Two’s Company, Three’s a Crowd

D. E. Larsen, DVM

I came through the back door of the clinic in Enumclaw, I liked to get into the clinic early. Jack was just cleaning up from an early morning call.

“You are here a little early,” Jack said as I squeezed past him at the utility tub.

“I have been coming a little early to organize the morning a little different,” I replied.

“A little different,” Jack said, “Things have run the same way around here for the last 30 years. I am not sure we need things to be a little different.”

“We have the surgery patients coming in during the late morning, and we don’t get to them until the afternoon after all the farm calls are done,” I said. “If we brought them in early in the morning, we could get the surgeries done before noon on most days. That way we could send them home in the evening. That would save a lot of cage cleaning for the girls in the morning. It would also be better than having them here overnight, unattended, following surgery.”

“Well, you might have something there,” Jack said. “I will have to give it some thought.”

“I have Mrs. Nielsen coming in this morning with a couple of cat spays,” I said. “If there are no urgent farm calls, I thought I would do the surgeries first thing this morning and send them home at 4:00 this afternoon.”

“Well, hopefully, I took care of our emergency for the day,” Jack said. “I had a calf to deliver at about 5:00 this morning. It was an easy pull. Tiny calf, one of those that you have to hold in there for a few minutes, so the farmer thinks he gets his monies worth. Then I hooked an OB strap on the legs and pulled it with one hand.”

“That sounds easy,” I said.

“But there is more to the lesson,” Jack said, anxious for me to listen. “One thing you want to do when you pull a calf is to go back in and check for another calf. Sure enough, I did that this morning, and there was another calf. It was backward, hind feet sticking into the birth canal, it was as small as the first one. Came out without any problems.”

“That is something that they always stressed in school,” I said.

“You don’t see twins very often, and it is easy to get used to thinking that there is no reason to check,” Jack said. “I seem to forget to check some of the time, just a good idea to do it every time.”

“Thanks for the update,” I said. “I will be sure to make it a habit. I have to hurry upfront so I can speak with Mrs. Nielsen when she drops off her two cats this morning.”

The girls had just completed getting Mrs. Nielsen’s cats into kennels when I got to the front desk.

“I am glad I caught you before you got out the door,” I said.

Smiling, Mrs. Nielsen said, “I am glad too, Ole wanted me to make sure I met you today. He is impressed with you, young man.”

“I just wanted to make sure that you were going to pick up these cats this afternoon,” I said, ignoring her husband’s compliment.

“That is different,” She said. “Always in the past, they were kept overnight. But Ole said, “Anything Dr. Larsen says is fine with us,”

“We are just changing the schedule a little, I will do the surgeries this morning, and they will be ready to go home anytime after 4:00. They will do better at home than down here overnight with nobody watching them.”

“And we close at 5:30,” Mary said, speaking over my shoulder.

“I will be here at 4:00,” Mrs. Nielsen says as she starts out the door.

The girls were used to a slow morning at the office. All three of us veterinarians would depart and do farm calls, usually not getting back into the office until the afternoon. Today I had two cat surgeries to do before starting on my farm calls.

“Let’s get the exams done on these cats and get set up for surgery,” I said. “I have been assuming that they were both females, but we better check.”

The first cat on the exam table was probably approaching a year old, and I didn’t have to look for testicles to know he was a young tomcat. His neck and cheeks were already growing thick, probably the life around the barn required these guys mature early if they are going to survive.

“This morning schedule just got a whole lot easier,” I said. 

We finished an exam, did his vaccines, and gave him a dose of atropine to start getting him ready for anesthesia.

The second cat must have been a brother as they looked like two peas out of the same pod.

“I am sure she was talking about spaying these cats,” Mary said.

“People are often confused about the term, spay,” I said. “I can’t say that I know where the term came from. It makes no sense to me.”

With the first cat on the surgery table, I gave him a dose of Ketamine by IV injection. I gave 0.4 cc IV. This was a dose that would provide excellent anesthesia and immobilization for about 20 minutes and would allow a smooth recovery within 30 or 40 minutes. Some residual pain control lasted for several hours with Ketamine. 

