Raw Milk, Benefits and Risks

 D. E. Larsen, DVM

I stopped in front of the house on North River Drive and double-checked the address on my sheet. This was the address, but there were only houses around, no sign of a place for a cow.

 Mary came out of the house as I checked my notes, I rolled down my window.

“Hi, Mary,” I said. “Where is the sick cow?”

“If you go down this driveway,” Mary said as she was pointing out the driveway to the cow. “The milking shed is on the left, just past the trees. There is a gate there, and the cow is in her stanchion. You go ahead, and I will be along shortly.”

The driveway was long, but after going about a quarter of a mile, I could see a pullout and the gate. I pulled over, making sure I was out of the way of any traffic. 

The cow was standing quietly. She was probably wondering why she was there, well before milking time.

I didn’t have any specific information other than the cow was sick. But I grabbed my things and squeezed through the gate.

The cow was content to stand as I started looking her over. She was a friendly little Jersey cow, my favorite breed. Of course, I was partial since I grew up on a Jersey dairy.

Exam-wise, nothing seemed to jump out at me. She was standing quietly and not eating, but other than that, her front half looked pretty good. I put my stethoscope on her abdomen and checked her gut sounds, and there was no abnormal ping on the left side. Her rumen motility was reduced, which would go along with her not eating.

I checked her temperature with a rectal thermometer, which was slightly elevated. I checked her udder, and there was no evidence of mastitis.

I pulled a plastic sleeve on my left arm and stepped behind her to do a rectal exam. After squirting some lube on the sleeve, I grabbed her tail with my right hand and started to insert my left hand into her rectum.

She humped up and started to pee. The urine hit the wood floor of the shed and splattered. Her urine was bright red. I immediately jumped back, trying to avoid the splatter.

“Lepto,” I said to myself. I recalled Doctor Craig’s story about when he and a partner had worked a herd, and they both contracted Lepto. Roy noticed blood in his urine in the morning, and he went to the doctor and started antibiotics. His partner waited a few days, and he ended up dying.

Mary came through the gate about that time. 

“Are you finding anything?” she asked.

“Bloody urine,” I said. “Have you noticed that before?”

“I thought it looked bad last night when I milked her,” Mary said. “But this morning, it was really red. That’s why I called. What causes that?”

“It could be several things, but Leptospirosis is highest on the list,” I said. “Are you using her milk in the house?”

“Yes, that is all we use,” Mary said. “You’re not going give me a lecture on the evils of raw milk, are you.”

“I grew up drinking raw milk,” I said. “But that was a different time and a different place. I wouldn’t drink it today or give it to my kids. But that is all beside the point. The point is that this cow likely has Lepto, and she could be passing that disease in her milk, and she is definitely passing it in her urine. In an open milking situation like this, it is possible to contaminate the milk with her urine. You should discard what milk you have in the house.”

“I don’t know why I should throw out good milk,” Mary said. 

“It is not perfectly good milk,” I said. “It could make your family very sick, and someone could die from drinking it.”

“We are fine,” Mary said. “Nobody is sick. Raw milk enhances our immune system.”

“You should at least pasteurize it. The county extension office could help you with information about that process,” I said. “Today, I am going to draw some blood from this cow to send to the lab. Then I will put her on a high dose of antibiotics for a week. You should discard her milk while she is on antibiotics and for seven days from the last dose. It would be okay to feed the milk to a calf, but you shouldn’t use it in the house.”

“Do you understand how much money you are asking me to dump out on the ground?” Mary asked. “I wouldn’t think a little antibiotic would hurt much. You say it is okay to feed a calf, which we don’t have now. That must mean that it won’t hurt the kids much, either.”

“Well, I can’t force you to do anything,” I said. “I will write down my recommendations and have you sign the note, and you can do what you want with the milk. I will have the county environmental health department contact you to see they can be of any help for you.”

“Okay, we have that resolved,” Mary said. “Do you think Betsy is going to be okay?”

“Is she bred?” I asked. “Lepto does cause abortion sometimes.”

“No, we were going to get a friend’s bull next week,” Mary said. “She should be coming into heat in a couple of weeks.”

