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 ahead....off 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.
Monday, February 21, 2011
Beet Pulp
It is nice to be known for being good at something. In my particular case I had recently moved to an area where the previous veterinarian was not a horse person. When word spread around the equine community that I had a bit of horse sense, I quickly gained a following of devoted horse owners. Normally I would be flattered by this but as you might guess at times it can lead to some interesting situations. Just like everyone I know I enjoy a little time off. I had gone on a trip to visit some family for a long weekend. On my leisurely drive back home I received a concerned phone call from one of my devoted clients. She was concerned that her horse was choking and assured me that she wasn't going to have the other doctor look at it, but instead wanted my opinion.
Perhaps I should explain a little more about choke. In most choke cases that I deal with we are not talking about half-swallowing a peanut, not being able to breath, and needing someone to do some quick fist-to-gut action to save your life. Instead we are talking about an obstruction of the esophagus (the tube that takes food and water from your mouth down to your stomach). Lets continue with the story. Of course, the first thing that I told her was that I was not yet back home and would not be able to come right out. I recommended that another vet really should look at it to make sure she got the care she needed right away. Instead, upon finding that I was unavailable, she said that she thought the horse was going to be fine and just wanted to know for sure what things to watch for to make sure. Well the two big keys are if a choked horse can eat and drink they are no longer a choking horse. The owner called me back later to tell me that the horse was eating grain and drinking water and I thought it was the end of the story.
I thought wrong. She called me the next day, concerned about her horse again. Unfortunately finances were a major restriction in what the client was able to do for her horse so she was trying to manage as best she could simply getting advice over the phone. Again she assured me that the horse was drinking water and in my mind sound like it was still doing okay.
The next day rolls around and she finally decides that the horse is too valuable a performance horse and really needs to be looked at. When horse and owner arrived I knew we were in trouble. The mare was very gaunt, dehydrated, and weak. Bad, bad news. First we tried passing a tube. No luck. Next we tried an injection of a smooth muscle relaxant. No luck. Tube again: no luck. As I said before finances were a big constraint and the owner said she really was at her limit for spending and couldn't afford anything else.
Having heard of this but never tried it because of the risk for complications I offered another option. I said we could try to break the choke up (by this time we had figured out that our most likely cause of the choke was a pelleted dry beet pulp that the mare had attempted to eat three days prior) working from the top down. The idea was to flush small amount of water in and the siphon it back out with chunks of the beet pulp coming along for the ride. It would cost very little and would just be time and energy put into it. Unfortunately there was a good deal of risk of too much water being flushed and having it then breathed in to the lungs to start a bad case of aspiration pneumonia. With these concerns in mind the owner opted to go for it as it was pretty much her last and only chance to save this good horse.
After 45 minutes of flushing and siphoning I felt that little progress was being made. Of course I had other cases and appointments to take care of and couldn't stand their flushing all day. The owner, on the other hand said she was willing to sit and keep working at it for as long as I would let her stay. Seeing no more harm in that than just euthanizing the horse directly I showed her what to do and set about some of my other tasks. Checking in every few minutes and doing more flushing it seemed that very little progress was being made.
After what seemed like all afternoon we finally started to see some progress. There were actually some flushes that seemed to be working. The owner wanted me to take over again and I agreed to try one more time. A couple good flushes of water in were successful at siphoning a good long stream of beat pulp back out. On my next push down the esophagus I was amazed to find that nothing was stopping my tube. I continued pushing until I reached the stomach and I was relieved to say that we had just saved this horses' life. The owner and her friend started dancing around and hugging me and almost crying. No, I am pretty sure they were crying...but these were definitely tears of joy.
Sometimes it pays to never give up.
Perhaps I should explain a little more about choke. In most choke cases that I deal with we are not talking about half-swallowing a peanut, not being able to breath, and needing someone to do some quick fist-to-gut action to save your life. Instead we are talking about an obstruction of the esophagus (the tube that takes food and water from your mouth down to your stomach). Lets continue with the story. Of course, the first thing that I told her was that I was not yet back home and would not be able to come right out. I recommended that another vet really should look at it to make sure she got the care she needed right away. Instead, upon finding that I was unavailable, she said that she thought the horse was going to be fine and just wanted to know for sure what things to watch for to make sure. Well the two big keys are if a choked horse can eat and drink they are no longer a choking horse. The owner called me back later to tell me that the horse was eating grain and drinking water and I thought it was the end of the story.