With the cat under anesthesia and on his right side, I plucked the hair from his scrotum. Mary prepped the scrotum as I pulled on a pair of surgical gloves. Jack had graduated in the 1940s. His method of castration in the cat was to incise the scrotum over each testicle, grasp the end of a testicle with a forceps and apply slow, steady traction, pulling the testicle out until the cords stretched and broke off. 

I had been told of this procedure in school and instructed to never use it as it was outdated. There were few complications with this old procedure, but time marches on. I used one of several methods. All involved incisions over each testicle. 

I would pull the testicle out until I could feel the cremaster muscle tear, clamp the cord with a hemostat, and place a ligature on the cord before removing the testicle. This procedure consumed a package of suture material and took a little more time. 

The other procedure and the one I used most often was to pull the testicle out of the scrotum, incise the tunic and separate the tunic from the testicle, then open the tunic with scissors down the length of the exposed cord. Then I would tie the testicular vessels and the tunic in several throws of square knots before removing the testicle and residual tunic.

With any procedure, it was over in minutes. We would clean the surgery area and return the cat to the kennel to recover. With Ketamine anesthesia, the blink reflex is absent until the patient is fully recovered. The surface of the cornea must be protected with the application of an ointment.

This morning, I had the two cat neuters completed, and the record work completed by a little after 8:30. I would be able to get through my farm calls almost on their regular schedule.

Then the phone rang. Both Jack and Don had already left on their calls. Mary answered the phone.

“No, Jack has already left the office. Dr. Larsen is still here, would you like to talk with him?”

Mary hands me the phone. “This is Harold, you know him, I think. He lives out on that little knoll. This is about the twins that Jack delivered this morning.”

I take the phone from Mary, “Hello, Harold,” I say. “What do you have going on?”

“Jack was here about 5:00 this morning,” Harold says. “He delivered a set of twins. Those two are doing well, but the old cow doesn’t seem right to me. She is uncomfortable, not really straining, but sort of doing little pushes.”

Harold was one of our younger dairy clients. He had a herd of 50 or 60 cows. He probably wasn’t the sharpest tack in the box, but he was generally pretty observant, and if he didn’t think things were quite right, it probably meant that I should check the cow.

“Harold, it sounds like I should run out and check the cow,” I said. “If you have her in where we can get to her, I can come right now.”

“I still have her in the calving pen,” Harold said. “I will go get a halter on her and have her tied up and waiting for you.”

Harold’s place was only a mile down the road. I checked to make sure I had water in the truck, pulled on a pair of coveralls and boots, and started down the road.

Harold’s place was laid out a little different for the area. His house, barn, and all the outbuildings were perched on top of a knoll. All his pastures were on the level valley floor, leaving quite a little hill for the cows to climb to the milking parlor and barn twice a day.

I filled a bucket of warm water from the truck, grabbed a bottle of scrub and one of lube and headed for the barn with a couple of OB sleeves in my back pocket.

Harold was waiting in the calving pen with the cow tied in the corner. The twin calves were running around, nursing on mom and then on Harold’s knees.

“They look like they are doing okay,” I said to Harold as I squeezed through the gate, blocking the way, so the calves didn’t escape.

“They are doing great, but I am not sure about this old gal,” Harold said as he rubbed the cow on her back.

She was standing okay, but her tail was raised. That would suggest some continuing contractions. With the calves out of there, that shouldn’t be happening. The calves were small enough, there should not have been any injury to the birth canal. 

“Will, let me get her cleaned up, and do a quick check on her,” I said as I tied a piece of twine to the switch on her tail. I tied the other end of the twine in a loop around her neck, pulling her tail along her side and out of the way.

“You must feel pretty good, getting two heifers out of such a good milker,” I said to Harold as I was scrubbing the vulva on the cow.

“Yes, it is nice. I don’t think I have had twins before,” Harold said. “In fact, I don’t think I have seen twins before.”

“They happen, but not very often,” I said as I pulled on an OB sleeve and applied a handful of lube.

