When Melissa and Steve Gilgenbach brought home Bill and Bob, year-and-a-half-old Belgian horses, they had big plans. The couple, who live on a farm in western Wisconsin, have kept Belgians for more than 16 years and train them for competitive pulling. Bill and Bob were the newest additions to their family.

Unfortunately for Bill, things took a frightening turn shortly after his arrival.

After a routine castration, Bill went right back to grazing before the sedation had fully worn off. Within hours, he developed choke, an esophageal obstruction that prevents a horse from swallowing. Gilgenbach came home from work to find him standing, head hanging, visibly uncomfortable, saliva running from his nose.

“We had never had a case of choke before,” Melissa Gilgenbach says. “It was very scary.”

When a veterinarian came out to try to clear the obstruction, there was an inadvertent complication from an intravenous injection, triggering a severe inflammatory response.

Over the following days, a lump formed on Bill’s neck and continued to grow. He developed a fever. The swelling eventually burst open, and despite antibiotics and warm compresses, it wasn’t improving. Then Bill developed a second case of choking. The Gilgenbachs decided it was time to take Bill to the College of Veterinary Medicine’s Veterinary Medical Center.

By the time they loaded Bill onto the trailer on Nov. 15, the couple had been managing one crisis after another for three weeks. They arrived at the VMC that Saturday afternoon, exhausted and anxious.

Sarah Lewis, a second-year large animal internal medicine resident, was the first to examine Bill. She found that the infection and swelling in his neck had grown so severe that it was compressing his esophagus, the root cause of his repeated choke episodes. Making matters more complicated, an abscess was identified dangerously close to his carotid artery, making surgical drainage a risky proposition.

“There are so many important structures in that area,” Lewis says.

Rather than rush to surgically drain the abscess, a procedure that carried real risk given its proximity to the carotid artery, the team opted first to assess how Bill responded to medical management, a decision that reflected both caution and experience.

The team at VMC’s Large Animal Hospital started Bill on intravenous antibiotics, anti-inflammatories, and pain medication, while carefully managing his diet, feeding him small, frequent servings of soft, wet mash to prevent another obstruction. They monitored him with serial ultrasounds to track the swelling and watched closely for signs that his esophagus might be permanently damaged.

"Every veterinary procedure, including intravenous injections, carries some risk of complications," says Christie Ward, associate clinical professor of large animal internal medicine at the VMC, who was part of Bill’s care team. “Adverse reactions, while uncommon, are a reality of veterinary medicine.”

The original plan was for Bill to stay about seven days while receiving IV antibiotics. Things improved slowly, leading to a nearly two-week stay.   

“When he first came in, he was definitely quiet, especially for a 1-year-old horse,” Lewis recalls.

The staff expected a rambunctious youngster, but got a subdued, uncomfortable horse instead. As Bill healed, though, he realized someone showed up with food every two hours and started jamming his face through the bars of his stall to greet them. The team braided his mane. They took a group photo with him before he left.

“Sometimes very young horses are difficult to work with,” Ward says. “But Bill was just hilarious. Just a great youngster.”

Bill went home on Thanksgiving Day with the Gilgenbachs, committed to administering oral antibiotics three times daily for several weeks, while gradually transitioning him back to regular hay.

A follow-up visit in early January confirmed the infection was completely resolved. Bill was cleared to live his life.

He’s making the most of it. He’s gained 75 pounds since his release, is catching up in size to his companion Bob, and has revealed a personality Melissa describes as “spunky and playful.”

“He’s a year and a half old,” Gilgenbach says. “We just could not give up on him. If we hadn’t gone to the U that day, I don’t think Bill would have made it much longer. We are so fortunate to have the U of MN so close to us, and very thankful to the entire team that helped Bill heal.”