My Calf Needs a Little Repair

D. E. Larsen, DVM

“Doc, I think I have a calf that needs a little repair,” Larry said into the phone.

“What is the problem Larry,” I asked?

“One of the hind legs is not working quite right. I think it is broken. The cow was having a problem getting it out. She got out into the oak grove up here and was twisting around and slammed it into one of those big oak trees. Is that fixable?”

“That depends, Larry. Where is the break located?”

“I think it is the thigh bone,” Larry said.

“Tell me about this calf, Larry. Sometimes the best medical decision is not necessarily the best financial decision.”

“He is a nice looking bull calf, a half Simmental, but just a market animal,” Larry said.

“The thigh bone is not very amendable to a splint like we used on the front leg of that heifer of yours a couple of years ago. That leaves a surgical repair. My guess is the Vet School in Corvallis would love to repair it, but you will have to sell him and several of his friends to cover the expense.”

“Do you think you could fix him,” Larry asked?

“Well, bring him down to the clinic, and I will get a look at him. If we cut a few corners and get lucky, I might be able to fix him. I need to know if this kind of a repair is a viable option at this clinic anyway. At least we can try. I could maybe split the profits with you.”

The calf was a healthy newborn that was over 100 pounds. He was a bit of a handful, but with several sets of hands, we could get him under anesthesia with a mask.

After he was under anesthesia, I could do a good exam. His left femur had a mid-shaft fracture.

“Larry, this feels like a clean break, but without taking x-rays, it will depend on what we find in there. I am planning to place a couple of pins in this bone, and if we are lucky, this guy will walk out of here.”

“Do your best. That is all I can expect,” Larry said. 

“Plan on picking him up a little after noon, this surgery won’t take long, and he will recover pretty quickly,” I said.

We prepped the leg and draped it for surgery. I made a lateral approach to the femur with no problem. 

“I am planning to use both of those large quarter inch intramedullary pins,” I explained to Ruth.

“Wow! Why two pins,” she asked?

“This guy isn’t going to lay around for a few weeks. He is going to be up following Mom and gaining weight daily. We will try to get Larry to keep her in the barn for the first few days, but that is a bit of a two-edged sword. It will reduce his activity, but the incision will be kept cleaner out in the pasture. This repair has to be strong enough to support that activity. By stacking two pins side by side, we provide enough strength to hold the weight, and they will control any rotation at the fracture site.”

Once exposed, the fracture was a simple transverse fracture with no splintering of the bone. I placed both IM pins retrograde in the upper fragment, pushing them out through the top of the bone at the hip.

With the two pins in position and ready to be pushed into the distal fragment, I brought the fractured ends together and drove the first pin into place. When I finished seating the second pin, I was pleasantly surprised at how stable the fracture site was when I manipulated the leg.

“I think this is going to work pretty well,” I said to Ruth. “Now I just need to close this up and wake this guy up.”

The closure went well, and we recovered the calf in the large dog kennel.

“He is going be a lot bigger when we take those pins out in six weeks,” Ruth said.

“My guess is there is not going to be any taking those pins out. This guy will grow so much, those pins will be buried in the bone. That is probably a good thing because anesthesia is a much bigger problem in an older calf than in a newborn.”

“Why is that,” Ruth asked?

“In six weeks, this guy will have a rumen that is starting to function.  He will have to be starved out for 24 or 48 hours before anesthesia. Then we will need to use an endotracheal tube rather than just a mask. Not to speak of the fact that he will be much larger and harder to get on that table.”

The calf was on his feet when Larry returned to pick him up. 

“He looks pretty good, Doc. Better than I expected,” Larry said.

“If we can keep him restricted for a few days, that would be ideal. But if he can’t be in a clean stall, a small pasture would be better.”

“Yea, I think I can put him and his Mom in the small orchard behind the house for a time. That way, I can watch him better, and they won’t have to deal with the rest of the calves.”

“The other thing, Larry, those pins we put in this bone are going to stay there. When it comes time to slaughter this guy, you need to remember to tell the butcher that those pins are there. Otherwise, he is going to be pretty pissed when he runs his ban saw into them.”

The calf did exceptionally well. I stopped by a couple weeks later and took the sutures out, and you couldn’t tell anything had happened to the leg except for the incision. 

“I think you can turn them out with the herd and treat him like any other calf,” I said. 

The calf grew normally and became a fine market steer. He was close to 1100 pounds when he went to slaughter. And Larry brought the femur in to show me. The butcher had boned it out and carefully cut around it in the middle to expose the pins. Larry probably still has that bone and pins.

Photos by Larry Coulter

Shot by a Neighbor

D. E. Larsen, DVM

We moved the exam table to the side of the exam room to give a little more room to examine Michael’s Great Pyrenees. Jasmine was sore and had s small spot of blood in the middle of her back.

