Wooden Tongue

 D. E. Larsen, DVM

The old cow was in the middle of the corral as I pulled up. Her head was extended, and her tongue protruded a bit from her open mouth. Saliva hung from her mouth in long, thick streams that nearly reached the ground.

I stepped out of the truck, pulled on a pair of coveralls, and slipped on my overboots. I could see Ed coming out of the house and heading for the corral at a trot.

“Sorry to keep you waiting, Doc,” Ed said as he approached the truck. He was breathing a little hard, and I noted a pack of cigarettes in his shirt pocket. “I don’t know what the heck is wrong with this old gal, but I noticed her having trouble eating a few days ago, and I’m not sure she can drink today. She stands at the water trough with her nose down in the water.”

“Sounds like we need to look at her,” I said. “I will grab my rope and see if I can throw it this morning.”

I chuckled under my breath. It always amazed me how the guy that would apologize for making me wait half a minute while he trotted out of the house was the same guy who never had the cow waiting at the chute or tied in the corral.

I was learning a bit. I made a mistake early in my tenure here in Sweet Home by displaying my skill with a rope. Now I always tried to look awkward in handling the rope, and I made sure I missed the cow several times before landing a good catch.

Since the gate was at the far end of the corral, I crawled over the top rail of the corral with my rope in hand. I just hoped that Ed could hand things over the fence, or I would be getting plenty of exercise this morning.

The cow didn’t move, I could probably just place the rope around her neck, but I wanted Ed to see how much difficulty I could have throwing the rope. I stood back from the cow and threw a loop at her neck. The rope plowed into the side of her neck with a thud. The cow never moved.

I gathered the rope and threw another loop that missed her all together. I figured that was enough of a display for Ed. I walked up to the cow, placed the rope around her neck, and fashioned a halter. Again, the cow never moved.

“I think you probably need a little practice throwing that rope, Doc,” Ed said.

“Roping is really not in my job description, Ed,” I said. “You could save a lot of time for yourself and me by upgrading this corral with a squeeze chute.”

“That is a lot of expense, Doc,” Ed said. “I have just never been able to justify it.”

“My brother-in-law always says that if he had to do it over again, he would have bought the squeeze chute before he bought his first cow,” I said. “And really, you don’t have to have a squeeze chute. I can help you with the design. You can do wonders with just a crowding alley and a headgate. That would save you the expense of a chute. In fact, if you’re a good carpenter, you can build a headgate. Just make a good stanchion on a gate that opens at the front of the alley. It is a little cumbersome, but it can work if the expense is a big item.”

“I’ll give it some thought, Doc,” Ed said.

That was cryptic for I think it is BS.

“I think I could look at this cow without a rope,” I said. “She is pretty distressed. I think she is just going to stand right here. Can you hand me that bucket of water and that black bag on the truck tail gait?”

I plugged in a thermometer and clipped its lanyard to the hair on top of her tail, and she had no problem with that procedure. But when I got to her mouth, she objected, shook her head, and moved away from me a few steps.

“Looks like she wants to be tied up,” I said as I led her to the nears post and tied her short.

When I grabbed her swollen tongue, it was hard. With my fingers putting pressure on the roof of her mouth, I held her mouth open and explored the base of the tongue with my fingers. There was no foreign body and no apparent injury.

I allowed the cow to relax. Her temperature was a little elevated, but otherwise, she looked okay.

I washed my hands vigorously with Betadine surgical scrub.

“What do you think is wrong with her, Doc?” Ed asked.

“She has Wooden Tongue,” I said. “I’ll give her an IV injection of sodium iodide, which should take care of it. Sometimes we need to repeat the injection in a week.”

“How do you suppose she got it?” Ed asked. “I ain’t never seen anything like this before.”

“It is caused by a bacteria, and Actinobacillus is the name,” I said. “It is probably around in the environment and just pops up once in a while. It gets into the tongue through an injury, often just a small puncture from course feed. But we usually can’t define a source.”

“I know a guy in Crawfordsville who lost a bunch of bone on the side of his face to an Actino bug of some type,” Ed said.

“Yes, I know the guy,” I said. “His case was a little different and probably a lot more serious. It was Actinomycosis that caused his problem. Similar names, but Actinomycosis invades the bone, and it is more difficult to treat. That is probably why he lost a lot of bone on the side of his face. He said the doctors told him he probably got it from chewing on a stem of grass. Who knows?”

I retrieved a bottle of sodium iodide from my bag and attached an IV set to it. I placed a fourteen gauge, two-inch needle into her jugular vein and hooked the IV set to the needle. The infusion only took a couple of minutes.

