Midge

D. E. Larsen, DVM

I had met Midge when she was 2 days old. I was looking at a cow at Ron’s place. I mentioned that we were looking for a dog for the kids.

“We happen to have a new litter of pups. Lab mixes, I would guess,” Ron said.

“The mother is a lab?” I asked.

“No, she is an Australian Shepherd. Well, mostly Australian Shepherd.”

We finished up with the cow, and Ron took me over to the pump house. There was Bessie, curled up in her box with a litter of 8 black puppies. All the pups only had short stubs for a tail, inherited from mom.

“You bring your kids back in 6 weeks, and they can have the pick of the litter,” Ron said with a broad smile.

“You have a deal, I am sure they will enjoy picking out their pup from the bunch. But you had better give away any of the pups you can. The pick of the litter is not that big of a thing for the kids. You wait on us, and you might end up with 7 dogs running around here.”

The kids marked off the weeks on the calendar. They were excited to be getting a new puppy. We all loaded in the car and headed out to Ron’s ranch. It was a warm day in the early summer, and the whole valley was green and growing. It made for a pleasant drive, out Pleasant Valley Road, and over the hill on Berlin Road.

Both Ron and Helen were waiting for us when we pulled into the driveway. The kids were bailing out of the car as soon as it came to a stop. Ron led the parade to the pump house. When he opened the door, the whole litter came tumbling out, falling over one another. They were happy puppies and happy kids. And the black lab mix pups all had legs not much over an inch long.

“These pups are fine, but you know, I don’t think they are black lab crosses,” I said to Helen as we watched the kids. Amy and Dee were on the ground with pups swarming over them, trying to lick the faces. Brenda had made her selection and had scooped her up early. My guess is that would be our pup.

“They have to be labs, there was no other dog around here,” Helen said, looking at Ron for support.

“The only other time there was a dog on the place was when Les came over,” Ron said.

“Yes, but Les’s dog was a Dachshund,” Helen said. “There is no way they could have got together.”

“My guess is when there is a well, there is a way,” I said. “You know the system is made to work. She probably laid down for him.”

Brenda loaded the little female pup into the back seat with the other girls. They had named her Midge before we were out of the driveway. Her legs were never over three inches long, and she conducted herself like a perfect little German Lady.

Block and Tackle C-Section

D. E. Larsen, DVM

Another 3:00 AM emergency, I thought to myself as I started loading things up for my trip into the barn. Glenn was not a regular client but often helped out down the road at Ayer’s place. This large old barn told a familiar story of bygone days, once a thriving little family dairy farm, now the kids are grown, Glenn stove up enough to just being able to manage a few cows and the market for milk from small dairies has long since dried up.

I shook off the chill of the early morning air, hopefully it will be a little warmer in the barn.  Glenn was waiting with the large barn door pushed open slightly. 

“Morning Doc,” he said with a smile, “sorry to call you so early but she has been at for several hours with no progress.”

I could see the heifer tied to a center post. A large Simmental heifer with a single foot visible at her vulva. The foot was huge, this was not going to be a simple morning. 

I approached the heifer cautiously and scratched her forehead. I should have known, she was like a pet, probably the only replacement heifer Glenn had and a far cry from a wild range heifer.  I adjusted the halter to make sure it would not choke her if she went down during the exam and then moved to her rear end. The second hoof was just inside the vulva, the soles of the hooves were up. These were hind feet and they were very large, nearly filling the entire birth canal.

I tied a length of twine on the switch of her tail and secured the other end in a loop around her neck. This held the tail out of the way.  Then I scrubbed the vulva with warm water and Betadine surgical scrub. After pulling on a plastic OB sleeve I carefully inserted my hand and arm into the vulva to explore the situation. There was just enough room for my arm and the two legs of the calf. I could reach the cervix and palpate the calf’s hocks. This was a massive calf. I strained to reach past the hocks to the rump of the calf. No vulva, this was a bull calf. I inserted a finger into the rectum. There was a strong tightening, he was alive.

“Glenn, this calf must weigh 150 lbs. His two legs and my arm fill the entire birth canal,” I explained.  “The only way he is coming out of her is if we do a C-Section. He is in posterior presentation, he is alive but I don’t know if you and I can lift him out of her.”

I thought about the situation. Glenn was a small man but I knew he was no weakling. I have had difficulty in the past bringing the uterus up to a flank incision with a large calf in a posterior presentation. It would be best to use ventral midline incision. Laying the heifer down would be no problem but then lifting this calf out of her was going to be tough. 

“Glenn, do you have a block and tackle?” I asked.

“Sure, Doc, what do you want to do with it?

I pointed to a spot in the rafters that could hold the block.  “Let’s hang it there, I will lay this heifer down and roll her onto her back. Maybe we could block her up with a couple of hay bales.”

Glenn hung the block and tackle while I got things together for a C-section. The block and tackle looked like it could lift 1000 pounds. These C-sections always took me a couple of hours, probably no chance of getting back to bed before office hours.

