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"?

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.

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.

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.

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"

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.

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.

Studs

Of all horses that I deal with I would have to say that stallions come with the most baggage. I think this stems from many things. First of all they are ruled by testosterone; probably more so than any male of another species that I deal with on a regular basis. Rearing, striking, kicking, biting, fighting, aggressiveness, and all kind of unpredictable behavior around other horses, as well as people would be all in a days work for the average stallion. Also, they are amazing athletes. Power and agility combine in a body that can weigh well over a thousand pounds performing the previously mentioned antics. Add to that the financial aspect of them generally being the most valuable animal in the herd and every interaction with a stallion becomes exciting. I have two stallion stories that occurred during approximately parallel time periods with similar conditions.
The first stallion came to me with this written on the book "old cut on leg". We will call this stallion Bob since that is a very masculine name. Bob was not your typical stallion in that he was not led off the trailer on a halter. He was let out of the trailer and then put into the cattle handling facilities for his tranquilizers. Then he was released to lay down and take a nap so that I could examine the wound. Bob was a very successful rodeo horse...not the kind that the cowboys ride, but the kind that they get bucked off. Bob had gotten in a fight with another stallion about 10 days prior. The problem was that there was a fence in between them and he got his leg stuck through the rails of the fence and was torn up pretty bad.
Once he was sleeping peacefully my first thought was, "This doesn't look good". But, as has happened more than once in my career as a veterinarian I was wrong. My second thought was, "This looks awful". After exploring the wound more closely my third thought was "This horse is going to be euthanized". The reason for such a bright outlook was the fact that the wounds went down to the bone and the pastern joint was sub-luxated (2/3 of the way dislocated) and open to the clean fresh air. The clean fresh air was a joke. The wound was very dirty and infected and any infection in joints in horses is very, very bad. Time is your worst enemy and this horse was 10 days past a good chance. That is how I met Bob.

Fred will be the made up name of stallion number two. Opposite of Bob he was a very well trained and well mannered stallion, highly valued by his owners to produce similar well mannered foals, carrying his good bloodlines and performance ability. Unknown to us was the initiating cause for his run in with the fence. Unfortunately for him he picked a windbreak fence made of corrugated tin to kick his back leg through. Sharp metal edges and a horse's leg doesn't require much imagination. He had three large lacerations over the fetlock joint, cannon bone, and the hock. If you thought he got lucky and the cut were superficial not involving any of the joints...you thought wrong. Both the fetlock and hock were open and draining joint fluid. If you didn't get the memo before, joint infections in horses are bad to the point of being career and sometimes life ending.

Both owners decided to treat the stallions as best as they could. After consultation with surgical specialists for Bob the recommendation was made to see if we could get the infection to clear up, then reevaluate to see if surgery was even an option. The plan for Fred was to try and keep an infection from starting to see if we could save the function of the limb enough for breeding purposes.

After several weeks of antibiotics both stallions were checked again and you will never guess...they both looked awful. Not hardly improved. Radiographs of Bob showed severe arthritis and the limb was still huge and infected. Fred had one ray of hope in that the bacteria that had infected his joints were for a lack of a better term "wimpy" and susceptible to almost all antibiotics. Unfortunately he was still severely lame, barely touching his toe on the ground and both joints still draining fluid.

Let pass another couple of months on antibiotics and finally some progress was made. Both stallions were improving. Starting to use the leg some and wounds actually looking like they were healing. Go another two months down the road and both owners report marked improvements although Bob's leg is still quite swollen and Fred is just starting to really put weight on the leg.

Neither owner held out great hopes for breeding season but turned the stallions out with a pasture of mares and waited on luck or fate or whatever you believe in.

At the end of the summer, Bob's owner reported that the leg is still swollen (arthritis caused the joint to be about three times the size as normal) and slightly lame but that he bred the few mares that he was with just fine.

Fred's owner was much more concerned. Checking him all throughout the summer he said that he was moving around the pasture just fine, but that he never saw him breed a single mare. Fred's owner had me come out at the end of the season to ultrasound all of the mares including the nine that were Fred's responsibility. All I can say is that someone must be living right because every single mare was pregnant and Fred looked great.

These two horses illustrate one of the main reasons why I like fixing animals and hate trying to fix my car. Animals, regardless of what we try and do to them and for them can sometimes do amazing things to fix themselves. My car does not ever fix itself.

Sometimes people make me wonder

Today was a funny people day. As a veterinarian I hear this a lot, "Oh it must be nice working with animals, and not have to worry about working with people." I think they forget that the animals don't drive themselves to the clinic. There is usually some form of human attached to each animal that comes in. So here are my two funny people things today.

