Dr. Liz Arbittier wasn’t too worried as she approached the stall, even though her trainer had just called to tell her something was wrong with her horse. Ephraim is unique, a former Amish driving horse. He had just spent two days in training at a show-jumping barn, ridden by Olympian Kevin Babington. And she had turned him out the night before, as usual.
It couldn’t be that serious, thought Arbittier, a staff veterinarian on New Bolton Center’s Equine Field Service team. But then she opened the stall door.
“I took him out of the stall and was shocked to see that he was staggering sideways,” Arbittier said. “The hind end fell one way and the forelimbs walked as if he was on a tightrope, crossing over in bizarre fashion.”
This experienced veterinarian knew the diagnosis could be dire. First she thought of equine herpes virus, described in the lead story of this publication, which could lead to a quarantine for her home barn, the show-jumping barn, and possible death for her beloved Ephraim. But the samples sent to the state for diagnostic testing came back negative.
What could be wrong with him? “I took a deep breath and started forming a plan,” she said. “I found myself torn between thinking he was neurological or just really broken somewhere, but I couldn’t assess him with any objectivity. I brought him to New Bolton Center at my first opportunity.”
Arbittier’s journey in the role of Clinician as Client began.
An Unlikely Love Affair
The story with Eph, as she calls him, actually began in the snowy days of December when Arbittier was looking for an easy horse that she could ride through the Chester County countryside. She consulted with a friend, who is a trainer, about a steady draft horse cross. Instead, the friend told her about a four-year-old Dutch Harness Horse-Standardbred cross.
Ephraim was an Amish driving horse who didn’t pass muster, and was sent to the trainer to be started under saddle and sold. Ephraim had failed a vetting due to abnormal radiographic findings in his feet, so the owner had decided to send him straight to auction. The trainer candidly wrote Arbittier that this very large horse was petrified of people, but had not put a foot wrong during his training.
For once, Arbittier was looking for a trouble-free horse, after years of taking on rescues and hard-luck cases. A Penn Vet graduate, she had owned several horses, but sold them and her farm when she decided to join New Bolton Center’s Equine Field Service in 2013. She had previously spent several years at a private equine practice, specializing in pre-purchase exams.
“I made the craziest equine-related decision of my life,” Arbittier said. “I purchased, sight unseen, an Amish buggy horse with significant fear issues and bad X-rays, and had him shipped from North Carolina to Pennsylvania.”
Meeting him for the first time, she encountered an enormous black creature, standing about 16.3 hands. “What stood out were strangely conformed legs, a giraffe neck that went straight into the air, and the biggest head and ears I’d ever seen,” she said. “Then I caught his eye—worried, but so kind. I was smitten.”
Arbittier has been chronicling her journey with Eph in a blog for Chronicle of the Horse.
Solving the Mystery
Now her Eph seemed seriously ill or injured. Arbittier had considered, beyond equine herpes virus, a neurological condition, a broken back, a broken pelvis, broken ribs, but she couldn’t correlate his “bizarre” stance in the front end to those conditions.
First, she took him to neurologist Dr. Amy Johnson, Assistant Professor of Large Animal Internal Medicine and Neurology at New Bolton Center.
“I worried how he’d mentally handle the visit, but my fears were unfounded,” Arbittier said. “Ephraim fell in love with Dr. Johnson. She is very quiet in nature and he immediately started snoodling with her.”
During the examination in New Bolton Center’s world-class Equine Performance Clinic, Johnson noted that his bizarre gait, while very abnormal, was also very deliberate. They then called in Dr. Elizabeth Davidson, Associate Professor of Sports Medicine at New Bolton Center, and an expert on lameness.
With Penn Vet students, residents, and clinicians in attendance for his examination, Dr. Davidson diagnosed that he was lame in his left hind leg.
“She jogged him for me and I wanted to cry,” Arbittier said. “He was broken-bone, lame left hind, and it was hard to watch.”
Next, Arbittier made an appointment with New Bolton Center for nuclear scintigraphy, commonly known as a bone scan. Dr. Michael Ross, Professor of Surgery at New Bolton Center, confirmed a fractured pelvis.
“I was actually very relieved,” Arbittier said. “It will heal with several months of stall rest.”
Now Eph is recovering in a rehabilitation farm just behind New Bolton Center, close at hand for Arbittier.
“I adore this horse and only want him to be as happy as possible while he heals,” she said. “I visit him every morning before work and, so far, he’s doing very well.”
The journey for this clinician as a client was a valuable one, Arbittier said.
“I try really hard in my daily practice to remember how concerned my clients are about their horses, Arbittier said. “I am focused on the medicine, but I work to balance that responsibility with the fact that I’m dealing with strong human emotions – love, fear, confusion, sadness.”
Often there is not one clear answer when it comes to medicine, she said. “Coming up with the right answer for that particular horse is what makes this job so hard and interesting and rewarding,” she continued.
“Finding myself in my clients’ shoes, so worried about Eph, was a good reminder of why I work so hard at that balance. I cannot be objective when the subject is my animal, so I rely as much on the New Bolton team as my clients do on me.”