A Veterinarian’s Legacy

D. E. Larsen, DVM

Mrs. Dannele stood at the front counter with Dixie in her arms. Well over six feet tall and muscular. She was a large and very proper lady. My guess is she was descended from some good pioneer stock.

Dixie was a black and white Boston terrier in a pink harness. Dixie was excited and squirming in Mrs. Dannele’s arm. But Mrs. Dannele had her locked in the crook of her left elbow, and she didn’t even notice Dixie’s struggles as she filled out the new client sheet with one hand.

“We were Dr. Campbell’s patients before he died,” Mrs. Dannele explained to Sandy.

I did not get a chance to meet Dr. Campbell before his recent sudden death, but I had heard stories of him. He was well-liked and well known, even to my clients in Sweet Home. Veterinarians who die while they are in practice always seem to walk on water for many years following their death. I knew that from the stories about Dr. Story, who practiced in Lebanon and died several years before I arrived. 

I did have dinner with the young veterinarian who assumed his practice. At least more youthful than me, he was young, well educated, brash, and felt that he knew everything. In the dinner at a local veterinarian association event, I learned everything I needed to know about the guy. And none of what I learned impressed me. On the way home that evening, I had told Sandy that he would have trouble filling Dr. Campbell’s shoes.

“Dixie is having some chronic diarrhea, and the new doctor that took over for Dr. Campbell has not been able to solve the problem,” Mrs. Dannele said. “We have heard good things about Dr. Larsen and would like him to look at her.”

“We were sorry to hear of Dr. Campbell’s death,” Sandy said. “We never had a chance to meet him, but we have heard nothing but good things about him.”

“Yes, he was a super veterinarian and a good man,” Mrs. Dannele said. “Dixie loved him, and so did we.”

“Let’s get you into an exam room, and Dr. Larsen can get a look at Dixie.”

When I entered the exam room, Mrs. Dannele was quick to take command of the conversation.

“Good morning, Dr. Larsen, I am Mrs. Dannele, and this is Dixie. Our daughter gave us Dixie because she thought I needed some companionship when I was away from home on business. That was a good thought, but she might be more than I want to deal with away from the house.”

“I understand that Dixie is having some diarrhea problems,” I said as I laid my hand on Dixie’s head and rubbed it a little. 

Dixie was wiggling all over the table. And trying to jump up to lick my face.

“We were Dr. Campbell’s clients, and we loved him. This young doctor who took over his practice is a world apart from Dr. Campbell. We just don’t know what our options are at this point.”

“You don’t have any commitment to the new doctor,” I said. “You are free to go where you would like.”

“That makes me feel better,” Mrs. Dannele said. “We almost felt like we were sneaking behind his back when we came here today.”

“There are many factors that go into a selection of a veterinarian, or any professional, for that matter. Actually, location, or proximity, is the number one factor. But it is important for you to feel comfortable with the relationship. And you should not feel guilty about making a change. People do that all the time.”

“But let’s get a look at Dixie,” I said. “Is she eating okay?”

“Yes, everything is fine except for her nasty diarrhea, and it doesn’t go away. We have changed diets, and he has given us a lot of different medications. And now he wants to do some testing to check her pancreas.”

“Will, the pancreas is sometimes a problem, but that is pretty rare,” I said. “I was always taught that when you out around a barn and you hear hoofbeats, you should look for a horse, not a zebra.”

I worked through a clinical exam and found nothing out of order except for diarrhea. There was a large drop of loose stool on the thermometer when it was removed from Dixie’s rectum. I placed that on a microscope slide.

“I am going to get a real quick look at this under the microscope,” I said. “And then we can talk about what we can do for Dixie.”

Taking the slide to the microscope, I placed a couple of drops of floatation solution on the small sample. I mixed it a little before dropping a coverslip on the liquid.

When I focused the microscope on the sample, the field of view was covered with roundworm eggs. I would expect to see a few, maybe, but nothing like these numbers on a simple smear. Dixie had a massive roundworm infestation.

“Mrs. Dannele, when was Dixie dewormed last,” I asked?

“I don’t know for sure, probably when she got her puppy shots.”

“She has a massive roundworm infestation. If we deworm her, it will undoubtedly solve her diarrhea problem.”

“Now, why didn’t he find that? It only took you a couple of minutes,” Mrs. Dannele asked?

“That is the difference between looking for a horse instead of a zebra.”