First, people need to learn to count. I went out to a farm to pregnancy check 200 cows according to the schedule in the book. I know that this was written down correctly because I was the one who made the appointment and I remember particularly the farmer saying about 200 head. Well, as we were working I came to the conclusion that I was either a particular wimp today or just really tired, or really slow, or a combination of all three because my arm and shoulder sure felt like they had done over 200 head and it was definitely past lunch time. When we were finished with the cows one son said,
"Do you want to do the bred heifers or the prolapse next?"
I was thinking to myself 'Bred heifers? You mean we haven't even done 200 yet? I really am a wimp.'
Well we did get done, eventually, and as I was leaving I asked the farmer what the head count was.
He replied, "350 head." !!!

Second funny people story. This was not my case but I was at the clinic and got asked for a second opinion. A llama came in for an ultrasound to see if she was pregnant. The doctor came to get my opinion on the case. As we were walking back to the chute he filled me in on the story. The owner had purchased the llama recently at a sale barn. He was told it was a female and just wanted to know if it was pregnant or not. The doctor wanted to know if I also thought it was a male. A very quick exam of anatomy revealed that I was in agreement with the other doctor and he was trying to ultrasound a neutered male llama. My first thought was, "Don't the people at the sale barn look to see if it is a male or female?" Then come to find out this llama was brought into the ring by the owner with "her" baby at her side. Either the owner was really clueless or really shady. With people you just never know.

Top Ten

If it is not number one then this day has to be close. Number one worst day ever, that is. It started out with food poisoning trips to the bathroom from 2 am to 7 am, but I won't go into details. After laying on the couch for a couple of hours without further problem I decided to go into work. Since no one else at work wanted to be locked in the same room with me I was sent out to "look" at some lame cows. After being told that they were all in the corral I wondered aloud why they were not bringing them in. "Because it isn't convenient for them and they won't do anything that is inconvenient for them." Great. Just to understand my displeasure a little I will describe the options.

Option One:
Bring the cows in and look at them at the clinic. We have a hydraulic chute that we can tip each cow up on her side with straps that go around each foot so that they are unable to kick and we have easy, clear access to all four feet to perform whatever type of foot work the cow is in need of. I think it is a wonderful invention that is safe, easy, and allows for the optimal result from a medical standpoint.

Option Two:
We regularly look at lame cows on the farm when they are out on pasture (often many miles from the home place) and the owner is unable to get them in to bring them down to the clinic to work in the wonderful hydraulic chute. In the case of the pasture cows we tranquilize them with the dart gun and work on their feet while they are heavily sedated and laying down. Although not as good as the clinic, this is still a generally effective diagnostic and treatment system.

Option Three:
Look at the cow on the farm in their working facilities. In other words, standing in whatever kind of chute they have, tying up the leg in question and trying to get a decent look with the cow kicking and fighting the whole time.

Yes, I was going into option three with a group of five lame cows. The first cow was brought into the chute and the hired man put a rope around her hind leg and tied it up to the side of the chute lifted about 18 inches off the ground. After repeated kicking convinced her that her foot was there to stay she stood quietly and I began my exam. Reaching down I began to move the toes to have a better look and suddenly a sharp blow sent me reeling. I rolled backwards out of the chute area, laying on the ground with my hands over my face trying not to black out.
"Do you need an ambulance? Do you need an ambulance? Go call the ambulance. Are you knocked out? Are you okay? Wow, you are really bleeding. Do you need an ambulance?"

"No, don't call an ambulance yet. Let me just lay here for a minute."

With my brain in slow motion I figured out what had happened. The cow had kicked me in the head (I still don't know how she was able to get enough slack in the rope and reach high enough) my head had bounced off the back end of the chute palp cage and then I rolled back out of the way. I had a small gash in the bottom of my eyebrow about a quarter inch from the side of my eye that had half of my face covered in blood and a large goose egg on the opposite side of my head where I had bounced off the chute. My brain did not take long to ask itself, "Why did I ever come into work today?"

Some warm water, surgical soap, bandages, and several Ibuprofen later I was ready to take charge of the situation. Each cow came into the chute for her IV injection of Xylazine and then she was released into the pen to let the tranquilizer take effect. I wasn't about to get kicked in the head again and I wasn't concerned about the added expense to the farmer for sedation of all the animals. Not surprisingly I didn't hear one word of complaint out of the farmer either. Two hours later, after lots of sweating and unpleasant words being thrown in the general direction of the two more stubborn cows, our project was complete.

