Meter Reader Mishap

D. E. Larsen, DVM

“Dale is waiting on the phone for you,” Judy said. “He is the manager of PP&L.”

I knew Dale from the Rotary Club, but I wasn’t aware that he had any animals. I put the little pup back in the kennel. Dale was lucky. Another few minutes, and we would have had the puppy sedated, and he would have had to call back.

I picked up the phone, “Dale, what can I do for you today,” I said?

“Doc, one of my meter readers, ran over a duck this morning,” Dale said. “The owner says it has a broken leg. I was hoping you could get a look at it for me. We will be paying the bill.”

“Dale, if it is a duck with a broken leg, you should maybe be talking with them about buying the duck.”

“I tried that, Doc,” Dale said. “This is some sort of special duck. She called it a Khaki Campbell. Does that mean anything to you?”

“I am not much of a bird person, Dale,” I said. “I do see farm birds once in a while. Chickens mostly, but I have treated a few geese and a duck or two. I would have to look up the breed.”

“We are between the old rock and a hard place,” Dale said. “Our truck ran over the duck in their driveway. We are obligated to fix it. And this old gal is so mad she is spitting nails.”

“Send her in, and I will see if there is anything I can do for the bird,” I said. “Do you want to approve any estimate on repair cost?”

“It is only a duck, Doc,” Dale said. “I would hope the cost would be in line with the value of the bird.”

“Dale, I would be broke if I based my fees on the value of the animal,” I said. “You will be paying for my time and expenses. You should understand that.”

“I know, and judging from what this gal says, the duck is worth a bundle,” Dale said. “When I told her to put it out of its misery, and we would send her a check for a hundred dollars, you should have heard the explosion.”

“Send her in, and we will do what we can,” I said.

Leah was visiting the clinic that day on a sixth grade career day visitation. She was full of information on the Khaki Campbell domestic duck. Apparently, it was a breed developed in England, and it was famous for its egg-laying and raising ducklings.

When Grace came in with the duck, she was still red in the face from her conversation with Dale.

“This is the best duck I have ever owned,” Grace started. “And he wanted me to wring her neck or something.”

“Let’s get her in the exam room and let the doctor get a look at her,” Judy said as she ushered her into the exam room.

“This is Waddles,” Grace said as soon as I came into the exam room. “She is the best duck I have ever had. She is a Khaki Campbell. Do you know anything about that breed?”

“I have been learning a lot about it in the last hour,” I said. “Our visiting student, Leah, is very knowledgeable about the breed. They a quite the egg layers, I am told.”

“I am impressed, Doctor,” Grace said. “If the power company had been the least bit concerned, you would have thought they would have at least tried to look her up.”

“Let’s look at this leg,” I said as I rolled Waddles over.

Waddles had a fractured tibia on her left leg. It felt like a pretty clean fracture without a lot of bone fragments.

“We might get lucky here,” I said. “I think I can pin this fracture without even opening the fracture site. We will need to get a set of x-rays, and I think we can get this done and send Waddles home this evening.”

“I don’t want you to leave a stone unturned,” Grace said. “I want this to be the biggest bill you can make. I want that guy at PP&L to spit out his coffee when he hears the fee.”

“I think Dale has come to understand your attachment to Waddles,” I said. “He said, “I am prepared to pay the bill”. But, my guess is he will choke a little when he gets it.”

The tibia in a duck is the bone we call the drumstick in a chicken or turkey. X-rays showed a simple fracture, and the surgery went very well. I was able to thread a steel pin down the bone from the stifle joint and get an excellent reduction of the fracture.

“This will heal really well,” I told Leah when I had finished.

“Do you leave the pin in the bone,” Leah asked?

“No, we will take it out in 6 weeks. Maybe we could bring your entire class down to watch that surgery.”

“Yeah, they would like that,” Leah said.

Waddles woke up from anesthesia and walked on the leg with no problem. We called Grace so she could pick her up.

“I want you to make sure she stays out of the water until this is healed,” I said. “It would probably be best to keep her in a cage until we take this pin out.”

“When is going to happen,” Grace asked?

“We will make an appointment to take sutures out and recheck her in 2 weeks. Then we will take that pin out in 6 weeks.”

When Waddles came in for her pin removal, you could see a slight limp when she walked.

