Thursday, August 30, 2012

Hope and despair, love and death

-->There’s always a lull after Thoroughbred Owner & Breeder goes to press each month when I have a few quieter days and can attempt to get to grips with dull paperwork and other such mundane tasks. On Tuesday, 24 July I had even managed to book a long overdue hair appointment. Arriving home in high dudgeon after my hairdresser was a little too scissor-happy, I glanced out of the window at the back of the house and my stomach instantly flipped over at the sight of my beloved hack Panto down on the floor by the gate and in obvious distress.

I ran out to the field and managed to get him up and back down the path to the yard but it was clear that he was in a bad way and he was soon down on the floor again, throwing himself around. An emergency call to Newmarket Equine Hospital summoned Jess Austin, who gave him a sedative and painkillers but, despite having calmed him a little, Jess still wasn’t happy and suggested that, with his history of colic attacks, he should go in to the hospital for observation. I remember thinking at the time that this was perhaps over-reacting a little. After being colic-free for several years, Panto had had several mild attacks through the spring and early summer but after being given fluids and buscopan he was always fine. Apart from the fact that his symptoms were more dramatic this time I had still convinced myself that he’d once again be absolutely fine.

We took Jess’s advice, however, and drove Panto ten minutes down the road to NEH where he was met by a team that I would get to know much better in the ensuing weeks. Still not really grasping the seriousness of the situation, I left Panto in the care of Dr Mark Hillyer, assuming that a night of observation and fluids would see him right and I’d be picking him up the next morning. Reality bit hard within an hour.

Not long after we got home, a call from Mark to John informed us that Panto’s condition was deteriorating and that he was in increasing discomfort. Mark needed a decision from us as to whether he should operate or let Panto slip away. Despite the fact that John broke off to consult me, he knew that there was only one decision I could make: we had to try to save him in surgery.

Over the last month I have repeatedly issued silent prayers of thanks that we live so close to an equine hospital of such excellence. Not only is Mark Hillyer one of the best equine surgeons in the country (the best, in my opinion) but so many of the vets at NEH are well known to us. They include our friend Simon Waterhouse, who is not our vet here at the yard but has known Panto since before he was with us and has even ridden him several times. Simon is married to Gemma, who is very much part of the team here at Beverley House Stables.

Not wishing to bother Mark, I sent Simon a message to let him know of Panto’s plight. It’s typical of the kind of friends Simon and Gemma are that he instantly opted to give up his evening to sit in on the surgery so he could keep me posted. Hours passed when I wanted the phone to ring and didn't want the phone to ring. Most of all, I didn't want to see Simon’s car arrive in our drive, fearing that if the news was really bad he would most likely come to tell me in person.

Around 10pm Simon let me know that he’d come through surgery, thankfully just having to have part of his intestine untwisted rather than removed. Mark called later to say that he’d woken up and was back on his feet. I kept repeating that a major hurdle had surely been overcome but it wasn’t enough to kid myself into a decent night’s sleep.

The first of what would become many early morning text messages arrived the next day at about 7am. He’d made it through the night and looked brighter than anyone could have hoped for, said Simon. This I saw with my own eyes as I was allowed to pay a fleeting visit en route to an all-day conference at Tattersalls for the International Breeders’ Meeting. I returned at lunchtime to see him walk out gently alongside Louise, who was looking after him in the ICU, and through the afternoon session at Tatts I relaxed. All was going well, he was through the worst, surely.

By the time I returned to NEH later that afternoon, things weren’t looking so promising. As I arrived, bags of lidocaine were being suspended in his stable which would be drip-fed via a catheter in his neck. Mark explained that food, water and walk-outs had been halted after his heart rate and temperature had risen and the discomfort of 24 hours earlier had returned. Despite the fact that his gut was no longer twisted, it hadn’t started working properly again. It’s a common complication post-colic surgery, I believe, but also alarming. The discomfort is caused by the reflux which builds up in the stomach as food and fluids are unable to take their usual course.