“I will give you a call in a couple of days, Ed,” I said. “She should be mostly normal in forty-eight hours. If that is not the case, we will need to give her some other antibiotics. Then, next week, we will decide if she needs another one of these infusions.”

“Do you think I should keep her up?” Ed asked.

“I would keep here until I talk with you in a couple of days,” I said. “Just in case we have to give her something else. Just have some good grass hay and maybe a little grain for her. I would guess she will be noticeably improved by morning.”

I untied the cow and handed my things across the fence to Ed. Then I crawled over the rails. 

I got out of my coverall and boots and washed my hands again.

“Okay, I’ll call in a couple of days,” I said. “You call if she is not improved in the morning. And Ed, do call and set up a time for me to go over your corral system. There is no charge for me doing that, and you can always ignore it if the plans don’t work for you.”

***

The old cow was back to normal when I called Ed in two days. And I just stopped by and talked with Ed as we looked at her in the pasture two weeks later.

And, true to form, Ed never did come by the clinic to discuss his corral system.

Photo by freestocks.org from Pexels.

Hold the Horse Down

D. E. Larsen, DVM 

Mike was sitting behind the desk in the large animal hospital, his standard position during every one of our weeks of night duty at Colorado State University.

“Mike, you seem to like the desk job,” I said.

“Naw, not so much. I just need the experience of talking to people on the phone,” Mike said.

This was Thursday evening, nearing the end of our week of night duty. Seniors were assigned night duty every couple of months. Ten of us ran the hospital from closing at five until ten o’clock. We were managed by two interns, one on the small animal side and one on the large animal side of the hospital. We got to go home at night. The interns slept over at the hospital. But they had our telephone numbers if the need arose.

“Larsen, you need to get the whole group together for a quick conference here,” Doctor Reese, the intern on duty, said. “We are going to have an issue tonight.”

I headed out to the small animal side of the hospital and started gathering everyone for this conference.

“Conference?” Rod asked. “What is going on?”

“I have no idea what’s up,” I said. “Doctor Reese needs us all together to discuss the night.”

“Is he going to keep us here all night?” Rod asked.

“I say again, Rod,” I said. “I have no idea what’s going on. I’m just the go-for out getting everyone over to the large animal office.”

“It looks like we are missing a couple of guys,” Doctor Reese said.

“Chuck and Rod are finishing up doing the evening treatments over on the small animal side. They should be here shortly,” I said.

“I’ll wait till they get here. I don’t want to have to repeat everything twice,” Doctor Reese said.

The two latecomers came through the door just as Doctor Reese made that statement.

Chuck sat on the corner of the desk. “What’s up, Doc,” Chuck said.

“Okay, for those of you who don’t know it,” Doctor Reese started. “Doctor Adams had an emergency surgery today. He had the American champion endurance horse come in with a fractured humerus.”

“That is almost an automatic euthanasia, isn’t it?” Jim asked.

“In most cases, yes. But this horse has an exceptional value. So it was decided to give the repair a try,” Doctor Reese said. “It was a complicated surgery, even for Doctor Adams. Repairing a fractured humerus in the horse is almost an unheard of surgery.”

“So, how does that affect us?” Chuck asked. 

“It was a seven-hour surgery,” Doctor Reese said. “Seven hours lying on its left leg, and on recovery, there is radial nerve paralysis in the left leg.”

The radial nerve controls all the muscles that extend the front leg. Without radial nerve function, the animal cannot stand on that leg. I had never heard of it in a horse. In the dog, the leg drags along, wearing the skin off the top of the paw in short order.

“That’s another automatic euthanasia in the horse,” Jim said.

“So the surgery team has been holding the horse down in the recovery stall all evening,” Doctor Reese said. “The plan is to let them go home at ten tonight. We will be responsible for holding the horse down tonight. We will pull two-hour shifts with two of you on each shift.”

“I’m not sure I understand the plan,” I said. “I mean, if we had radial nerve paralysis with the horse on its side during surgery for seven hours, can we expect anything different if we hold the horse down on the other side for ten or twelve hours?”

“It is the only option we have,” Doctor Reese said. “They gave the horse a big dose of dexamethasone. The hope is to see some return to function by morning so they can get the horse in a sling. I will agree, the odds are not good for the horse. But, Larsen, if you want to discuss the plan with Doctor Adams, you can just march right down there and talk with him.”