I thought wrong. She called me the next day, concerned about her horse again. Unfortunately finances were a major restriction in what the client was able to do for her horse so she was trying to manage as best she could simply getting advice over the phone. Again she assured me that the horse was drinking water and in my mind sound like it was still doing okay.
The next day rolls around and she finally decides that the horse is too valuable a performance horse and really needs to be looked at. When horse and owner arrived I knew we were in trouble. The mare was very gaunt, dehydrated, and weak. Bad, bad news. First we tried passing a tube. No luck. Next we tried an injection of a smooth muscle relaxant. No luck. Tube again: no luck. As I said before finances were a big constraint and the owner said she really was at her limit for spending and couldn't afford anything else.
Having heard of this but never tried it because of the risk for complications I offered another option. I said we could try to break the choke up (by this time we had figured out that our most likely cause of the choke was a pelleted dry beet pulp that the mare had attempted to eat three days prior) working from the top down. The idea was to flush small amount of water in and the siphon it back out with chunks of the beet pulp coming along for the ride. It would cost very little and would just be time and energy put into it. Unfortunately there was a good deal of risk of too much water being flushed and having it then breathed in to the lungs to start a bad case of aspiration pneumonia. With these concerns in mind the owner opted to go for it as it was pretty much her last and only chance to save this good horse.
After 45 minutes of flushing and siphoning I felt that little progress was being made. Of course I had other cases and appointments to take care of and couldn't stand their flushing all day. The owner, on the other hand said she was willing to sit and keep working at it for as long as I would let her stay. Seeing no more harm in that than just euthanizing the horse directly I showed her what to do and set about some of my other tasks. Checking in every few minutes and doing more flushing it seemed that very little progress was being made.
After what seemed like all afternoon we finally started to see some progress. There were actually some flushes that seemed to be working. The owner wanted me to take over again and I agreed to try one more time. A couple good flushes of water in were successful at siphoning a good long stream of beat pulp back out. On my next push down the esophagus I was amazed to find that nothing was stopping my tube. I continued pushing until I reached the stomach and I was relieved to say that we had just saved this horses' life. The owner and her friend started dancing around and hugging me and almost crying. No, I am pretty sure they were crying...but these were definitely tears of joy.
Sometimes it pays to never give up.
Sunday, January 30, 2011
Stay in Bed
Being on call is always interesting. Some times you will go days at a time without a call and then for some reason a night like this happens. I was fast asleep in my bed, as most people should be around midnight on a weekday, when my phone rang. Miss horse owner was very distressed. Her horse kept going down and didn't seem to want to get up. I was just starting to get into the details of what was going on when another call beeped in on me. I quickly asked permission to switch lines and tell the person I would call back. Cow owner on the other line said he had a cow calving and I could call him back in a minute. Now back to the distressed horse owner. I sat listening quietly for about ten minutes while the owner went over what had happened multiple times and then asked if I could come out. I mentioned that I also had a cow calving that would be coming into the clinic and it would be best if she could come in with the horse. She said that the storm was already picking up at her house and she thought the trailer was drifted in but she would go back and check.
In the meantime I phoned cow owner back and tried to determine just how much of an emergency he had. He assured me that the calf was already dead and he was in no rush. I soon understood why. He said he had noticed that she had started calving yesterday morning...yes a day and a half before. But then later on in the day she kind of quite and then started into it again today and so he decided to check on her. As much as I would have liked to berate him for lack of timely care I listened until he was done. I asked him how the cow was doing now and if she was acting sick at all. He said she was doing great and was showing no signs of being sick. I layed out the options for him for the middle of the night. First, we could have him bring her in after I was done with the colicky horse which would probably be in a couple of hours. Second, since he said she was doing great we could actually get some sleep tonight and bring her in first thing in the morning as it would really only be a few hours difference and the calf was already dead. We also talked about the poor chances that a cow had with a calf that had been dead inside for a couple of days. To make my middle of the night he decided that he wanted it down as soon as I was done with the colicky horse. Great.