The reflux is dealt with by passing a tube up the horse’s nasal passage to the stomach to draw off the fluid via suction. It’s a hideous process – distressing for the horse and unpleasant for the poor intern who has to suck on the end of the tube to draw the vile-smelling fluid – but it works. For the next four days it was a process that Panto would have to endure. The tube was passed so regularly that his nose ran constantly and his breathing started to sound like Darth Vader. Effectively being kept alive on the drip, he nevertheless had to be kept slightly dehydrated to reduce the level of reflux, which caused him to start manically licking the empty water bowl, then the wall in his stable, until his tongue became red and raw.

I spent Thursday, Friday, Saturday and Sunday in ICU3 with Panto, desperately hoping to see some improvement but seeing only that he was becoming weaker, thinner and more dejected. The light in his eye slowly dimmed to the extent that I slumped in the corner asking myself whether I was doing the right thing by allowing the vets to keep him alive. Every hour one of the interns would come in and take his temperature, monitor his heart rate and listen to his gut to see if there was any sound of movement. His stomach kept rumbling on enough to give us a window of hope that we were doing the right thing but, depressingly, he just wasn’t really improving.

On Saturday morning, John came to see him for the first time since he’d been admitted on Tuesday. Having grown up with and worked with horses his whole life, John’s usually pretty brave when it comes to dealing with adverse situations, so when I looked across and saw silent tears sliding down his face I knew we were in trouble. John went home, I stayed, Simon came in later, on his weekend off, to see how Panto was doing. I could see from Simon’s face that it wasn’t good but he also quite sensibly reassured me that I would know if and when the time was right to make a drastic decision. 

During that day the horse in the next box to Panto, who had been colicky and under observation for several days, went into surgery. He sadly didn't make it back to his box. A mare was later admitted with a very sick young foal. They went into the box opposite and I could hear the voice of the girl who brought them in breaking with emotion as she said to Mark, ‘Do whatever you can to save him’. They were the exact words used by John on the previous Tuesday evening. How often does a veterinary surgeon hear people say those words while chewing on tears?

Sunday passed in much the same way. No worse, no better, still refluxing, still reliant on his drip. Gemma was his visitor this day. In her typically demonstrative way she hugged me, hugged him, and said simply, 'Please don't die.' 

Having drilled Mark with questions on Friday I knew that he had been hoping for some improvement within 24 to 48 hours of Panto being hooked up to the lidocaine. ‘I can remember the ones that lasted beyond three or four days because there are so few of them,' he told me.

These words haunted me through the long weekend as the drip, drip, drip of his bags of fluid, sometimes the only sound in Panto’s box, seemed to signal the emptying of the hourglass. The sand was running out, with Sunday night a self-imposed death knell. 

As I left him, reluctantly, on Sunday evening, he was still holding on, his ever-diligent tag-team of interns assuring me that they would continue through the night with this course of treatment and see how he was in the morning.

I woke up crying on Monday, telling John I thought that today would be the day we would have to put him down. ‘Yes,’ he said. ‘I think you have to prepare yourself for that.’

Wanting so badly to see him but also terrified of going back into NEH in case it was for the last time, I dragged myself there to find him much the same. Mark appeared to tell me we should give him the day but that he’d like to see some improvement during that time. Finally having to get some work done and joining a meeting by conference call which I should have attended in London in person, I left Panto for a few hours to make a pretence of a normal life. By the time I returned there was a nugget of encouragement on hearing that he had not had to be tubed all day and reflux didn't appear to be a problem. The straw was grasped.

I don't think Mark ever gave up on him but there were moments over that weekend when I questioned whether I was keeping him alive just for my sake. Thank God I was wrong. Somehow, that dear old horse found the courage and stoicism to survive even at his lowest ebb. Mark knew how far he could go, presumably having seen similar situations in the past. 