The best words I heard as I was getting ready to leave the farm were, "Next time we will bring them down to the clinic."

Not always Rabies

Living in North Dakota brings with it some unique experiences. One thing very common here that I haven't had to deal with anywhere else is Rabies. It is a big problem and we have several cases a year. I know you are all having flashbacks to Old Yeller right now. We actually see cases very commonly in cattle as well as dogs, cats, horses and really most of the species we deal with. We rarely see a foaming at the mouth animal that is trying to bite someone. Generally ours are just acting funny or walk funny or can't stand up. Rabies is endemic in both skunks and raccoons in the state so we have a doubly great chance of contracting rabies.

Since it is so common we have many clients that have animals acting unusual and almost always the first question out of their mouth is, "Could it be Rabies?". Not surprisingly our very diplomatic answer is generally, "It could...and there are some other things we should think about". A case this week was one of these.

A cow presented with history of drooling with her tongue hanging out and acting a little funny. As she walked off the trailer I was pretty sure that it wasn't rabies. The tongue was hanging out and she was drooling but she also had a big lump on the side of her cheek and was very thin. My immediate thought was that this cow had broken her jaw. Another doctor was right there with me and began examining her mouth and immediately piped up with, "well you guessed wrong". One quick look in her mouth showed that a broken bone was the problem, but it wasn't hers...she had half of the pelvis of a calf jammed sideways in her mouth and was completely unable to close her jaw or move her tongue. Of course we took it out, gave her antibiotics and an anti-inflammatory and sent her on her way.

Just goes to show you that your first guess, and all too often your second guess isn't always right. That and not every cow that "foams at the mouth" has rabies.

I wish not

Most of the time I love my job as a mixed animal veterinarian. There are very few times that I look at what is going to be coming in and have an unpleasant intrinsic reaction. One thing that can really make me want to run and hide or pretend that I am doing something really important so that another doctor will have to take that appointment is as simple as three little letters: DRC. Now anyone involved with the medical world knows that there are acronyms for all kind of medical things. In fact I read a medical record that went something like this.

Patient BAR, MM pink, moist CRT< 2 sec, EEN clean clear, H/L/T aus WNL. Abdominal/LN palp WNL. HR 110 BPM, Resp 28 BPM, Temp 100.6 F, EDUD WNL

I think you get the picture

Anyway back to the DRC. If any of you get squeamish you might want to stop now. DRC means Dead Rotten Calving.

These are particularly popular this time of year because most of the cattle are out on the pasture and not checked as often as usual. Some of these cows may have been calving for a couple of days before they are found. Combine that with hot summer weather and you have the perfect recipe for a rotten calving experience.

On this particular day I decided to take one for the team and tackle the DRC. Sometimes they really aren't that bad, but the fact that I could smell the cow while she was still outside did not bode well. The apologetic owner (as they almost always are with this kind of thing; one even brought me doughnuts as a peace offering) said that he didn't know how long she had been calving. She was out in a pasture that doesn't get checked often and they even thought that she was open (not pregnant) and that was why she was in that pasture.

I was delighted to smell two legs that appeared to be front legs hanging out the back out of my patient. The fact that 1/2 of the hair had already sloughed off the legs was a pretty fair sign that she had been at it for more than a couple of hours. Once I started manipulating and pulling on the feet the half rotten skin tore open on one leg revealing the bones beneath. Fortunately I already had my gag reflex under control and I was in for the long haul. As the long bone was only succeeding in tearing my plastic sleeves we decided to pull it off. I know that sounds gruesome but guess what - Junior died three days ago and he can't feel that we just pulled off his femur.

Yes, I did say femur. The legs only looked like front legs because they had decomposed sufficiently to allow all the bones in the joints to separate and bend any way that they wanted.
Without further ado, a lot of lube, some careful manipulation, and about 40 minutes we were able to remove the remainder of the partially decomposed calf.

Now many of you would say, "serves you right for being a large animal vet!" And to be honest, when confronted with such cases I have had similar thoughts. Why didn't I go into small animal where everything is easy?

Well wouldn't you know the next day I had another experience. The schedule book said dog whelping. Hey that sounds like fun.

First, I will say as a veterinarian I try not to judge people and how they are with their animals. While I will not jump on the band wagon that many veterinarians do about the evils of breeding dogs when there are so many in shelters etc etc (you can feel that way if you want to) I do occasionally run into a person that I say should absolutely not be breeding dogs. This was just such a case. Because of that there will be no reference whatsoever to owner age, gender, identity or breed. I will simply say that she was a larger breed dog.

