Voluntario’s Miraculous Recovery – Part 1

The Lusitano stallion Voluntario Interagro and owner/rider Dr. Tracy Durham in 2013, about six months before his accident. That year, Voluntario was the Adequan®/USDF International Andalusian & Lusitano Horse Association All-Breeds Fourth Level Open champion. (Photo courtesy of Tracy Durham.)

After her prized Lusitano stallion slipped and fell in the snow, his owner faced a devastating diagnosis and dimming prospects. She and her horse persevered, against all odds.

By Tracy Durham

The fall seemed like a minor spill.

It was January 2014 in upstate New York, and my 12-year-old Lusitano stallion, Voluntario Interagro, was acting silly as usual as I led him across snow-covered paths to his turnout paddock. He slipped, couldn’t quite regain his balance, and went down gently into the snow.

That very morning, we’d had a wonderful training ride. Voluntario had reached a milestone in his training, performing all the figures for the advanced dressage tests with ease. He was very proud of himself, and I found myself dreaming of future competitive success.

I’d been introduced to Iberian horses near the end of my veterinary education at Cornell University, when the Ringling Brothers and Barnum & Bailey Circus imported several Andalusian stallions. The stallions were quarantined at Cornell, supervised by a Polish elephant trainer who neither spoke English nor rode. The trainer made it known that he wanted the horses exercised. The quarantine supervisor called me, knowing that I was a dressage rider, when she realized that the horses knew more than she.

I was enthralled with the stallions and never forgot their superior temperaments. Several successful but very difficult horses of my own later, I finally found my own Iberian stallion.

Voluntario was a dominant, opinionated horse, but he always came up large when it counted. We amassed a number of regional and national dressage awards in the early 2010s, and he even served as my therapy horse when in 2011 I suffered a severe accident that left my left leg paralyzed. Wheelchair-bound for 12 weeks, I rode for two months before I learned to walk again. My spirited horse allowed four people to put me in the tack and to pull me from his back. He was quiet as a lamb while I sat on him and then pranced back to his stall as if pleased with his role in my recovery.

When Voluntario did not get up after his fall in the snow, it was obvious that he was in trouble. I shouted for the farm owner, Peter, and gave my horse an IV dose of anti-inflammatory pain reliever. When Peter arrived, we packed sand, pine shavings, and rock salt around Voluntario, hoping that he just needed better traction to get up.

Our efforts proved fruitless, and we began making calls, looking for a wrecker to hoist Voluntario up. A state trooper, realizing that we needed an articulated boom for the job, called a towing company. By some miracle, a driver was only 15 minutes away from the farm.

An equine-rescue specialist with my equestrian auto plan guided us through the process of placing the nylon web straps—designed to lift 18-wheelers, not horses—safely around Voluntario so that a strap would not rupture a vital organ when the horse was lifted. By this time there were 30 people on site—a mix of farm help, firefighters, state troopers, and the wrecker’s driver and his boss. One young fireman sat in the snow with my horse’s head in his lap for 40 minutes while we sedated Voluntario and placed the straps to lift him. Placing the straps required rolling the horse over—not an easy or safe task, even with sedation. But Jeff Peabody, the wrecker driver, lifted 1,200 pounds of live weight as smoothly as an old pro.

Once we had Voluntario off the ground, my regular veterinarian, Dr. Ellen Johnson, performed an orthopedic exam. My horse had not sustained a lower-limb fracture, but we couldn’t rule out a spinal or pelvic injury. Then began the agonizing process of attempting to keep Voluntario calm in his sling—still suspended from the articulated boom, with every other horse on the property in hysterics over the commotion—as the sedation wore off, so that we could move him into the indoor arena.

As Voluntario “came to,” he began to flail in the nylon straps. Everyone who could reach him put a hand on him, and I shouted, “STOP! We’re trying to help you!” To our astonishment, he immediately ceased thrashing, put his feet on the ground, and leaned into the nylon webbing for support. He then allowed Jeff to swing the articulated boom 180 degrees while we helped him walk the 80 to 100 feet to the indoor arena, one agonizing step at a time, all while barely supporting weight on his left hind leg.

Voluntario and I spent the next four days in that arena. He had to be monitored constantly because it was imperative that he not lie down. Several friends dropped everything to take round-the-clock shifts in subfreezing weather. Dr. Johnson was hopeful that the problem was simply a lot of bruising, and that two or three days of rest and pain management would result in significant improvement.

A Terrifying Turn for the Worse

Four days into the ordeal, my friends and I were cold and exhausted, and Voluntario remained barely ambulatory on his left hind leg. I scheduled a visit from my friend and colleague the large-animal surgeon Dr. Christina Cable, who planned to assess Voluntario’s injuries and to determine a game plan for his care.