“That will probably be okay,” I said. “But you should tell your friend. Cows will sometimes shed this bacteria for some time after treatment. As long as they have clean water and a dry pasture, there would be a major exposure. However, there is mention of rare venereal transmission of Lepto in cattle. I would guess if it is after the antibiotics are completed, the risk to the bull would be low.”

I secured Betsy’s head with my nose tongs and drew a tube of blood from her jugular vein. I also placed an official ear tag in her left ear. This wasn’t required, but with the reluctance of Mary to heed my advice on discarding her milk, I wanted an official identification on the cow.

I gave Betsy a large dose of Polyflex, a new ampicillin suspension formulated for livestock. I left the bottle with Mary with instructions for daily dosing.

“What happens with the blood?” Mary asked.

“I separate it and send the serum into the lab,” I said. “They will do titers on it. Lepto is one of those diseases that have many varieties. They are pretty similar, but each is a little different. If those titers are negative, then I can rethink my diagnosis.”

“You seem pretty sure of your diagnosis,” Mary said.

“Sure enough that I am going to use a lot of soap and water to scrub myself before I get back into the truck,” I said.

***

Betsy’s titer came back positive for Leptospira grippotyphosa. This was a relatively new strain for western Oregon. 

Betsy recovered uneventfully, and Mary’s family squeaked by without an illness. Although, I believe they were fortunate.

Photo by Luke Stackpoole on Unsplash.

Buffy and Harry, from the Archives

D. E. Larsen, DVM

Harry’s car pulled up to the clinic’s front and bumped hard into the curb in the diagonal parking space. One wheel of the vehicle almost coming up on the curb. 

Watching out the window, Joleen said, “It looks like Harry has been drinking too much again.”

Harry stepped out of the car, and you could appreciate how large of a man he was. He just seemed to keep coming. He studied himself a bit, with both hands on the roof of the car, and leaned in to pull Buffy off the passenger seat.

Harry was an older man, well into his seventies, if not eighty. He lived by himself. The story goes that he started drinking heavily after his wife’s death, almost 10 years ago.

“I wonder what Buffy has been up to this time,” Joleen said?

Buffy was one of those dogs who could be termed a mutt on his medical record, and he would fit the bill. If one had to pick a breed, you would probably call him a terrier. Small and rugged, he was not much to look at, but he was intensely loyal to Harry. He was perhaps the one thing that kept from going off the cliff with his drinking.

Buffy was also a tough little guy and would take on the biggest dog on the block every chance he could get. We had sewn up more than one gash on his body. His thick bristly hair coat hid most of the scars well.

  Most of the time, when we would see Buffy, Harry was drunk. Sometimes, almost falling down drunk. It often took Harry several days to remember where he had left Buffy. As is often the case when the owner needs someone to watch after him.

Buffy was always protective of Harry and his space. Most of his visits came from wounds received in dog fights: bite wounds, broken legs, and various scrapes and bruises. Harry somehow always paid the bill.

Harry came through the door holding Buffy with bloody hands. He immediately handed Buffy to Joleen.

Joleen looked at the wounds and gasped. “What in the world happened to Buffy this time.”

“Two big dogs got him. They bit me, breaking up the fight. They were going to kill him this time.”

  Buffy had deep punctures on both sides of his lower back and extensive muscle and skin damage.  

“Harry, we will take care of Buffy,” I said. “You need to go get a doctor to look at that hand. Do you have somebody we can call to drive you there?”

“Yes, I have already called Jim to come to pick me up,” Harry said. “I think he just pulled up.”

“What should I tell Harry about how long will we be keeping Buffy?” Joleen asked as she started helping Harry out to the waiting car. 

“Don’t worry about it. We will know more about how Buffy is going to do by the time Harry remembers where he left him.” I reply.

Buffy’s wounds were a real challenge, and had he not been so tough, he would not have survived. By the third day after admission, we could recognize extensive tissue death in the area of his wounds. 

We went through a series of three or four surgeries to remove dead skin and muscle. By the time we had all the dead tissue removed, Buffy had lost a significant portion of skin and muscle on his left side and hip.

Buffy spends twenty-one days in the clinic, and he hated it every day. One could hardly blame him. Two or three injections and the constant bandage changes must make him believe we exist only to torture him. He cowers every time he sees me.  