The conversation went something like this.
Owner comes in and says, "I am not sure what is wrong with her, I think she might be having a problem.
She had one puppy without any trouble but now I don't know what is going on.

My turn,

"How long ago did she have the first puppy"

Owner

"Well, I guess it was the night before last so about a day and a half ago"

Me

stunned silence.
Thoughts whirling though my head: you have got to be kidding me, your dog had a puppy almost two days ago and she has a large piece of placenta hanging out the back of her vulva and you think there MIGHT be a problem?
Don't say anything rude, even though you are thinking it right now.

On vaginal exam of the dog I could feel just the tips of two feet. Unfortunately, I was unable to get a good enough hold and the feet weren't out quite far enough so we gave her some oxytocin and some time to get her back into labor.

Half an our later I was able to get a good hold on two back feet and wouldn't you know - the hair just sloughed right off in my hands. The dead puppy was backwards and dry and was not wanting to come out. Thankfully with a lot of lube and manipulation and way longer than I have ever had to work on another puppy the very dead, nasty puppy came out. Yes, small animal vets do get their occasional nastiness too.

Radiographs showed no more puppies, which sparked two very choice remarks from owner;

"Dang it there are no more puppies?!?"

"When we breed her again will she have any problems?"


I wish not to have these experiences again...both the nasty part and the choice owner...but I am young and will probably have even better!

Guts?

Before starting practice I thought I had a pretty good idea of the types of things I would be seeing and the calls that I would get from clients. Of course I was wrong in that assumption and now it is to the point that when someone calls and tells me something, I believe almost anything they say is possible. Earlier this spring I got back from a day in the country to find an interesting case waiting for me. The owner said that he had a newborn calf that the guts had come out of the navel when it was born. I have seen this occasionally and asked how long it had been out and how clean they were. He said, "Oh, the guts aren't actually out there is a big ball of skin around them". Of course now I was curious and thinking that we had just a regular hernia. As always you don't know until you look so out we went to peek in the back of his pickup to see what we had.

Mildly confused is how I started out as he was right there was a sack full of something hanging out of the calf's navel. It was a thin sack with no hair on it that looked mostly just like connective tissue and the contents were about the size a women's basketball. Once I started to feel it my confusion moved up to a moderate level. Part of the contents were very soft and squishy, and part was very firm; almost like muscle. The hole in the navel was very small and I was unable to return any of the contents back into the abdomen. Because the sack was not clear I couldn't see the contents and decided to cut it open for a better look. At this point I was expecting that the "squishy" part was normal small intestine and the "firm" part was small intestine the was twisted or strangulated and was very full and tight. Not to my surprise; I was wrong. To my surprise; when I cut the sack open, I found some small intestine and a large section of liver. No one has to go to years and years of school to know that no part of the liver should be hanging in a sack outside of the belly. You also don't have to go to school to know that a volleyball sized piece of liver did not go through a hole as big as two of my fingers. That the leaves the option that the liver (or at least a section of it) was actually formed on the outside of the body.

Now that we had established what we were dealing with the discussion went something like this:

So the liver is outside of the body?

Yes.

Can you put it back in?

Yes

Does it have a chance?

(This is where my philosophy is that honesty is the best policy)

I have absolutely no idea.
Since we know that this part of the liver was formed outside of the body I don't know anything about he connections to the blood supply, whether the liver will function properly, what other malformations there may be, or really anything to indicate whether this calf could live.

Wow, that's really interesting. So what would it cost to operate on it? Well, what the heck, I am curious to give it a try and see if it will live.

So we proceeded to do a liver-returning-into-abdomen surgery in the back of his pickup and sent him on his way.
That was two months ago.

The other night I was out to their farm to fix a broken leg on a calf and son number one says "Well your miracle calf is still alive, in fact you can't even pick it out from the rest of the calves unless you know which tag number it is!"

Now when people ask me is there a chance I think I will repeat what I heard somewhere:

"Where there is a heartbeat there is hope."

6th Grade

Calving season is finally slowing down. Although the entire season has potential for unusual and unexpected things, sometimes the end brings the biggest surprises. Yesterday and the week before I had similar experiences. I was told by one of our office personell that there was a heifer coming that was calving. Now for those of you who are not particularly farm animal terminology savvy a heifer is a young female of the bovine or cattle species. In general that name applies to all females up until they have their first calf. Naturally I assumed that my soon to arrive patient was the typical two year old heifer having her first calf.
When the heifer arrived I soon realized that something was not as previously assumed as the heifer was much smaller than would be expected. This was particularly evident as I had just been out to Bangs (Brucellosis) vaccinate the heifers of this farmer and knew that he fed is cattle very well. In fact she looked no bigger than any of the those just coming yearling heifers I had vaccinated a few months previously. I am sure by now that many of you have guessed that she actually was one of those heifers and was now just over 14 months.
The first heifer's calf was delivered by a C-section.

