Initiation by Fire

D. E. Larsen, DVM

We tried to hire at least one high school student to work at the clinic most of the time. This provided them with some dollars in their pockets and some valuable work experience. It also provided them with some exposure to a medical care environment.

We generally allowed ample time to train and learning by osmosis, which I preferred. Typically, after a couple of weeks, most of the students were helpful around the clinic.

“I don’t know if we can get much busier than we are right now,” Jolene said.

“I have always felt that a solo, mixed veterinary practice was sort of self-limiting,” I said. “One person can only do so much. If everything is going to be done by a professional, there is a definite limit. I can’t work twenty-four hours.” 

We were running a little short-handed with Sandy and Jolene, the only employees. That was when we decided to hire a high school student to help out in the afternoon.

Today was Lauren’s first day at work. Sandy had filled out all the required paperwork while Jolene and I completed an afternoon emergency surgery. 

“I have to run to the bank and to the accountant to do some errands,” Sandy said as we just finishing up in the surgery room. “You guys and show Lauren around a bit.”

Sandy was no more than out the door when the phone rang. Jolene rushed to answer the call.

“Sweet Home Veterinary Clinic, good afternoon. How can I help you?” Jolene said into the phone.

“This is Byron. I have one heck of a mess out here,” Byron said. “I have my best cow in labor, and nothing is happening. I went in to her, and all I feel is a bunch of legs. She either has twins, or something is all twisted up in there. I need Doc out here right now!”

“Just a minute, Byron,” Joleen said. “I will talk with Doc and see when we can get out there. Things are sort of a piled-up right now.”

“I don’t have a minute,” Byron said. “This is an emergency. I need Doc now, not a couple of hours from now.”

With that, the phone was dead.

“That was Byron,” Jolene said. “He has a calving problem with his best cow and wants you out there now.”

Okay, let’s get ready and go,” I said.

“It might be an hour or more before Sandy gets back,” Jolene said. “Lauren hasn’t had any instruction. This is her first day, almost her first hour.”

“We will just have to make do,” I said. “I will need a hand at Byron’s, he seldom has those cows caught, and they are usually in the far end of the barn.”

We double-checked the truck to make sure we were ready to go, then I went back into the clinic to give some basic instruction to Lauren.

“Okay, Lauren,” I said. “You are going to have to run this place until either Sandy gets back or we get back. For any phone calls, you take a message, and we will return the call. Make sure you know who you are talking to. You are in command of the conversation. You get their full name, telephone number, and problem. You do the same with anybody who comes through the door. Don’t take any money. It can wait. You will just get in trouble with Sandy if the drawer doesn’t balance. Got it?”

“I guess,” Lauren said, looking a bit overwhelmed standing behind the counter.”

“Initiation by fire,” I said as I walked out the door.

It was a short drive out to the Calapooia River, where Byron’s place was located. We pulled up to the barn where Byron was waiting.

“I have her in the calving pen in the back,” Byron said. “Thanks for coming so quick.”

The cow was easy to catch, and we tied her in the corner. I tied her tail out of the way and scrubbed her vulva. Nothing was showing as far as a calf was concerned. I scrubbed my left arm and ran into her vagina.

There were three legs at the cervix. It took me a couple of minutes to sort things out. These calves were small, based on the size of the feet and legs. Three front legs meant two calves.

Finally, I got my arm in far enough to find the head of one of the calves. It was turned back to its left side. This calf was small enough to allow me to correct the head position and pull the head and front legs into the birth canal. Then with a good pull by hand, I pulled the calf the rest of the way out. The calf hit the ground and shook her head. 

“Looks like you have a nice little heifer,” I said to Byron. “Now we just have to get the next one out.”

“There’s another one?” Byron asked.

“There’s at least one more,” I said. “This calf is pretty small, and you are in the middle of your calving season. There could be three.”

“I have never seen triplets,” Byron said.

“I have once,” I said. “In Enumclaw, and we lost one of those because it wasn’t detected at first.”

I reached in and grabbed the two front feet at the cervix now. This head was turned back to the calf’s right side. Again, the head position was quickly corrected, and the calf was delivered with the traction of one hand.

“Another heifer,” I said. “You have hit a gold mine here, Byron.”

“That’s good,” Byron said. “I will take all the heifers I can get out of this old girl.”

I reached back into the old cow. There was another calf, deep in the uterus. It took me a moment to get a grip on the feet and get the calf up the birth canal. This calf felt a bit larger than the first two.

I was still able to deliver him with manual traction, but the final tug required both hands. He landed on the ground and shook his head. I looked; it was a little bull.

“Bad news, Bryon,” I said. “This one is a bull calf.”

“What does that mean?” Byron asked. “Oh, doesn’t that cause a problem with the heifers sometimes?”

“Almost all the time,” I said. “I don’t know about triplets, for sure. Usually, it requires a fusion of the membranes, and it could be that only one of these is involved. The male hormones develop first, and it interferes with the development of the female. Over ninety percent of the heifers born twin to a bull calf will be a Free Martin. They will be infertile. There is a growing body of evidence that the males will have somewhat reduced fertility also.”

“So that doesn’t sound good. If I breed these heifers and one gets pregnant, is anything transmitted to their calf?” Byron asked.

“No, if they breed, they are good to go,” I said. “Just don’t get your hopes up.”

“This cow is going to have a bunch of membranes to pass, and these multiple births often have retained membranes,” I said. “So I am going to put some antibiotics into her uterus, just to get a jump on things. You need to watch her closely and call me if she stops eating or if she still hasn’t passed her membranes in a couple of days.”