I left Voluntario in good hands for two hours so that I could take a shower and keep a dental appointment. When I returned to the farm, I was horrified to find my horse soaked in sweat and in extreme distress, with an enormously swollen left thigh and gaskin. I realized what had happened: A probable pelvic fracture had shifted and lacerated a major blood vessel, resulting in hemorrhagic shock. My beloved Voluntario was bleeding to death.

I called Dr. Cable in a panic, fearful that I was going to watch helplessly as my horse died. She shouted over the phone, “Load him on the trailer and get to Cornell ASAP!”

Yet another miracle occurred when we needed it most: Minutes later, my friend and farrier Mike Kurty stopped by to see how we were doing, and he happened to be driving his towing vehicle rather than his farrier’s rig. My own truck was an hour away, and Mike’s had the correct hitch for my trailer, which was at the farm. In an added stroke of luck, although it was freezing cold, there was not so much snow or ice that we couldn’t back the trailer up to the door of the indoor arena.

Voluntario followed me onto the trailer as Mike and one of the farm workers lifted his hindquarters and “wheelbarrowed” him forward up the ramp. My friends Joanne and Carol stayed by my horse’s side with a large piece of plywood. We hoped that, if he collapsed, we could push him onto the plywood and drag him onto the trailer. I told Voluntario that we were making the trip because I wouldn’t lose him without a fight. But I promised him that the decision to carry on, or quit, would be his.

Mike gave up a day’s business to drive us to Cornell, and I sobbed silently for the entire 60-minute trip. I was so certain that we would arrive to find Voluntario dead on the trailer that I begged Mike to be the one to check him when we arrived.

As we pulled in to the parking lot of the Cornell University Equine Hospital, Voluntario bellowed his arrival to the other horses. Not only was he still alive; he was still on his feet! He had decided to fight.

A Diagnosis and a Decision

Dr. Cable was waiting for us at Cornell, as were two of my former professors, the gifted equine orthopedists Drs. Alan Nixon and Norm Ducharme. Mike sat in the waiting room with me as I awaited the results of the diagnostic radiographs.

Dr. Nixon and large-animal surgery resident Dr. Hayley Lang delivered the news: Voluntario had an acetabular fracture that went into the left hip joint but did not appear displaced. His performance career was over, but Dr. Nixon gave my stallion a fair chance of recovery as a pasture ornament and possibly for breeding.

The fracture was not operable, so immobilizing the patient was the only recourse. Voluntario would need to remain in a sling for at least four to six weeks. The risk for complications was nearly overwhelming, among them catastrophic failure of the uninjured limbs, colic, and claustrophobia leading to destructive panic episodes.

But Voluntario had already survived for four days with the fracture and was eating like the proverbial horse. He loved people so much that I felt frequent visitors and positive attention would meet his social needs. Most important, his rapid understanding of the articulated wrecker’s support indicated that he should adapt to the sling quickly. I decided to proceed, and Dr. Nixon agreed.

Voluntario was slowly and painfully helped to the stall where he would spend the foreseeable future. His sling was adjusted such that he could bear some weight on all four limbs or lean on the sling for support. His feet were fitted with special boots, designed to reduce abnormal forces on the feet and legs and thus to minimize the risk for suspensory collapse and laminitis.

For two years Voluntario lived in this sling during the long and arduous rehabilitation process. Photo courtesy of Tracy Durham.

I spent the next two days with Voluntario, trying to reassure myself that my horse’s short-term suffering was worth the possibility of a comfortable retirement. Within 48 hours, the worst of his pain seemed under control. He had learned how to use the sling to rest his haunches, or his forelegs, or one side of his body at a time. Now all we could do was wait and see whether his fracture would heal sufficiently to allow him to lead a somewhat normal life. Equine fractures take at least 12 weeks to heal, so I hunkered down for a long wait.

A Long Road

The next few weeks were monotonous, but I lived in a constant state of dread, becoming anxious before each daily update from Cornell. Voluntario continued to do well in his sling, and his hematomas slowly resolved without complications. He maintained his weight, his good appetite, and his spirits. His feet and legs showed no sign of failing, although he lost all the muscling over the left side of his back and pelvis. He was kept on an aggressive pain-management regimen coupled with gastro-protectants to limit ulcer and colic risk, as well as injectable joint protectants in an effort to avoid the development of crippling arthritis in the damaged hip.

The Cornell veterinarians put Voluntario on an extensive rehab program. “Sweat” bandages helped to reduce the edema in his hind legs, which resembled tree trunks for the first couple of weeks. He wore a magnetic blanket for an hour several times daily. My friends Drs. Mette Larsen and Jenny Susser sent a red-light-therapy device to use on his acupressure points. It was during the red-light treatments that Voluntario started to place more weight on his fractured side in order to rest his good right hind leg—a milestone in his recovery. We made it to week nine without major complications, and my horse was starting to stand on his left hind leg more reliably.