I ran my left arm into the vagina. Everything was normal in the vagina. The cervix was still open, and there were still membranes present. Retained fetal membranes were not uncommon in difficult deliveries and in multiple births. 

I extended my reach into the uterus. There was the problem. All of a sudden, I was holding the tail of another calf. Reaching a little further, this third calf was in full breech presentation. It was maybe a little bigger than the other two but still small. I inserted a finger into the rectum, it tightened. The calf was still alive. 

Then came the bad news. There was no vulva, and reaching a little further, there were the testicles. Harold’s twin heifers suddenly became triplets with a bull calf. This meant the heifers were likely freemartins.

Freemartins are female cattle born twins to a male calf. In cattle, and occasionally, sheep, goats, pigs, deer, and camels, there is a fusion of fetal membranes, and the male calf shares some cells with the female. Those cells produce enough male hormones that the development of the female reproductive structures are affected, and the female calf is sterile. The male calf is only slightly affected, but there is some reduction in his fertility.

“There is good news and bad news Harold,” I said. “The good news is there is another calf in there, and he is alive. Getting him out will solve the immediate problem. He is in a full breech position, but I should be able to correct that with no problem.”

“And the bad news?” Harold asked.

“The bad news is the calf is a male,” I said. “That means that there is over a 90% chance that these little heifer calves are freemartins.”

“What is a freemartin?” Harold asked, “I have never heard that term before.”

“Heifer calves born a twin (or in this case a triplet) to a bull calf are affected by the male hormones, and their reproductive tract doesn’t develop correctly,” I explained.

“I guess the thing to do is just to sell them,” Harold said. “The market of heifer calves is pretty good.”

“We see that done, for sure,” I said, “but that is not very ethical. Then somebody spends a lot of time and money and ends up with a heifer who will not get pregnant. That is pretty unfair to the buyer.”

“Now you make me feel like I am cheating somebody,” Harold said.

“Just be honest,” I said. “Tell the buyer what the problem is, so they know what they are getting. Just don’t do anything that your mother would not approve of, that is the best test.”

“Now, let me get this calf out of her.”

I reached deeper into the uterus and could only touch the hock of the calf as the hind legs were both extended forward along the body on the calf. I could use a crutch now, a device to push the rump up and forward and making it easier to reach the hocks. We didn’t have that available in this practice.

I turned my arm so I could elevate the rump with my elbow. That allowed just enough elevation to allow me to grab a hock and pull the right hind leg back to the rear of the calf. Then I grabbed the cannon bone, midway between the hock and the hoof. By pushing the cannon bone up, then pushing the hock forward, I brought the foot to the brim of the pelvis where I could pop it into the birth canal.

Attaching an OB strap to this hoof, I could apply enough traction that I could reach the other leg with ease. I repeated the maneuver with the cannon bone. Once both legs were in the birth canal, I was able to pull this small calf with simple traction.

He hit the ground and I picked him up and swung him by his heels to drain a lot of fluid from his airways. Another couple of hours and we would have lost this guy.

“Will I guess having three calves for sale is almost as good as one to raise,” Harold said.

“This is probably the only set of triplets I will ever deliver or help to deliver,” I told Harold. “I will have to tell Jack to check for another after each calf.”

“Maybe you should check to make sure there is not another calf, Doc,” Harold said.

“Good point, Harold,” I said. “I am going to put some antibiotics into her uterus anyway. There has been a lot of in and out of there today. And she has a big bunch of membranes to pass. I opened a package of 5 grams of Tetracycline Powder on two sides and carried it into the uterus. I unfolded the pouch and dispersed the powder into the uterine fluids.

“You need to watch her close,” I said. “If she has not passed those membranes by tomorrow afternoon, we should recheck her.”

I cleaned up and headed back to the clinic. The afternoon discussions will be interesting today. 

Photo by Corinna Widmer from Pexels.

