All Hell Broke Loose

D. E. Larsen, DVM

“I have been looking at Sophie’s horse for a couple of days now,” Don says as we were lining out our morning calls. “I would like you to come along this morning and get your opinion. This is low-grade colic. I think it must be an obstruction, but I have not been able to confirm it.”

The three of us in the practice in Enumclaw were cow doctors. We did fine with the small animals, but horses were a different story. We had a few horse doctors around, and we tried to send most of the horses their way, but a few of the dairies would have a horse, and we were usually stuck with taking care of them.

“I didn’t know they had a horse,” I say. 

“She bought it a few months ago,” Don says. “Harold says he isn’t going to spend any money on it, but you know how that goes.”

We pulled into the barnyard in Don’s truck. The horse was in an open shed across from the milking parlor. She was standing, head down, and kicking at her belly every minute or two. 

“Have you done a rectal exam?” I ask Don. 

“Yes, but I didn’t find anything,” Don says. “But I am not sure about the horse’s gut. That’s why I wanted you to get a look. Your schooling is a lot more recent than mine.”

I started a full exam just so I wouldn’t miss anything. All her vitals were normal, except her pulse was a little elevated. Then listening to her abdomen, there are virtually no gut sounds.

“I guess I should do a rectal exam. I hate doing one on an unrestrained horse, but I don’t think we are going find a stocks around here.”

“She was pretty good for me,” Don says. “I will hold her for you.”

“Maybe we should put a twitch on her,” I say. 

“Don’t let Sophie know about that,” Don says. “She was pretty protective of her when I did the first exam.”

“If she says anything, just explain that a rectal exam on an unrestrained horse is dangerous to the vet, but also dangerous to the horse,” I say. “If she jumps or kicks, she could end up with a ruptured colon. That is probably fatal.”

I wrapped the tail to keep the hair out of the way and lubed my OB sleeve with a large amount of J-Lube. Standing on her right side, I held the tail to the side with my right and slid my left hand and arm into her rectum. She stood still. 

The colon was utterly empty. Don was probably correct in this being an obstruction colic. Pushing my arm in deeper, I explored the gut that was within reach. I found nothing in this initial exploration.

I reached deep and down on the left side of her abdomen, searching for the pelvic flexure, that spot where the large colon of the horse does a u-turn. It is a small portion of the colon and it is often the site of obstructions.

Finally, the pelvic flexure almost jumped into my hand. There was a firm impaction in the flexure. I massaged this mass, and the mare danced from side to side. This impaction was not large. I was surprised that the earlier treatments with mineral oil had not moved it. I slowly removed my arm and rinsed her rectum.

“You are right about this being an obstruction,” I say to Don as I unwrapped the tail. “There is firm impaction at the pelvic flexure, and it was painful for her for me to try to massage it.”

“I figured you had found it when she started acting up,” Don says.

“I know the experts say not to mix mineral oil and DSS,” I say. “But if you have treated her with oil a couple of times over the last 3 days, I think we should give her a big dose of DSS. If that doesn’t do it, and Harold doesn’t want to send her over the mountain to Washington State, I think we should talk to them about doing surgery.”

“That’s a big step,” Don says. “Are you sure about that? I have always been told never to touch the gut of the horse.”

“When I was home a couple of years ago, I went on a call with Dr. Haug to look at a horse he had done a flank surgery on for an impaction at the pelvic flexure,” I say. “That surgery went well. He just made a left flank approach, pulled out the pelvic flexure, and massaged the impaction to break it down. Worked like a charm.”

“I guess we could give it a try,” Don says. “I know Harold will go for it. He is sure this horse is going to cost more than they paid for it in the first place.”

“When I went back to school after visiting with Dr. Haug, I asked Dr. Adams about that procedure,” I say. “He said, if you have no other option, get in and get out as quickly as possible, and you will be fine.”

We gave the mare a full dose of DSS and some Dipyrone for pain. As we were finishing up, Harold came out of the house to talk with us.