We moved the heifer over to where I wanted the throw her. Tied her to a post and place a Flying W on her. This is a standard rope throw that I often used. It always amazed these old farmers and the story would be told over many a cups of coffee.  I put the rope over her neck in the middle of the rope, tied a loose knot that fit between her front legs.  Then threw each end over her back so they cross in the middle of her back. Then put the ends between her hind legs, exiting on each side of her udder.  I grabbed these ends, pulled hard and leaned to the right at the same time. The heifer made a hard flop onto her right side.  Glenn looked at me and smiled. By his reaction, I am certain he had never seen that before. I rolled her up on her back, and tied each hind leg to the rope so when she stained or kicked against the rope it would putt more pressure on Flying W and increase the restraint. Then we placed a bale of hay against each shoulder to maintain her on her back.

This done, I stood up and stretched a little. “I hope you can get me an extension cord?” I asked.  

Glenn had one hanging on the wall near the door and he had it plugged in and stretched out in no time.  I plugged in my clippers and clipped the ventral abdomen from the umbilicus to the udder and to both side. I scrubbed it with Betadine Surgical Scrub and wiped the incision are clean. I used 2% Lidocaine for local anesthesia, about 90 cc and left 30 cc in the syringe in case I needed more.

I did a second prep of the area and wiped it with alcohol, then spayed it with Betadine solution. I laid out my surgical pack on a hay bale and opened 4 packs of #2 Dexon suture material and a scalpel blade. Then I put on a pair of surgery gloves and dropped to my knees beside the heifer. I made an incision through the skin on the midline, about 12 inches long. Extended this though the subcutaneous tissues and exposed the linea alba (white line in Latin, that fibrous band on the abdominal midline). I made a small incision through the linea alba and inserted a thumb forceps to protect the abdominal tissues from the blade. I opened the linea the full length of the incision.  

I pulled the omentum forward and there was the uterus filling the abdomen. With one hand I tried to externalize the uterus, I could hardly move the head.  I found a foot and moved it to the incision.  I incised the uterus, using the space between the toes as a guide to the incision.  With this foot exposed through a small incision in the uterus I attached a nylon OB strap to it and hooked the loop of the strap to the hook on the tackle block.

“Take up some slack and put just a little tension on this foot,” I instructed Glenn.

I enlarged the incision just a little to allow me to reach in and find the other foot. I pulled it out and attached it to the other end of the OB strap. “A little more tension,” I said.

As the legs extended through the uterine incision, I enlarged it toward the head of the calf. Now, with most of weight on the block and tackle, I could left head of the calf to the incision. I worked the head through the incision, looked at Glenn and said “Pull”.

The calf glided out through the incision with ease. I guided the hide feet out and away from the heifer and Glenn lowered it to the floor.  Indeed, this was the largest calf I had delivered, ever bit of 150 pounds. 

He snorted and shook his head.  Glenn was all smiles. I took a towel and wiped the mucus from his nose and mouth and rubbed his chest a little.  “He will be up before his Mama,” I said.

I changed gloves and started back to work on the cow.  I removed some of the membranes through the incision but most were left to pass vaginally.  I dumped a package of 5 grams of Tetracycline powder into the uterus. I closed the uterus incision with #2 Dexon in a continuous Utrecht closure. I returned the uterus to the abdomen and covered it with omentum.  Then I started on the closure of the linea alba. I closed the linea alba with an interrupted sliding mattress closure using doubled #2 Dexon sutures. Then the free edge was closed with a simple continuous suture using #2 Dexon. 

With this done I relaxed a little, thinking to myself, if I dropped dead now the rest of the incision would probably heal on its own.  About this time, the heifer strained against the rope. The right foot came mostly free and she kicked hard. The hoof caught me on the left side of my jaw and felt like a very solid punch. It was hard enough to almost set me back on my butt. I shook my head and realized that I was okay.  I got back to my knees and retied the foot with an extra wrap or two.

I changed gloves and completed the closure. I used a simple continuous in subcutaneous tissues and a standard mattress on the skin, all with #2 Dexon, I didn’t want to have to crawl under this heifer to take out any sutures.  I sprayed the incision with Furacin spray and the whole area with fly spray.  Done at last, I thought as I stood up, pulling my gloves off.

Glenn had the calf on his feet already.  I took a bottle of Betadine and filled his umbilcal cord, saturating the surrounding area.  Then I gave him a 200 pound dose of MuSe, a vitamin E/Selenium supplement. This calf looked a month old already.  

We untied the ropes and moved the hay bales. The heifer rolled to her side and onto her sternum in one motion. When Glenn pushed the calf toward her, she jumped to her feet and took control of the calf. I gathered up my stuff and got everything back in the truck. We untied her tail and removed the halter. 

“I’ll leave her here for now.” Glenn said.

