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  1. #1

    Default Vet misdiagnoses irritated sheath as colic – what would your reaction be?

    Okay, this does not involve my horse, but the vet in question is one that I use and recent events make me question things.

    What would you think if a vet misdiagnosed a dirty / irritated sheath as colic?

    Horse in question started kicking at his belly / sheath area rather suddenly and often. Vet was called out for “colic”. Horse did not exhibit any other signs of colic, no increase of vitals, full gut sounds, eating and drinking. Horse is palpated and tubed / oiled for possible “impaction colic”. Food is removed.

    Horse continues to kick at belly – which is further construed as “colic”. Vet is out three more times to check on horse and treat “colic” as the kicking and now biting at belly is has not stopped. Food is still being with held etc. Another boarder finds a VERY itchy spot in front of the sheath, horse goes mad with delight when it is scratched.

    Horse owner relays this to vet – as a possible reason for belly kicking and biting – vet responds with, “they kick their belly when they are colicing”.

    I am tasked with keeping an eye on the “colicing” horse – who still has completely normal vitals, and seems normal besides the kicking and biting (and he is now hungry because food has been withheld for a good 24 hours – only a few tiny snacks offered). I observe the horse drop and now kick at his penis several times.

    I relay this to the owner – who has the vet out for now a 5th time, to clean the sheath.

    Vet finds irritation in the sheath, says it must be from an invasive parasite, and prescribes a number of medications, and multiple times a day treatment. Horse is declared to not be colicing.

    This little episode really shook my trust in this particular vet. It seemed so obvious from the start that the horse’s issue was related to his sheath, yet he had to undergo uncomfortable “colic treatment”.

    Further the vet was paid for multiple farm calls and treatments – following his misdiagnosis.

    Would you give something like this a pass?



  2. #2
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    No.

    Maybe I would be gracious about it taking a second visit, but with the full gut sounds, eating and drinking, but still kicking at belly even I'd have looked at the sheath eventually, and I'm a novice and I have a mare. I wouldn't lose all trust in the vet, as we all make mistakes (preferably not the same one four times in a row), but would respectfully and constructively ask the vet what the vet thinks went wrong here, and what the two of you could do going forward to keep two-way communication and minds open for your horse. If the vet has a problem with that conversation, the vet would be gone, in my world. And I would expect an adjustment on the price for the missed diagnosis, just because it was missed for several visits.


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  3. #3
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    Maybe once--I had a BO call me in a panic and call a vet I didn't even know (it was my first week in a new town and at a new barn) and pull me out of call in the ICU because my horse was "colicking". What she WAS doing was lying down and groaning, which she had done all her life and still does. The initial treatment was sort of "blanket therapy": banamine, walking, observation, and she was perfectly fine because . . . she never was colicking!

    My point is that I completely think the BO was doing the right thing, and the treating vet--didn't know me, my horse, it was 11pm . . . he did the right thing for a "suspected colic". But multiple visits for the same issue? I'd be a little less happy with that situation. NO vet wants to miss a potentially deadly diagnosis, but if things are not fitting after a couple of visits, it's time to probably expand the differential.

    Still, every practitioner can tell a story about something that mimicked something else and was missed. One never wants to miss something BAD and call it something BENIGN--we are all programmed to assume the worst and start there, to some degree.
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  4. #4
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    FYI a horse who has colic is "colicking"


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  5. #5
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    Quote Originally Posted by trafalgar View Post
    FYI a horse who has colic is "colicking"
    Oh for heaven's sake - SO WHAT. Get a life. Preferably as the English teacher you so want to be.


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  6. #6
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    Wow. Someone is offended easily and doesn't want to learn!


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  7. #7
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    Quote Originally Posted by trafalgar View Post
    FYI a horse who has colic is "colicking"
    I will say that I actually appreciate this because it will prevent me from looking like an idiot in the future...as long as I remember... Thanks!


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  8. #8
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    I had a vet diagnose my horse's eye goobers as a cancerous tumor. I don't use that vet anymore.


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  9. #9
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    I had a friend who's vet treated her horse multiple times for colic for what turned out to be a staple from a shavings bag stuck in its lip. It had no appetite. Was tubed twice. I won't call that vet, that's all.


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  10. #10
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    ps I would have had that horse on the truck to the hospital



  11. #11
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    I think any vet can have a bad day. But by the second visit I would a good vet to start looking for a zebra if vet continues to hear hoof beats. The main thing for me would be what was said, how it was said, and what happened next.


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  12. #12
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    Was the horse passing manure?
    Were ulcers ever a consideration?



  13. #13
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    Well, kicking at the stomach is one of the signs of colic. But then did the owner or BO tell the vet that manure was normal? Or that the horse was straining while urinating. There are lots of questions that I would want to know the answers to, from the owner of the horse or the BO where the horse is boarded, before I'd blame a vet.

