D. E. Larsen, DVM
I pushed my left arm deeper into the birth canal of the young heifer, sweeping my hand left to right, trying to decide as to what was wrong here.
Then I encountered intestines, this was not good. They were too large to be from the calf. This uterus was ruptured. I shoved my arm up to my shoulder. Finally, there was the calf. The calf was in a breech position. I stuck my finger into its rectum. A contraction, this calf was still alive.
I pulled my arm out and washed. “Sue, someone must have tried to pull this calf,” I said.
“Yes, my son Joe was here a bit ago, and he tried to work on it but said that he couldn’t get anywhere.”
“This heifer has a ruptured uterus. The calf is still alive. If we do a C-section, I can save the calf. I don’t know if I can fix the uterus or not.”
“Okay, do what you can,” Sue said. “This is Sam’s favorite heifer. She is kind of small, but he treats her like a pet. I hope you can save her also.”
The heifer was lying on her left side. This was probably good. A right flank incision might give me the best access to repair the uterus.
For me, c-sections on cows were a chore. But most of the work was closing things up. This one would depend on what kind of damage had been done to this uterus.
We clipped and prepped the right flank, and I did an inverted L block with Lidocaine. It did not take long, and we had the calf out, and she was shaking her head as she looked around at her surroundings in this small barn.
The uterus was mostly torn off the cervix. It was held by a narrow strip of tissue. There was no way to repair this.
“Sue, this uterus is almost completely amputated from the cervix. I don’t think that I can repair it,” I said.
“You spay dogs and cats all the time. Can you just remove it,” Sue asked?
The question stunned me for a moment. I looked at the torn mass of uterus and pondered the situation.
The largest dog has a uterus with a diameter less than my index finger. By comparison, this was a massive uterus. But it was worth a try. Otherwise, we shoot the heifer. If the surgery doesn’t work, at least we tried before shooting the heifer.
“I hadn’t given that any thought, Sue,” I said. “I guess it is worth a try.”
I had difficulty reaching the left ovary. With that problem solved, I placed a transfixed ligature on each ovarian pedicle. After severing the pedicles above the ovaries, I hung the uterus out of the incision. Severing the remaining attachment at the cervix was no problem. I placed a couple of stay sutures in the cervix to keep it close to the incision when I removed the uterus.
With a good twenty pounds of uterus laying in the straw, now all I needed was to close the cervix and ligate a couple of bleeding vessels. Then it was a standard closure of the external incisions. This probably all took less time than a typical c-section.
After giving the heifer some antibiotics and a Dexamethasone dose, I let her up to tend the calf.
“What do you think,” Sue asked?
“Ask me in the morning,” I said. “If she survives the night, I would guess we are good to go. But don’t expect her to have a calf next year.”
“Is she going to be able to raise this calf,” Sue asked?
“That should be no problem. The uterus and the ovaries are not necessary for milk production.”
“Mom and calf were doing well,” Sue said when she called the following morning.
When I was out to take the sutures out of the heifer, the incision had healed well. The calf was bouncing around, happy to be in this land of the living.
“When you sell her, make sure you are honest,” I said. “Some poor guy will go nuts trying to get her pregnant.”
“My guess is Sam will make a pet out of her. She will probably never leave the farm.”
It was not long after this event when Pat called. Pat was the elementary teacher with a bunch of classroom pets. It had not been too long ago that I had repaired a fracture on a hamster’s leg for one of her pets.
“It’s Sally, Doc,” Pat said. “She has to be days overdue for delivering babies. And now she is not feeling well. The kids think she has a problem.”
“Tell me more about Sally,” I said.
“Sally is a mouse. They have a gestation for something like 20 days,” Pat said. “We have been watching for babies for over a week now. I am certain that she has to be 4 – 5 days overdue. I can get away for a few minutes shortly, can a drop her off for you to look over?”
“Does she bite,” I asked?
“Sally is the sweetest little mouse,” Pat said. “She loves to be petted and handled, and all the kids love her. That is why everyone is so upset.”
Sally was just as Pat described, sweet as could be. I rolled her onto her back and rubbed her belly in a manner that became palpation. Sure enough, Sally was pregnant with what felt like 8 babies. They were hard as marbles with no feeling of fluid in the uterus. These babies were dead.
I called and talked with Pat.
“Pat, her babies are dead, and there is a bunch of them,” I said.
“What can we do,” Pat asked?
“If we don’t get them out of there, Sally is going to die,” I said. “She is already dehydrated. I think I should try to do a spay on her. If, by chance, there are any live babies, we could save them. But I don’t think there is anything alive in her uterus.”
“You do what you think is best. The kids and I trust your skills,” Pat said.
We gave Sally a dose of Ketamine for anesthesia and some subcutaneous fluids for her dehydration. I used a razor to shave her belly, and with a surgical prep completed, she was ready for surgery.
With her fur gone from her belly, you could see the lumps in the uterus through the belly wall.
“I think I am going to need some magnification,” I said as I put on my loupes. “Things are going to be pretty small in there.”
I opened the abdomen and externalized the uterus, two horns of the uterus, one on each side, with 4 hard nodules in each horn, each about the peanut size. The babies were long dead, and all the fluid had been resorbed from the uterus.
The anatomy was the same as a dog or cat, just a lot smaller. I Iigated the ovarian vessels and the uterine body and removed the uterus with the dead babies.
Closing the abdomen required only a couple of sutures. Sally recovered slowly from the Ketamine, but she was up and eating when I checked her in the morning.
Pat and her class were happy with the results, and we were paid with twenty-some pages of hand-drawn pictures with thank you notes.
The entire class brought Sally in for suture removal. Typical of classrooms that visited the clinic, some students struggled to be as close to the action as possible. Then some sought the comfort of the reception area.
Sally enjoyed the attention. And she managed to live a year or two longer than a mouse in the wild.