An Unfortunate Family Conflict 

D. E. Larsen, DVM

Cody almost danced on the exam table. His stub of a tail wagged so hard that it wagged his entire rear end.

“Whoa!” I said as Cody was trying to lick my face. “You can hardly contain yourself, Cody.”

“He is so happy to go in the truck. He doesn’t care where he goes,” Renea said. “But he does seem to like you, Doc.”

Cody was almost two years old, and his activity level showed it. He couldn’t sit still if his life depended on it. He was a dark liver and white springer spaniel, healthy, happy, and high-strung.

“What are we doing for Cody today?” I asked.

“He is overdue for his rabies vaccination, and my sister and her family are coming for a week next month,” Renea said. “She has a little boy who is a holy terror. The last time he was here, he wouldn’t leave Cody alone. I just want to be safe and make sure Cody’s rabies vaccine is up to date.”

“You’re being very wise,” I said. “Just in the event Cody would nip the little hellion, you will keep the public health people out of the issue if his vaccine is current.”

After the exam and vaccine, we put Cody down on the floor. He bounced around the room. He was so happy he nearly knocked me down.


It was several weeks later when I noticed Renea sitting in the busy reception area, wringing her hands as she waited to talk with the front desk. When she caught my eye, she jumped up and came back to talk with me.

“Doctor Larsen, I have to talk with you. Do you have a minute?” she asked.

“We’re pretty busy, but I can spare a moment,” I said. “The exam rooms are busy. Let’s step into my office.”

As soon as the office door closed, the tears started.

“I just don’t know where to start,” Renea said as she dried her tears. “My sister’s little boy tormented Cody from the moment he came through the door. It went on continually. I tried to keep them separated, but I couldn’t do it all the time. Anyway, he was on the back porch with Cody, pulling Cody’s ears, when Cody had finally had enough. Cody snapped at him and caught him on the side of his face.”

“I hope it wasn’t a vicious bite,” I said. “Is the little guy okay?”

“Yes, he is okay,” Renea said. “It was just a snap, but it did break the skin, and it looks like there may be a scar. But you would have thought the world came to an end.”

“So, if he is okay, what is the problem?” I asked.

“My sister is insisting I put Cody to sleep,” Renea said. “If I don’t, she will never visit again. I just can’t do that, doctor. She doesn’t understand. Cody is my child.”

“There must be a resolution here,” I said. “Have you explained your position to your sister?”

“Yes, but I don’t think it meant anything to her,” Renea said.

“A little tincture of time will help,” I said. “Give her a couple of weeks, and then talk with her again. There should be an easy compromise to offer. Maybe you could board Cody in a kennel or with some friends anytime your sister visits. Cody might not like that, but it might be better than the alternative. Some dogs love going to a kennel. It is sort of a social event for them.”

“My sister thinks I’m crazy to call a dog my child,” Renea said. “Do you think I am crazy?”

“When I was in vet school, we had a similar event happen,” I said. “It was a couple of classmates in the class ahead of us. The circumstances were a little different because the bite was a vicious one, and it caused significant injury to the child. I am unsure if there was any provocation involved. But it led to a lot of discussion in the school. Dealing with the ethics of pet ownership and the owner’s bond to the pet. And the child substitute pet, which is becoming more common.”

“How did that turn out?” Renea asked.

“I’m not sure I know the whole story,” I said. “I know the dog was not put to sleep, and there was never a consensus from all the discussions between classmates. But I don’t think the friendship between the two involved survived. However, it’s much easier to give up a friend than to give up a sister.”

“That is for sure,” Renea said. “I like your advice about the tincture of time. The emotions will have cooled in a couple of weeks, and I think she will accept the kenneling offer.”

“Now you should know, I was in favor of euthanasia for the dog in Colorado when I was in school,” I said. “But the situation was different. It was a vicious bite that scarred the kid’s face for life. That doesn’t say anything about the potential emotional scars after being attacked by a dog. And there was no clear evidence that the child provoked the attack. I felt at the time that the dog was untrustworthy. Your situation is far different. Cody is a good dog; he just had his fill of being tormented. And to answer your question, no, I don’t think you are crazy.”