He is ecstatic when Harry finally takes him home. He still has large open wounds, but they are healing well, and finally, I believe, the wounds can be managed by Harry at home.  

On the fourth day after Buffy was home, Harry calls the clinic. He’s drunk, but he can still talk.

“Buffy’s sick, can hardly walk.” Harry finally stutters into the phone.

Not sure who could hardly walk, Joleen asked, “Can you get him to the clinic, Harry?”

“Don’t think I can drive much right now.” Harry replies, with a stroke of insight that is uncommon for him.

“We will pick him up right after lunch, Harry. I just need to know where you live.”  

I have received many different sets of directions in my years of practice. I have often criticized women for what I perceived as a failure to pay attention to details and inability to give accurate directions that a person could follow. But Harry’s directions were impossible.

Despite those directions, Joleen and I pulled into his driveway shortly after lunch. Harry lived in a small run-down shack, but it was surprisingly well kept.  

We knocked on the door, and in a few minutes, Harry opened the door. He was hooked up to his oxygen bottle and having a little trouble walking. Buffy was at his heels. When he looked up and saw us, he had real dread in his eyes.  

“My God, they know where I live,” those eyes seemed to say. Buffy reared back and headed for the back room, staggering on stiff legs. He was attempting to crawl behind the small cabinet when I caught up with him.

“What is wrong with him,” Harry asked?

“It looks like Buffy has tetanus,” I said. “Tetanus in the dog is rare. I have only seen it in one other dog. The good thing is dogs are resistant to the disease, and most will survive with treatment.”

Joleen took Buffy from my arms, “I think he feels safer with me.”

“We will probably need to keep him for another week or two, Harry. We will give you a call when he is ready to go home,” I said.

Buffy spent another twenty days in the clinic. He responded well to treatment. We kept him a few extra days to make sure Harry could handle his treatments at home.

This time, we had Harry bring Buffy to the clinic several times a week. Just so we could keep track of the wounds. These visits became a struggle. Buffy would be under the car seat before Harry was fully parked in front of the clinic. Joleen had to wrestle him out from under the car seat and into the clinic.  

“Harry, next visit, you call when you leave the house, and you park over at Safeway,” Joleen instructed. “I will come over there and get Buffy.”

On the first trip after that, Joleen opened the passenger door and grabbed Buffy before he could get off the seat. Harry staggered his parking location on each visit, and Buffy never seemed to catch on to the game.

Finally, Buffy’s wounds healed. He was scarred but functional.

“Now you just have to keep him from going out and picking a fight with the big boys,” I told Harry as he made his last visit.

“I think this little guy is going to be an inside dog from now on,” Harry said. “I will probably have to stop drinking. That is what got him into trouble last time. I let him out to do his business because I was too drunk to walk him.”

“Maybe both of you have learned a lesson,” I said. “It will be a good thing if Buffy helps you to slow down on the bottle.”

“How much do I owe you, Doc,” Harry asked?

“Your bill is pretty big,” I said.

“I don’t have much, but I will pay you $50.00 a month, probably forever,” Harry said as he shook my hand.

Harry faithfully paid $50.00 a month, every month until he died. He was always thankful for Buffy’s recovery. If people were half as sincere as Harry, credit problems would be non-existent.  

Buffy hated me for the rest of his days.

Photo by Annie Spratt on Unsplash

Foster’s Problem

D. E. Larsen, DVM

Jim was waiting for the exam when I came through the door. He wasn’t smiling today, and Foster, his old black Lab, was standing with his head down.

“What going on with Foster today?” I asked.

“That’s what we are here to find out,” Jim answered. “We were over at Joseph this weekend, and I noticed that he had some blood in his pee. It has been getting worse every day. We got home last night, and it took him forever to get done peeing before he came in the house, and that’s not him at all, Doc. He can usually mark every post with no problem. Last night he was just standing out there dribbling blood.”

“That doesn’t sound very good for an old dog,” I said. “Let me get him up on the table and look things over.”

“You be careful, Doc,” Jim said. “You know he’s over a hundred pounds.”

Foster was an older black Lab and a constant companion for Jim. He was an old-time Lab, with a large dog with a large head that was almost square. Foster was getting older now, approaching ten years of age. And like many of the older Labs, he had some arthritis in his knees and back. But his heart was still strong. And he was still an intact male.