As was expected the horse trailer was well drifted in and so I had to go out. When I arrived I found a bad situation. The horse was down and thrashing in a cramped box stall. One side was a fence instead of a wall and the gelding was showing how adept he was at sticking his legs through the fence and then trying to roll with his legs stuck in the wall. Great. The owner's adult son was sitting on the horse's head in an attempt to minimize the thrashing from side to side. A quick vitals check showed that his heart rate was elevated over 100 beats per minute (normal fit horses are usually 20-30) and breathing rate was at about 60 breaths per minute (normal being less than 20). His intestines were not moving anywhere on his right side. His color was poor and he was obviously in extreme pain. He attempted to thrash multiple times in the first couple of minutes so I quickly gave him an IV of a heavy sedative. After he was sedated I finished my exam and things weren't looking good.
After about ten minutes the horse began thrashing around again. This was a really bad sign as the dose should have lasted him for closer to an hour. I discussed with the owners the need to make a decision on further treatment or euthanasia. Unfortunately, though I can strongly encourage people to make a decision quickly, especially with the drugs already wearing off, I cannot make decisions for people. Over the next half an hour we sat and watched the horse becoming worse while they continued to ask questions, watch the horse, discuss with each other, ask some more questions, watch the horse some more, discussed with each other some more and told me the horse's life story and on and on. Finally I said that a decision had to be made, the horse was suffering, and I had a cow waiting for me to help it calve. I told them I had to step outside and call the cow owner to tell him to bring the cow in and in the meantime they needed to make a decision. When I finally got back in from the wind they had decided to euthanize the horse. Sad ending to story number one.
I headed back into the clinic and the cow and owner met me there shortly after I arrived. When I told him to bring the cow into the chute I found that things weren't quite as the owner had said. The cow was sick. Really sick. She was down in the trailer and didn't want to get up. When the owner said that wasn't a good sign I had to agree. He said maybe I should just take her home and shoot her and again I had to agree that his option was probably the best as she probably would not make it through the stress of pulling the calf. Unfortunately, after a few seconds thought he decided that he was stubborn and he wanted to try. Great.
After 20 minutes of heaving and pushing and cursing the owner finally got the cow into the chute. Believe me, if it had been anyone else they would have given up long before but this owner was a really big man and he got her in by shear weight and will power. Now the cow was showing just how sick she was. Breathing hard, barely able to move, and eyes sunk in were all a good indication that the toxins from the dead calf had spread to the rest of her body and she wasn't far from following her calf.
After reaching in I found that her cervix was only about half dilated and the calf was a true breach; backwards with the legs forward, not to mention bloated and full of gas. The smell was almost over-powering. I had a frank discussion with the owner of how bad things were looking. But once again, after some time for consideration he repeated that he was probably too stubborn but wanted to try to get the calf out. To the cow's credit she did much better than I thought she would, and I was more successful than I thought I would be. I was able to get the cervix to relax some and also was able to get both feet back. We started to pull the calf but made very slow progress as all natural lubrication was long gone and I spent most of my time working synthetic lubricant into the uterus and around the calf. As is always the case with these type of deliveries things went excruciatingly slow.
After what seemed like an eternity we finally had the hips clearing the pelvis and I thought for a second that we might win. Mind you it was a very short thought because right at the moment is when the cow decided that she had had enough. She started to go down on the front and and I scrambled and got her back up. Then she went down on the back end and wouldn't try to rise. I released the sides to try and roll her onto her side as she started to go down on the front as well. I could tell that she was going and grabbed a stimulant to give as an IV but it was a wasted effort. All told it had been about 90 seconds since she started to go down and within a minute she was dead. Super great.
Now I had a 1400 pound cow dead in my chute, with a dead calf halfway out, and no tractor to pull it out. Fortunately the owner had some long chains so he unhooked his trailer and backed up as close as he could. He pulled with the truck while I used a bar to pry her feet up through each of the obstacles along the chute and finally we had her out. Luckily he had a bale lifter on his flatbed and he loaded her directly onto there.
Forty five minutes later the clinic was clean. Forty five minutes after that I was getting out of a very long shower. No matter how many times you shampoo and soap, the smell of the dead rotten calf just does not go away. Right around five am I was climbing back into bed. All I could think was I had been up all night and all I had to show for it was sore and aching muscles from working so hard to deliver the calf, a stench that wouldn't leave, and three for three dead patients. I should have just stayed in bed.