A Day at the Track

D. E. Larsen

The late afternoon sky looked very threatening. The clouds were black and bellowing up to great heights. The Company G CQ was having difficulty getting the company to line up. Nobody was looking forward to marching to our night classes in the rain. Just about the time he was on his elevated stand and called the company to attention there was a large ‘Crack’ as a bolt of lightening struck a telephone pole in the middle of the company street. The corporal hollered “Dismissed” after half the company was back in the barracks. We would be a little late for class tonight. I had never seen lightning like this. Massachusetts was a strange land for a farm boy from Oregon. Maybe now, I could understand how Ben Franklin was interested in his electricity experiments. 

As the sky cleared our class started off on the mile long march to school. We were in class for the Army Security Agency at Fort Devens, Massachusetts. Tonight was to be the end of the first section of the course of study. Tonight the class would divide, some going into tactical equipment and the rest of us into strategic equipment.  Next week we would move to the secure compound for the remainder of our training on classified equipment.

At the end of the evening the instructor came up to me and gave me a 3 day pass. I had earned this for finishing at the top of the class in the first section. This was the weekend before payday, I tried to get it changed to the following weekend when I would have more money in my pocket but no deal, this is how the program is set up.

So Friday morning I took my pass and walked to the bus depot in Ayer. It was nearly 3 miles but I was in great shape. My funds were very limited. I purchased a round trip bus ticket so I would at least be able to get home. The Friday morning bus was mostly empty, very different from the chaos of the Saturday morning bus rides. I sat in the back and stretched my legs out. I would have to walk again when I got to Boston. I planned to stay at the YMCA; you could get a room for $5.00.

The weather in Boston was great. Still enough of Spring remained that there were blossoms on many of the trees in the commons. The streets were not busy in the mid morning so my walk was an enjoyable one. My mood changed when I got to the YMCA. 

“There are no rooms available tonight. I can reserve you a room for tomorrow night but for tonight I can only offer you a cot on the gym floor. The cot comes with use of the gym shower. It will be a full gym tonight. We generally have a couple hundred sailors sleeping here on Friday night. The fee is $1.50 for the cot and $5.00 for the room,” the clerk said in a manner suggesting that he repeated the speech many times during the day.

I paid the $6.50 and looked at my wallet. It was a good thing that I had eaten a large breakfast at the mess hall this morning because I could skip lunch today. Dinner tonight and Saturday night, maybe a beer or two and a couple other meals, it was looking pretty thin. I would probably be riding the subway or spending time in the USO for the only entertainment I could afford.

My Friday was just about that, I purchased a handful of subway tokens and then walked as far as I could down the Commons. The USO was not far from the Commons. Friday noon and I was about the only one there. There were a few donuts and some crackers available. I ate a couple of donuts and filled a pocket with the crackers and headed for the elevated subway stop.

There were two sailors waiting for the subway. They were in the same boat I was in. Payday came the first of the month, and for an E-3 that meant $110.00. By the last weekend, there was generally not much available. We boarded the subway together. These guys were typical sailors, thinking they had the best deal the military had to offer.

“What do you guys do?” I asked, as the subway pulled out heading toward Harvard. 

“We are on our last liberty before going to the Bahamas for a shake down cruise. Once there, the Captain says we get liberty every night for two weeks,” the talkative one answered.

“Shake down cruise? That sounds like you are getting ready for a big trip or something,” I said.

“Yes, we are on an ice breaker. We are heading for the Arctic Ocean and will be there for 6 months,” the sailor stated.

“By the end of 6 months, 2 weeks of liberty will be a distant memory,” I said.

They were a little quiet after that and exited on the next stop. I rode the subway to the end of the line, got off and caught the first car heading back to Boston. I had a few dollars to spend on a hamburger and maybe a beer in the Combat Zone. Won’t be much of Friday night on my budget.

The Combat Zone seemed more hype than anything, just a bunch of drunken sailors getting ripped off. It didn’t occur to me that this was going to be the same bunch that I would be sharing the gym floor with in a couple of short hours. I entered a bar and stood up to the bar. The barmaid was prompt, checked my ID and wanted to know what I wanted.  

“How much for a beer?” I asked.

“You have to buy two,” she said. “Two beers cost $6.00.”

