Friday, June 28, 2013

Mind reading

I am certain every veterinarian in the world has on a regular basis wished they could read the patient's minds. I have certainly wished the same on many occasions i.e. where do you really hurt, how long has this been going on, what bad thing did you eat or drink that your owner doesn't know etc. But in this case I had just one question, "What in the _____ were you thinking cow"? The type of call was not unusual, a uterine prolapse on a cow that had just calved, but the timing was a little. It was the middle of the summer when most ranchers are long since finished calving. It was 10 pm and the rancher's adult son calls and says he has a problem. The problem was that the cow had prolapsed but she was in a summer pasture far from the yard or any kind of facilities to catch and restrain her. He didn't have a rope available but did have a tractor. Since the cow was laying down I told him to see if he could lower the front end loader bucket down so that it laid flat on top of the cow's back to prevent her from getting up while I ran into the clinic to collect my equipment. Well I arrived on location out in the middle of the prairie just as it was getting dark to what appeared to be a situation under perfect control. The cow was laying happily under the bucket of the tractor with a uterus splayed across the ground. I put the epidural in and began getting may equipment ready back at my rig. As I began walking back towards the cow the rancher said, "maybe I should lower the bucket it looks like she might have too much space their between her back". Even though cattle are very precocious at birth and generally skip the crawling step in development, this cow decided it was an opportune time to show us just how accomplished a crawler she was. In about 2 seconds flat she crawled out from under the bucket, stood up and walked off. Since we don't know how long it would take to lay back down the rancher headed back to the home place to grab a rope in case she didn't lay down again. Sure enough in the 15 minutes he was gone she just stood there. When he got back we discussed options and decided to try and rope her. I have never been a great roper and so offered to let him try first... Lets just say a swinging rope caused a fairly dramatic temperament change in this cow. She who had been standing quietly decided that every time a rope was swung near her she should spin on the spot and bolt off as fast as she could. This behaviour caused me severe angst as a bouncing and flopping uterus can very quickly tear internal arteries and be fatal for the cow. We quickly decided to change plans of attack as by this time Grandpa had arrived. Now the new plan was to follow the cow slowly in the tractor and drop the loop of the rope over her head from the bucket. For the next 20 minutes I watched as the tractor lights meandered slowly around the field. When the lights got to the corner of the pasture was I knew it was time for me to go and help. There was a large dug-out pond with built up banks around it in that corner. I could tell from the constant forward, back, and changing of directions of the tractor lights that our patient was using this dugout banks to evade the tractor. I arrived to find grandpa down off the tractor following the cow on foot trying to get her away from the pond to rope her. I guess the other cows in the field were interested to see what the excitement was as they also came running up as I did. It seemed like a simple ideas that grandpa would come from one side, I would come from the other and we would haze her off with the other cows back away from the pond. About that time is when I wanted to become a mind reader. Instead of turning with with other cows and walking away from the pond she paused for a second then turned away from the herd and plunged straight into the dugout. She walked in to about chest deep and stood there out of reach of our lariats and I thought she could stand there all day and we couldn't do anything about it. Fortunately she did't stand there all night. Unfortunately, her escape route was full steam she went swimming across the pond. Grandpa yelled, "quick let's see if we can get around to the other side and rope her as she comes out". So here we are running around both sides of the pond trying to beat the swimming cow to the other side. Our exertions were a bit of a waste as she got the the other side where she could touch her feet again and just stood there. By this time grandpa was pretty fed up and roped her right where she stood. Now we thought we are finally getting somewhere. Boy were we wrong. She stood there for about 30 seconds and then rolled over on her side and stuck her head under the water. All three of us grabbed on to the rope and tried to pull her back upright again. For a moment we were successful and she righted herself. But then the rope was too tight around her neck and she began to have trouble breathing and down she went again. We went through several cycles of rolling, thrashing, then standing, releasing slack on the rope, and then her going back down again. We were slowly inching her over to the edge where I jumped in with my rubber boots to try and flip the loop of the rope over her nose in a make-shift halter. Super bad idea. I quickly realized that this mud was sticky and I was stuck in place inches from a thrashing head and legs. With effort I managed to unstick my boots and get out of harms way. Now staying on dry ground and with luck we worked her head over close enough to make the halter and finally really pull to get her out. But alas, we were to lose again. About this time she started doing her best impression of a whale. Despite our best efforts to stop her she began dunking her nostrils under water blowing like a fountain in the mall. I am sure it doesn't take too much imagination to figure out what happened next. Whether she died because she was bleeding internally or because it is difficult for cattle to get an appropriate amount of oxygen out of inhaled water I will never know. What I do know is no matter how long I work on animals there will always be days where I will shake my head and wonder, "what were they thinking"?