The heifer from yesterday was a small black angus heifer that probably didn't even weigh 800 lbs (mature weight can be anywhere from 1100-1800 lbs). The owner had looked at her ear tag and found that she was just over 13 months old. Of course I did the math in my head and realized that this heifer had to have been bred when she was a 4 1/2 month old calf at her mother's side and here she was 9 months later with her own bouncing bundle of calf. I guess this is what would be the animal kingdom equivalent of a 6th grade pregnancy.

Wallow

If I could choose to be an animal it would not be a pig.

It had already been a very busy weekend on call with more than enough challenging and patience-trying cases to go around. I was driving home and was one block from my house when the phone rang yet again; a heifer with a uterine prolapse, could I please come right away. I called my wife and reassured her with these foolish words, "He doesn't live very far away, so it hopefully won't take very long."

As I may have mentioned previously we have had an awful weather winter. Record snowfall combined with record flooding. Then to make this weekend extra nice we got rain, followed by snow, followed by pouring rain, then more snow, then a little more rain. I think wet and cold pretty much miserable sums it up.

When I arrived at the farm the farmer greeted me with, "She was going crazy in the chute so I tranquilized her, and now she laid down". Normally that would not be a problem but this chute happened to be a small old chute that neither side would open on and she was twisted and cramped sideways with her legs tucked far up underneath her. Normally I would try and get both legs out behind the cow and the uterus goes in much more easily but that was not an option. Hoping that maybe this time would be the exception and everything would go in easily I went right to work.

I got the uterus cleaned off nicely and starting stuffing things inside without too much ado. It was like the heifer had a threshold for a specific amount of uterus that she was willing to have inside of her. Once I got to that point and tried to push any more she would give a big abdominal thrust and push everything back out on top of me. Not one to give up easily it quickly turned into a push-o-war. Me pushing in and her pushing out. Now the part that I failed to mention was that this chute we were working in was outside in the middle of the corral. In order to get a good angle on this laying down, butt twisted sideways and downwards uterus, I got to play pig in an 6 inch deep puddle of muddy water and you-know-what-else-turns-water-brown. Fortunately I was wearing my waterproof bibs, OB top, and overshoes. Unfortunately, that was not enough and I still ended up stinking and soaking. I don't understand the thrill that pigs get from that. The worst part was that she was winning and the uterus was not going in.

Next we tried letting her out (with a halter on tied to the side of the chute). Of course she was too sedate and wouldn't move so the farmer got his loader tractor to pull her out of the chute to put her in a more workable position. Perhaps she could sense our intentions as the loader pulled up toward her head and she suddenly had enough energy to stand and walk out. Now I was able to get the uterus back into the heifer without too much trouble...just a little dancing back and forth through deep mud, trying not too get my shoulder dislocated.

Today I did not love being a cold, wet, dirty, and my wife would add stinky, country vet.

C-section on the side

Many times I have pondered how things would be different had I decided on human medicine rather than veterinary medicine. Often when working with farmers or pet owners they comment on how much smarter veterinarians are than human physicians because we have to be able to diagnose the problem without the luxury of verbal communication from the patient. Add to this the frustration when the statement "hold still, this will only hurt for a minute" has absolutely zero affect on my patients. I guess the closest comparison could be with pediatric doctors working on babies. At best this is a weak comparison as I don't know many babies that would like to kick you into next week or toss you over the fence for doing something painful to them.