“Well, I’m glad I came and talked with you,” Renea said. “I feel much better now. Thank you.”

“If your sister wants to talk with me, that would be fine. Just have her call me,” I said.


Things worked out between the sisters. Cody went to stay with Renea’s friend and neighbor, Marsha, whenever her sister visited. I never met her sister or the little boy, but I don’t believe the boy was scarred for life, either physically or emotionally.

Photo by Celyn Bowen on Unsplash.

The Heel Fly 

D. E. Larsen, DVM

I watched in amazement as the group of cows ran through the lower field with their tails in the air. They all came to a stop at the edge of the pond and waded out into the shallow edge of the water.

“What makes those cows run like that?” I asked Dad as he worked on the mowing machine.

“They are running from the heel flies,” Dad said. “Those flies bite them on their heels, and that is why they stand in the water. Those flies cause the warbles we see on the back of cows.”

I had seen the warbles on most of the cows and watched as my older brother sometimes squeezed a large grub out on them. It was a bit of a mystery to me how a fly could cause a warble on the back of a cow by biting her on the heels.


My attention was averted from the new leaves sprouting on the trees outside the classroom window as I heard the parasitology professor mention heel flies.

“There are two species of the heel fly, Hypoderma bovis and Hypoderma lineatum,” the professor explained. “These flies lay their eggs on the hind legs, usually on the heels of cattle. After a few days, the larva hatch and penetrates the skin, then they migrate through the body, ending up on the back of cattle, in what is called a warble, some four to six months later.”

“I’ll be damned,” I thought as I concentrated on the remaining lecture.

“The important thing to keep in mind is the timing of treatment for these grubs,” the professor continued. “By fall, they will be massed around the spinal cord or the esophagus. Treatment at this time will have the potential of causing life-threatening reactions as the dead larva cause local inflammation.”

The veterinary school continued to resolve my childhood mysteries. As a boy, there were no treatments available for these grubs. The large warbles set atop some of the most valuable meat on the carcass of slaughtered animals, and there was no thought of treatment in my world.

“These times vary, depending on latitude,” the professor continued. “You need to make sure you read the label of any of the products you use.”


In the late spring of 1975, I took a call to look at a Jersey cow with a problem involving the warbles on her back. Fresh out of school, I was in a dairy practice in Enumclaw, Washington, and I was intrigued to be looking at warbles. Most of the time, in my early experience, they were just there and caused no real problem.

“This is a cow belonging to George and Sue,” Ann explained. “They are that hippie couple who bought the Allen dairy a few years ago. They have some strange ideas, so it is hard to say what you will be looking at.”

It was a short drive out to the old Allen dairy, and Sue had the young Jersey cow waiting in a stanchion when I arrived. 

“What’s going on with your cow?” I asked Sue as we walked to the barn.

“This is Cindy. She had a bunch of warbles on her back, so George treated her with a mixture of rotenone and linseed oil,” Sue said. “Now it looks like the skin is dead over all those warbles.”

“I have never heard of treating warbles once they are on the back,” I said. “We generally treat them with a pour-on product in the early fall. Dairy cows have to be in their dry period before you treat them. But it is important to do the treatment before November.”

“Yes, but rotenone is a natural product,” Sue said. “We don’t use any of those new artificial products.”

I looked at Cindy. Her back was covered with a mass of warbles, and dead skin covered each warble. I pinched at one warble, and the skin and exudate easily pulled off, leaving a hole almost an inch in diameter.

“This is a mess, Sue,” I said. “Just because it is natural doesn’t make it an appropriate treatment option. Any of the new insecticides would have had the same results. Rotenone killed the grubs, but this isn’t the time to be treating these grubs. The dead grubs lay in there and rotted, which set up an infection that killed the surrounding tissue and skin. This is what you have left.”

“What are we supposed to do to treat them?” Sue asked.