“What do we do now?”

“We will send you home with some liquid worm medicine,” I said. “You will see Dixie pass a surprising number of roundworms. It will gross you out, I am sure. It might cause her a little distress, but it will be for a short duration. I would expect her to have a normal stool in a day or two. When her stool is back to normal, we should check a sample to make sure she doesn’t have some other parasite. The medicine we give her will take care of roundworms and hookworms, but there are other worms and parasites, and we need to check to make sure she doesn’t have those.”

“Is she going to take this medicine at home,” Mrs. Dannele asked? “Maybe you should give it here.”

“This stuff most dogs will lick off the spoon,” I said. “The deal is, Dixie has a massive number of roundworms. On that microscope slide of a tiny sample, there must be a hundred roundworm eggs. That type of sample is generally not a good way to make a diagnosis. I might expect to see an egg or two in a puppy with a heavy infestation. I am afraid that if we give Dixie medication here, you might have her passing worms before you get home. There is a possibility that she will vomit worms also. You don’t want that going on in the car.”

“We will take the medicine home and give it there,” Mrs. Dannele said.

“We will give you a call in a couple of days. I expect Dixie to have a normal stool by then, and we will ask you to bring a sample in to have it checked.”

When Sandy called, Dixie was back to normal. Mrs. Dannele was already on her way with a sample.

“We are so pleased, and Dixie is pleased also,” Mrs. Dannele said. “Now, we would like to know what we have to do to move Dixie to your clinic.”

“From our view, it is done. You may want to call the other clinic and have them send her records. There is nothing more you have to do.”

“I think something should be said to the new doctor,” Mrs. Dannele said. “He needs to know that he missed a simple diagnosis.”

“You could make a statement to the receptionist when you ask for the records to be sent. The doctor would get the message.”

“Do you think that would be enough or appropriate,” Mrs. Dannele asked?

“It is appropriate, but to be honest with you, I have met this young doctor, and he is well educated. His problem is he thinks he knows all there is to know. I doubt there is anything you or I could say that would teach him anything.”

“Thank you for your honesty. We will just leave it at that. We are going to be far happier here.”


Photo by Erik Mclean from Pexels

Isabelle, Saved by a Bite

D. E. Larsen, DVM

The two girls standing at the counter were holding something bundled in a sweatshirt. They were young girls, probably 16 or 17. 

“I hope you can help us,” the young blond girl, Sidney, said. “This cat was hit by a car out in front of our house, and she is hurt pretty bad.”

“Whose cat is it?” Sandy asked.

“I don’t know, we have never seen it before. But we couldn’t just leave it lying in the street.”

“Are either of you 18,” Sandy asked?

“No, but this is not our cat.”

Joleen ushered them into the exam room and sat the bundle on the exam table.

“Let’s look at what you have here,” Joleen said.

“She is pretty scared,” Sidney said.

Joleen said. “I think I had better get the doctor.”

Joleen and I unwrapped the sweatshirt with care. The young calico cat poked her head out of the sweatshirt. I grabbed her by the nape of the neck. With some petting and some soothing words, she calmed down and relaxed under my grip.

When we got her out of the sweatshirt, she was bleeding from her right hindfoot. The foot was mangled. Mangled well beyond repair. Most of the skin was gone, and broken bones were sticking out everywhere.

“Whose cat is this,” I asked?  

“We have never seen it before,” Sidney said. “It was hit out in front of our house.

“We will check around, but if we can’t find an owner, we will probably have to put her to sleep. We can’t let her suffer from that foot.”

The girls said their goodbyes to the cat they thought they had saved, and they collected their bloodied sweatshirt.

“You guys give Sandy your contact information and a parent’s name. In case we need to contact you for some reason,” I said as they departed the exam room.

At the front desk, Sandy was busy getting their information.  Sue, the little brunette, held out her hand and showed Sandy a deep bite wound at the base of her thumb.

“Did that cat bite you,” Sandy asked?

“Yes,” Sue said. “She is not mean. She was just scared and in pain.”

“This changes the whole thing,” Sandy said. “Just a minute while I get the doctor.

“Dave, one of those girls was bitten when they picked up this cat,” Sandy said.

“Great,” I said, looking down at the little cat. “You just got an extension on your death sentence.”