Some of these uncooperative patient thoughts came to mind on a recent calving call that I went on. I arrived a the farm just as yet another blizzard was starting. An unimportant side note but this one dropped somewhere between 15- 20 inches of snow and brought the grand total less than two inches shy of the all time snow record for the area. Loving winter here for sure. Back to the story. The cow was a smaller cow expecting her second calf. When I arrived she had a very large set of feet sticking out the back end and the farmer had already tried to pull it. Some of our farmers are not very experienced in offering assistance but this was not one of those. I knew even before getting to the farm that this was most likely going to be a C-section. The set up was a very common calving pen for our area; a head catch next to a wall with a swing gate that fastened with a chain to the wall to hold the animal relatively still for calf deliveries. I noted as we were pushing the cow against the wall that some pressure had to be put on the gate to get it close enough to hook the chain. The top half of the gate could then be swung open to allow easy access to the left para-lumbar fossa (the area in front of the hip bone and behind the ribs where we make our incision for a C-section). I proceeded with my c-section; all appeared to be going well as farmer Jake and his adult son were both there and ready to help.
No sooner had I completed my incision into the abdominal cavity then the cow decided she was tired of standing and laid down. In the clinic this is no problem at all as we just open one side of the chute, position the cow on her right side and continue the surgery there. Instead we were dealing with the setup on the farm and were just starting to find what problems we were going to have. With her now laying down body wedged against the gate it was impossible for the three of us to apply enough pressure to be able to unlatch the chain. Complicate this with the open hole in the left side of the cow with her trying to rub her rumen and other intestines against the far-from sterile swing gate. Fortunately we were able to bend the latch and get enough pressure to release the cow. Unfortunately this freed her to immediately push against the wall with her feet and roll onto her left side. Suddenly the swing gate was very sterile in comparison to the barn floor covered in straw, dirt, urine, feces and anything else nice that you might find on a barn floor. While I futilely attempted to keep my hands covering the 15 inch incision, farmer Jake and son tried to push the cow up off her left side. A quick phone call brought reinforcements from the house in the form of the other adult son and our cow was able to be tipped up to be sitting upright.
After scrubbing up again as best I could I was ready to get this calf out and reached in to try and pull the calf over to the opening in the body wall. She had other ideas and decided that now was as good a time as any to try and push the calf out with all her might. With each new push came part of the rumen, often accompanied by intestines protruding out of the incision, each time only inches from touching the dirty floor before I could get them back in. As this was definitely not working we readjusted again and laid her over on her right side hoping for better success.
Stupid cow, as I had by this time named her in my mind, was trying her best to be as uncooperative a patient as possible. I am not sure why she had such a death wish, but it sure seemed like she was doing everything in her power to get herself started on a really good abdominal infection. Even on her right side she continued to push with all her might and would repeatedly pop out her rumen and intestines despite my best attempts to keep everything inside. First point against me: the cow was repeatedly pushing her guts out. Second: the calf was very large and in the down horn; as absolutely far from the incision as it possibly could be. Third: the rumen was very full and putting a great deal of pressure down on the calf. What had originally appeared to be just another night at the office was turning into anything but. After several unsuccessful attempts to move the calf anywhere near the incision with constant pushing from the cow my thoughts of human physicians being able to ask their patients to hold still reverberated in my mind. Farmer Jake must have been having similar thoughts as he asked if we could sedate the cow. After expressing my concerns about likelihood of losing the calf he still felt that was our best option to complete the surgery and I had to agree.
An IV injection of xylazine in the underside of the tail worked almost immediately and I was ready to pull out a calf. Unfortunately (this seems to be a recurring theme in this story), though we had solved point one against me, points two and three were still insurmountable and I had to do something I have never done previously and hope to never have to do again. Because I could feel the feet deep inside the cow, but was completely unable to move them, I needed to get some extra help. I took my scalpel, held tightly between my thumb and forefinger to cover the sharp edges, and reached deep inside the cow. The whole time in my mind I was praying/hoping/wishing that she didn't override her sedation and decide to push just at the wrong time. Thankfully, I was able to blindly cut the uterus over the point of the hoof, without cutting my fingers or her intestines in the process. With access to the hooves I was now able to put a chain around them and have my two helpers pull the calf up and out. It made me feel better that the two of them together still had to sweat and struggle to get the 130 lb calf out.
Now the race was on to see if we could revive the very sedate calf before it died. A slow IV of tolazine to reverse the sedation, combined with an injection of the respiratory stimulant dopram did wonders for the comatose looking calf. Fortunately, he quickly came around and was trying to stand up even before I was done sewing up the cow. Before too long the sedation began to wear off for the cow and she began pushing and kicking but with two guys sitting on her neck and shoulders and one more holding her back legs tied to a post we finished the job. She appeared no worse for wear and I was off again; into the blizzard to help some other cow that wouldn't stand, or lay, still when I told it to.