Doctor Adams was almost a god in the world of lameness and orthopedics in the horse, and he had a massive influence in the veterinary school. He could kick a person out of school in a heartbeat, and there were rumors of him doing just that in the past. True or not, the potential threat made students conduct themselves with an extra measure of decorum. 

“I think Jim and I will volunteer for the first shift,” I said.

“Okay,” Doctor Reese said. “We need to get everyone signed up for a shift. You guys take a phone into the recovery stall with you. There is a phone plug-in there. You give the next shift a phone call a half hour before they are due to be here. Everybody needs to take the responsibility to make it here for your shift. That way, all of us can get some sleep tonight.”

“I need to call Sandy and let her know I am going to be late tonight,” I said.

“You other guys go ahead and head home now,” Doctor Reese said. “Jim and Dave, gather the clipboard with the list and bring a phone. We can go down to the recovery stall and get instructions for the night.”

The recovery stall was a large room, maybe twenty feet square. It was padded with thick rubber mats, like a wrestling mat, on the floor and all sides. Once you were in the room and the door was closed, it was just you and the horse, and do place to duck for cover if the horse was flopping around.

“You guys have had a long day,” Doctor Reese said as we squeezed through the large door that was opened only a crack for our entry. “We are set up with two-man shifts at two-hour intervals. We just need some instructions.”

“All you need to do is have somebody sitting on his neck all the time,” Doctor Adams said. “He is fully recovered and will try to jump up if he gets a chance. His left leg has no radial nerve function, and bone plates on his right humerus will not hold his weight. His only hope is to get enough return to function so we can get him in a sling tomorrow.”

Jim placed his knee on the horse’s neck as Steve stood up, and then Jim swirled around and sat down on his neck. It looked like an easy maneuver, but the horse did try to raise his head during the change of position.

“I’m about beat,” Steve said as he pushed past me. “I don’t think I will be going into Equine Orthopedics after today. We have been working on this horse since ten o’clock this morning. You should have been in on that surgery. I will never complain about the surgical approach of the humerus on a dog again.”

“Retracting the muscles must have been a chore,” I said. 

“I don’t think most people could have done the surgery,” Steve said. “Doctor Adams is so strong, and he made some of it look easy. But, a seven-hour surgery is almost too much for this kid.”

The surgical team filed out of the recovery stall. 

“Call me if you need anything. I will try to get some shut-eye,” Doctor Reese said as he left the stall and shut the door.

I plugged in the phone and laid the clipboard down in the corner, and set the phone on the clipboard.

“I guess if we hold the horse down, the phone will be safe in the corner,” I said.

“I hate being closed in this room with a horse,” Jim said. “There is no way to be safe if the horse is really flopping around.”

“Well, it’s one thing if you are recovering a normal horse,” I said. “This horse has almost zero chance of recovery, and here we are, stuck in this recovery stall with it.”

“The thing that I don’t understand is how are they going to get this horse in a sling anyway?” Jim asked.

“I don’t know. I would guess they will have to sedate him to lift him into it,” I said. “I don’t know why they didn’t do that this evening. By morning, the nerve on the repaired leg will be shot too.”

“I think Adams just wants to be able to write up this repair,” Jim said. “I doubt if it has been done before.”

“I don’t think so,” I said. “If it has, it hasn’t been done very often.”

“Have you heard of a radial nerve paralysis ever returning to function?” Jim asked.

“I haven’t heard of it occurring in the horse before, but in the dog, the leg gets ruined before there is any return to function,” I said. “At least that is the impression that I get from Doctor Creed.”

“It’s probably about time we switch positions,” Jim said. “My butt is getting tired.”

I moved around the horse and knelt with my knee on his neck. Jim stood up and stretched, and I tried to turn on my knee and sit down on the horse’s neck. The horse swung his head up at the same time, knocking me off his neck, and suddenly I am lying on my back beside his front legs. I scrambled away from his legs, and he was immediately was up on his sternum. In an instant, he tried to stand.

His left leg hung uselessly, and he placed his repaired right leg out to stand. It held together for a brief moment, and then the leg collapsed as the repair broke apart.

I looked at Jim and shrugged my shoulders.

“I wonder what Adams is going to say about this?” I said.

“We better call Doctor Reese,” Jim said as he picked up the phone and dialed the intern quarters.

Doctor Reese was there in a flash.

“Oh, boy,” he said. “Not much to do now. I will go call Doctor Adams.”

It didn’t take Doctor Adams long to get to the hospital. I have no idea where he lived, but I would guess he drove fast.

He entered the recovery stall with a frown and knelt down to examine the horse’s leg.

