EQUUS

TIME TO GO HOME

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breathing noise that can persist after a prosthetic laryngopla­sty. He would still be able to whinny using the intact vocal cord on the right side of his larynx.

So two days after his primary surgery, Cory the Brave stepped into the stocks for an endoscopic laser ventriculo­cordectomy. The computer screen showed his handsome new larynx as well as the vocal cord that drooped across it. Through the endoscope, Hackett and her team inserted the long flexible tip of their diode laser, a tool that has revolution­ized human and animal medicine. Watching the endoscopic screen, surgeons laser tissue out of internal areas without external incisions or general anesthesia.

As Hackett separated the vocal cord from its moorings with her laser spark, smoke seeped from Cory’s nostrils. I’ve heard difficult horses called “firebreath­ing dragons,” but this was a first.

“Couldn’t the vocal cord have been removed while Cory was under general anesthesia to rebuild the larynx?” I asked. “Yes,” Hackett said with a twinkle in her eye, “but we didn’t want to blow him up.” She explained that inhalant anesthesia contains flammable oxygen. And the laser spark … Aha. Tense until that point, we all laughed in comic relief at my inadverten­t suggestion of blowtorchi­ng Cory’s throat.

Hackett and her resident continued moving the laser in tiny brush strokes to cut away the vocal cord and surroundin­g tissue. As they burned, they held the tissue tightly with little tweezers---er, bronchoeso­phageal grasping forceps---that reached all the way up Cory’s nose and into his throat. Vocal cord tissue is tough, requiring a tight hold and an hour of laser ablation. In the end, Hackett fished out a lump of tissue about a quarter-inch wide and an inch long. It looked like raw steak with a line of gristle down one side.

After a week of hospital care, Cory was released. The final bill came to $2,796, including unexpected costs for a near-colic following general anesthesia. Both of us were tired, hungry and weak.

Hackett told me that Cory must eat from ground level for the rest of his life. This reduces the chance that he will inhale particles of food through the open larynx and into his lungs. Irritants like dust and ammonia must be avoided. For the next six weeks, he would need multiple medication­s several times daily and would have to be kept in a stall and hand-walked slowly for 10 minutes twice a day. I explained that Cory is more likely to relax with access to his small paddock ---indoor confinemen­t agitates him. Hackett consented.

Still, she warned, Cory must not move faster than a calm walk for six

For the next six weeks, he would need multiple medication­s several times daily and would have to be kept in a stall and hand-walked slowly for 10 minutes twice a day.

weeks, emphasizin­g that “the area needs time to heal and scar down to become secure.” She added that quiet recovery prevents complicati­ons related to anesthesia, surgical location and the size of the prosthesis. All of which sounds great, but keeping an off-the-track Thoroughbr­ed calm is like telling a bird not to fly. I explained that

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