“What do you two think?”

“We definitely have an impaction at the pelvic flexure,” I say. “We gave her some more medication. If she hasn’t passed anything by morning, we think we should do some surgery. Either that or send her over to Washington State.”

“We are not going to send her anywhere,” Harold says. “I’m not sure about you guys doing surgery either. But you know, Sophie will say we have to do what you say.” 

“Okay,” Don says. “No food, just like before. We will be here, ready to do surgery the first thing the morning.”

“I guess we should hit the books tonight,” Don says as we were driving back to the clinic. “I am not sure I can find the pelvic flexure. In fact, I have never done a flank incision on a horse.”

“Believe it or not, we did several while I was in school,” I say. “The incision is a piece of cake. In fact, the whole surgery is a piece of cake. It is just getting it done and not ending up with an infection following surgery.”

“We will plan for you to do the surgery. I will just be there to learn,” Don says.

The next morning we spent a lot of time packing and repacking our supplies for the surgery. 

“I don’t want to be out there and find out we forgot something,” Don says.

Finally, all packed up, we made the drive out to Harold’s place. When we pulled into the driveway, we could see the shed where the horse was being kept. As we got closer, we could see several boards were missing on the side of the shed. They were lying out on the pasture.

“That doesn’t look good,” Don says. “I hope the horse is still alive.”

When we pulled up to the shed, the mare was standing head up and eating some alfalfa. The inside of the shed was plastered with horse manure. And there were 3 boards kicked out on the side of the shed.

Harold came out of the barn when we arrived.

“About 3:00 this morning, it sounded like all hell was breaking loose.”

Sophie came up behind Harold. “We got up and came out here, and she was acting like everything was fine. She had kicked out the side of the barn, and there was horse shit everywhere. We figured that everything was okay, so I gave her just a little hay. She loved it.”

“This is the best thing that has happened to me in a long time,” Don says. “I have worried about this surgery all night.”

“What do we do now?” Harold asks.

“Let’s just go easy on the feed for a few days,” I say. “Maybe plan to be back on a full diet this time next week. Until then, just small amounts of hay and grain and plenty of water.”

We got back in the truck, and Don let out an audible sigh. “I am so relieved that we didn’t have to do any surgery this morning.”

“Makes the rest of the day easy,” I say. “Maybe we should stop off for a beer on the way home tonight.”

“That sounds good,” Don says. “I’ll buy.”

Photo by T.J. Checketts from Pexels

For the Want of a Few Pounds

D. E. Larsen, DVM

“Here comes Pete again,” Don said. “I think I will let you talk with him today. He just about talked my leg off yesterday.”

“What does he have going on?” I asked.

“He got a bunch of new feeder steers,” Don said. “He has been studying up on Ralgo, that new growth implant for pasture steers. He can’t decide if he wants to use it or not.”

Don faded into the back of the clinic as Pete got out of his car. Pete was an airline pilot and had a small hobby ranch on the edge of Enumclaw.  Like most of the pilots around, their house was enormous and elaborate. The farm was something that could be featured on the cover of a magazine. They all had more dollars than sense.

“Is Don around this afternoon?” Pete asked as he came through the door. 

“He is busy in the back,” I said. “Is there something I can help you with?”

“I was talking with him about using Ralgro and this new batch of steers I picked up,” Pete said. “I have been reading a lot, I just have a few questions.”

“Ralgro is pretty new, I don’t think we have anybody who has used it,” I said. “If you have been reading a lot, you probably know more than either Don or me. We have read some on it.  And we had a salesman in with his pitch on it.  It might be something useful for some of our clients. Your pastures look pretty good. It might be something that will give you a significant increase in weight gain.”

“How much of a weight boost do you think I would get?” Pete asked. 

“I think they are talking about 4% to 8% over a 120-day pasture cycle,” I said. “That means if you are feeding steers for 120 days, or 4 months, that start out at 450 pounds, and you normally finish them at 800 pounds. You could expect them to finish at 814 to 828 pounds. If you figure the cost of the implant is covered by a pound or two, that is a significant boost in profits.”