In the meantime I phoned cow owner back and tried to determine just how much of an emergency he had. He assured me that the calf was already dead and he was in no rush. I soon understood why. He said he had noticed that she had started calving yesterday morning...yes a day and a half before. But then later on in the day she kind of quite and then started into it again today and so he decided to check on her. As much as I would have liked to berate him for lack of timely care I listened until he was done. I asked him how the cow was doing now and if she was acting sick at all. He said she was doing great and was showing no signs of being sick. I layed out the options for him for the middle of the night. First, we could have him bring her in after I was done with the colicky horse which would probably be in a couple of hours. Second, since he said she was doing great we could actually get some sleep tonight and bring her in first thing in the morning as it would really only be a few hours difference and the calf was already dead. We also talked about the poor chances that a cow had with a calf that had been dead inside for a couple of days. To make my middle of the night he decided that he wanted it down as soon as I was done with the colicky horse. Great.
As was expected the horse trailer was well drifted in and so I had to go out. When I arrived I found a bad situation. The horse was down and thrashing in a cramped box stall. One side was a fence instead of a wall and the gelding was showing how adept he was at sticking his legs through the fence and then trying to roll with his legs stuck in the wall. Great. The owner's adult son was sitting on the horse's head in an attempt to minimize the thrashing from side to side. A quick vitals check showed that his heart rate was elevated over 100 beats per minute (normal fit horses are usually 20-30) and breathing rate was at about 60 breaths per minute (normal being less than 20). His intestines were not moving anywhere on his right side. His color was poor and he was obviously in extreme pain. He attempted to thrash multiple times in the first couple of minutes so I quickly gave him an IV of a heavy sedative. After he was sedated I finished my exam and things weren't looking good.
After about ten minutes the horse began thrashing around again. This was a really bad sign as the dose should have lasted him for closer to an hour. I discussed with the owners the need to make a decision on further treatment or euthanasia. Unfortunately, though I can strongly encourage people to make a decision quickly, especially with the drugs already wearing off, I cannot make decisions for people. Over the next half an hour we sat and watched the horse becoming worse while they continued to ask questions, watch the horse, discuss with each other, ask some more questions, watch the horse some more, discussed with each other some more and told me the horse's life story and on and on. Finally I said that a decision had to be made, the horse was suffering, and I had a cow waiting for me to help it calve. I told them I had to step outside and call the cow owner to tell him to bring the cow in and in the meantime they needed to make a decision. When I finally got back in from the wind they had decided to euthanize the horse. Sad ending to story number one.
I headed back into the clinic and the cow and owner met me there shortly after I arrived. When I told him to bring the cow into the chute I found that things weren't quite as the owner had said. The cow was sick. Really sick. She was down in the trailer and didn't want to get up. When the owner said that wasn't a good sign I had to agree. He said maybe I should just take her home and shoot her and again I had to agree that his option was probably the best as she probably would not make it through the stress of pulling the calf. Unfortunately, after a few seconds thought he decided that he was stubborn and he wanted to try. Great.
After 20 minutes of heaving and pushing and cursing the owner finally got the cow into the chute. Believe me, if it had been anyone else they would have given up long before but this owner was a really big man and he got her in by shear weight and will power. Now the cow was showing just how sick she was. Breathing hard, barely able to move, and eyes sunk in were all a good indication that the toxins from the dead calf had spread to the rest of her body and she wasn't far from following her calf.
After reaching in I found that her cervix was only about half dilated and the calf was a true breach; backwards with the legs forward, not to mention bloated and full of gas. The smell was almost over-powering. I had a frank discussion with the owner of how bad things were looking. But once again, after some time for consideration he repeated that he was probably too stubborn but wanted to try to get the calf out. To the cow's credit she did much better than I thought she would, and I was more successful than I thought I would be. I was able to get the cervix to relax some and also was able to get both feet back. We started to pull the calf but made very slow progress as all natural lubrication was long gone and I spent most of my time working synthetic lubricant into the uterus and around the calf. As is always the case with these type of deliveries things went excruciatingly slow.
