A Little Bit of Magic Helps Sometimes

D.E. Larsen, DVM

“How long has she been down, Dick?” I asked, standing over a young heifer that had just delivered a calf.

“When I got this afternoon, she had this calf hanging halfway out of her,” Dick said. “The calf was dead, I hooked onto it with the tractor and drug her and the calf around the pasture. On the second time around, we hit a bump, and the calf popped out. When she wasn’t up when I got home after the football game this evening, I figured I had better give you a call.”

“I think you would have been better off if you had called me before hooking up the tractor,” I said. “When I have a calf in a hip lock, and the calf is dead, I cut the calf into a few pieces to get it out without doing any more damage to the heifer. But that is water under the bridge now. Let me check her over, and we can talk about what needs to be done at this point in time.”

“What do you do if the calf is alive?” Dick asked.

“That is my worst nightmare,” I said. “We have a few options today, but it is a nightmare. Decisions are often made based on economics. How much is the calf worth versus how much is the heifer worth.”

“This calf was half Simmental,” Dick said. “They say she would be worth $1200.00. That is a lot more than this $400.00 heifer is worth. Or should I say, was worth.”

“Sometimes, we can manipulate the calf in the birth canal,” I said. “If we can turn the calf 90 degrees, so the hips are up and down in the birth canal instead of across the canal, we can sometimes pop the calf through. If the hips are only slightly too wide, pushing them higher in the birth canal will do the trick. The heifer’s pelvis is wider at the top. Then there is a high-risk procedure for the heifer. If the heifer is young enough, we can split the pelvis’s bottom and get the calf out.”

“That doesn’t sound like fun,” Dick said.

“That is what I was saying,” I said. “It is my worst nightmare. Luckily, we have solved the problem somewhat by measuring the pelvis on the heifers before breeding. That, and people are learning that these big Simmentals don’t make the commercial producer any more money than the standard breeds.

We were in a small pasture on the top of Marks Ridge, overlooking the entire town of Sweet Home. It was quite a view at 10:00 PM, with all the lights shining brightly.

“You have quite a view up here,” I remarked.

“Yes, I really enjoy it,” Dick said. “But it is one hell of a drive to town in the wintertime. The wife worries herself sick about one of the kids killing themselves going down the road in the snow.”

“I guess there are pluses and minuses to any location,” I said.

I cleaned the heifer up and did a vaginal exam. Somewhat to my surprise, there were no vaginal injuries. Her hind legs had really restricted function, however.

“Dick, this heifer has Obturator Paralysis,” I said. “When that calf was stuck at his hips in the birth canal, and then you pulled her out in the manner you did, the obturator nerves were damaged. Those are the main nerves going to the inside muscles of the hind legs.”

“I suppose I have nobody to blame except myself,” Dick said. “Is she going to be alright?”

“Time will tell,” I said. “Some of these cases never get up again. Some get up in the first few days of injury, and some get up after a week or two of working with them. Some veterinarians hoist these cows up with a medieval contraption that clamps on the hips bones. It takes some pressure off the muscles when a cow is down for an extended period. I have never liked those. After a few days, you end up with damage up here on the hip bones.  If these cows are going to walk again, they will do it in a few days. Beyond that time, the odds are not good.”

“What do we do with her tonight?” Dick asked.

“I am going to give her a big dose of magic,” I said.

“That sounds like witchcraft,” Dick said.

“The good thing is we are not long after her injury,” I said. “My magic is in a dose of Dexamethasone. This is a potent steroid, a big anti-inflammatory medication. With a little luck, we can reduce the inflammation around those injured nerves. If we get really lucky, she might be on her feet in the morning.”

“That would be good,” Dick said. “If not, I would guess I should be moving her to get her undercover.”

“Yes, but we have to do that carefully,” I said. “Many of these heifers, that would get up, end up being injured because they are moved around or picked up with all sorts of jury-rigged contraptions. Many times, those injuries end up being fatal. For tonight, we will just leave her here. You give me a call first thing in the morning, and I will run up here and help you move her if she is not up.”

“Well do,” Dick said. “And you need to take it slow going down that hill tonight. There will be some frost on a couple of those corners this time of the year.”

Dick called first thing in the morning. He was in a jovial mood.

“Your magic seems to have done the trick,” Dick said. “That heifer was up waiting at the feed rack when I went out this morning. Thanks for your good work and quick response last night.”