“Yes, I would keep her close for a few days, just to make sure everything is okay,” I said.  “Call if you have any concerns, but I would expect things to be fine.  She should pass the rest of her membranes tomorrow or maybe the next day.”

I got back in the truck and rubbed my jaw a little.  Opened my mouth wide, everything was okay. My guess is that foot was slowed down by the rope a little, otherwise it would have been worse.

As I headed back toward town the sky was starting to show some light in the East. I would get home for a shower and breakfast before I was due at the office.  No rest for the wicked. Sort of reminded me of my Army days.

Wounded by Her Dinner

D. E. Larsen, DVM

  I looked around as I stood in the middle of the exam room. There was nobody with me to lend a hand. All the girls in the office were suddenly gone, they were nowhere in sight. Not even watching from the far side of the clinic.

  In front of me, a near life or death struggle was unfolding. Mike and Don were trying to extract my next patient from a large dog kennel that they had sat on the exam table. The patient was making it clear, in no uncertain terms, that she was not coming out of the kennel.

  These were a couple of big boys. Actually, young men, they were both well over 6 feet tall, with broad shoulders and muscular, athletic bodies. You would think that they could handle any contents of the kennel with no problem.

  Don had assumed the lead role. He was in front of the open door to the kennel. Sort of making little sways, to and fro, following the head of the soon to be patient, Sonja. Finally, Don took a deep breath and plunged into the kennel with both hands outstretched. He had her by the head, and she didn’t like it. There were loud hissing coming from the kennel. Don pulled back with the head in his hands.

  I could see the muscles on her massive head bulging, her mouth wide open and hissing. Don began to pull her out of the kennel. The kennel bouncing and banging in all directions as she struggled to stay inside. Mike moved in to try to control her body.

  “She is really pissed!” Mike said as he grabbed her body.

  Mike’s assessment was pretty accurate. Sonja was no small snake. At twelve feet long and over 50 pounds, she was a fine specimen of a Burmese Python. Don had managed to pull her head out of kennel two or three feet. The remainder of her body was coiled in a large mass in the kennel. She continued to bang the kennel up and down on the table with forceful throws of her coils, and she had no intention of coming the rest of the way out.

  Don managed to get her head out far enough to where he could turn his body and put more pressure on extracting her.

  “Don’t let her get on my back!” Don screamed at Mike. There was real excitement in the air now. 

 “I have her!” Mike replied equally loud and excited.

 Mike had one arm around her body about six feet behind Don, and he was trying to push the kennel back with his other hand. Joleen had peeked out of the back to check on the screams.

And then it happened!

  Sonja shit a brick, literally. Big snakes eat about once a week and have a BM on about the same schedule. This BM was a white block, about four inches square and nearly a foot long. It was last week’s rabbit. 

  The odor was overwhelming. Veterinarians are said to lose their sense of smell by the end of their second year of school. For the most part, that is true. But this was unlike anything I had ever smelled before.

  Jolene turned and disappeared again. Mike turned his head away and gagged. 

  Don looked at me and said, “That really smells bad. That means she is really mad.”

  A few more minutes, and they had her out of the carrier. Here were two large, strong young men, honestly struggling to maintain control of the giant snake. I began to appreciate the power that this snake possessed. It was all of a sudden apparent that if we messed up, someone could be in real trouble. The thought brushed my mind, what would happen if this snake got loose in the clinic.

Finally, they had her under control enough that we could talk about her problem. There, on top of her head, was a large festering wound. It extended deep into the muscles of the head. It was the result of a bite from a rabbit, just before dinner time.

Snake abscess always looked different from what I was used to seeing. The exudate is dry, almost laid down in layers, reminiscent of an onion.

  I swabbed this wound with some Betadine and started scraping the exudate out, one layer at a time, beginning in the center. After all the accumulated debris was removed, I found a good bed of new, healthy, granulation tissue.

 I cleaned the wound thoroughly and disinfected it with Betadine. After cleaning, it was about the size of a dime and a centimeter deep. The good thing was the outer opening was the widest part. This would should heal uneventfully at this point. 

  Antibiotic use in the reptiles is not without some significant risks. My thought was with this wound cleaned out, and with healing underway, we would forgo any antibiotics. I layered some NewSkin over the wound.

  I handed the kennel off to be cleaned in the back. Getting the brick out to dumpster made the working environment much more pleasant. Now our only problem was to get Sonja back into the kennel.

  With the kennel sat up on end on the floor, with the door looking up, Mike began stuffing her into the carrier. I think when she realized where her body of going, she sort of relaxed. Finally, with only her head to go, Don threw her head into the kennel, and they slammed the door closed.

Everyone relaxed, you could feel the tension drain from the room. Mike and Don were both sweating and looked like a couple of guys who just stepped off the wrestling mat. 

  “I think we should probably recheck this wound every day for a few days,” I said with a smile on my face.

  The expression of the faces was worth the joke. I think everyone was happy to load the kennel back into their truck.

Image by sipa from Pixabay 

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