After what seemed like an eternity we finally had the hips clearing the pelvis and I thought for a second that we might win. Mind you it was a very short thought because right at the moment is when the cow decided that she had had enough. She started to go down on the front and and I scrambled and got her back up. Then she went down on the back end and wouldn't try to rise. I released the sides to try and roll her onto her side as she started to go down on the front as well. I could tell that she was going and grabbed a stimulant to give as an IV but it was a wasted effort. All told it had been about 90 seconds since she started to go down and within a minute she was dead. Super great.
Now I had a 1400 pound cow dead in my chute, with a dead calf halfway out, and no tractor to pull it out. Fortunately the owner had some long chains so he unhooked his trailer and backed up as close as he could. He pulled with the truck while I used a bar to pry her feet up through each of the obstacles along the chute and finally we had her out. Luckily he had a bale lifter on his flatbed and he loaded her directly onto there.
Forty five minutes later the clinic was clean. Forty five minutes after that I was getting out of a very long shower. No matter how many times you shampoo and soap, the smell of the dead rotten calf just does not go away. Right around five am I was climbing back into bed. All I could think was I had been up all night and all I had to show for it was sore and aching muscles from working so hard to deliver the calf, a stench that wouldn't leave, and three for three dead patients. I should have just stayed in bed.
Sunday, October 24, 2010
Say it was a cow
Anytime people find out I am a veterinarian they ask what type of animals I work on. I always answer that I work in a mixed animal clinic which includes large and small animals. I do, however, have a terrible fear of snakes and I always tell people that I don't work on exotics. Now, I really need to stop saying that as my list of interesting animals that I have done work on now includes elk, reindeer, camels, water buffalo, and the one this story is about.
A client of mine came in one day and asked if I had a dart gun. Of course I do and I said yes. Next he asked if I could hit something from about 200 yards away. Naturally my first question wondered what on earth we needed to tranquilize from 200 yards; and secondly, why? Well he quickly explained that he had a musk oxen that had gone through a fence. The going through the fence wasn't too disconcerting, the fact that she was still out and was dragging half of the fence around with her was the true problem. After much discussion on the solutions to his problem and the efficacy of the dart gun, particularly on the very windy day, we didn't have a good plan, but we went to see what we could do.
My assistant and I were excited to see if we were going to become musk ox hunters. After arriving at the ranch we quickly surmised that the first thing to try would be to herd the little musk ox back into the enclosure with the rest of the herd. Much to our delighted surprise she ran back in without any trouble and we were congratulating ourselves with our good luck. Little did we know that the fun had just begun. She quickly rejoined the herd and we thought it would be a simple matter of chasing the group into the holding pen where there was a working alley, tub, and chute, designed for handling buffalo. The owner failed to mention that one section of fence was torn down and the musk ox quickly disappeared through the fence and over the hill. Having never herded musk ox before I was ready for an adventure. I was excited until the owner told me that they usually move well, although sometimes they circle up and if they get really worked up they may start chasing you. So here there I was running over the rolling hilltops "chasing" a herd of miniature cattle look-alikes that have massive horns and could decide to put them to good use and I have nowhere to hide. Fortunately we were able to haze them into the smaller pen without too much worry.
Next in my musk oxen handling course was sorting 101. Unlike cattle or horses that you put in a pen and walk through to sort out the one you want, musk ox sorting is a little more involved. Mostly I stood and watched as my client would first start getting the group to move back and forth along the far end of a very large pen until they were kind of spread out. At this point he would charge directly at the herd and one of two things would happen: either the group would whirl into a protective circle with all horns facing out, or some members of the group would scatter sprinting away. If the latter happened you had to sprint away from the gate that they needed to leave, or sprint toward the gate to stop them if the "wired" cow was in the group. After several minutes of sprinting, whirling, sweating, breathing hard, nearly falling down once, and getting scared twice, the group was finally whittled down to leave the lone cow in question.
She ran into the alley and tub quickly but then there she sat and would not move another inch to go forward into the chute where we could actually catch her to do any kind of work. Now first I must explain that musk-oxen have similarities to cows but the also are similar to sheep and goats. They are much smaller than cows, this one weighed probably 400 pounds, and far more athletic. Instead of moving forward she simply sat crouched against the gate, painting her horns green by continually bashing her head against the chute and gate. The owner was reluctant to climb in behind her because he said he has seen them rear up on both hind feet and do a complete about face and smash the gate that was behind them. With the help of a sheet of ply wood we finally got her forward into the chute and began the work that we had originally come to do.