“The best time to treat them is with a systemic product in the fall. The cow has to be in her dry period, and she has to be treated before November. If you are not going to use a product that kills them in the migratory phase, then you shouldn’t treat them at all,” I said. “It’s not a big thing if the cow isn’t going to be slaughtered. It might cause some loss of production when there are this many warbles, but it’s not a major loss. In the early summer, the grubs come out and fall to the ground, where they turn into a fly. Then the wound on the back heals, and the cycle starts over again.”

“And what do we do with her back now?” Sue asked.

“I’m going to remove all these patches of dead skin, flush out the exudate and apply some antibiotic ointment,” I said. “Then we will put Cindy on some antibiotics for a week.”

“We don’t like to use antibiotics,” Sue said.

“Well, I guess we could just let her die a horrible death then,” I said. “Not using antibiotics in this situation would be close to animal abuse.”

“What do we need to do with her milk while we have her on antibiotics?” Sue asked.

“You will need to discard it,” I said. “You can use it for feeding the calves or the cats, but otherwise, you should discard it. There will be a withdrawal period to observe after you complete the course of antibiotics. Things are set up for the appropriate use of antibiotics. If you make a mistake and ship her milk, it might get expensive. They test your tank before putting it on the tanker truck. If your tank tests positive for antibiotics, you could end up paying for an entire truckload of milk.”

“George is pretty careful, so we won’t have that to worry about,” Sue said. “Let’s go ahead and treat her.”

I clipped the entire area of her back involved with the warbles and scrubbed it with Betadine Surgical Scrub. Then I removed the necrotic skin and flushed the pockets with hydrogen peroxide to remove all the pus and debris. I applied a thin coat of nitrofuran ointment to the lesions. Her back was covered with a mass of open wounds.

“You’re going to have to keep these wounds clean,” I said. “I am going to give Cindy an injection of Polyflex and leave you a bottle for daily injections.”

“That sounds expensive. Can’t we just use Combiotic?” Sue asked.

“They have changed the withdrawal times on Combiotic to thirty days,” I said. “Polyflex has a five-day withdrawal time. The money you will lose on milk sales with a thirty-day withdrawal will make your Combiotic much more expensive.”

“Okay, I am sure George will want to talk with you about all this stuff,” Sue said. “I am not sure I understand all the life cycle stuff and why there are treatment times and the like.”

“I’m in the office on Saturday this week,” I said. “I am usually not busy this time of the year. It would be a good time for George to drop by and visit. I can make some copies for him on the life cycle and treatment recommendations.”


Cindy healed uneventfully, and George came by and discussed the heel fly’s life cycle and treatment options. I am sure that his decision was to do nothing for treatment.

Photo by Peter Scholten on Unsplash.

Gus and the Manure Pile, From the Archives

D. E. Larsen, DVM

Manure piles were (and still are to some extent) standard fare on Oregon farms.  They were located around the barn somewhere and served multiple uses.  They came in many shapes and sizes.  Smaller places had a simple pile outside a doorway where the barn was cleaned.  Larger farms had more elaborate piles.  In my experience their edges were the easiest place to collect a can of worms for a day’s fishing.  They also were used to dispose of small animals that were casualties during the year on the farm.  They were the ultimate compost piles.

Gus was a typical barn cat.  Well past middle age when I first met him when I came to Sweet Home in 1976.  Gus was lucky to have been neutered early in his life, but still had his share of scraps defending his turf.  He was nothing special, gray tabby in color and not large, maybe 8 pounds.  He lived with his extended family on a small acreage on a hill outside of Sweet Home.  Grandma and Grandpa lived on the “farm”.  Not much of a farm, but enough for a few cows and sheep and a small barn.  The son and his family lived about a quarter mile up the road on a neighboring taxlot.  When Gus came to the clinic he came with Carol, the daughter-in-law.

Over the first few years of practice in Sweet Home Gus was approaching his golden year.  In those times I didn’t see neutered male cats over 15 years of age.  This was before the advent of the feline leukemia vaccine, and diets did not address urinary tract and heart issues.  For barns cats to reach that age was truly exceptional.