I took a deep breath, bent over, and with my left arm across his chest and my right arm under his abdomen, I swooped Foster up and placed him on the exam table.

“Keeps me in shape,” I said to Jim with a smile.

Jim was a timber faller and was used to hard work and working with men who worked hard and used their muscles. He finally cracked a smile.

I looked Foster over, checking everything before getting to his urinary tract. When I finally palpated his abdomen, Foster registered his discomfort. I could feel his bladder was pretty full, which would help get a urine sample. Then I could feel his prostate immediately behind his bladder, and I should not have been able to feel his prostate. This prostate gland was the size of a large grapefruit, and Foster groaned when I palpated it.

“Jim, his prostate is the size of a large grapefruit,” I said.

“That’s what my sister-in-law suspected,” Jim said. “She a vet over by Madras, you know. Do you think it is cancer?”

“I have only seen one case of prostate cancer in the dog,” I said. “Most of the time in an older intact male, it is a benign hypertrophy, along with an infection.”

“How do confirm that, and what do you do to treat it?” Jim asked.

“We play the odds a bit,” I said. “If it were to be cancer, he is probably a dead dog. We need to get a urine sample to look at and do a culture. We need to get an x-ray to make sure there aren’t any bladder stones involved and do some blood work to ensure his kidneys are okay. Then with some medication and neutering him, most of these guys clear up in a few days. Getting those testicles out of the picture is the important thing. I had one old dog about Foster’s age that belonged to an old man who couldn’t afford much. We neutered that dog and put him on some antibiotics, and he was well in a few days. His prostate was almost back to normal when I took the sutures out. When I neutered him, the infection in the prostate was extending down the spermatic cords all the way to the testicles.”

“Doc, you know I don’t want to neuter this dog,” Jim said. “Can it be done without neutering him?”

“It can be done,” I said. “But it won’t be as fast, and you will be back in here with the same problem sometime in the future.”

We did the diagnostics on Foster and sent a urine culture off to the laboratory. The x-rays show a massive prostate hanging over the brim of the pelvis. It was so large it was interfering with the colon even though it was mostly out of the pelvis.

I sent Foster home on medication and checked him back in a few days when we would have the culture results.

***

Foster bounced through the door for his recheck, and Jim followed with a smile on his face.

“He is feeling like his old self, Doc,” Jim said.

“That’s a good thing,” I said. “We cultured an E. coli out of his urine. Sometimes that can be serious, but our antibiotic we started him on was the correct one.”

I palpated his abdomen with Foster on the floor and did a rectal exam. 

“It’s not back to normal quite yet, but much smaller today,” I said to Jim.

“What do we do now?” Jim asked.

“Now we finish the antibiotics and then recheck a urine sample in a couple of weeks after they are through,” I said. “Then, if the urine is okay, it is just a matter of watchful waiting. It will happen again, maybe next month or next year, and you just have to be watchful and catch things early.”

***

Over the next year and a half, Foster was in for his prostate problem several times. It was always the same. Jim had learned to notice as soon as Foster’s urinary habits changed a bit. His prostate was always large, but never the size it was on his initial visit.

“Jim, you know, Foster isn’t getting any younger,” I said. “One of these episodes will run into some major issues with kidneys or something. We could bring this all to an end by neutering him.”

“Okay, Doc, let’s go ahead and neuter the old guy,” Jim said. “He has slowed down in his old age, and I would guess he won’t get much use out those things at this stage in his life.”

We scheduled Foster’s surgery for the following morning. I wanted to get it done before Jim had second thoughts.

Veterinarians do neuter surgeries on dogs often, maybe not every day, but certainly, every week. They are always cautioned against calling a surgery routine, but a neuter is almost a routine surgery for most veterinarians. But they rarely neuter an eleven-year-old large dog.

The procedure is the same, but the tissues are different. Squeezing the testicle and its tunic out of the scrotum in a young dog is no problem and takes little effort. That same testicular tunic in an old dog is solidly attached to the inside of the scrotum. It is a real struggle to free from its attachment. But I got it done.

Foster went home a new man, and when we checked him back for suture removal, his prostate gland palpated normally. And he lived out his life without another issue with that gland.

Photo by Matthis from Pexels.