I should probably mention that at some point during all of this we brought my pickup with all the supplies into the enclosure for easy access. Some might say I am lazy but I didn't want to walk the 200 yards and climb through three fences each time I wanted to get something from the truck. Now back to the story.
Once the musk ox cow was in the chute she was amazingly quiet. The wire was wrapped around her head and neck and wrapped tightly around a couple of her legs as well. Of particular concern was the back leg. The hair was rubbed off but, luckily the skin seemed unaffected and once we untangled all of the wire it looked like she was good to go.
In general, releasing an animal after the procedure is usually the quickest and easiest part. Not true with her. With the side gate completely open she refused to move. My assistant and I were on the far side behind the chute by the truck and the owner was behind the side gate he had just opened. Finally she walked out of the chute and seemed to be ready to leave until she paused. She stopped, turned around, and charged straight back at the chute where the owner was waiting. He quickly climbed up the chute out of harms way. As she finished bashing up the side of the chute the owner and my assistant smiled and observed out loud to each other that my truck was red. Not thirty seconds later, as she trotted to the front of the chute, she saw my assistant and came charging around the chute after him...or so I thought. I scrambled to jump into the back of my pickup just as it began to rock! Instead of chasing my assistant she had come around the chute and charged straight into the side of my truck!
Having done her intended to damage my pickup she turned and went back around the chute where she began attempting to get at the owner and my assistant who sat perched eight feet off the ground on the top of the chute. After 10 minutes of her repeatedly charging the front and side of the chute and even trying to jump into the air to try and get at my assistant she finally gave up and ran away without even a look back.
After apologizing no less than fifty times the owner had one piece of advice for me. He said, "When you tell your insurance company, just say it was a cow"
A client of mine came in one day and asked if I had a dart gun. Of course I do and I said yes. Next he asked if I could hit something from about 200 yards away. Naturally my first question wondered what on earth we needed to tranquilize from 200 yards; and secondly, why? Well he quickly explained that he had a musk oxen that had gone through a fence. The going through the fence wasn't too disconcerting, the fact that she was still out and was dragging half of the fence around with her was the true problem. After much discussion on the solutions to his problem and the efficacy of the dart gun, particularly on the very windy day, we didn't have a good plan, but we went to see what we could do.
My assistant and I were excited to see if we were going to become musk ox hunters. After arriving at the ranch we quickly surmised that the first thing to try would be to herd the little musk ox back into the enclosure with the rest of the herd. Much to our delighted surprise she ran back in without any trouble and we were congratulating ourselves with our good luck. Little did we know that the fun had just begun. She quickly rejoined the herd and we thought it would be a simple matter of chasing the group into the holding pen where there was a working alley, tub, and chute, designed for handling buffalo. The owner failed to mention that one section of fence was torn down and the musk ox quickly disappeared through the fence and over the hill. Having never herded musk ox before I was ready for an adventure. I was excited until the owner told me that they usually move well, although sometimes they circle up and if they get really worked up they may start chasing you. So here there I was running over the rolling hilltops "chasing" a herd of miniature cattle look-alikes that have massive horns and could decide to put them to good use and I have nowhere to hide. Fortunately we were able to haze them into the smaller pen without too much worry.
Next in my musk oxen handling course was sorting 101. Unlike cattle or horses that you put in a pen and walk through to sort out the one you want, musk ox sorting is a little more involved. Mostly I stood and watched as my client would first start getting the group to move back and forth along the far end of a very large pen until they were kind of spread out. At this point he would charge directly at the herd and one of two things would happen: either the group would whirl into a protective circle with all horns facing out, or some members of the group would scatter sprinting away. If the latter happened you had to sprint away from the gate that they needed to leave, or sprint toward the gate to stop them if the "wired" cow was in the group. After several minutes of sprinting, whirling, sweating, breathing hard, nearly falling down once, and getting scared twice, the group was finally whittled down to leave the lone cow in question.