“Did you make sure we have all the necessary contact information of these girls and on a parent of Sue’s. We will have to hang onto this cat for 10 days. That probably means I will need to amputate this foot unless the County Health Department authorizes another option.”

I stepped out to the front office to look at Sue’s hand.

“Sue, that bite wound is a major injury. A cat is the only animal that has put me in the hospital. And that was from a bite wound not too different from yours. You want to call your doctor and get some treatment instructions as soon as you get home. We will report this bite wound to the County Health Department. They will probably contact you. You probably gave us some extra time to try to find an owner. We have to keep the cat for 10 days to make sure it doesn’t have rabies.”

“What are you going to do with her foot,” Sidney asked?

“I will probably do a modified amputation at the joint. Just removing the injured part of the foot. If we find an owner, I will do a full amputation. Either way, we will hold this cat here for the full 10 days.”

“That makes us feel better,” Sue said.

The girls left feeling as good as could be expected. They were going home to search for an owner of this little calico cat. We were left doing surgery with little or no chance of getting paid.

“Set up surgery for just a simple amputation,” I said to Joleen. “This is a contaminated wound, and I am going to remove this foot through the hock joint. I won’t need anything other than a standard surgery pack.”

We finished the appointments for the day and then took the cat to surgery. In that time before surgery, Sandy had the cat calmed down and purring.

“What do we want to call her for the record,” Sandy asked?

“It makes no difference to me, you pick a name, and we will use it.”

“I think we will name her Isabelle,” Sandy said.

The surgery was brief. There was enough skin to cover the stump with no problem. I removed the foot by cutting through the tarsal joints, ligated the bleeding vessels, and closed the skin over the stump. Now we just had to recover her, control the pain, and wait out the 10 days.

“What is going to happen after 10 days,” Joleen asked? 

“If we don’t have an owner, she gets put to sleep.”

The days passed slowly. Sandy spent more and more time with Isabelle. She was labeled a Rabies Suspect because she was on the County watch list, and the staff was supposed to limit their contact with the patient. I mentioned that fact to Sandy.

“Do you consider me staff,” Sandy asked? “I don’t consider myself staff.”

I think it was the third day when Sandy said, “I don’t think I want you to put Isabelle to sleep. She is so sweet, I think we should make her a clinic cat.”

There was little reason for me to respond. I was probably the only person in the entire community who thought I ran this clinic. 

“You are probably right. It will make those girls feel better. And I can watch to see how well she does with a low leg amputation.”

And so it was written, when the 10 days of isolation were up, the County Health Department and the two girls were both notified that Isabelle was alive and well. Isabelle took up her new residence on the front desk, close to Sandy at all times.

Isabelle was a friendly cat. If she was away from the desk when a client came through the door, she would come running and jump up on the counter. Most people were surprised to see she only had three feet if they noticed at all.

Her residence at the clinic was over a year. Much longer than Newt’s and nearly as long as Blackjack’s. Her problem started softly. When some clients would pet her, she would nip at them. The nips soon became a soft bite, where Isabelle would grab the offending hand with her teeth and hold it for a second. Never breaking the skin, but the threat was there.

“I think the risk is too high to keep Isabelle here. We are going to have to take her home. One of these days, she is going to nail someone.”

Sandy agreed, and Isabelle made the trip to the house with us. Newt was still with us in those days. I always wondered if they compared notes.

As the years passed, Isabelle turned up missing one day. After some searching, she was found on the neighbor’s porch. We brought her home, and the following week, the neighbor called to tell Sandy that she was back on his porch. Sandy insisted on her becoming an indoor cat after those episodes.

As a three-legged house cat, Isabelle became a little overweight but still lived a long life in the Larsen household.

The Terrible Breech

D. E. Larsen, DVM

“Doc, this is Peter, out on Brush Creek,” Peter says on the phone. “I have been working on trying to pull this calf for two hours now. I am not getting anywhere. Do you have time to run out here and give me a hand?”

“Sure, I can come right away,” I said. “You caught me just at the right time. What is going on with her.”

“This morning, I noticed her with her tail up and sort of standing around a little odd,” Peter said. “When I ran her into the barn and got her tied up, I saw this tail hanging out of her. I cleaned her up like you always do and started working. There is just this butt of the calf in the birth canal. I can’t get ahold of anything.”

