D. E. Larsen, DVM
During the fall of my junior year in vet school, I worked part-time for Monforts of Colorado. At the time I worked for them, they ran two feedlots with about 100,000 head of cattle in each lot. My job was to work in the hospital during the weekends. This was an excellent opportunity for me. I was able to see a lot of management of a large feedlot and a lot of feedlot medicine. I also learned that education happens in more places than in the classroom.
The hospital for the Greeley feedlot was small but well laid out. There was a crowding pen that led to the treatment chute. The cattle that stayed for multiple days were held in a series of small holding pens, arranged according to the treatment group they were assigned. Treatment protocols were established by the feedlot veterinarian. As a hospital technician, I just did the daily treatments called for by the established protocol.
For example, the pneumonia protocol (the most common) called for 5 days in the hospital with IV antibiotics each morning and often some supportive medication if needed. Steers were treated, and the treatment was recorded on their record. They were returned to the treatment pen after they were treated. Any steers with unsatisfactory progress were put into another treatment group, and the protocol was intensified.
Each morning the cowboys would meet in the hospital and get ready for their day. While they drank their coffee, they would assign the pens that each group would check. In the central feedlot, the steers were held in large pens of approximately 500 head each. Two cowboys would ride through each pen each morning and check for sick or injured steers. During these morning sessions, they would make sure everyone knew if there were questionable steers from the previous day’s ride that needed to be double-checked. It was also time for them to kid the young ‘doctors’ working on the weekends. I was a little older than most of the guys who worked in the hospital, and I could hold my own most of the time.
After the cowboys mounted their horses and started out for their assigned pens, we would start with the daily treatment schedules. Our goal was to get all the hospital treatments completed before the cowboys were back with the new steers for diagnosis and treatment.
During the ride through the pens, if they found any steers needing treatment, they would cut him out of the large pen and put him in a holding pen until they had a group of 10 to 12 steers. These steers were then herded to the hospital by a couple of the cowboys. They would help us get them into the crowding pen, and they would relay any particular information to us that would help with the diagnosis. They also took the time to make sure the young doctors were teased a little.
This one morning in November was a bright, cold late fall morning in Northern Colorado. It was frigid, and the hospital was the only warm place available to anyone. We had the doors closed, and the electric ceiling heater was turned up full blast.
I was herding the last steer back to the hospital pens when the first group of new steers arrived from the central feedlot. The cowboys herded them into the crowding pen. When I got back to the hospital and warmed myself by standing under the heater blowing warm air, Eli Hernandez already had a steer in the treatment chute. Eli was the lead cowboy. He was a large Hispanic man, he towered over me. I considered him an old man in those days, that means he was probably in his early 50’s. His worn face told of his years of working in the sun. His large belly suggested that he drank a beer or two. I am sure his horse was enjoying the morning break.
Eli was anxious for me to look at this steer. “Doc,” he said, “what do you think about that mass on this steer?”
This was a test, and I understood that it was a test. Eli was really going to find out what kind of a cow doctor this kid was. I was going to have to make some thoughtful comments. This was a massive swelling on the right side of the abdomen. I had no idea what it could be, maybe a hernia, or could be a tumor. One thing I had been taught was it is okay to admit you don’t know something as long as you could illustrate a plan to find out what was wrong.
“I have no idea, Eli. We will probably have to stick a needle into it and get a sample under the microscope.” I replied.
Eli listened as he was cleaning his fingernails with a large pocket knife.
“Yeah, Doc, you get your needle ready, I have got to get back to the pens,” he said, half chuckling under his breath.
He looked down on me with a broad smile as he turned for the door. As he walked by the chute, he made a quick swipe at the bulging mass on the side of the steer. His knife was obviously very sharp, and it sliced through the skin like butter, opening a large gash in the belly of the steer.
The pus poured out of the swelling like you were pouring milk from a large pail. Eli made more look back at me as he opened the door. He still had a big smile, but there was no malice in his glance. Just like a professor who had provided a good lesson.
There was limited circulation of air in the hospital when it was buttoned up against the cold outside. The odor was suddenly overwhelming. Steam rose from the growing puddle of pus on the floor. There must be 5 gallons of pus on the floor, and it was reaching the drain very slowly. I headed for the garage door that had been closed all morning and pulled it open. The air was cold, but at least you could take a deep breath. Then I grabbed the hose and washed the bulk of the pus down the drain.
That taken care of, I turned to the steer. Eli had probably seen this type of abscess many times before and knew that drainage was the first line of treatment. The gash that he had made was maybe 6 inches long. That was good. This abscess needed adequate drainage to allow for the healing of the tissues on the inside of the abscess. This could take a couple of weeks.
The problem was the gallon of pus at the bottom of the abscess, below the gash. I shaved the area around the gash and down the abdomen so I could open the abscess at its lowest margin. I scrubbed the area with Betadine Surgical Scrub. Then injected some lidocaine into the gash and into the area of the planned opening. That done, I used a scalpel to open the abscess on its ventral margin. This time I caught the pus in a bucket. The smell still filled the room, but it was easier to clean up. The open garage door provided some air circulation. With the drainage complete, I threaded a large Penrose drain through the upper gash and out the lower incision. I tied the drain in a loop so it would stay in place for as long as it was needed.
Next, I flushed the abscess with a bottle of Hydrogen Peroxide. This made a lot of foam and probably provided some mechanical cleaning. I followed the Peroxide with dilute Betadine. The large gash was large enough to allow me to reach my gloved hand and arm into the abscess. I removed several large chunks of consolidated pus and explored the body wall to ensure it was intact. Then I found the culprit, a large splinter laying in the bottom of the abscess. Probably from a fence rail or a feed bunk. This abscess grew so large before it was detected because the steer would act normal until the size of the swelling started to interfere with his function. When looking at 500 steers, the cowboys look for steers acting less than normal.
Next, I gave a hefty dose of Combiotic, a Penicillin/Streptomycin combination, an antibiotic combination in use at that time. No worry about flies in this weather. This steer would be in the hospital for a week or two.
The diagnosis was an obvious abscess. This would be a common problem for me in the years to come. The size of the thing was what was exceptional. Turns out to be one of those once in a lifetime diagnoses. In over 40 years of practice, I have never seen anything to come close to the size of this abscess.