She ran into the alley and tub quickly but then there she sat and would not move another inch to go forward into the chute where we could actually catch her to do any kind of work. Now first I must explain that musk-oxen have similarities to cows but the also are similar to sheep and goats. They are much smaller than cows, this one weighed probably 400 pounds, and far more athletic. Instead of moving forward she simply sat crouched against the gate, painting her horns green by continually bashing her head against the chute and gate. The owner was reluctant to climb in behind her because he said he has seen them rear up on both hind feet and do a complete about face and smash the gate that was behind them. With the help of a sheet of ply wood we finally got her forward into the chute and began the work that we had originally come to do.
I should probably mention that at some point during all of this we brought my pickup with all the supplies into the enclosure for easy access. Some might say I am lazy but I didn't want to walk the 200 yards and climb through three fences each time I wanted to get something from the truck. Now back to the story.
Once the musk ox cow was in the chute she was amazingly quiet. The wire was wrapped around her head and neck and wrapped tightly around a couple of her legs as well. Of particular concern was the back leg. The hair was rubbed off but, luckily the skin seemed unaffected and once we untangled all of the wire it looked like she was good to go.
In general, releasing an animal after the procedure is usually the quickest and easiest part. Not true with her. With the side gate completely open she refused to move. My assistant and I were on the far side behind the chute by the truck and the owner was behind the side gate he had just opened. Finally she walked out of the chute and seemed to be ready to leave until she paused. She stopped, turned around, and charged straight back at the chute where the owner was waiting. He quickly climbed up the chute out of harms way. As she finished bashing up the side of the chute the owner and my assistant smiled and observed out loud to each other that my truck was red. Not thirty seconds later, as she trotted to the front of the chute, she saw my assistant and came charging around the chute after him...or so I thought. I scrambled to jump into the back of my pickup just as it began to rock! Instead of chasing my assistant she had come around the chute and charged straight into the side of my truck!
Having done her intended to damage my pickup she turned and went back around the chute where she began attempting to get at the owner and my assistant who sat perched eight feet off the ground on the top of the chute. After 10 minutes of her repeatedly charging the front and side of the chute and even trying to jump into the air to try and get at my assistant she finally gave up and ran away without even a look back.
After apologizing no less than fifty times the owner had one piece of advice for me. He said, "When you tell your insurance company, just say it was a cow"
Sunday, June 27, 2010
Close Call
Before I start, an apology for taking so long to update my blog. As I wrote last we made a pretty big move and now I am working in Canada. It has been quite a change in many ways, but now that I am a little more settled I will try to record some of my new interesting experiences.
Disclaimer: If you are in any way prone to a weak stomach this story is not for you... read at your own risk.
A few weeks ago I was told that a guy was bringing in a cat for a euthanasia in the afternoon. As a veterinarian this can be one of the more challenging aspects of our work. It is generally an emotional event where the range is somewhere in the surprised, upset, sad, really sad, heartbreaking, and then the occasional relief and feel better to be able to end prolonged suffering. This particular euthanasia was for me a brand new emotional experience...and it was not good.
The owners arrived with the cat laying prostrate on a blanket and I surmised immediately that this was a particularly bad situation. The cat was so emaciated that it appeared to be a skeleton covered with hair. The face of the cat looked something like this. The nose was completely crusted over with some type of bodily fluid. Both eyes were stuck shut and the left eye was draining what could only be described as a small river of pus. As a result of the dried nasal discharge/dried pus from the eyes the the cat was gasping for each breath.
The back half of the cat was a different color from the front as it was completely covered with dried, caked on feces. The cat was so weak it could hardly lift its head with each gasp so I immediately took the cat from the owner and went in the back to put the poor thing out of its extreme suffering.
Normally we sedate the cat first before attempting to do an intravenous injection of euthanasia solution, but this cat was so weak and so dehydrated that we decided to just go directly for the intra-cardiac injection. I grabbed one of the other doctors and asked for his assistance to inject while I held the cat. For a normal restraint to perform the injection you hold the scruff of the neck in one hand (just like a mama cat would) and with the other hand you hold the back legs of the cat so that it can't reach up to dig its claws in.
When I closed my grip on the neck I felt my fingers sink right through the skin! I jumped back and sat down against the wall because I was so grossed out. The other vet thought that the cat had bit me. I said "No, look at the neck" He finished the injection to complete the euthanasia as the cat was too weak to even respond then reached up to investigate the neck. Once again he thought wrong as he had assumed I had pulled out a big chunk of hair. He started to pull on the hair and pulled off a piece of skin about three inches long! That was the closest I have come to vomiting for a veterinary related reason.
