A Stone for his Mantle, From the Archives

D. E. Larsen, DVM

Urinary stones in beef cattle in the Willamette Valley were uncommon, meaning that I would see a case once or maybe twice a year at the most. Often going several years between cases. I do not recall ever seeing more than one case on any one ranch.

With that in mind, I found it uncommon when Walt called with a little steer calf who was standing around twitching his tail and stomping his hind feet. Uncommon, in the fact that Walt would recognize that as enough of an issue to call me early. It demonstrated how some of these old farmers were so in touch with their animals that they knew when there was a serious problem.

Walt was a tall, thin man with a broad smile on his face most of the time. Thin does not mean that he was not strong. Thin and wiry, he was tough as nails, and could work most men into the ground. Walt had a team of draft horses, Belgiums, that he used every year to put up hay in the field that was next to the highway. I am sure that many people would observe him and fail to realize how rare the spectacle was today. I always enjoyed watching the horses work and would often take the back road so I could stop and watch for a time.

Today was a nice late spring day with mostly blue sky, but some heavy dark clouds. Walt was waiting when I and Ruth Slagoski pulled into his barnyard. Ruth was short with dark hair. She had worked for me for a couple of years and although not a farm girl she really enjoyed the farms we visited. Walt’s farm had offered a variety we didn’t often see, with draft horses, along with the cattle.

Walt greeted us with his beaming smile and an outstretched hand. His hand shake was firm and sincere. I knew these men judged the men they met by their hand shake, something I didn’t learn in school but I had learned long ago growing up around men who earned their living working with their hands.

“I have them in the back of the loafing shed. The little guy is really uncomfortable,” Walt said. Showing his obvious concern with a fading smile.

We walk into the shed and the black baldy mamma cow and her calf were standing on the back wall. The calf was twitching is tail constantly and stomping both hind feet as if to a rhythm. “Walt, this guy probably has a stone plugging up his urethra and he can’t pee,” I explained. “It is early yet and he is uncomfortable because of his distended bladder. In a little while, one of two things are going to happen, either his bladder breaks or his urethra breaks. When that happens, the pain goes away but the problem becomes much more difficult to fix. It is a very good thing that you called early.”

The calf was easy to catch and we tied his head and then ran the mamma cow outside. I was sure of my diagnosis but completed a quick exam. Temperature was normal and his chest was normal. I did a digital rectal exam and laid my finger tip on his pelvic urethra. It was pulsating constantly.

He was a small calf, I am not sure I had seen a stone in this young of a calf before. I took another rope and tied a loop in the middle of the bite of the rope. I slipped this loop over his neck with the knot laying between his front legs. Then both ends of the rope went up over his back, crossing in the middle of the back, then down his sides and out between his hind legs.  This was called a “flying W” and is a standard method to throw a cow, generally not used on a small calf but we were going to have to tie him down for surgery.

I grabbed the two ends of the rope and pulled, the calf stiffened and fell on his side. We rolled him up on his back, flexed his hind legs and tied each leg with the ropes in a manner that when he would kick, it would put more pressure on his back and add more restraint.

Once restrained, with me on my knees, I could palpate the length of his penis. Stones generally lodge at the point of the attachment of the retractor penis muscle in the sigmoid flexure of the penis. I grasped this portion of the penis with my left hand to stabilize it. With my  right hand I could easily palpate the stone.

“This is going to be easy,” I said to Walt. He was watching close. Most of these guys had not watched a calf thrown so easily before.

We clipped and prepped the site for surgery and Ruth opened the surgery pack while I put on gloves. This was barnyard surgery at its best. There was fresh straw down but the softness of the ground under my knees told me we were on top of a foot or more of straw and manure.

The surgery was brief, as I had promised. After clipping and prepping the area, I injected the area with Lidocaine for local anesthesia, grasped the penis to stabilize it, palpated the stone and made about a two inch incision over the stone. With a pair of forceps, I bluntly divided the tissues to expose the urethra with the bulge where the stone was located. Once this was exposed I elevated the penis and drove a scissors under the penis and out the other side to maintain the exposure, stabilize the urethra, and free up my left hand. I palpated the stone again, then carefully incised the urethra, feeling the grit of the stone as the scalpel pulled across it. With a forceps, I grabbed the stone and pulled it out of the urethra and placed it on the surgery pack. It was about the size of a pea, off white in color. I took a 22 inch, 8 French urinary catheter and ran it up the urethra toward the bladder. It was just long enough to reach the bladder. We relaxed as urine drained out of the catheter. I could imagine that the calf was feeling some relief at this point. When the urine stopped, I removed the catheter and then ran it the other direction to make sure the rest of the urethra was open.

Now we had some decisions to make, to close or not to close. We had the option of leaving the incisions open. I sort of favored this option because if there are more stones in the bladder they have the chance of passing out the incision. Barnyard surgery is not the best in the world, and closing the incision always gives a possibility of infection. And closing the urethra on such a small calf could lead to an even more narrow spot that could cause problems later. The only problem with leaving the incisions open was that urine would flow out of the incision for a week or so until there was enough healing to allow normal flow.

I was getting ready to discuss all of this with Walt when the calf kicked and got one hind leg free from the restraint. He kicked again and the surgery pack went flying. The decision was made by the calf. I grabbed the scissors, releasing the penis to return to normal position. Ruth started gathering instruments that were scattered through the straw.

Walt was crawling across the straw on his hands and knees, concentrating on one spot. He ran his hand across the straw a couple of times. The with a beaming smile raised his hand, he had found the stone.

“This is going on my mantle,” he said, still smiling. 

We let the calf up, sprayed for flies and explained the urine flow issue to Walt. Things turned out okay, and I will never know how Walt was able to keep track of that stone in all the commotion.

Photo by Matt Seymour on Unsplash