A Saturday Afternoon Outbreak

D. E. Larsen, DVM

It was almost a perfect Saturday afternoon. Late August in the Willamette Valley provides a short stretch of weather that acts as an interlude between the summer heat and the fall’s rains.

We were still getting settled into our newly purchased house. We had the kids outside, working in the garden, and playing in the grass. I started to consider setting up the garage to see patients for a couple of months while waiting for the clinic construction to be completed.

The afternoon’s calm was broken when the phone rang.

“Doc, I know this is Saturday evening,” Dave said while trying to catch his breath. “But Doc, I was just out in the pasture, and I have seven dead calves, all about 2 months old. They were healthy as could be yesterday. I have about 30 more out there. What do you think I have going on?”

“It sounds like we need to get a necropsy on one or two of those dead calves,” I said. “The Diagnostic Lab at OSU is closed for the weekend. I can do a necropsy, but any lab work would need to wait until Monday.”

“If seven of them died overnight, they might be all dead by Monday,” Dave said.

“I agree, Dave,” I said. “I have a pretty good background in pathology. I worked in the necropsy room at CSU the summer following my sophomore year in vet school. I can likely get a good diagnosis with a gross necropsy. I will collect samples, just in case we need them for Monday.”

Seven dead calves amounted to about 15% of his herd. That was probably the profit for the year, at least a good chunk of it. A dead animal usually was not an absolute emergency, unless it was a herd animal. Unless it was a bunch of animals that died in a short time.

Dave had all seven dead calves lined up at the pasture gate when I pulled in the driveway. 

What a waste. All seven calves were in good shape, looked good for a couple of months old. I surveyed the herd out in the pasture. Good pasture for August, and the herd looked like nothing was wrong.

“Where do they get their water?” I asked.

“There is a pond, just over the rise, at the far end. You can’t see it from here.”

I pulled on a pair of gloves and looked over all the calves. Jaundice was evident in each one.

“Let’s take the smallest one and pull him over here out of the pasture,” I said. “We don’t want to contaminate things any more than they are already.”

I laid the calf on his left side and quickly reflected his skin and right legs. Stretching them out over his back. I took a moment to remember Dr. Norrdin’s words, “Work with your mouth closed.” Then I opened the chest and abdomen. The chest was fine, but the liver was swollen and dark in color. The urine in his bladder colored with bile. This was an acute outbreak of Leptospirosis. 

Lepto was known to cause abortion ‘storms’ in pregnant cow herds. Acute outbreaks in young calves occurred only rarely. It always amazed me how I always seemed to see all the rare events in my first couple of years out of school.

I collected samples for the lab on Monday if we needed them, liver, kidney, spleen, gall bladder, urine, and blood. Then I roughly closed the animal up. 

“Dave, I think you have an unusual outbreak of Lepto in these young calves.”

“Is there anything we can do to stop it?” Dave asked.

“Have you had any cows abort this year?” I asked.

“We had one cow abort about a week ago. I never thought much about it. It is not unusual for us to have an abortion or two every year.”

“There is an antibiotic treatment that will stop an abortion storm in cows. The entire herd is treated with a single dose of Streptomycin. I don’t think anything is written about controlling an outbreak in young calves. But my guess is if it stops abortions in a herd, it will stop an outbreak in calves.”

“So where am I going to get enough streptomycin to treat a herd at this hour on Saturday evening?” Dave asked.

“You’re lucky enough that I ordered it on my initial stocking order. I didn’t think I would ever use it, but I wanted to have it on hand. So, I think I have you covered in that regard.”

“There are a couple of other items we need to cover,” I said. “Number one, this is contagious to people. And it can do the same thing to people that it does to these calves. I was just talking with Dr. Craig the other day, he worked a herd with another veterinarian, and they both got sick. Dr. Craig went to the doctor as soon as he noted some blood in his urine, he got well. The other veterinarian waited till the next morning, he died.”

“Number two is the pond. Lepto is usually spread via contaminated water sources. If you had a cow with a Lepto abortion, she sheds organisms in her urine for several weeks. If she pees in or near that pond, calves that drink out of the pond can end up here,” I said as I pointed to the dead calves.

“You need to fence that pond and put a water tank in the pasture,” I said. 

“Do you think I should inject these calves tonight?” Dave asked.

“If you’re up to it, that is what I would recommend,” I said. “You might wake up in the morning with another batch of dead calves.”

“I will get you enough Streptomycin and vaccine,” I said. “I would give both. Lepto vaccines have some limitations in that there are many strains of Lepto. The vaccine protects against three of the most common strains, but there are others, and there is not a lot of cross-protection. It is the best we can do at the moment.”

“What should I do with these calves?” Dave asked.

“Move them out of the pasture. If you will have the rendering truck pick them up, that is okay. Otherwise, bury them deep. And don’t let the dogs get into this calf that we opened. They can get this also.”