We cleaned things up and hurried back to the clinic. 

“I hope things haven’t been too bad for Lauren,” Jolene said. “That phone can go crazy at times.”

Sandy was back in the office when we returned. Lauren had handled things pretty well and had a list of calls to be returned.

“That was not fair of you to leave Lauren here by herself,” Sandy said as I came through the door.

“I don’t know,” I said. “At least we found out that we made a good hire. Like I told her when we left, Initiation by Fire.”

Photo by Clair Rush on Unsplash

Bicycle Mishap for Tucker

D. E. Larsen, DVM

June and her two boys, Joe and Josh, were waiting impatiently in the reception with what looked like a rather painful Tucker.

Tucker was about a three-year-old Springer Spaniel who was usually bouncing off the walls in the clinic. Today he was standing, hunched up and reluctant to move. Something must be terribly wrong.

Dixie had them in the exam room, but Tucker was so painful that he was still on the floor.

“What’s up with Tucker?” I asked when I entered the room.

“Joe ran over him with his bicycle a couple of hours ago,” June said as Joe held up his elbow to show me a road rash he had sustained. “He seemed okay when it happened but then started getting painful. Just a little painful at first, but then it started getting worse. He doesn’t want to move now.”

I squatted down to look at Tucker, and he snarled as I reached out to touch him.

“I think I had better fashion a little muzzle for him,” I said. “He is so painful he doesn’t want to be touched.”

“He won’t bite,” June said.

“Under normal circumstances, that may be true,” I said. “But when a dog is painful, he will bite, I assure you. So just to be safe, I am going to tie his mouth with a loop of gauze.”

I took about three feet of roll gauze and made a loop in the middle with one throw. I placed the loop over Tucker’s muzzle and pulled it tight with the throw on top of his muzzle. Then I crossed the gauze under his muzzle and tied the ends behind his head.

Then leaving Tucker on the floor, I carefully started to run my hands over him to find the source of his pain. Tucker snarled at my very touch.

Tucker showed no response as my hands started at his nose and moved over his head and down his neck. There was no pain in his front legs or chest. I stood up and moved behind Tucker to carefully palpate his back and hips. He tensed and growled when I started to palpate his hind legs, but that growl stopped when I reached his knees and lower legs. I carefully pushed on his abdomen, no pain was detected. I moved back to his hind legs, and the growl started again. I lifted his rear up to look closer, and there it was.

Tucker’s right testicle was almost twice the size of his left testicle. I reached to touch the swollen testicle, and Tucker sort of exploded. Without the muzzle, I would have been bitten. Tucker maintained contact with my left arm with his muzzled mouth, just to make sure I wouldn’t try to touch that again.

“Well, it looks like I found it,” I said. “Tucker must have gotten a testicle ran over.”

“I am shocked,” June said. “I have never seen him act like that before.”

“Don’t hold it against him,” I said. “When these guys are really painful, that is their only defense.”

“What do we need to do with him,” June asked.

“I need to get him under anesthesia and figure out what happened to that testicle,” I said. “My guess is that it is going have to be removed. I just need to make sure there is not a hernia involved.”

“It looks like that is our only choice,” June said. “Can you do that right away?”

“I have a couple of things to do first, but we will give him some pain stuff while he waits for surgery,” I said. “The best thing would be to take both of those things while we are doing this. It really wouldn’t add anything to the surgery bill and would make a better dog out of him.”

“I will ask Jerry, but we have talked about neutering Tucker before, and Jerry is pretty dead set against it,” June said. “Sort of a guy thing, I guess.”

“Okay, but just between you and I, Tucker’s life will be much happier if he is neutered,” I said. “He won’t be worrying about that little chippy down the street. Or fighting with the big dog down there with her.”

“I know,” June said. “But I’m afraid there is no changing Jerry’s mind.”

“Okay, I will plan to only remove the injured testicle unless I hear from you,” I said. “We will be getting to surgery in an hour or so. Is that enough time for you to talk with Jerry?”

“I think so,” June said. “But if you don’t hear from me, just remove the injured testicle.

I gave Tucker a dose of Innovar for pain and put him in a kennel while we finished things up so we could get him into surgery.

June called the clinic just before we started into surgery with Tucker to confirm that Jerry did not want to remove both testicles unless necessary. 

“You could tell him a little white lie,” Dixie said with a smile. She knew I would not do that.

“I have to be able to live with myself,” I said. “Telling little lies makes that hard to do, and it leads to bigger lies. Pretty soon, you can’t remember what you said to whom.”

We prepped Tucker, and I made a mid-line incision in front of the scrotum. Then, pushing the injured testicle into the incision, I incised the soft tissues over the testicle and pushed the testicle out of the incision.

The problem was immediately apparent. There was a full two twists in the cord of the testicle, a testicular torsion. There was no saving this testicle. The bicycle wheel must have spun this testicle as it ran over it.

At this point, I opened the tunic covering the testicle. I completed a standard orchiectomy, removing the injured testicle and closing the incision.

We recovered Tucker from anesthesia, and we had the old Tucker back, bouncing around the kennel. He was ready to go home.

I called June to give her the news. 

“June, Tucker can go home anytime this afternoon,” I said. “He had a complete torsion of his right testicle. The bicycle wheel must have spun it around a couple of times. There was no saving the testicle, but Tucker is wide awake and bouncing around like the old Tucker we know.”

When Tucker was picked up, he was jumping up and licking at the faces of both Joe and Josh, showing no remorse for the accident, if he was even aware of it at all.

Photo by John Debrey on Unsplash

From the Archives, one year ago

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