One cold winter morning Grandpa hurried into his pickup truck in the carport on the side of the barn.   It was cold and he was anxious to get the truck started.  “Thump, thump” came from under the hood.  Gus had sought the warmest spot he knew of to sleep the night before.  The warm engine block was one of his favorites.  Usually able to scramble out before the engine started, this morning it didn’t work.

Grandpa knew what the noise meant, he had seen more than one cat caught in a fan belt on cold mornings.  He was disappointed when he found Gus, he had been such a good cat.  Gus was a mess, broken leg with bone poking out, left eye hanging out of the socket, several large lacerations and bleeding from his mouth.  In Grandpa’s mind there was only one thing to do.  Picking up a hammer, he made a quick whack to the back of Gus’ head.  Disposal was easy.  Gus’ final resting place was the manure pile on the other side of the barn.

In most cases that would be the end of the story, but remember, cats have 9 lives.  Gus had already used several of his just surviving to this advanced age.  Now he would need to cash in all the others.

Carol had noticed that Gus had not been to his dish on the back porch for several days.  She mentioned his unusual absence to Grandpa.  Grandpa was quiet, knowing the she would have rushed Gus to clinic and spent a lot of money on an old cat.

The next morning, she heard a noise on the porch.  She opened the door and was aghast at the scene.  There was Gus.  Covered with manure, left eye hanging out, broken and torn.  How had he managed to make it to the door? How had he known which door was the one to provide him help? She carefully boxed Gus and headed for the clinic.  Grandpa was outside as she drove by so she stopped to show him what she had found.  Grandpa had no choice but to confess.  He said that the vet could do a better job than him, assuming that Gus would be put to sleep.  In those years, in Sweet Home, if a cat couldn’t be fixed for $100.00 it probably was not going to be fixed.  Gus would surely be well over that figure.

Carol laid Gus on the exam table and related the story.  Gus looked hopeless to me.  She wanted to know her options. Gus was a pitiful sight as he lay on the table, looking cautiously at me out of his one good eye. 

“What are your options, Gus?”  I thought to myself as I pondered the situation.

My initial thought that Grandpa had Gus’ best interest at heart, he just didn’t do the job very well.  I’m not sure that was what his owner wanted to hear.

“We have a lot problems here” I started.  “Contaminated compound fracture of the tibia, fracture of mandible, eye that needs to be removed, broken teeth and multiple lacerations that are very contaminated.  The first question we need to discuss is do we want to put him through all this over the next few weeks?”

Carol was quick to respond, “We are not going to put him to sleep, not until we don’t have any other option.  I don’t care what it costs. If we have to, Grandpa can log a few trees.  That’s the least he can do after what he did to this cat.”

I knew Grandpa.  He would log his trees for his family or for the Grandkids.  I wasn’t so sure about a cat.

Now we were on to option number 2.  Referral was out of the question. There were no specialty clinics around at that period of time.  If Gus was going to survive it was going to be by my hands only.

“We have several things to do, first we need to sedate him and get him cleaned up, get him on some fluids and antibiotics.”

“The wounds are too contaminated to close; if we clean them up and remove the grossly contaminated tissues, they will heal if he lives long enough.”

“I can probably wire the jaw and remove the broken teeth.  The eye is toast and has to go.”

“The fractured tibia is too contaminated to fix, the ends of the bones are likely dead,  The leg has to go.”

Carol finally spoke, ” I want to save the leg!”

“Can’t be done.”  I responded.

Again Carol spoke, “I want to save the leg, we can try!”

“Okay, we can try, but if it happens it will be a miracle.  And the leg will be short.  We will try.  He will have to stay a few days.  I don’t know what this will cost.”

Carol left, convinced that Gus was going be back to his old self in a few days.  Might take a little longer than that, I thought.

We sedated him with a dose of Ketamine and got him under the spray nozzle in the tub.  After cleaning the manure and dirt, it looked like things were almost doable.  We got him dried off and an IV started.  Antibiotics on board and warmed up a little, he was ready for the first of several procedures.