Jim and I stood aside, not saying a word but waiting for Adams to explode.

“I have to go call the owner,” Doctor Adams said. “Then we will put him to sleep.”

That was all that he said. I could hear Jim take a deep breath when Doctor Adams left the room. Doctor Reese looked relieved also.

It was maybe five minutes later when Doctor Adams returned with a bottle of euthanasia solution.

“It was a long shot anyway,” Doctor Adams said as he drew up the solution into a couple of large syringes. “I have never seen radial nerve paralysis in a horse before. Too bad, I really wanted this repair to work.”

With that, he gave the injections and patted the horse on his head.

“We can move him back to necropsy in the morning,” Doctor Adams said as he left the room.

We stood there a couple of minutes, nobody said a word.

“I will call the others,” Doctor Reese finally said. “You guys can go home.”

“I think this was the best outcome for the horse,” Jim said. “But somehow, I feel like we dodged a bullet tonight.”

“Doctor Adams likes to look mean,” Doctor Reese said. “But he is really a nice man, down deep.”

Photo by Missi Köpf from Pexels

There is Gold in Them Hills, From the Archives

D. E. Larsen, DVM

It was 11:10, and Bob should be coming through the door any minute. He was sort of the highlight of our morning in the office. Bob had been our Postman ever since the office opened. He was older, probably getting close to retirement, but he was a joy to talk with.

I think he must have us as a scheduled break on his route. He always seemed to have several minutes to talk. Bob was a Sweet Home native or as close as one could be to a native. He knew everyone in town. If we wanted to know about someone, Bob could give a pretty good synopsis. 

Bob could talk gold. He knew where to look in every stream, and he shares that information only to a trusted few. I liked to think I was one of those entrusted few. Bob had lost a son who was my age, a Lieutenant in the Army. In those years of the Vietnam War, Bob was probably preparing himself for his son serving in the war. Instead, he was driving home from the East Coast, and died in an auto accident.

The reality of the thing was he knew I was too busy to chase any of his stories.

We bumped into Bob one afternoon when he was panning gold with a friend. Bob took the time to give the kids and me a lesson on how to work the pan. We came up with a lot of black sand but no color. Bob truly enjoyed teaching his hobby to the kids, including myself. Hobby was probably the wrong word. I think gold was Bob’s true vocation. His postal job and any other work in his life only allowed him to pursue his real life’s work.

Bob told me a story one day about one of his trips to the California goldfields. He and a group of friends would make an annual trip to the areas out of Sacramento, California to pan for gold. This was a working trip for this group of guys. They would rework some of the same streams that were the site of the 1849 gold rush.  

Bob said that on one of these trips, they had a new guy along. He was always underfoot and trying to learn every little thing he could from these old guys. Bob finally tired of putting up with this guy. Bob pointed to a distant sandbar up the creek.

“Why don’t you go up there and work that sandbar,” Bob said.

The guy took his shovel and pan and headed up to the sandbar that Bob had pointed out. Bob and the rest of the crew continued to work with the dredge where they had been all morning.

“That was the biggest damn mistake that I ever made,” Bob said to me. “Just before quitting time that afternoon, this guy comes down the creek with a gold nugget the size of the end of your finger. I was so mad at myself after that, I almost couldn’t eat dinner.”

One August afternoon, we had a new client, Rob, came in with his dog, Yoda, a pit bull cross. Yoda had a pretty severe laceration on his large pad on his right front foot. Yoda was camping with his owner way up the Calapoolia River at the mouth of State Creek.

“Yoda spends most of the day in the river with me,” Rob said. “If he is not in the river, he is chasing a squirrel somewhere up the creek. I don’t know when this happened, I noticed him licking his foot last night, and then this morning he was limping on that foot quite a bit.”

Yoda was an excellent dog, and he didn’t flinch while I examined his foot. This was a deep laceration that extended halfway across the carpal pad, front to back. It was deep also. This was going to be challenging to get healed. Especially in a dog who was used to spending a lot of the day in the river.

“Pad lacerations are difficult to manage, in the best of circumstances,” I said to Rob. “In a dog who is spending a lot of his time in the river, it might be impossible.”

“I can keep him out of the water for a couple of weeks,” Rob said. “I am not on any schedule, I am just spending the summer up there panning for gold.”

“I suture most of these,” I said. “By suturing them and keeping them wrapped for a couple of weeks, most of them will heal. If we can’t keep a dry wrap on the foot, there is little chance that the sutures will hold.”

“When can you do this?” Rob asked. “Keep in mind, I am a long way from camp.”