That was too rich for my wallet. I went across the street and had a cheap hamburger for dinner. From the restaurant window I could do a little people watching. Sort of felt sorry for the sailors.

I walked back to the YMCA. It was across the street from the Boston Gardens. I had not noticed that on my first trip there. I was not impressed, it did not look like it did in all the pictures. It was sort of dark and dingy. 

There were cots set up covering most of the gym floor. I picked up my blanket, pillow and sheets from the janitor manning the storeroom.

He was correct on every count. I picked a cot in the middle of the room and I could hear guys coming in all night long. The good thing was I was one of the first in the shower. I got my change of clothes from my bag and decided to leave the bag in the locker until I could get into my room. I made a short walk to a little restaurant I had noticed last night. It would cost a couple bucks more than the YMCA breakfast but I had just about had enough of the sailors.

My Saturday was not much different from Friday. I rode the subway, walked the Commons and dropped by the USO. The USO had some sandwiches on Saturday and it was packed with sailors. I headed back to the YMCA in the afternoon and checked into my room. Not much, but private and quiet. I took a little nap. I would have to find a place for dinner and beer when I woke up.

On Sunday morning I ate breakfast at the same little restaurant and bought a Sunday newspaper to read. Maybe I could figure out something to do. After breakfast I sat on a park bench with a bunch of old men.  One guy was watching me pretty close. As I read the paper an ad jumped out at me. Suffolk Downs was racing horses today. That was great, I thought, as I counted my assets.

I had my bus ticket home, two subway tokens and $2.50 cents. Not much to go to the races on, but that is what I am going to do. As I stood up, the old man raised a hand to me.

“If you are done with that paper, can I have it?’ he asked.

I tossed him the paper and headed for the subway. I knew nothing about horse racing but I knew animals and I would think I could pick a good horse once in a while.

The subway on the way to the track was packed. I stood the whole way. The subway car was filled a quite a group of characters, but at least, not a single sailor among them. When we came to the stop at the track the whole group poured out of the car like a small army with a mission. I followed the group to the gate. Admission was 50 cents, I had not figured that into my budget. Now I was down to  $2.00 in my pocket, one subway token and a bus ticket home.  This might be a short adventure.

I scoped everything out, they were just bringing the horses into the paddock for the first race. I went down and watched them close, picked my horse and headed to the $2.00 show window.  There was my last $2.00 gone. I went out and watched the race. My horse won. I went to the window and collected $5.40. That was easy, I thought.

The next 4 races were the same.  I watched the horses in the paddock, picked my horse and bet $2.00 for him to show. In each race my horse won. By now I was not rich but I had nearly $30.00 in my pocket. I went and bought a hot dog and a beer and headed over to the paddock for the 6th race. Confident now that I was a master at picking winning horses, it was time to change strategy a little. 

In the paddock was the best horse I had seen today.  A big black horse with long legs, he stood a good 2 hands above the other horses. Without any hesitation I went to the $10.00 window and bet him to win.  I was going be rich after this race.

This horse took off and my horse left the field in his dust. On the back stretch he was probably leading by 20 lengths. I was excited, counting my money now. He came around the last corner and his legs began to flail. He acted like he was having trouble staying on his feet. His lead evaporated as first one horse and then another passed him like he was standing still. Finally the race was over. He did get across the finish line, dead last, so much for my new strategy.

For the remaining 5 races that day, I returned to my $2.00 bet to show. Each of the next 5 horses I picked won. This day at the races, I picked 10 out of 11 winners. I left the track with $78.00, almost a small fortune for a GI in training. I was very content on the bus ride back to Ayer. It was dark when I arrived. Unlike Friday, there was a large group of guys getting off the bus and heading for the base. There was even a bus to waiting to take us to the base.

Photo by Sheri Hooley on Unsplash.

A Shot in the Dark

D. E. Larsen, DVM

The phone jarred me awake, it took a moment to orientate myself. I glanced at the clock, 3:00 AM. I sat up on the edge of the bed and shiver a bit as the chill of the bedroom air hits me.  I picked up the phone.