Panto spent exactly four weeks in ICU3, being cared for with continued devotion by Mark, Jodie, Louise, Jen, Olivia, Rosie, Katie and many other people at NEH whose names I missed but whose presence was always reassuring. While he still has a long way to go and currently looks painfully thin, he is continuing to show steady progress and has moved next door to complete the next stage of his recuperation at the National Stud, where he is receiving equally diligent care and a constant supply of fresh, lush grass.

That should have been the end of the story but, as we know with horses, things are rarely that simple. A fortnight after Panto’s operation, just as he’d started to turn the corner, John went off to Market Rasen with another stable favourite, Kadouchski. I helped John load him that morning and the next I saw of the lorry was when I met it later that evening on the roundabout outside NEH. 

Hugh and I had watched the race at home, saw Kadouchski go amiss on the flat after only a few hurdles and be pulled up sharply by Will Kennedy. By the time the remaining runners in the race came past him on the next circuit we could see Kadouchski in the background being held by John, obviously lame, and about to be loaded onto the racecourse horse ambulance. The call came from John that it looked like a fracture to his near hind but that after being sedated and bandaged by the racecourse vets, Kadouchski was being allowed to travel home. Hopes were raised but the decision was taken to go straight to NEH to assess the extent of the damage.

As I filed in behind the lorry on the roundabout and then along the access road to NEH, Charlie Smith, the on-call vet, loomed up behind me in his car, perfectly timed to meet the incoming patient. My mind was running through the irony of having two horses in the hospital when we’ve hardly ever had cause to be there in the past. Fully expecting Kadouchski’s x-ray to show a fracture that could be healed with box rest, just as Alcalde’s had done earlier in the year, even my untrained eye could tell, when the black and white impression of his pastern flashed up on the screen, that that would not be the case.

Charlie knew instantly, as we both did, that this was not an injury that could be overcome. Willing it not to be so, he took x-rays of the fracture from every angle but the fact remained that there was no way back for Kadouchski. With Panto just metres away on the other side of the yard having survived a situation that for days looked beyond bleak, it was now scarcely believable that some miracle could not be performed for Kadouchski. Before we could even really take in what was happening we said our goodbyes to the little horse who had given us so much pleasure and pride, leaving Charlie to perform the sorriest task.

Ever since that night the thought has niggled away at my brain that somehow a cruel equine god had decreed that Kadouchski be sacrificed in order for Panto to survive. It’s a ridiculous, irrational thought but one which refuses to leave my head. A day hasn’t passed since 24 July when I haven’t cried, first for Panto, then for Kadouchski, usually for both of them. I know I won’t relax until Panto is back home in his box where I can see him from the kitchen window. And even then, I won’t really be happy, as four boxes up I will never again see Kadouchski’s lovely head over his door.


The picture above was taken by John last year as Panto and I turned in at the bottom of the Long Hill canter to lead Ethics Girl and Jamie. We've had few mornings such as this during this wet summer and I've had too few mornings on my horse this year. I held onto this image in my mind all the time Panto was sick, thinking that, even if the worst happened, I would always have the memory of riding a special horse on Newmarket Heath as the sun comes up behind Warren Hill. It is a matchless thrill and a privilege which I try not to take for granted.

Thank you to everyone at NEH for their best efforts in keeping my horse alive, and for their quiet compassion at times when the outcome is not so good. And thanks to all my friends and family who have enquired regularly about Panto, even from as far away as Australia. He's getting there.


clare williams said...

Wonderfully written Emma. I so feel your pain. It must have been such a difficult time for you and John - and everyone there.

Hope Panto is ok.

Clare Williams

Wizby said...

Incredibly compassionate & moving piece, filling up here. A real insight into some of the terrible downs of racing and the devotion of so many in the industry, thanks for writing it. Fingers crossed Panto enjoys many more gallops on the heath with you for years to come.