“What do you think is wrong, Doc,” Michael asked?

“I don’t know. We need to shave some of this hair and look for the source of that blood. When did this happen?”

“She was fine last night, and I had to really coax her to get out of her bed this morning.”

Jasmine winced when I felt over the bloodied hair. Rather than a clipper, I shaved the hair away with a straight razor. 

“Looks like a bullet wound to me,” I said. “It is probably a twenty-two, based on the size of the hole. Looks like we are going to have to lift her onto the x-ray table.”

With Michael’s help, we got her on the x-ray table and took a set of x-rays.

“This bullet is lodged in her lumbar spine. It looks really close to the spinal cord, but she is neurologically normal.”

“Do you think we need to remove it,” Michael asked?

“This looks like a difficult surgery for me. Dr. Slocum in Eugene would have the equipment to get in there and remove the bullet,” I said.

“And I am sure that would cost a bundle,” Michael said. “My thinking is if you can’t do it, it is not going to get done.”

“We leave a lot of bullets right where they lay,” I said. “As long as they are not causing any problems, sometimes you do more damage trying to remove them than you do good. This isn’t the old west.”

“That sounds good to me,” Michael said. “Does she need any treatment?”

“I will clean up the wound and give her some antibiotics and some anti-inflammatory medication. Then we will just have to watch her closely for problems with her hind legs.”

We scrubbed the wound, and I flushed it with a saline and antibiotic solution. Then I gave an injection of antibiotics and Banamine. Banamine was not approved for use in the dog. Still, it was the only non-steroidal anti-inflammatory available at the time.

We sent Jasmine home with some pills and some Banamine paste.

“I want to see her the first of next week,” I said. “If you notice her unable to use her hind legs or any weakness there, you call right away.”

The next week, Jasmine’s wound was healed, and she acted like there was nothing wrong. There was no neurological disfunction to her hind legs.

“Looks like we are good to go,” I said as I patted Jasmine on the head. “Now you just have to figure out who did this.”

“We already know who did the shooting,” Michael said. “He is a neighbor and has complained about the dogs more than once. There is a good fence, and there is no way Jasmine was out of our property.”

“You know, you can talk with the Sheriff,” I said.

“Not much sense in that. It would be far more hassle than it is worth.”

Jasmine was in and out of the clinic a couple of times of the year for the next several years and displayed no problems. One could have easily forgotten her bullet wound had it not been noted on her records’ front page.

Michael called one morning, about three years after the gunshot injury.

“Jasmine has trouble walking this morning,” Michael said. “She was fine yesterday, but today she has a lot of trouble making her hind legs work.”

“Let’s bring her in and get a picture of that back.”

There we were again, struggling to lift a 200-pound dog onto the x-ray table. 

“I think this shows pretty well that we are going to have to go in and get that bullet. It hasn’t moved, but you can see the bullet is surrounded by this dark shadow on the film if you look close. That is the bone dissolved, probably from a chronic infection around the bullet. It is probably eroding into the spinal canal.”

“Do you think you can get it,” Michael asked?

“Three years have not changed much. There are better experience and equipment in Eugene. But with all that stuff around the bullet, it should be easy to remove if I can get down to it.”

“We have pretty much decided that we are not going to Eugene. So if it going to get done, you are the one who is going to do it. Marilyn and I have total trust in you. You just do your best, and we are fine with whatever the outcome happens to be.”

In a small veterinary clinic, a 200-pound dog makes everything more complicated. Anesthesia is difficult just from the size. The dog requires a larger endotracheal tube. The oxygen and gas consumption is high enough to be worrisome if the procedure ends up being a long one.

I carefully mapped the location of the bullet. With a midline incision on her back, I carefully moved the muscles away from the vertebrae. Once the vertebrae were exposed, some black fluid leaked from the hole occupied by the bullet. I was able to grasp the bullet with forceps and pull it from the hole. There was a slight sucking sound as the bullet was removed from the hole. Now there was this hole filled with black exudate. 

I carefully packed off the area with gauze sponges and started aspirating and flushing the material from the hole. Once it was cleaned, I carefully explored the area. The hole looked clean, and I could not see any evidence that there was any leakage into the spinal canal.

After a final flush with saline and antibiotics, I packed the area with an antibiotic powder and closed the incision.

We recovered Jasmine in a large kennel. Once she was awake, I opened the kennel door, and she jumped up, apparently cured. She was stable on her hind legs.

I gave an audible sigh of relief.

Jasmine went home and healed uneventfully, Returning to her duties on the farm. And, I trust, avoiding the far fence line. 

Photo by Shane Kell from Pexels

From the Archives, one year ago

https://docsmemoirs.com/2020/02/10/two-down-at-once/