I fixed up Dave with the necessary antibiotic and dosages and left him enough vaccine for the entire herd. He had a crew coming to help him. When I left that evening, I left him with one last piece of advice.

“Dave, you make sure everyone works with their mouth closed tonight,” I said. “And make sure they shower before going to bed.”

“Thanks, Doc, wish me luck,” Dave said.

“There is very little luck in this business. That is why it is important to do things the best we can at all times,” I said. “I will give you a call in the morning.”

I spent a long time drinking my coffee in the morning, and Sandy noticed.

“What is wrong with you this morning?” she asked.

“I am dreading calling Dave,” I said. “I am hopeful that I solved his immediate problem last night, but if I didn’t, he might have a bigger problem this morning.”

“Dave, this is Doc. I was just checking in with you on how things went last night and how things look this morning,” I said.

“We got the herd done, had to get out some floodlights for the tail end of it, but they are done. Things look good so far this morning. I have a couple of guys stringing an electric fence around the pond this morning, and I have a small water tank in the pasture. I am getting ready to run to Albany and see if I can pick up a large tank. Can’t thank you enough, Doc. I will keep you posted.”

Dave never had another problem, and the lab confirmed the Lepto diagnosis on Monday. In the next forty years, I never saw another outbreak like this one. Go figure the odds.

Photo by Kat Jayne from Pexels

The Dart’s Glance

D. E. Larsen, DVM

Fred Briggs waited patiently while I was finishing up on my office calls. He always came at the end of the day, maybe because we were close to his home in Albany, but I liked to think because he knew he would have more time to talk with me.

Fred was a salesman for one of the drug companies that supplied our clinic. He was older and had been in the business for many years. I enjoyed his monthly visits, not only for the information he provided and the orders he took but because of the stories he would tell.

Fred knew all the veterinarians on his route. I would guess he had a little card on all of us. What we liked to talk about, what drugs we favored, and what we wanted to do in our spare time.

When the last client left, Fred showed himself back to the pharmacy area and opened his briefcase on the counter.

“Have a story to tell you, Fred,” I said. “I will be with you in a couple of minutes after I finish up in the back.”

Sandy was there to place our order and place the flyers on the new products in a stack to transfer to my desk later.

“I will take them, and he will glance at them,” Sandy said. “I can never tell how much he absorbs with a simple glance, but it must be a bunch. He always seems to know what it’s all about.

“I think a lot of these vets just absorb things by osmosis,” Fred said. “They are always too busy to sit down and read anything.”

“How are you doing this evening,” I said as I shook Fred’s hand. “I have been wanting to tell you about using that new capture drug that you got for me.”

“How did that work out for you?” Fred asked.

“Worked like a charm,” I said. “We darted a bull elk. We have captured him every year for the last couple of years. He gets sort of ornery during the rut, so we saw his antlers off just to keep his pasture mates safe. He killed a little Sika buck a couple of years ago. It was always such a struggle just using Rompun.”

“The sad news is, I hear that they are probably going to pull it off the market,” Fred said. “It’s ten times the concentration of Ketamine and Ketamine is becoming so popular as a street drug, they don’t want it out there.”

“That’s too bad, just when you find something that works and you don’t have to keep it in a safe deposit box, and they pull it off the market,” I said.

“You know when they first started using those capture guns, they used Nicotine Sulfate for the drug,” Fred said.

“That was not a very safe drug,” I said.

“Let me tell you a little story,” Fred said. “One of the Albany vets bought one of those capture guns. I walked into his clinic just as he got ready to go out on a farm call to castrate a 600-pound boar hog. He asked if I wanted to ride along and watch. I figured it would be a good show.”

“A 600-pound dose of Nicotine Sulfate loaded into one of those darts would be dangerous if it misfired,” I said.

“Let me finish. We got to the place, and they had this boar in a small shed. The vet stood at one doorway and sent me around to stand at the other doorway. They had a couple of boards tacked across the doorways, but if this boar wanted to go through them, the boards wouldn’t even slow him down.”

“So here I am, standing in the doorway,” Fred continued. “And this vet aims at the rump of the boar and pulls the trigger. This dart glances off the boar’s butt and sticks in the top of my Wellingtons. Probably would have got me if I hadn’t had on those leather boots.”

“While, a 600 pounds dose of Nicotine Sulfate, you would not have even survived for the ambulance to get to you,” I said. “Would not have made much of a difference. There is no antidote. You would have been a dead man.”

“The face of the old vet was pretty pale as he was looking at that dart stuck in my pants leg,” Fred said. “He thought it was in my leg. That sort of brought that farm call to a conclusion. He was just getting some color back into his face by the time we got back to town. He stopped at the back of the old T&R truck stop and threw that capture gun into their dumpster.”

“And I thought I was the one who would be telling the story this evening,” I said.

“What are you going to be doing this weekend?” Fred asked. 

“I don’t have anything planned,” I said. “If this place doesn’t tie me down, I am probably free.”