Putting Gus on some gas anesthesia, we started cleaning wounds.  Shaving hair from the wounds. We removed contaminated tissues and packed with Furacin Ointment (the best topical antibiotic ointment I had at the time).

I worked on the tibia next.  The ends of the bone were dry and brown with debris stuffed into the ends.  I cleaned the wound as best I could.  Calculated that I would have to removed bone from both exposed fragments.  I couldn’t make myself think this was going to be anything but a waste of time. We packed the wound with antibiotic ointment and would do the repair tomorrow.

The left eye was hanging out of the socket and did not require much to remove.  Placed a single suture around the optic stalk and removed the eye.  I could deal with closing the socket later.  

The mouth was clean compared to the rest of the cat.  Gus was missing both upper canine teeth and one lower canine tooth.  His jaw was fractured on the left side and separated at the symphysis (the mid point at the front of jaw were the mandible bones join in a non movable joint).

The symphysis was repaired by passing a 20 gauge wire around the mandibles just behind the lower canine teeth, exiting on the ventral midline where I twisted the ends to tighten the ligature, cut the ends short and buried with a single suture.  The fracture of the mandible was stabilized by wiring around two teeth on each side of the fracture.  Probably will need to do more but later.

The next morning Gus was looking pretty good and actually was ready to get out of here and back to his barn.  We gave him a few laps of gruel and continued the fluids.  We were going to tackle the leg later today.  I still felt this was a waste of time.

With Gus under anesthesia, I went to work on the exposed bone.  To my surprise, I did not have to trim too much bone before I came to bleeding bone.  The marrow cavity appeared pretty clean with the superficial debris was removed.  I repaired the fracture with a threaded intramedullary pin.  Inserted at the knee and threaded down the marrow cavity to the fracture site.  Placed the ends of the exposed bone into normal position and seated the pin into the distal fragment.  This was the common repair at that time.  We will have problems due to the contamination at the fracture site.  I cleaned up the wound as best we could and closed this wound.

Gus was ready to go home for a few days before we started the next round of repair and treatment.

Both Carol and Gus were happy to see each other.  Gus was actually stepping on the fractured leg.  Cats always make surgeons look like they know what they are doing.

Over the next few weeks, Gus became a standard visitor to the surgery room.  We would clean on his open wounds, which were granulating well.  We closed his eye socket and placed an additional wire in his jaw to improve the repair.  On each visit I was more and more cautious on how the leg was healing.  The soft tissues were looking good but I was still skeptical about the bone.  Carol was in great spirits, and I think that Grandpa was getting to come out of the doghouse once in awhile.

Finally, push comes to shove.  Time to x-ray the leg to see how the repair is going.  Gus is still quite a sight.  One eye and one lower canine tooth protruding out on the outside of his upper lip.  Larges patches with no hair, but the wounds are mostly healed.  Probably as good as they would have healed had they been sutured.  He would purr and he was bearing weight on the fractured leg.

The x-rays were better than I expected.  There was some healing but not what was needed.  We would have to try something different.

So at 6 weeks from the time of injury I removed the IM pin.   There was a pretty good fibrous union of the fracture, but no boney union.  The next try was an external fixation device, 4 small pins driven into the bone, 2 above and 2 below the fracture site and bolted to an external pin to fix the bones in position.  A tall order for a cow doctor but I got it done.

Another 4 weeks and we were done.  The leg was healed, Gus was happy, Carol was happy.  I don’t know about Grandpa.  The total dollars are lost to a clouded memory.  Anyway, it was never about the money.

The last time I saw Gus was almost a year later.  Into his golden year now, and with none of 9 lives to spare, he was truly an old cat.  He was in for routine stuff, an abscess on the side of face, (left side, he probably didn’t see the punch coming) and tapeworms.  Still defending his turf and still able to catch a mouse or two. I always wondered about his final resting place.  Was it the manure pile, again?

Photo by Pitsch on Pixabay 

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