All the while, in between trips to Cornell, I maintained a fairly normal schedule in my job as a small-animal veterinarian. After I’d endured a few hairy drives through the snow to Ithaca, a colleague who lives two miles from the equine hospital, Dr. Megan Cox, offered me her guest room. Her generosity was a ray of sunshine and hope when I needed it most. We became good friends in the ensuing weeks, and I remain grateful for the kindness of a near stranger.

My charismatic horse also made new friends. Voluntario, who is a very dominant stallion, was perfectly behaved around the veterinary students with little equine experience but was not above sneaking a nip at the more confident handlers. He amassed a three-page-long visitors list and recognized each person who came by his stall. The students were astounded by his ability to communicate and to read humans’ body language.

Two months after Voluntario’s fall, we took new radiographs. The results were disappointing. Not only did the fracture show minimal new bone formation, but we also saw a second ileal fracture, which had previously been hidden by muscle. Had we known about the second fracture at the start, we would have euthanized Voluntario. Two fractures involving the acetabulum dramatically worsened the prognosis. I was sick.

Cornell University’s Dr. Hayley Lang hand-walking Voluntario in May 2014. Video courtesy of Tracy Durham.

I decided to listen to my horse, who was continuing to do well, rather than focus on the radiographs. After lengthy discussion, the Cornell veterinarians and I chose to continue care for another two to three weeks, then to start a program of gentle physical therapy. Our hope (educated theory?) was that Voluntario’s fractures were developing fibrous connective tissue as part of the healing process. Fibrous unions don’t show up on radiographs, but they provide enough stability for improved comfort and weight-bearing. The one positive finding was that the joint space around Voluntario’s hip was a normal width, with no arthritic changes. This suggested that the integrity of the hip joint had miraculously been preserved despite the two fractures.

Eleven weeks after Voluntario’s accident, the staff at Cornell saw my horse lift, extend, and place his left hind leg for the first time. A couple of days later, Voluntario took a step forward with his left hind leg, showing minimal toe drag. These small movements constituted another huge milestone in his recovery. Voluntario continued to make these small, purposeful steps for the next two weeks.

In April, still in his sling, Voluntario started on a physical-therapy regimen of passive range-of-motion and weight-bearing exercises. Soon he was able to lift his left hind leg for a second or two, and to bear weight on it for a few seconds while his right hind leg was lifted. The therapists gradually loosened the sling to increase weight-bearing and to make Voluntario engage his core muscles.

Cornell University Equine Hospital large-animal surgery resident Dr. Hayley Lang hand-grazes Voluntario in May 2014, four months after his catastrophic fractures. Photo courtesy of Tracy Durham.

By mid-month, Voluntario had made enough progress to be disconnected from the sling hoist, although the body of the sling was left in place in case he fell. He looked stable standing on his own, so we asked him to take a few steps forward. There are no words for the horror I felt as I watched his left hind leg buckle. He staggered nearly to his knees before catching himself. After staffers got him stabilized, Dr. Lang asked Voluntario to walk out of his stall, turn around, and walk back in. The process took more than five minutes, and I held my breath until my horse was once again secured to the mechanic’s hoist. He looked relieved to have the familiar support, and I cried the entire drive home.

Dr. Lang repeated the process daily for the next two days, and Voluntario gained confidence with each effort. Although his gait was permanently altered as a result of the injuries—he walked with a “post leg” and became unstable if he moved too fast—eventually he was able to travel the length of the barn aisle with minimal assistance. In May, after weeks of gradually stepped-up therapy, Dr. Lang removed the sling entirely. She began to walk Voluntario short distances outside and allowed him to hand-graze for a few minutes each day. It was wonderful to see him enjoying the sun after his long sojourn in solitary confinement.

The moment of truth came a few days later, when Voluntario was allowed to lie down for the first time since his accident in early January. We all knew that he could not leave the hospital unless he could function as a normal horse.

Voluntario enjoyed a long nap in the deep bedding, but I was heartbroken when Dr. Lang called to say that he was unable to rise on his own. He struggled to get up but couldn’t push his pelvis off the ground, and was becoming frustrated and exhausted. Dr. Lang sedated him and used the sling to lift him, and he remained in the sling for two days, tired, sore, and a little depressed following his failed attempt to rise. Dr. Lang encouraged me to stay calm; she thought that Voluntario would have a bit of a learning curve, just as he had when he began to walk again. Within 48 hours he was once again bearing more weight on his left hind leg and walking in his stall supported by the sling.

Dr. Lang removed the sling again, and Voluntario stood unsupported for three days before lying down again. In hindsight, although no one was to blame, this was a mistake.

Tracy Durham, DVM, is a small-animal veterinarian at Vestal Veterinary Hospital in Vestal, New York. A longtime student of 1992 US Olympic team bronze medalist Carol Lavell and a dressage trainer and clinician herself, she is a USDF bronze, silver, and gold medalist who has earned national and regional titles from Training Level through Grand Prix.

Continue this amazing story by reading Part 2 and Part 3.


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