“I am putting together a float trip down the Molalla River. I thought I would see if I could get you and another vet hooked up with a steelhead.”

The fishing trip was a soaker. No fish, just a lot of rain. But it was a good time. Free time away from the practice was precious in those early days.

Photo by Brett Sayles from Pexels

Blood Please, Fill Her Up

D. E. Larsen, DVM

She came through the door in a rush, a young girl, probably in her early twenties, with a very limp, pale orange tabby cat in her arms. 

She stopped at the counter. “I need to see the vet. This is an emergency,” she said, visibly trying to maintain her self control.

Under a lot of financial stress for a new clinic, this was one of our most difficult situations to handle. This patient was an obvious need for emergency care. Still, we were not in a place where we could provide a lot of expensive medical care without some assurance that we would get paid.

Sandy escorted her to the exam room, and Ruth was right there to check her status. 

“I’ll get the Doctor,” Ruth said.

“We require payment at the time of service,” Sandy said.

“I have a credit card,” Valarie said.

I came into the exam room and lifted the lip on the cat, a year old female named Sissy, lying almost lifeless on the exam table.

“We have to be very gentle right now,” I said. “This kitty is hanging onto life with by thin straw.”

“This has happened before,” Valarie said. “She is positive for Feline Leukemia Virus. All she needs is a blood transfusion.”

“I wish it was that simple,” I said. “A transfusion will be like magic for her right now. But it will buy her very little time. She will be back here again, in the same condition. And one time, she will not survive the trip.”

“She does just fine after getting a transfusion,” Valarie said.

“That’s why she is here in this condition,” I said. “When was her last transfusion?”

“It was about 3 weeks ago,” Valarie said.

“The virus crowds out her normal bone marrow cells so she can’t make her own blood. These FeLV positive cats have a short time to live once we start to see symptoms. Sometimes it is dysfunctional bone marrow like this. Sometimes it is leukemia. Sometimes it is a nonfunctional immune system, and sometimes it is a lymphatic tumor in the chest or abdomen.”

“Can we just get some blood into her?” Valarie asked.

“Sure, we just happen to have a donor cat in the back today,” I said. “I just want you to know that this is not as simple as you seem to think. Any undue stress on this cat right now, and she will seizure and die, just like that.”

I wish I could say this case was unusual. But in the late 1970s and early 1980s, we would see cats in this condition often, maybe 2 or 3 times a week. The only thing unusual about this case was the cat was still alive.

Often, the client would storm through the door with a cat in a kennel. Throw the kennel on the exam table, and drag the cat out for an exam. With the trip’s stress and a PCV of about 6%, the cat would have a seizure and die right before their eyes.

We took Sissy into the back and placed an IV catheter. Her PCV (packed cell volume) was 6%. Low normal is 25%. I had only seen a handful of cats survive with a 6% PCV.

I sedated our donor cat with a small anesthetic dose and collected 60 ccs of blood into a syringe. Then I turned around and administered this out of the syringe into Sissy’s catheter. Sissy was back to life before half the syringe was administered.

When I sent Sissy home later that day, I again tried to caution Valarie that Sissy was a lucky cat today. And that this may not happen next time or the next.

“Valarie, Sissy looks good right now,” I said. “But she is running on borrowed time and borrowed blood. Likely, her bone marrow is not producing blood like it should. Two weeks from now, she will be in the same situation, and one time she will not survive.”

“She looks so good. I can’t thank you enough,” Valarie said as she picked Sissy out of the kennel and held her against her chest.

I am not sure if she didn’t hear me or just chose to ignore my thoughts. But she went out the door happy.

It was just like clockwork when Valarie rushed through the door two weeks to the day later.

This time we ran a PCV first. It was 4%.

“Valarie, I have never seen a cat that was alive with PCV of 4%,” I said.

“All she needs is some blood,” Valarie responded.

“Yes, some blood and some functional bone marrow,” I said. “We will try, but I have no confidence that she will live through the process.”

We took Sissy to the back treatment table. As predicted, she died while we were placing an IV catheter.

To say that Valarie left the clinic unhappy this time would be an understatement. Valarie left the clinic pissed off.

To her credit, Valarie came in the next day and apologized for her behavior. 

“I was pretty unhappy yesterday,” She said. “I realize that you had warned me of Sissy’s status several times. I am sorry I acted the way I did.”

“We all get upset at times of stress,” I said. “Losing a pet is a hard thing. This Feline Leukemia Virus is tough. It is very prevalent around here.”

It was half a dozen years later when a vaccine for Feline Leukemia Virus became available. The vaccine immediately changed the landscape for Feline Leukemia Virus associated diseases. 

Today that vaccine has fallen in use and in favor. It does have some problems. Those problems do not begin to compare with what was seen in the cat population before 1984. Those veterinarians who fail to endorse that vaccine were not practicing before 1984.

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