“Sounds like you have a calf in a full breech position,” I said. “I should be able to take care of that with little problem. At this point in time, almost all of these calves are dead. I mention that just so you know. When the calf is in a full breech, there is nothing to engage the cervix. The cow doesn’t usually go into hard labor for a day or sometimes two.”

“I can understand that,” Peter said. “But we have to get it out of there. I would guess you might have to do a C-section.”

“That all depends. Most of the time, I can get the hind legs up and just pull the calf. If not, I usually do a fetotomy. I don’t like to do a C-section on a dead calf unless there is no other option.”

“I have her in the barn. There is no need to stop at the house,” Peter said.

Peter and his young son, Tom, were waiting at the barn door when I pulled up in my truck. Peter was in his late 40s and usually looked too well dressed to be a rancher. Today, that was not the case. His hat was sitting crooked on his head, and it failed to conceal his uncombed hair. He had a swab of blood and mucus across his forehead. Both sleeves of his shirt were bloodied to his shoulders.

“Tom, it looks like your dad has been working hard this morning,” I said.

“He is pretty tired,” Tom said.

“I don’t know how you guys do it?” Peter said. “I have been at this for two hours, and the only thing I have accomplished is to wear myself out.”

“There are a few tricks to learn,” I said. “The most important thing to learn in bovine obstetrics is to set a clock on yourself. If you haven’t accomplished anything in 20 minutes, you need to do something else. That means you should have called me about an hour and a half ago.”

“That’s what Mom said,” Tom said.

“Well, that is enough of the storytelling. Let me get a look at what we have going on,” I said.

Working on a cow that the owner has struggled with for two hours has its own set of hazards. The untrained hands can do all sorts of damage. I have seen ruptured uteruses, broken legs on the calves, and gross contamination of the whole track. That meant I had to check for all of that first, or it would fall on my shoulders.

“I see you have her cleaned up well. That is a good thing.”

“I have watched you before,” Peter said. 

I washed the cow one more time and ran my hand into her vagina. The vagina and what uterus I could easily reach were intact. The calf’s rear end sort of worked like a cork in the birth canal. I stuck a finger in its rectum. No response; this was a dead calf.

“The calf is dead like I explained on the phone,” I said.

“How did you determine that so fast?” Peter asked.

“I stuck my finger in his butt. If he was alive, he would have responded to that. No response equals a dead calf.”

I ran my hand down under the calf. I could reach the hocks with no problem. Peter had stretched out the birth canal in his earlier efforts. I had no trouble getting down and grabbing a cannon bone. With a firm grip on the middle of the cannon bone, I pushed the hock forward to provide room to pull the hoof up into the birth canal. In one motion, I pulled the leg back, and the foot popped out of the vulva. I quickly reached in and repeated the process on the second leg. Now it was a simple extraction in posterior presentation.

“Doc, you embarrass me,” Peter said. “I have been working on her for two hours, and you come along and have the feet out in two minutes, and that includes time for some idle conversation.”

“It is just a matter of knowing a few tricks of the trade,” I said. “Give me a hand. I think we can pull this guy out of here with no problem.”

Tom was quick to jump in to help. At twelve, he was getting strong enough to consider himself almost a man. With the two of us, we quickly pulled the calf. It flopped lifelessly on the ground, and the membranes followed with a splatter of fluid. Tom jumped back, trying to avoid the mess, but it was too late. His pant legs were covered with fluid and mucus.

“One more lesson for today,” I said. “You always want to go back and check the cow. You check for another calf, and you check for any injury to the birth canal. Today, because you worked on her for so long, I will put some antibiotics into that uterus. That probably makes me feel better than it does her any good. Whatever I put in will drain out in a couple of hours.”

I finished up and cleaned up, and we turned the cow out.

“You want to watch her closely for a day or two. Just in case she develops an infection in her uterus.”

“And Tom, it was a good experience for you to be surprised by that splash of fluid. When I was in the delivery room with our first baby, I was surprised at the gush of blood that came with the membranes.”

Tom didn’t say anything but looked at his pant legs with a frown.

“Can I put another calf on her?” Peter asked.

“Sure, most cows will take another calf,” I said. “If you have an orphan or buy one at the sale. There are all sorts of tricks. Keep them in a small pen for a few days. Maybe take the skin off that dead calf’s back and tie it around the new calf, or smear the new calf with the membranes.”

“I will give it a try,” Peter said. “And thanks, Doc. You are good at the things that you do.”

Photo by Erik Mclean from Pexels.