“That will clear up as soon as we get this pin out of there,” I assured Grace.

We had Leah’s entire class in the clinic to watch the surgery. We lined them up against the wall in the surgery room where everyone could see. As was typical in these events, several kids tried to stay and watch, but as we got closer to the actual surgery, they had to go out front.

I don’t think any of the kids really knew what to expect. Pin removal is not much of a surgery, just a small incision over the pin’s head, grasp the pin with forceps, and pull it out of the bone. 

The real surprise comes when I pull the three-inch steel pin out of the tiny incision. It is sort of like the magician pulling the rabbit out of the hat. There were several gasps.

Waddles was happy after she woke up. And she enjoyed all the attention from the kids gathered around her kennel.

Dale was very quiet on the phone as I gave him the bill’s information for Waddles’ fracture repair.

“If she was a goose, I would expect her to be laying golden eggs,” Dale said.

Photo by Magdalena Smolnkcka on Unsplash

Agroceryosis, The Lack of Groceries

D. E. Larsen, DVM

“What do you think, Doc,” Al asked as we stood at the fence watching a skinny cow in the corral.

“It doesn’t look like she has any diarrhea. When did you deworm last?”

“I gave her some pills I got at the feed store a couple of weeks ago,” Al said.

This was my first visit to Al’s place. Al in his 50s and dressed like he just stepped out of his office. My guess was he is a hobby farmer, probably a retired police officer out of California. I was a little surprised he had wormed the cow.

“Is she nursing a calf?” I asked.

“Yes, and the calf isn’t doing really well either,” Al said.

“Let’s get her in a chute, and I will get a look at her,” I said.

“A chute, what do you mean by a chute?” Al asked.

This was going to be a bigger problem than I expected. This guy doesn’t know anything.”

“I guess I better grab my rope,” I said. “Are these posts strong enough to hold her?”

“I think so. They were here when I bought the place last summer. I bought this cow then also. She looked good when I bought her. She calved with no problem. Now she is skin and bones.”

I threw the lasso over her horns and took a couple of wraps on the corner post. She wasn’t wild, and I quickly pulled her up the post and tied her close.

“What are you feeding her, Al,” I asked?

“My pasture is dry as a bone now, but she gets all the hay she can eat.”

I examined the old cow. She looked fine, except she was skin and bones. Her udder was mostly empty, but the milk I stripped out looked fine. I collected blood and fecal samples.

“Al, what you call hay, in the feed rack there, is straw,” I said as I turned the cow loose and crawled back across the fence. “I will look at these samples when I get back to the office. But her problem is Agroceryosis.”

“Agroceryosis, I have never heard of that. It sounds serious,” Al said.

“It is serious, Al. If it is not corrected, it will surely kill her,” I said. “What it means is there is a lack of groceries. That straw you are feeding doesn’t have much in it. We need to have a little discussion on basic nutrition.”

“That’s why I called you. I need to learn all I can,” Al said.

“How many cows do you have,” I asked?

“She is my whole herd, her and her calf,” Al said. “I figured I needed to learn with small numbers before getting a bunch.”

“That was probably the best decision you could have made. We have a couple of months to get her ready for winter. Otherwise, I would have been out here on an emergency call when she was down and dying at the first snowfall.”

“You sound pretty sure that is what would happen to her,” Al said.

“Every year that I have been here, the first snow brings a rash of calls. Usually, it is a horse and a couple of cows. They all look the same. And they have inadequate shelter, no fat on their bones, not a snowball’s chance in hell of surviving the night. The thing I have never been able to figure out is how the owners can figure out they are going to die tonight but can’t figure out they need to feed them a little.”

“Well, I could at least recognize that she needs something,” Al said.

“Without getting out the nutrition books, you can probably understand that the cow has basic needs that need to be met. She needs protein, and she needs an energy source. Sometimes you can meet all those needs in good grass hay. That hay might contain 8% protein. This straw probably has less than 2% protein. She can’t eat enough to meet her protein requirement. They say she is bulk limited. It is sort of like you would be trying to live on lettuce.”

“So I need to go shopping for hay,” Al said.

“This cow is going to need more than just grass hay. She has to make up some ground before winter. And her milk production requires a lot of energy. That is one reason she is so thin.  She has put all of her fat reserves into producing milk for her calf.”