    My first reaction is that no one should have a horse with a dirty sheath. Horse owners act like a penis and sheath are not to be touched by the human hand. People make fun of me for cleaning my horse's sheath and dock, and for cleaning my mare's udder and dock often. (Although one German friend of mine has 2 geldings with penises and sheaths that never have those pesky flakes of smegma because she cleans them more than I do mine.) Checking the penis and sheath is a daily part of grooming for me. Plus I check daily their manure and check their urine to see if it is yellow (clear is better) or God forbid, dark. My horse lies down all the time, and then dirt enters the stealth and collects smegma around the edges. This is easy to take out and keep the opening normal.

    So unless the vet has made other errors, I'd say to let it be.

    Did the owner not notice anything abnormal about the sheath? I can tell if my horse's sheath is swollen. (Yep, if you clean it too often, it will get swollen.) I know people whose horses have totally gross and grimy penises and sheaths. If the horse is "relaxed" or urinating and the penis is cruddy, then it is time to clean the sheath. And does the horse owner not notice if the horse has trouble urinating?

    Before I'd blame the vet, I'd blame the owner.
    While I'd think that the vet would have asked some basic questions about manure and urination, I'd not blame the vet for the owner or BO not telling him. (My vet asks me and still checks out everything for himself, just in case I'm mistaken.)

    As I've told my vet before, I'd rather pay the money and find out it is nothing than not call the vet and have a sick or dead horse.


    Has this vet made other misdiagnoses? If not, no worry. I'd rather pay for a vet call than have it be colic. And I'd rather use banamine than not use it and end up with a colicky horse.

    Ok so I've owned 3 geldings in my lifetime, and all 3 had pink penises. Easy to see if anything is hanging on there.

    At least the vet didn't operate. As the former, yes former head of the Emory ophthalmology department did, when he enucleated the wrong eye on a patient. Everyone errs. The idea is not to put the patient, human or horse, in a worse condition than before, if the doctor (here the vet) errs.


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  14. #14
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    Quote Originally Posted by trafalgar View Post
    FYI a horse who has colic is "colicking"
    She's been a teacher for many years. Can't help correcting errors in english.



  15. #15
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    CaC, my horse didn't have a dock, he had a slip. And it was at the marina.



  16. #16
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    Colic means "pain". That's it. It doesn't matter if it's pain from gas, impaction, twist, or sheath irritation. So the OP's original post can conceivably fit the colic diagnosis. And this is how:

    A boarder from way back had a horse with an allergy to tea tree oil. She didn't know it though, and cleaned the sheath with a commercial sheath cleaner that contained the ingredient. Three times she did this, and all three times the sheath became swollen and irritated so badly that the horse could no longer urinate, with the gelding exhibiting all of the signs of the horse in the OP. The diagnosis all three times until she wised up: colic. A catheter had to be inserted to drain off the urine, and banamine was used to control the pain and swelling until the sheath returned to its normal size. Once she went over to KY Jelly for cleaning, the problem disappeared. Two of her vet calls were placed after hours on the weekends, so she ended up with one heck of a vet bill. The vets involved are equine-only vets, and have taught in large animal hospitals. So yes, I can see where an irritated sheath with symptoms of pain can result in the colic diagnosis. If there was a bean in the penis which restricted the stream and caused urine to be building up inside, then there would be pain as well.
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  17. #17
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    Quote Originally Posted by DutchWannaBe View Post
    Would you give something like this a pass?
    I'd give the vet a pass - ie get rid of him/her.
    ... _. ._ .._. .._



  18. #18
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    Quote Originally Posted by Chief2 View Post
    Colic means "pain". That's it. It doesn't matter if it's pain from gas, impaction, twist, or sheath irritation. So the OP's original post can conceivably fit the colic diagnosis. And this is how:

    A boarder from way back had a horse with an allergy to tea tree oil. She didn't know it though, and cleaned the sheath with a commercial sheath cleaner that contained the ingredient. Three times she did this, and all three times the sheath became swollen and irritated so badly that the horse could no longer urinate, with the gelding exhibiting all of the signs of the horse in the OP. The diagnosis all three times until she wised up: colic. A catheter had to be inserted to drain off the urine, and banamine was used to control the pain and swelling until the sheath returned to its normal size. Once she went over to KY Jelly for cleaning, the problem disappeared. Two of her vet calls were placed after hours on the weekends, so she ended up with one heck of a vet bill. The vets involved are equine-only vets, and have taught in large animal hospitals. So yes, I can see where an irritated sheath with symptoms of pain can result in the colic diagnosis. If there was a bean in the penis which restricted the stream and caused urine to be building up inside, then there would be pain as well.
    So if the vet thought this "colic" was the horse's sheath (as it turned out to be) why was oil tubed into the stomach?



  19. #19
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    Pass, the chances that a sheath issue would cause those symptoms are extremely unlikely.



  20. #20
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    Ah, the caveat is "the practice of medicine". Seems weak on the vet's part that it took 5 trips to see a horse with no distress in it's vitals before he considered something else, especially after a first hand witness offered up a relevant observation. A curious vet is a GOD send, a distracted vet is expensive.


    4 members found this post helpful.

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