“I can probably do it shortly,” I said. “But it is going to take a little time from Yoda to wake up.”

“This dog is the toughest dog I have ever owned,” Rob said. “You could probably sew this up with giving him anything. Is there any chance you could do it with local anesthesia?”

“We can try,” I said. “Yoda will let us know if that is an option or not.”

We moved Yoda into the surgery room. Laid him down on his side. He did not react as we started scrubbing the wound. Rob stood on the opposite side of the table from me and scratched Yoda’s ears. 

I drew up a syringe of Lidocaine and looked at Rob.

“We are going to find out right now, this stuff stings a little, I hate it myself,” I said.

Avoiding the laceration, I slid the needle through the skin at the front edge of the pad. Injecting a little at a time as I advanced the needle under the pad. I injected half the syringe here and then repeated the process from the back edge of the pad.

After a few minutes, I parted the edges of the laceration. There was no response from Yoda. Spreading the wound wide, I scraped the deep crevice of the wound. I applied some Neosporin to the in the wound and wiped it out with a sterile sponge. Then I draped the wound.

Taking a deep breath, I stabbed the pad with a suture needle. There was no response from Yoda. I glanced and Rob and smiled as I continued to close the wound. In this type of deep pad lacerations, I would use a deep vertical mattress suture using stints, made from IV tubing, on each side to spread the tension across the wound edges so the stitches would not tear the tissues.

Closure only took a few minutes. And then I applied a wrap that extended halfway up the leg. 

“The key to healing this wound is the wrap,” I said. “If it gets wet, it needs to be changed. Otherwise, we will change it every 3rd day. Is that a schedule that will work for you?”

“I can work with that schedule,” Rob said as he let Yoda stand up on the table.

“I will put him on some antibiotics just to make sure we keep the infection down as much as possible,” I said.

With that, Rob and Yoda headed back to camp. We started on their schedule of regular visits. Rob did a great job of keeping the wrap dry, and the wound looked better with each wrap change. After two weeks, we had a decision to make.

“We could go without the wrap starting now,” I said. “This wound looks good, but I really would like to go one more week.”

“The squirrels are going to love you, Doc,” Rob said.

The following week we removed the wrap and the sutures. This wound healed as well as any pad laceration that I had managed. I patted Yoda on the head when I set him down on the floor. 

“It has been fun working with Yoda,” I said as I shook hands with Rob. “It has been good working for you too. How long are you going to be around these parts?”

“I will probably break camp in a couple of weeks,” Rob said. “You never know about a guy like me, I might back next year, or I might be in Colorado.”

As the days passed, Rob and Yoda sort of slipped to the back of my mind. I was a little surprised when Rob was in the reception room one afternoon. He motioned to me, indicating he had something to show me. I invited him back into the exam area, and he looked at an empty exam room and stepped into it.

“I have to show this, Doc,” Rob said. “I saw this under a large boulder, and it took me three days to get to it.”

Rob had something wrapped in a square of rawhide in his left hand. He held his hand out as he peeled back the folds of rawhide. There, in the palm of his left hand, was the largest gold nugget that I had ever seen. I didn’t have words.

“Wow!” I said.

“This is what keeps us guys with gold fever going,” Rob said.

It was a few days later when I had time to meet Bob when he came through the door with the mail.

“Bob, I have a story to tell you,” I said.

“Will now, that is a switch,” Bob said, “you telling a story.”

“Bob, I just spent a few weeks working on a dog for a guy who was camped up the Calapoolia River at the mouth of State Creek,” I started.

“I know the area,” Bob said.

“He came into the clinic the other day with a nugget wrapped in a piece of rawhide,” I said. “This nugget covered the palm of his hand and was over an inch thick.” 

I motioned on my hand the size of the nugget. Bob grabbed my forearm, his eyes wide open, and his pupils expanded as wide as possible. 

“No!” Bob said, “I have been all over that river and that area. There is gold there, quite a bit of the stuff. But it is all small, tiny stuff really. I have never seen a nugget come out of the Calapoolia.”

“Well, I don’t know,” I said. “That was the biggest nugget I have ever seen.”

“That is a $20,000 nugget, maybe $30,000,” Bob said. “But, I can’t believe it came out of the Calapoolia.”

“I guess, when I think about it, he never specifically said it came out of the Calapoolia, I just assumed it,” I said. “He has been camped up there most of the summer.”

“Now you have done it,” Bob said. “I am not going to be able to sleep until I can get up there and start looking through the place myself.”

Photo by Csaba Nagy from Pixabay