Wednesday, January 30, 2013

My Baby

Every veterinarian that works on small animals is aware of the classic battle. Small dog versus big dog. Now I know many of you will say to yourself, "I know so and so's little dog and it is so tough it puts all those big dogs in their place". That might be fine and good for so and so's dog but I am talking about the battle where big dog is not intimidated by small dog and as proof picks up small dog in its mouth. The resultant injuries can vary from mild to severe and this case was one of the worst. Shortly after the call came in a small ball of blood covered fur with legs, teeth, and ears was carried in by a very distraught owner. The dog was in shock and was bleeding from multiple wounds. After shaving the dog we found severe bite wounds on both sides of the abdomen with one side of the dog bulging out oddly. A look with the light through the small tooth hole confirmed my suspicion that the bulging was caused by intestines under the skin with no evidence of a body wall to hold anything in. I personally think the worst part of being a veterinarian is having to deliver bad news. I discussed with the owner how grave the situation was with her dog. I told her what things we could offer at our clinic and what could be done elsewhere. Of course we discussed the necessity of surgery and potential for the dog expiring at any minute. She implored us to do everything we could to save the dog but she was not interested in going elsewhere. We immediately started the dog on intravenous fluids to stabilize it and prepared to go into surgery. The owner was too emotional to stay at the clinic and said to call her on her cell phone if we needed anything. Once we got into surgery things went from bad to worse. As soon as I opened the incision through the skin I know we were in big trouble. The only way I can explain without posting a very graphic photo is to say that the inside of the dog looked like hamburger and sausage. The entire side of the abdomen (the muscle) was the hamburger torn open with the intestines (the sausage) coming out with multiple areas of damaged and bleeding blood vessels interspersed. I immediately had my technician call the owner and put her on speaker phone while I stayed in the sterile surgery. By the way, if the vet is calling you on speaker phone from surgery, they are usually not calling to wish you a happy birthday. Avoiding the hamburger and sausage analogy I explained that the dog had a very very poor chance of A: having me get it all back together in a semblance of a whole piece and B: having all of those stitches stay in and C: not dying during surgery and D: even if it survived surgery not dying from infection in the meantime. I once again, this time very strongly, recommended euthanasia. She essentially ignored my recommendation and instead said do whatever you can in surgery to save the dog. Then she said, "Just promise me that everything is going to be ok. Promise me that my baby is going to be just fine." Again I re-iterated that the dog's injuries were extremely severe and likely life threatening with a good chance of not making it through the surgery. Her response, "Just promise me that he is going to be okay and be just fine". On occasion, rare occasion, I am tempted to reach through the phone, grab the client by the shoulders, look them straight in the eye, shake them just a little, and say, "Are you listening to a word that I am saying?" By some miracle, and a lot of creative suture work, I was able to get all the insides back inside and the hamburger wall to be one piece. By another miracle the dog was alive at the end of the surgery. Sadly this fluffy little dog had used up all of its miracles. It appeared to be waking up shortly after surgery, but then returned to comatose and after about 4 hours passed away. During those four hours I had been on the phone multiple times with the owner letting her know the progression of events and unlikelihood of survival. Finally after the dog passed away I got to make my least favorite phone call and share the bad news. She expressed her gratitude for all the work we had done for her dog and calmly said she wouldn't be able to come in and pick up the body till in the morning. She was very quiet and gracious and though I was surprised at how she handled things I figured that would be the end of the story. The middle of the next morning I was out in the large animal section of the clinic when I suddenly heard what I thought was a siren of some sort followed by some pounding noises. Confused I listened more carefully to try and figure out what was going on. Once the cow I was working on in the chute stopped banging around I could very clearly hear this. (Keep in mind the siren type sound) WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH MY BABY!!! WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH pound pound pound pound etc. MY BABY!!!! WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH. Followed by the loudest screaming sobbing I have ever heard. Realize I can hear all of this through one concrete wall and two interior walls. Then it would quiet down for about 2 minutes and the cycle would repeat itself. WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH MY BABY!!!! I think you get the idea. This cycle repeated itself for a solid 15 minutes with mild variations. My technicians and receptionists described the scene to me after the fact. The explanation to the noise was of course the owner of the fluffy dead dog. She went in to see her dead dog which was located in our kennels at the back of the clinic. She walked quietly up to the front reception area then suddenly her blood curdling screaming began and she sprinted back to sob beside her dead dog. The gentlemen with her would get her calmed down and begin walking her out of the building only to have a repeat performance every time she reached the reception area. For a few minutes my staff thought they were going to have to call the authorities to have her removed. I always chuckle inwardly when people make the comment along the lines of I bet you went into veterinary medicine so that you just have to deal with animals and not people. Without a doubt some of our most rewarding and most challenging times are dealing with people and the emotions attached to their animals.