Vet Adventures: Big Angus, Part Two

In last week’s column, Dr. Diehl had just finished drawing blood to help determine the cause of Angus’s stubborn weight gain that no diet seemed to help. Angus, a Quarter Horse, is the beloved childhood horse of Lily, whose mom, Greta, is now caring for him—although Lily still drops by from college to check in on him now and then.

Dr. Diehl suspected Cushing’s disease or equine metabolic disease could be at play. After the blood draw, however, Angus wouldn’t stop bleeding from the jugular vein long after the needle was removed. His gums were covered in purple splotches, called petechia, a sign of leaky blood vessels.

“What would cause that?” Greta asked anxiously.

“There are a few possibilities,” I said. “Liver disease, blood parasite, even cancer. There could be an infectious disease causing it, but we usually don’t see it in this region of the country. There are a few genetic diseases that could explain it, but those usually manifest much earlier in life. The bloodwork will hopefully answer a lot of questions.”

No Easy Answers

The bloodwork answered a few questions, but all the tests for infection, liver problems, infectious diseases and parasites of concern were negative. Angus had a very low platelet count, and he also had high insulin levels and Cushing’s disease, neither of which explained the low platelets or the bleeding.

I consulted with the specialists at the University, and their suspicion was cancer.

I ultrasounded Angus’s belly and chest but didn’t see anything abnormal, tapped his belly and found normal abdominal fluid, and even performed a rectal exam, which was also normal.

I ran a fecal on normal manure, and tested normal urine. I was stumped.

Angus continued to decline, and when I returned the next day, I could see a line of edema (swelling caused by trapped fluid) forming on his lower abdomen. He was weaker, but still wanted his food and was still passing manure normally.

I carefully gave him several injections of steroids, vitamin K, and a medication to help the blood start to clot. I had no idea what I was trying to treat, but I had to try something.

The First Clue

The next day was even worse, and I was starting to fear that we were going to lose Angus to this mystery killer. I was listening to his chest and wincing at the new crackles and rattles in his lungs when Greta handed me the phone.

“It’s Lily. She wants to talk to you.”

I slowly took the phone. Lily had trusted me with the care of her best friend for her entire life, and I was about to completely let her and Angus down.

Lily was crying into the phone. “It’s bad, isn’t it?”

“I’m afraid it is, Lily.” I said gently. “I’ve tested him for everything we can think of but he’s getting worse, and I don’t know what’s causing this.”

I was only half-listening as Lily described everything that Angus had done and everything that she had done just 10 days before when she was home.

Then I heard her say, “I really thought the supplement was helping him,” and I suddenly remembered that her roommate’s father was a horse trainer.

An Answer, at Last

“Lily, what supplement? Did you put him on something?”

“It’s supposed to help with weight loss. My roommate’s dad suggested she give it to me.”

Greta retrieved the small plastic tub. I sniffed the odorless white powder, shook some out on the table and finally stuck my finger into it and tasted it. It was horribly bitter, but suddenly I knew exactly what was wrong with Angus.

“Greta, I’m no pharmacologist, but I’d know aspirin powder anywhere. When did he last get this?”

Greta was shamefaced. “This morning,” she whispered. “We thought it was just herbs.”

It was a rare reaction, but a well-documented one. The aspirin was destroying Angus’s platelets, and we had to get him off it immediately.

The lab confirmed that the powder was aspirin, and I put Angus on some oral medicine to help his stomach recover. For almost a week, there wasn’t much change. But then he slowly started to get better.

I started the Cushing’s medicine as soon as I dared, and kept a gimlet eye on his platelets, but they were steadily rising.

There for Each Other

One day I was pulling my stethoscope away from Angus’s chest when a tall blur with wild black hair leaped at me, crushing me in a bear hug.

“I almost killed him,” Lily sobbed. “He’s really going to be OK?”

“He’s really going to be OK. And no more powders from horse trainers, understand?”

Lily was now haltering Angus.

“I promise, Dr. Diehl. And I’m staying home to take care of him.”

I watched them walk slowly down the driveway, their heads together as though they were sharing secrets. Angus’s ears were pricked forward in delight and his neck was arched.

He still had his girl to raise. And, despite his ordeal, I knew without a doubt that he was going to be OK.

This conclusion to Angus’s story appeared in the January/February 2024 issue of Horse Illustrated magazine. Click here to subscribe!