Anger management

Springtime in a mixed animal practice generally means one thing: calving season. Saturday was a usual busy calving day with a wide variety of calls from farmers with sick calves, calving problems, and uterine prolapses. I was momentarily at a loss for words when Farmer Fred called and said,
"I have a heifer calving and I just got her into the barn and she went Ape-@#$%.!"
"What do you think I should I do?"
After getting clear in my mind what he had just said I replied,
"Leave her alone for half hour to an hour and see if she will calm down."
I recommended this mostly due to the fact that many cows can get themselves worked up into a frenzy with too much stimulation especially during a stressful time like calving. I also recommended this because I knew I was going up to the area to do a uterine prolapse and I wanted to buy a little time to complete that task. The farmer made it clear that he would be calling back in about an hour if her mood wasn't much improved and would be wanting my assistance. I decided to throw in the dart gun just in case. Sedating a cow that is calving is a really last resort thing because the calf will also be sedated and that combined with the stress of delivery is often too much and we lose the calf. In real bad cases where the cow is also very stressed and down for a long time, you could potentially lose the cow as well

To no-one's surprise my phone had a couple of voice mail messages as I left the farmer with the prolapse, one of which was another plea for help from farmer Fred.

When I arrived on the scene it didn't take long to evaluate the situation and surmise that we were in for a bit of an adventure. Farmer Fred quickly warned me that we would have to dart her because she would try to kill anyone that got close to her. The heifer was in a large pole barn with one other cow and calf. The only door that wasn't frozen shut from excessive snow and ice we had received this winter was in the middle of the east side. There was a head catch with one length of panel next to it in the northeast corner, about 20 yards from the door. The remainder of the barn was wide open space without any other corrals or posts. Our patient was standing in the northwest corner facing the door and charged full speed towards us as we attempted to enter. At a distance of about 30 yards my pistol was not particularly accurate and I needed to get a better shot that wasn't head on. After a couple more futile attempts to enter slowly I began trying to calculate whether I could run fast enough to reach the safety of the panel and head catch before the angry cow could get to me. Even though I ran sprints in high school track I would have to put my money on the cow to win this match race.
With that decision made I began to look around the barn for other options and noticed the rafters and 2x4 braces running horizontally the length of the wall. Spaced like a giant ladder up the wall I realized they were the key to success. I handed my loaded dart gun to farmer Fred and quickly climbed the 2x4s up the wall to the rafters. Fred handed me the gun and I began the climb down the length of the barn halfway hanging from the rafters with my toes walking along on the 2x4 on the wall. Awkward would be an apt description of my movement along the wall hanging/climbing all the while carrying a loaded dart-gun pistol. The cow watched the entire time taking several threatening steps forward. As a result when I reached my destination and jumped down behind the panel she was a short easy shot away. Several minutes later she was down for the count and we sprang to action, hoping that we would be able to get the calf out fast enough to save its life.
Of course, that is not the end of the story. Because my truck was in the shop for some repair work I was borrowing the truck of another doctor and as a result all of his equipment. I got the cow tied up and held down with a rope with a quick release mechanism on it which we soon found out was broken. The cow made one thrashing motion and the quick release did its thing and she was up and we were running faster than you could say "angry cow on the loose".

For my next trick I got another rope; this one a simple lariat. First I tried to toss a loop over the panel onto the head of our angry, yet very sedated, patient. Several attempts of this were unsuccessful and I finally climbed the corral panel. Standing with one foot on either side, almost like you were standing up pigeon-toed in the stirrups on an emaciated horse, I swung my loop like a real cowboy and caught her first try. Surprised at my good luck but needing to hurry we finally got her to go down and we were able to pull the calf without too much effort.

The newly delivered calf was alive but very sedated. I quickly grabbed my reversal and gave it slowly in the vein. I must say that having to give a drug slowly is irritating when you are trying to save a life. I love happy endings and this was one of those. When I left, mom and baby were both alive and well and I was off to my next adventure.

Sad Cat

I realized I hadn't posted any stories about cats. I will admit they are not my very, very favorite patients (the whole claws on every foot, sharp teeth, reflexes much faster than my own, and a willingness to use all three) but this story deserves to be told. A few months ago I met an energetic kitty named George. George came in with a complaint of occasional vomiting. He seemed like a happy and healthy kitty and the owner said he was "full of life" he would just vomit every once in a while. Now of course as a veterinarian we love to have something come in the only problem being occasional vomiting. With that history we can usually narrow it down quite quickly to only two or three hundred possible causes! Because the cat seemed to be doing so well otherwise, was a finicky eater, and bloodwork only showed an increased eosinophil count (type of white blood cells usually increase with parasites and allergies), the owners opted to try deworming and changing food rather than pursue further diagnostics at that time. With instructions to get back in touch with us if things didn't improve or got worse, I didn't give the cat another thought. That was of course until a couple of weeks ago when I was requested as a doctor to look at a cat that I had seen previously for vomiting.