It was Jack, “Good morning, he said, I have a call, a downed cow with a uterine prolapse. I would like you to come along so I can show you how we do things. I’ll pick you up in a few minutes.”

I sprang up, pulled on my pants with a quickening heart rate. This was exciting stuff for a new graduate. This was my very first emergency call, and I could hardly contain my excitement.

I had finished vet school 3 months ahead of most of my class due to a new schedule at Colorado State University College of Veterinary Medicine. They had divided the class into 4 groups, each group took their quarter break at different times in the school year. My group had Spring Quarter off. 

Sandy and I had 3 kids, and at this time, we were close to being broke. I got a temporary license and went to work. This was Wednesday night, actually Thursday morning, of my first week in a professional position.

I was a little surprised at my excitement. I was no kid, I was 30 years old. I had spent 4 years in the Army Security Agency. Mostly at top-secret border sites in South Korea and Germany. I had been through some exciting and tense times. I had regularly briefed generals who visited the locations. I had been in the middle of the scramble for intelligence during the Russian invasion of Czechoslovakia. And here I am,  excited about going out at 3:00 in the morning to look at a sick cow.

Jack was a big man. I considered him an old man. He had been in practice for over 30 years, graduating from Washington State in 1943. He must have been all of 57 years old. 

Jack lived only a few blocks away, but I was dressed and waiting when he pulled up in the truck. The cow was at Fred’s place, only about a mile out of town.  

It is common for a dairy cow to get milk fever around calving time. It results from low blood calcium levels due to a delay in mobilizing calcium from the bones to meet the demand of milk production. Most of the time, it is rapidly progressive, and the cow will be down and unable to rise. If not treated promptly, it will result in death. The uterus can prolapse with or without milk fever.

We pulled into the barnyard. Cows were lined up for the morning milking, and the milker was busy in the parlor. We walked through the loafing shed and found the cow flat out in the straw and manure.  Her uterus was completely everted on the straw. The cow was comatose, suffering from advanced milk fever and probably compounded from shock associated with the uterine prolapse.

I started to collect some vitals on the cow, laying my stethoscope on her chest.

“Looks like we’re going to need some help with this one.” Jack says. He has already seen all he needs to see for his diagnosis. I tuck my stethoscope back inside my coveralls as Jack starts toward the milking parlor.

“We need some help with this cow.” Jack says to Charlie, the milker. “We will need the tractor with the frontend loader.”

“I can’t help, Fred is particular about milking time.” Charlie replied. “You need to get the hired man up to help. He lives in that small house across the barnyard.”

I follow Jack across the barnyard to the hired man’s house. I feel a little like I did in school, following some doctor around waiting to learn something but nothing really to do with yourself otherwise.

Jack knocks hard on the door of the little house.

“Who’s there?” The hired man calls out from inside the house. A light comes on.

“This is Doc,” Jack replies in a loud voice, leaning into the door to make sure he is heard. “We’re here to take care of a cow down with a prolapsed uterus.  We need you to get up and give us a hand.”

There is a short pause.

“I don’t get up at 3:00 in the morning for no damn cow,” the hired man replies. The light goes out.

Jack’s face reddens and he leans into the closed door, almost pressing his forehead into the door. 

“I don’t get up at 3:00 in the morning either if I don’t get any help!” Jack booms at the door.

There is no reply from inside the small house. Jack turns and steps past me, almost brushing me aside. He walks briskly to the truck. I follow, not sure what is next. Jack pulls open the door, reaches under the seat and pulls out a pistol, checks the clip, and chambers a shell. He heads back across the barnyard.

Jack finally calms himself enough to talk. 

“No reason for the cow to suffer because of that lazy bastard.”  

Jack places the gun against the back of her head and pulls the trigger. The cow stiffens and is gone.

”At least she won’t suffer any longer.” Jack says as he heads back to the truck. 

We drive home without talking. Jack drops me in front of the house.

“See you in the morning.” He says as he pulls away.  

Photo by Corinna Widmer from Pexels

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