“What are the downsides,” Pete asked.

“Not many, besides the labor involved in working the steers and doing the implants,” I said. “It is a piece of cake after you do one or two. Ralgro is a synthetic estrogen, so there is some chance of getting into some behavioral stuff. Still, it is my understanding that is not much of an issue in a group of steers.”

“So, I think I will go ahead and do the implants,” Pete said. “Is that something you can order for me?”

“I think we got a shipment in yesterday,” I said. “I can set you up and go over the procedure with you if you would like.”

I got a package set out for Pete and went over the injection technique for doing the implant. Then I went over the package insert with him. I pointed out the few possible complications. At the bottom of the insert, I pointed to the withdrawal period before slaughter. At that time, there was a 60-day withdrawal. That meant that once implanted, the steer was not eligible for slaughter for 60 days.

“That means, if one of them gets caught in the fence and breaks a leg, you won’t be able to salvage him,” I said.

“I have a crew lined up for Saturday,” Pete said. “I will let you guys know how it goes. Tell Don that I appreciated his input also.”

The following week, I drove by Pete’s place and admired a dozen steers he had in his pasture. A picture-perfect field and these steers were knee-high in the grass. They were a pretty sight.

And then came the April shower. It was not much of a rainstorm. It was more of a heavy mist that filled the air all morning. It was a miserable morning to be out working. Too wet for a light jacket and too warm for rain gear. Don and I were both back in the office after doing our morning calls when the phone rang. It was Pete.

“I think they are all dead,” Pete cried into the phone. “Can somebody come out and give me a hand.”

Don and I jumped in Don’s truck and made the short drive out to Pete’s place. It looked like half the town was there. We pulled into the barnyard, and then we could see the pasture. Pete was correct. It looked like all the steers were dead. 

We jumped out and ran out to the pasture. Going from one to the other. Every steer was dead. Dead from bloat, several had green foam bubbling from their nostrils.

I walked through the pasture, kicking up the grass that was weighed down with morning mist. This pasture must have about 50% white clover in the deeper levels of the grass. Wet white clover was a perfect recipe for frothy bloat.

“My wife’s folks came in last night,” Pete was telling Don. “I came out and turned out the steers, and then we went to Auburn for breakfast.

When we got back, they were all dead. Never in my wildest dreams would I expect this. What do you think happened?”

“This mist wet everything down, and you have a lush pasture that is about 50% white clover,” I said. “That is a perfect recipe for frothy bloat. Had you been here and recognized the first one or two to go down, we maybe could have saved some of them. But once you get this many involved, it is a losing ball game.”

“Can I make hamburger out of them?” Pete asked. 

“It is always a little risk to eat a dead cow,” Don said.

“This is no different than shooting an elk,” Pete said. “Sometimes, it takes a couple of hours before you can dress them out.”

“That true, and with bloat, it probably would be okay,” I said. “But the other problem is you implanted these guys last week with Ralgro. Remember, it has a withdrawal time.”

“That’s right, so I guess it is just a loss,” Pete said. “What a waste. I guess it might help with my taxes.”

Photo by Kat Jayne from Pexels

One Bite Deserves Another

D. E. Larsen, DVM

“Doc, I know it’s late, but Rex is hurt pretty bad,” Reese said into the phone.

“What’s going on with him, Reese?” I asked.

Reese was an old rancher. He still worked a few cows, but his son did most of the hard work now. Reese was a big man, big all over. And his features were rough. He shaved about once a week, and wrinkles seemed to soften a once stern face.

“I was working a few cows tonight,” Reese said. “Old Rex, if they don’t do what he wants, he gets sort of mean. Rex grabbed this old black cow by her heel, and she kicked at him pretty hard. Old Rex, he ain’t smart enough to let go. She broke his mouth up pretty good.”

