Don’t Die on Me Now

D. E. Larsen, DVM

I could hear the old ewe breathing as I approached her in the open pasture. I grabbed her by her long wool, and she made no attempt to move.  This summer heat must be unbearable for her. It didn’t look like she had been sheared in a couple of years.

I parted the wool on her chest and held my stethoscope against the bear chest wall. I moved to a couple of spots. The air rushing in and out sounded like a freight train. This was severe bronchopneumonia. This old ewe was going die.

I walked over to the blueberry patch where the owner was working.

“This old ewe has severe pneumonia,” I said. “I can treat her with some antibiotics, but my guess is she is going to die.”

“How long do you think the old girl has to live?” Jim asked.

“Your guess is as good as mine. You maybe have heard the old saying, sheep are born looking for a place to die. I think if she doesn’t die tonight, she’ll die in the next couple of days.”

“Don’t you treat pneumonia?” Jim asked, hoping I would give him some optimism.

“Sure, we treat pneumonia. But when it involves the entire lung field on both sides of the chest, there is little chance that treatment is going to do any good.”

“She’s my wife’s pet. I would like to try to save her if that is possible.”

“I have a new antibiotic. It is the best one on the market right now. The problem, it’s a little expensive. But we could give it a try if you like. I can give her an IV injection now, and if she is alive tomorrow, you can pick up some more to give in the muscle.”

“Yes, I think I would like to try that if you think it will work,” Jim said.

“I didn’t say I think it would work. I think this ewe is going to die. But if you want to treat her, I think her only chance is to use the best drug available.”

“What would you do if she was yours?” Jim asked.

“I don’t usually answer that question, but if I had an old ewe that sounded like she sounds, I would put her to sleep.”

“I think my wife would want to at least try to save her. Let’s go ahead and give her an injection today, and I will check with you tomorrow.”

I went back to the truck and filled a syringe with an antibiotic injection along with some dexamethasone.

When I got back to the ewe, she hadn’t moved from where I had first looked at her. I used scissors to trim some wool away from her jugular vein. I placed a needle in the jugular, attached the antibiotic syringe to the needle, and slowly gave the injection.

Immediately, the old ewe sneezed a couple of times and shook her head. Then she fell forward, banging her nose into the ground, almost lifeless. 

“Damnit, don’t die on me now,” I said to the ewe.

I had only seen one other anaphylactic reaction. That was in a horse in school when given a penicillin injection. That horse reared and went over backward. The horse was dead when he hit the ground.

I looked at the truck. It was probably forty or fifty yards away. If I ran, I could get the epinephrine and be back in fifteen or twenty seconds. I took off as fast as I could across the rough ground.

I grabbed the bottle of epinephrine from the refrigerator and a bottle of sterile water. Then I headed back to ewe at a run. 

Epinephrine was one of the drugs that I had to have but never used. I always bought a new set of bottles every year to make sure it was not outdated.

I got back to the ewe and dropped to my knees. I drew a dose of epinephrine into the syringe and diluted it with sterile water. I gave this dose in the jugular vein. It had been more than the twenty seconds I had initially calculated but less than a minute.

The ewe blinked, turned her head, and looked at me. Maybe she would live to see the moon this evening. 

She rolled up on her sternum and stood up. That was more activity than I had seen out of her. Probably stimulated from the epinephrine.

I gave her a hefty dose of dexamethasone. Probably not the best practice in treating pneumonia. But in this case, she needs all the help she can get.

“Jim, I had a little excitement with that injection,” I said. “The ewe had an allergic reaction. I was able to reverse it with some epinephrine, but it was a close call.”

“That’s good. Maybe we can have another miracle with the antibiotic,” Jim said.

“It’ll take a miracle,” I said. “Don’t be surprised if you find her dead in the morning.”

“You don’t provide a lot of hope, Doc,” Jim said.

“I provide hope when there is hope to give. Otherwise, I provide reality. There is some danger in that reality. Telling somebody that a patient is going to die is one of the riskiest things I do. If she lives, you will be telling me about her for the next twenty years.”

“I’ll call in the morning, Doc,” Jim said.

***

The phone rang early in the morning. It was Jim.

“Doc, the old ewe is dead,” Jim said. “Do you think that reaction had anything to do with her death?”

“Jim, it probably did do her any good, but the epinephrine gave her more energy than anything else. But remember what I told you before I treated her.”

“Yes, I know, you told me she was going to die,” Jim said.