special digital radiology program is attached to the machine. I've done the old-school method of having to manually process the films, and it is a pain in the ass, especially when after 20 minutes of developing, you realize you need to re-take the view, either because the animal moved or the contrast is poor! With digital, you place the patient on the table and there is a special plate underneath the table top that captures the image. You have a pedal that you can hit with your foot (or put on the table and press with your hand) that will take the shot. This pedal is often tricky-you have to press it first to get the rotor of the machine whirring (this sound with the accompanying vibration will make the patient jump almost 95% of the time!) and then you really step down to take the shot, at which time the machine will beep and you know it was taken. Then you look over at your computer screen, which is always set right next to the x-ray machine, and you will see your radiograph.

Bottle cap in a dog's intestines. From the Animal Emergency Clinic of Rockford website. Aren't digital radiographs beautiful?

That's the easy part. The difficult part is manipulating the patient into cooperation so they can hold still long enough for you to take that view. For abdominal and chest radiographs (the most common views), the patient is first placed in lateral recumbency (lying on their side, right side down), and stretched out comfortably to allow the best possible view of their organs (you don't crank on their legs. Ouch! Plus old dogs tend to have arthritic elbows and hips). If we're taking chest rads, the doctors often want a left lateral view as well, so we have to carefully flip the patient to the other side to get it. Then the best part (NOT!) is the VD shot (ventral/dorsal) which refers to a shot taken through the ventrum (underside) of the patient. This involves placing the patient belly-up on a V-trough (a V-shaped tray made of foam and covered in soft plastic, very much like a school gym mat, that allows for easy cleaning), and held with front legs extended over their heads, and hind legs extended back. This is often terrifying for patients-per their body language, it's like you are forcing them into submission. We are very gentle with them, and we take it slow, and we don't hyper-extend their limbs, and most of the time we can get them to settle by talking baby talk to them and petting their heads or their chests until the second we have to take the shot. This is the part, however, where techs often get hurt with strained backs and popped discs while trying to flip a huge struggling dog onto his back, and it is also the view most likely to cause the patient, whether cat or dog, to try to bite. Sunday was one of these days-every single patient struggled, and I'm fairly short (5'4") and light (125-130 lbs) so an 80 lb intact boxer is certainly going to have an advantage (testosterone gives boys superpowers, I swear!).

Techs restraining a Corgi in lateral recumbency for an abdominal view. Note the correct use of protective equipment. This makes it extra-cumbersome to restrain patients, but it is a must! Photo from the Spanish Trail Pet Clinic website.

Overall, however, I'm always surprised at how much patients DO cooperate, as all I ever think about when I walk into that radiology room is an alien abduction. I can't imagine myself cooperating at ALL if I were placed on a whirring, vibrating table by creatures who don't speak my language, and then made to lie with all of my most vulnerable parts exposed. I would be a VERY BAD patient!

"Now hold still while we shine this-here radioactive light on you so we can observe your innards better!"
Uh, yeah - F that!

Oh, and orthopedic shots? Those are a whole other ball game, and they sometimes involve some crazy contorting of the patient just so you can get a leg straight in the view. For these, heavy sedation is often used, unless it is a very cooperative or very sick patient.

So if your vet recommends sedation for your pet during radiographs, or you're going to a clinic where every patient is sedated for radiographs (some hospitals do this) please don't argue about the cost. You are doing the hospital staff a favor, but most of all, you are helping your pet in a scenario that can be very stressful!

Thus, on Monday my back was sore from having to twist with patients-my middle back on the left side, wrapping around to the left side of my rib cage. My scarred hip, of course, was super-tight too, so it was all related. I was exhausted as well, but I figured I'd see how the two girls were doing, as I was scheduled to ride Jezebel again.

I went to get Jezebel in the field. The whole herd was at the very back of the field, so it was a long, long hike to get to her. She waited for me to come to her, and came willingly, so we made our way down to the chute.

The chute was very, very slimy and deep-my feet were sinking ankle deep in sucking mud. I was trying to pick the best way through so that neither Jezebel nor I would get hurt or twist an ankle, or God forbid wrench my back further, and slipping and sliding in the process, when I heard a big snort and a horse came up behind Jezebel. I looked back and stopped, assuming that this was the start of a stampede. But no, it was a single gelding whom I'd never really paid attention to before, who had decided that right NOW he had to come attempt to mount Jezebel! I had heard about one gelding in particular doing this, but I never would have dreamed he'd attempt it while a person was trying to lead a mare away! I had no idea how Jezebel was going to react, and afraid of getting trampled or kicked between the two horses, I tried to shoo him away. He was not leaving Jezebel alone, and kept circling around us like a shark and trying to come up behind her. I was terrified of getting hurt or the mare getting hurt, between the mud and the gelding and trying to not slip and fall. I ended up having to hit him several times with Jezebel's lead rope and yelling at him to get him to go away; I was in a panic. It took me over 15 minutes just to get through the chute during this struggle. He finally gave up and trotted away. I haven't been that scared around a horse in a long, long time.

Once in the barn, I put Jezebel on the cross ties and proceeded to groom her. While brushing the mud off her legs, I noticed a bleeding cut on the inside of her left hind fetlock. It was fresh-the trickle of blood from the cut had just dried but was still bright red. I put her in the wash stall and hosed off all 4 legs, noticing that she lifted the left hind when the water touched it. Back on the cross ties with clean legs, I checked it again. It was skin deep, going through all the layers of skin, but very small, about 1/2" in diameter. She didn't flinch when I touched it, and there was no swelling yet, but I noticed her resting the foot. I texted Sally to let her know what had happened, and we decided I'd try getting on and playing it by ear.

Jezebel was sound at the walk, but felt off at the trot, and did not try to zoom around. She actually seemed reluctant to break into a trot, for once. Concerned, I hopped off and put her on the lunge. There was a slight bob to the right, but it was so slight that I was second-guessing myself. I wasn't sure what to do, so I called Sally. She was around the corner. Once she arrived, I lunged Jezebel again, and she saw what I was talking about, which made me feel better-I'm not crazy & imagining lamenesses. We agreed to give Jez the day off. She was in RAGING heat, too-she would stop and squirt if she so much as smelled a boy!

I fetched Lily from the field and tacked her up. She was pretty wound up when I got on, enough so that I decided to get off and lunge her for a bit. Charles had shown up around then, and he took all of these photos.

She was really distracted right off the bat

Circling in shoulder-in

Shoulder-in down the long side of the arena

Trotting on a loose rein, trying to get her to lengthen, as her trot was really short and choppy.

I gave up, dismounted, and lunged her for about 10 minutes to let her release all of that excess energy.

Then we played around with groundwork. The previous night we had been practicing yielding at the trot, and Lily had just started to get the idea. We attempted it some more here.