Hoof Beats, Volume 1

In veterinary medicine, our version of the K.I.S.S. Rule is the Hoof Beats Rule.  The principle is simple: common things happen commonly.  So if you hear hoof beats, think horses; not zebras.

I have a special knack for finding zebras though, or maybe they find me.  Hard to say which.  It started in vet school with a pit bull named Peanut who had urinary stones.  That isn't an incredibly unusual thing, except that Peanut had the type of stones that show up primarily in dalmatians.  And so goes my career. www.soaysheepbreeders.com

Greta was my most recent zebra.  Her owner, who is a very astute shepherd, called me late one evening telling me that Greta came in from the pasture breathing very hard and not interested in eating.  Sheep, off-feed, breathing hard - it doesn't take a genius diagnostician to figure that this is likely pneumonia.  I instructed her owner to take her temperature, start her on a broad spectrum antibiotic, and give her a pain/fever reducer.  If she wasn't improved in the morning, I would come out and see her the next day.

The next morning, the update was that Greta had not had a fever last night, and this morning her temperature had actually gone down, to a sub-normal range.  The breathing had not changed.  When I saw her, she was quite calm but obviously struggling to breathe.  My first concern was that this was severe pneumonia that she hid from us until it was too late. (Sheep love to hide illnesses and then just fall over dead.)

Stethoscope to her chest and my first thought was: wow.  Those hoof beats I had heard earlier were not a horse.  They were a herd of zebras.   The lungs were not the problem, her heart was.  Further exam revealed distended jugular veins, free fluid collecting in the abdomen, and edema in the legs.

Greta, at 4 years old with no history of illness, was in congestive heart failure. There isn't an easy way to tell  someone that their animal is dying.  Zebras causing the problem are more difficult because it leaves you without a complete explanation about how and why.  It's one of those completely helpless moments where all you can do talk about the components of the problem and why I cannot fix them.

I will remember Greta as one of my very own zebras.  I'm sure they will continue to run me down when I get a little too comfortable diagnosing those hoof beats.