There is Blood Everywhere

D. E. Larsen, DVM

“Doc, this is Harold. You have to come quick. There is blood everywhere. I think she is bleeding to death!”

Then the phone went dead. I looked at the clock, 4:50. At least it is not 3:00 AM. That means something happened during the morning milking. What could have happened that would cause a cow to bleed so much in a milking parlor?

I jumped out of bed and dressed quickly. I have been going to Harold’s place too often, it seemed. This time I have to hurry into a mess that I can’t even begin to imagine. Hard to say what I was going to be walking into.

It was a short drive to Harold’s place. The driveway up to the barn was a little steep but well maintained. I pulled the truck as close to the milking parlor as I could. I jumped out of the truck and hurried to the door.

Harold was waiting for me and held the door open. He was covered with blood.

“Are you alright?” I asked with genuine concern.

“I am fine, but you need to look at this cow, quick.”

We went into the parlor, there was blood on the floor, running down the floor drain. The cow is a big animal, and losing a gallon of blood is probably no big deal. But I don’t think I was prepared for this much blood on the floor.

I got to the cow, still standing in the milking stall. Blood was still streaming from where a teat should have been.

“What the hell happened?” I asked.

“She had mastitis. I have watched you guys whack off a dozen teats before, so I just took my knife and whacked it off,” Harold explained with a motion of this hand to show how he had whacked the teat off.

“Harold, when we have cut a teat off, it is because the mastitis is so severe that the tissue is dead,” I said. “This teat is very much alive. I will explain more after I get this bleeding under control.”

I ran back to the truck and grabbed a bucket of water and scrub, scissors, a needle holder, and a pack of suture material.

After a rapid swab of the area, I started placing some mattress sutures around the bleed base of the teat, or where the teat should be. As I got all the way around the opening, the blood flow finally stopped. Harold was correct about one thing, this cow could have bled to death. In these large dairy cows, the udder receives a tremendous blood supply. This is evident when you look at the large veins running forward from the udder on the ventral abdomen. These veins are garden hose size.

With the bleeding stopped, I cleaned the wound as best I could. This quarter was obviously lost. I just hoped that we could keep the infection under control, so the cow was not lost. 

When the cow loses a quarter, the other quarters will show a compensatory increase in production. In this way, she does not lose 25% of her production, but more like 10 to 15%. So most of the time, the cow can remain a productive member of the herd. With the antibiotics that will be needed to prevent a significant infection, this cow’s milk will be suitable only for feeding to the calves, and the barn cats. She may lose a month of production, at least two weeks.

Finally, I relaxed enough to talk with Harold. He had been frantically trying to keep the milking string moving while I had been working on this cow.

“It is important for you to understand what went on here tonight,” I said. “When you cut that teat off, you threw away a quarter that could have been treated for mastitis and returned to full production. When we cut a teat off, it is because the infection is so severe that the whole quarter has gangrene, and the tissue is dead. That is why there is no blood when we cut a teat off. So, next time, if the teat isn’t black, don’t cut it off.”

“Doc, there ain’t going to be no next time,” Harold said. “I am just going to call you first. I just thought I could save a few dollars and look what happened.”

“This is going to take a little time for this wound to heal,” I said. “I am not sure just how we will handle it. I want to talk with Don and Jack in the morning, and we will come up with a plan. We are not going to be able to completely close the wound because there is going to be some milk drainage for a time. I think we might be able to close most of the wound and just place a rubber drain, but I want to discuss that plan before we do it.”

“Just tell what I need to do with her,” Harold said.

“For now, you need to keep her in a clean stall by herself,” I said. “I will be back later this morning, maybe with Don, and we will work on this wound again. You will need to discard her milk until we completed her antibiotic treatment.”

“Can I use it for the calves?” Harold asked.

“That will be fine, but you should milk her last, so there is no chance of getting any antibiotics into your holding tank,” I said. “Otherwise, you might end up buying a tanker truck full of milk.”

With that, I cleaned up and headed home. I figured I would just have time for a good breakfast before I had to be at the office.

“What did he do?” Don asked, somewhat, not believing my story. 

“Yes, He just took his knife and cut the damn teat off,” I repeated. “I thought I was walking into a murder scene when I entered the milking parlor. So now there is a big hole into the milk cistern. I placed a bunch of mattress sutures to get the bleeding stopped but I wanted to talk to you about how I should close the hole.”

“I agree about placing a drain for a few days and suturing most of the hole closed,” Don said. “Maybe this would be a place to try that closure that was in the Veterinary Medicine journal last month. That would probably hold better than sutures.”

“I have some time this morning, let’s run out there together,” Don said, “I want to see this.”

Harold was waiting with the cow in the parlor when we pulled into the barnyard.

Harold had cleaned up the blood from the morning fiasco, but there was still some blood on his apron hanging by the door.

“We are going to close up this wound, and hopefully it will heal without too much of a problem,” Don said as he looked closely at the gaping hole on the bottom of the udder. There was some dried blood around the wound and a slow drainage of milk from the hole.

We scrubbed the wound and sprayed Betadine around and into the wound. I injected a good dose of lidocaine around the wound. Then I placed a small Penrose drain in the front edge of the wound and secured it with a couple of sutures.

Neither Don nor I had done this new closure that was written up for teat lacerations, but it was simple enough. Teat lacerations were challenging to deal with, especially if they extended into the milk channel. This closure was fast and simple and provided a wide spread of the tension, so there was little chance of tearing the tissue.

After apposing the wound edges with a couple of towel clamps, I took three 18 gauge, 1½ inch needles, and placed them across the wound, evenly spaced, and entering and exiting about 1/2 inch from the wound edge on each side. Then using umbilical tape, I closed the wound by lacing around the needles, much like you would close the body cavity of a turkey before putting it in the oven.

This proved so simple and provided a tight closure with the tension distributed across the entire length of the wound. It would be unlikely to tear out. Both Don and I wondered why it had never been published before. I cut the sharp end of the needles off with a wire cutter and sprayed the area with some Furacin wound spray.

“I will be back in 3 days to check this wound,” I told Harold. “You need to give her an injection of 10 ccs of Polyflex each day. Otherwise, don’t do anything to the wound. If you notice these needles fall out, give us a call. And don’t cut off any more teats.”

Photo by Matthias Zomer from Pexels