Needless to say as soon as I had calmed down for a minute I went and had an interview with the two owners to ascertain that there were no other animals in their appalling "care". The most disgusting thing was that their excuse for not taking care of the animal...including bringing it in for euthanasia earlier was a lack of money. Normally I am very respectful and sensitive to financial constraints on treatment of veterinary patients but this disgusting neglect could have been prevented for the cost of lunch for two at most restaurants.
Disclaimer: If you are in any way prone to a weak stomach this story is not for you... read at your own risk.
A few weeks ago I was told that a guy was bringing in a cat for a euthanasia in the afternoon. As a veterinarian this can be one of the more challenging aspects of our work. It is generally an emotional event where the range is somewhere in the surprised, upset, sad, really sad, heartbreaking, and then the occasional relief and feel better to be able to end prolonged suffering. This particular euthanasia was for me a brand new emotional experience...and it was not good.
The owners arrived with the cat laying prostrate on a blanket and I surmised immediately that this was a particularly bad situation. The cat was so emaciated that it appeared to be a skeleton covered with hair. The face of the cat looked something like this. The nose was completely crusted over with some type of bodily fluid. Both eyes were stuck shut and the left eye was draining what could only be described as a small river of pus. As a result of the dried nasal discharge/dried pus from the eyes the the cat was gasping for each breath.
The back half of the cat was a different color from the front as it was completely covered with dried, caked on feces. The cat was so weak it could hardly lift its head with each gasp so I immediately took the cat from the owner and went in the back to put the poor thing out of its extreme suffering.
Normally we sedate the cat first before attempting to do an intravenous injection of euthanasia solution, but this cat was so weak and so dehydrated that we decided to just go directly for the intra-cardiac injection. I grabbed one of the other doctors and asked for his assistance to inject while I held the cat. For a normal restraint to perform the injection you hold the scruff of the neck in one hand (just like a mama cat would) and with the other hand you hold the back legs of the cat so that it can't reach up to dig its claws in.
When I closed my grip on the neck I felt my fingers sink right through the skin! I jumped back and sat down against the wall because I was so grossed out. The other vet thought that the cat had bit me. I said "No, look at the neck" He finished the injection to complete the euthanasia as the cat was too weak to even respond then reached up to investigate the neck. Once again he thought wrong as he had assumed I had pulled out a big chunk of hair. He started to pull on the hair and pulled off a piece of skin about three inches long! That was the closest I have come to vomiting for a veterinary related reason.
Needless to say as soon as I had calmed down for a minute I went and had an interview with the two owners to ascertain that there were no other animals in their appalling "care". The most disgusting thing was that their excuse for not taking care of the animal...including bringing it in for euthanasia earlier was a lack of money. Normally I am very respectful and sensitive to financial constraints on treatment of veterinary patients but this disgusting neglect could have been prevented for the cost of lunch for two at most restaurants.
Friday, December 25, 2009
Moving on
I don't remember the exact saying but the gist of it is that one thing in life stays the same; everything changes. For myself and my family that is true as well. There are some big changes coming in my professional life. I am going back to where I grew up and going into practice ownership. This means that I will be leaving behind the North Dakota that I have come to love.
It is going to be a bittersweet change for us. In many ways it will be exciting to move back near family and old friends. At the same time it will be sad to leave behind the many wonderful people that have been clients, friends, and even our family away from home. We will cherish the memories made here.
I am sure I will continue to have many exciting, interesting, sad, and funny experiences in my new practice and, of course, I will continue to write them down from time to time.
For any of the North Dakota friends we have made, you are welcome any time you want to come to Canada to visit.
You will be missed.
It is going to be a bittersweet change for us. In many ways it will be exciting to move back near family and old friends. At the same time it will be sad to leave behind the many wonderful people that have been clients, friends, and even our family away from home. We will cherish the memories made here.
I am sure I will continue to have many exciting, interesting, sad, and funny experiences in my new practice and, of course, I will continue to write them down from time to time.
For any of the North Dakota friends we have made, you are welcome any time you want to come to Canada to visit.
You will be missed.
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