When George walked in, or should I say was carried in, (cats don't generally walk into the clinic on their own), I almost didn't recognize him. This previously very playful cat was lethargic and for lack of a better word, emaciated. For those of you who are familiar with body condition scoring, he would be about a 1 out of 5. According to the owners they had tried several different foods which he generally didn't eat well and his vomiting had slowly increased over the past few months. Within the last couple of weeks they reported his condition deteriorating much more rapidly. As is the case with many pet owners, economics often plays a role in diagnostic and treatment plans. This owner was no different and had difficulty making the decision to take x-rays after other diagnostics had not yielded specific answers.

Fortunately radiographs were taken and revealed a very obvious answer to our several month problem. What appeared to be a perferctly round white spot was located in the abdomen near the pelvis. When the owners were brought in to view the films they both exclaimed "It's one of those glass beads". After more discussion it was determined that he must have eaten the decorative glass bead, the kind that you may see in a vase or on a glass plate, about 2 months prior to his first visit.

Next the discussion turned to options for treatment. It boiled down to two: surgery or euthanasia. Surgery was chosen after a long discussion about complications due to the severely debilitated state of the patient.

In surgery we were not surprised to find half a dozen places in the intestine with partial constriction. It would seem resonable that all of these locations were places where the bead had gotten stuck on its several month journey through the intestines and the damage to the wall of the intestine had resulted in the noticeable scarring and strictures. The marble was removed and surgery was completed without incident.

Unforntunately George did not recover well from surgery, was unable to mantain his own body temperature, showed signs of brain damage and was euthanized two days later.

Monkey?

I was out at a farm to pregnancy check and "Bangs" (Brucellosis) vaccinate some heifers. Things seemed to be moving along at an okay pace until we got one heifer that was just a little too impatient. As each heifer would come into the chute we would drop the tail gate so that the next heifer couldn't crowd in as well. This tail gate had a horizontal bar on the top and bottom and then vertical bars about 6 inches apart across the width of the gate. Well miss antsy just didn't have the desire to wait when the gate was dropped in front of her, reared up and stuck her legs over the top horizontal bar. Had this been all there probably would have been no problem as all she needed to do was pull her legs back down and she could stand quietly in the alley. Instead she jumped up stuck both of her back legs through the gate and hooked them over the bottom horizontal bar. Now we had a 700 lb heifer hanging on the back gate of the chute like a monkey. Of course, she was not complacent in her position and after a few seconds of the monkey-cling she began thrashing around. With no room to go forward and all four legs hung up on the gate there was only one option...backwards. Yes, she flipped herself completely onto her back on the ground, wedged between the sides of the alley. Then, like one pig waits for another at the feed trough, the next heifer in the row immediately proceeded to walk right on top of this upside-down heifer to try and push her way into the chute.

Fortunately for me we actually had several people there helping and after we got all of the other heifers out of the chute and alley we devised a plan to get our wedged turtle out as well. We fashioned a rope halter out of a lariat and while one man lifted and pushed on her head, the other three of us pulled on the rope and we were able to flip the heifer back over in the reverse direction that she had just gone. No worse for wear we finished the job and everyone was happy.

When people say cows aren't athletic I think of experiences like this and just smile.

Winter

One of the first questions that I asked before I came to North Dakota to visit was, "How bad are the winters really?" Now keep in mind that I grew up in Montana so a little cold doesn't frighten me. Unfortunately, the person who answered that question for me was also the one who was a transplant to North Dakota and had not been here that many years. His response was "Oh, they really aren't that bad; they are just like Montana winters".

When I came to interview it was the end of November and there was a storm the week I was here. It snowed a few inches, had some wind, and the temperature even dropped a few degrees below zero. Then after we had made the decision to take the job, we came out to house hunt in February. If you guessed that there was another snow storm you are very smart. It snowed several inches and got cold (down around O F again). We weren't too fussed about it after everyone reassured us that we had been here for about the only two storms for the winter, this was about as bad as it gets, and that North Dakota winters really hadn't been that bad for several years.

Fast forward to now. I realize that much of the country is experiencing really potent winter weather, but today's experience warranted some documentation. We are the veterinarians for two sale barns and our duties rotate among the doctors each month so we each get one day a month at each sale barn and they do not cancel due to weather. Today was my day. This morning was bitter cold....so much so that when we got gas on our way out of town several of the pumps were not working because they were frozen. As we were driving I was looking across the drifted white landscape and wondered out loud what our snow total was at. We are now at over 6 feet of snow for the year. With over 30 inches in December alone and only one day that came close to 32 degrees since the middle of November, all of the snow is still around. Up till now we have had cold days. However, a new record for ridiculous was set on our drive today. Just before arriving at the sale barn to start our day the thermometer read......
........-40 F !
What a great day to be a large animal vet that works outside!