“So I need some grain also,” Al said.

“Yes, you probably need some good grass hay, maybe a bale or two of alfalfa and a couple of bags of grain,” I said.

“You think that will do it,” Al asked?

“That and a mineral block. Then you have to change her ration slowly. You can change to the grass hay with no problem. But you need to get her on that first, then add a small amount of alfalfa and a little grain.”

What do you mean by a small amount and a little grain,” Al asked?

“You get her on good grass hay for a week, then start giving her a couple of cups of grain once a day. The third week, give her half of a flake of alfalfa on top of her grass hay. I will drop by sometime during that third week and just eyeball her. We should be able to see a change by then.”

“What about those samples,” Al asked?

“I will give you a call tomorrow. If you wormed her, I don’t think we will see much in the samples.”

“Okay, I will expect to see you in a few weeks,” Al said.

“Does she have access to the barn,” I asked?

“Yes, but she doesn’t seem to want to use it much.”

“She will when winter gets here. You can take this straw and use it to bed down a stall space for her and her calf. You might be surprised at how she reacts when she has a bedded stall.”

Several weeks later, I pulled onto Al’s place as I was returning from a call out at Crawfordsville. I waved at Al as he was pulling on his boots on the porch. I stopped out by the barn.

“Doc, she is a completely different cow,” Al said. “I am embarrassed now that I almost starved her to death.”

The cow and her calf were bedded down in the straw in the barn. They were both chewing their cuds and paid no attention to us.

“The calf never used to eat when I was feeding them straw, but now he bellies up to the feed rack and fights for position with his mother,” Al said.

I could still see ribs on the cow, but they were covered with a layer of fat already. Her hip bones looked smoother now also.

“It looks to me like she will be fine. I would start giving her a full flake of alfalfa and give her some gain twice a day. When she starts to look like your neighbor’s cows, you can slow down on the alfalfa and grain.”

“You think she will be okay for this winter,” Al asked?

“I think she is going to be okay. Before you go out and buy the rest of the herd, you need to drop by the office, and we can go over nutrition in a little more detail. And we can discuss a vaccination and parasite control program that will work well for a small herd.”

“Isn’t it funny, I remember cows on my Grandfather’s farm, and I had no idea what kind of work and knowledge went into raising them.”

“Those grandfathers didn’t need a book. They just knew the cows. They made it look easy,” I said.

“Thanks again, Doc. And I will remember to drop by the clinic before I get the rest of my herd.”

Photo by Mohau Mannathoko on Unsplash

Over-sized and Pocket-sized, A Spay is a Spay

D. E. Larsen, DVM

I pushed my left arm deeper into the birth canal of the young heifer, sweeping my hand left to right, trying to decide as to what was wrong here. 

Then I encountered intestines, this was not good. They were too large to be from the calf. This uterus was ruptured. I shoved my arm up to my shoulder. Finally, there was the calf. The calf was in a breech position. I stuck my finger into its rectum. A contraction, this calf was still alive.

I pulled my arm out and washed. “Sue, someone must have tried to pull this calf,” I said.

“Yes, my son Joe was here a bit ago, and he tried to work on it but said that he couldn’t get anywhere.”

“This heifer has a ruptured uterus. The calf is still alive. If we do a C-section, I can save the calf. I don’t know if I can fix the uterus or not.”

“Okay, do what you can,” Sue said. “This is Sam’s favorite heifer. She is kind of small, but he treats her like a pet. I hope you can save her also.”

The heifer was lying on her left side. This was probably good. A right flank incision might give me the best access to repair the uterus.

For me, c-sections on cows were a chore. But most of the work was closing things up. This one would depend on what kind of damage had been done to this uterus.

We clipped and prepped the right flank, and I did an inverted L block with Lidocaine. It did not take long, and we had the calf out, and she was shaking her head as she looked around at her surroundings in this small barn.

The uterus was mostly torn off the cervix. It was held by a narrow strip of tissue. There was no way to repair this.

“Sue, this uterus is almost completely amputated from the cervix. I don’t think that I can repair it,” I said.

“You spay dogs and cats all the time. Can you just remove it,” Sue asked?

The question stunned me for a moment. I looked at the torn mass of uterus and pondered the situation. 