“Okay, Reese,” I said. “I can meet you at the clinic in a few minutes.”

I could see that Rex had a significant injury to his mouth when they came through the door. His mouth hung open, and the right side of his muzzle drooped lower than it should.

Rex was one of my working dogs. He was mostly Australian Shepherd but darker in color than was typical for that breed. He also was a little more aggressive with the cows that most dogs.

“He really did it to himself this time,” Reese said.

I lifted Rex onto the exam table. I always marveled at the bodies of these working dogs. Some would be considered heavy if you just looked at their weight. But these dogs were solid muscle. And tough as nails. Rex did not act like his injury was bothering him at all.

I lifted his right lip, what a mess. He had a fracture of his maxilla, his upper jaw bone. He must have had a hold on the cow’s foot when she kicked. His canine tooth acted like a lever, and it produced a flap of bone that contained his canine tooth, two incisor teeth, and two premolars. The fracture line ran down the right-center on the roof of his mouth. 

“This is a mess,” I said. “But it is probably good that you brought Rex in tonight. I think I can fix it with a couple of pins and several wires. He is going to be uncomfortable for a couple of months.”

“Do you think he is going to lose any teeth?” Reese asked.

“All these teeth are still set in bone,” I said. “It is the bone that is broken. We might need a little luck here. But I think this will repair okay. The problem is I am going to have a couple of wires running across the roof of his mouth, and that is going to bother him.”

“How long will he have those wire?” Reese asked.

“Probably six to eight weeks,” I said. “Now that I think about it, I will probably wire between a couple of sets of teeth also. Sometimes when we do that, we will lose a tooth or two. But that won’t bother him.”

“He doesn’t have to smile for any pictures,” Reese said. “He won’t care as long as he can get back to work.”

“I think it is a good thing that you brought him in tonight,” I said. “With this wound open on the roof of his mouth, it would be a mess by morning.”

“Are you planning to fix it tonight, Doc?” Reese asked.

“I think that it is something I can do by myself,” I said. “And he will be far better off if it is repaired tonight. I would guess he will be ready to go home in the morning.”

With that, I showed Reese out the door after I had him hold Rex while I placed an IV catheter and started a bag of fluids on a slow drip. I got things set up in surgery and then gave Rex a dose of Pentathol via the IV.

The repair went pretty well. The slab of bone with the 5 teeth fit snuggly into place. I secured it with a couple of pins that ran through to the other side of the mouth and then placed tension band wires that ran across the roof of the mouth to hold the slab of bone securely in place.

That was all I needed. I did wire the teeth on each end of the slab to their neighboring teeth. And then, I covered all the sharp ends of the pins and wires with dental acrylic. Hopefully, the acrylic will last for the full eight weeks.

Rex went home the following morning, looking none the worse for wear. I checked him every couple of weeks. The repair held up well, and at eight weeks, his x-rays showed good healing. 

We sedated Rex and pulled the pins and wires. There were a couple of minor abrasions in his mouth, but nothing that would not heal well.

“I think you can probably start treating Rex like a dog again,” I said when Reese was in to pick up Rex.

“I think that he can’t wait to get back to work,” Reese said. “I bet he is thinking he is going to get back at that old black cow.”

“I don’t know,” I said. “Maybe we should put a muzzle on him for a couple of weeks. I’m not sure this repair will hold up to another bite like the last one.”

“We ain’t going to make no sissy out of Rex,” Reese said.

It was a long week later that Reese had Rex back in the clinic. He had landed a bite on the heel of that same old black cow, and sure enough, the same slab of maxillary bone was hanging loose.

“Looks like we need to do the same thing again,” I said. “But this time, we are going to extract both of those upper canine teeth. That way, when he bites, he won’t be able to hang on, and there won’t be a big lever to brake that jaw.”

“That sounds good, Doc,” Reese said. “Because we ain’t going to slow old Rex down.”

Rex healed well, once again, and didn’t seem to notice his missing canine teeth.


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