The largest dog has a uterus with a diameter less than my index finger. By comparison, this was a massive uterus. But it was worth a try. Otherwise, we shoot the heifer. If the surgery doesn’t work, at least we tried before shooting the heifer.

“I hadn’t given that any thought, Sue,” I said. “I guess it is worth a try.”

I had difficulty reaching the left ovary. With that problem solved, I placed a transfixed ligature on each ovarian pedicle. After severing the pedicles above the ovaries, I hung the uterus out of the incision. Severing the remaining attachment at the cervix was no problem. I placed a couple of stay sutures in the cervix to keep it close to the incision when I removed the uterus.

With a good twenty pounds of uterus laying in the straw, now all I needed was to close the cervix and ligate a couple of bleeding vessels. Then it was a standard closure of the external incisions. This probably all took less time than a typical c-section.

After giving the heifer some antibiotics and a Dexamethasone dose, I let her up to tend the calf.

“What do you think,” Sue asked?

“Ask me in the morning,” I said. “If she survives the night, I would guess we are good to go. But don’t expect her to have a calf next year.”

“Is she going to be able to raise this calf,” Sue asked?

“That should be no problem. The uterus and the ovaries are not necessary for milk production.”

“Mom and calf were doing well,” Sue said when she called the following morning. 

When I was out to take the sutures out of the heifer, the incision had healed well. The calf was bouncing around, happy to be in this land of the living. 

“When you sell her, make sure you are honest,” I said. “Some poor guy will go nuts trying to get her pregnant.”

“My guess is Sam will make a pet out of her. She will probably never leave the farm.”

It was not long after this event when Pat called. Pat was the elementary teacher with a bunch of classroom pets. It had not been too long ago that I had repaired a fracture on a hamster’s leg for one of her pets.

“It’s Sally, Doc,” Pat said. “She has to be days overdue for delivering babies. And now she is not feeling well. The kids think she has a problem.”

“Tell me more about Sally,” I said.

“Sally is a mouse. They have a gestation for something like 20 days,” Pat said. “We have been watching for babies for over a week now. I am certain that she has to be 4 – 5 days overdue. I can get away for a few minutes shortly, can a drop her off for you to look over?”

“Does she bite,” I asked?

“Sally is the sweetest little mouse,” Pat said. “She loves to be petted and handled, and all the kids love her. That is why everyone is so upset.”

Sally was just as Pat described, sweet as could be. I rolled her onto her back and rubbed her belly in a manner that became palpation. Sure enough, Sally was pregnant with what felt like 8 babies. They were hard as marbles with no feeling of fluid in the uterus. These babies were dead.

I called and talked with Pat. 

“Pat, her babies are dead, and there is a bunch of them,” I said.

“What can we do,” Pat asked?

“If we don’t get them out of there, Sally is going to die,” I said. “She is already dehydrated. I think I should try to do a spay on her. If, by chance, there are any live babies, we could save them. But I don’t think there is anything alive in her uterus.”

“You do what you think is best. The kids and I trust your skills,” Pat said.

We gave Sally a dose of Ketamine for anesthesia and some subcutaneous fluids for her dehydration. I used a razor to shave her belly, and with a surgical prep completed, she was ready for surgery.

With her fur gone from her belly, you could see the lumps in the uterus through the belly wall. 

“I think I am going to need some magnification,” I said as I put on my loupes. “Things are going to be pretty small in there.”

I opened the abdomen and externalized the uterus, two horns of the uterus, one on each side, with 4 hard nodules in each horn, each about the peanut size. The babies were long dead, and all the fluid had been resorbed from the uterus.

The anatomy was the same as a dog or cat, just a lot smaller. I Iigated the ovarian vessels and the uterine body and removed the uterus with the dead babies.  

Closing the abdomen required only a couple of sutures. Sally recovered slowly from the Ketamine, but she was up and eating when I checked her in the morning.

Pat and her class were happy with the results, and we were paid with twenty-some pages of hand-drawn pictures with thank you notes. 

The entire class brought Sally in for suture removal. Typical of classrooms that visited the clinic, some students struggled to be as close to the action as possible. Then some sought the comfort of the reception area.

Sally enjoyed the attention. And she managed to live a year or two longer than a mouse in the wild.

Photo by Colin Davis on Unsplash