“We got a little lucky,” I said. “What I want you to do now is go out and tape my phone number on the steering wheel of that tractor. Just so you remember to call me before you try to pull another calf with that thing.”

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Is He Dead Yet

D. E. Larsen, DVM

We were right in the middle of a story when the phone rang. Rod was closest, so he picked up the call. Everyone else on night duty tried to look busy. Our last couple of years in Vet School was a little more strenuous than regular college. Clinic rotations made it like an 8:00 to 5:00 job—actually, an 8:00 to 5:00 job that started about 6:30 and lasted until 7:00. Then every couple of months, you had a week of night duty with 10 seniors and 10 juniors. Most of the time, we were busy, but there were many slow hours. We were at the hospital until midnight, then on call for the rest of the night.

Rod hung the phone up and called Dr. Snow on the intercom. We had two interns on nights with us, one large animal intern, and one small animal intern.

“Dr. Snow, you have a turtle on the way in for an emergency exam,” Rod said on the intercom. “The lady wants to know if it is alive or not.”

Several of us headed to the small animal section to help with the call. This sounded interesting.

When Hazel and Matt came through the door, they actually had a small desert tortoise in Hazel’s hands. She was supporting it chin as the tortoise appeared limp.

We ushered them into an exam room and placed the tortoise on the exam table. I put a towel under the tortoise and positioned its legs and head in what appeared to be a comfortable position.

Dr. Snow came in and introduced himself. Dr. Snow was known to the students to be sort of a flake. A flake, but also pretty knowledgable about species that we would never see in a practice situation.

“Tell me about Henry’s problem,” Dr. Snow said to Hazel.

“Well, last night, when I was feeding him his vegetables, I noticed that he had a little bit of a runny nose,” Hazel said. “He has never been sick since we have had him, which is about 3 years.”

“So last night he had a runny nose, and tonight he looks dead,” Dr. Snow said. “What happened between then and now?”

“I knew I had to give him some medicine last night,” Hazel said. “I searched through our stockpile of old medication. The only thing I could find was some Phenobarbital.  It was given to help me sleep when I was sick a couple of years ago. Or I think that is what it was given to me for. Anyway, that is what I gave him. But I thought he was smaller than me, so I cut the pill in half.”

“You gave him 125 mg of Phenobarbital for his runny nose?” Dr. Snow asked.

“Yes, that is about right,” Hazel said. “Do you think that was alright?”

“Looking at Henry, I would guess, No, that was not alright,” Dr. Snow said.

“I just want to know for sure if he is dead before we bury him,” Matt said.

“The problem is that Phenobarbital is known to put some reptiles into hibernation,” Dr. Snow said. “We might have some difficulty deciding between death and hibernation.”

We turned Henry over and listened, but could not hear any heart sounds. We clipped a toenail and did get a drop of blood.

“Maybe we could try to get an electrocardiogram on him,” Dr. Snow said. 

“Oh, how much is that going to cost?” Hazel asked. “We are on a pretty limited budget, that is why we tried to treat his runny nose ourselves.”

“A phone call would have been a good idea,” Dr. Snow said. “We are pretty free with information around here. Whoever may not have known what to give a tortoise for a respiratory infection, but they would have known that Phenobarbital was not a good idea.”

“What are we to do now?” Hazel asked.

“Okay, I will let these students take Henry in the back, see if they can detect a heartbeat,” Dr. Snow said. “If we do that, you have to promise you will not tell anyone here in the hospital that I did that, or I will get into trouble. Do you agree with that?”

“That sounds fair,” Hazel said. “How are they going to find a heartbeat?”

“We will try to get an electrocardiogram on him,” Rod said. “If we use some needles as electrodes, that should be pretty sensitive.”

“Okay, but will you hurt him,” Hazel said.

“He is going to have a few needle pokes,” I said. “But in his condition, he won’t feel a thing. We will have him back here in a couple of minutes.”

We picked up Henry carefully and moved him back to the treatment room. We used aluminum needles, poked through the skin, and hooked the leads of the ECG to the needle hubs.

“We just need to do a lead two,” Rod said. “Any wiggle will mean he might be alive.”

There was not much on the tracing. But every once in awhile, there was a small blimp. 

“What does an ECG on a tortoise in hibernation look like?” I asked.

We settled the question by handing the strip to Dr. Snow when we returned Henry to the exam room.

“There is not much here to suggest he is alive,” Dr. Snow said. “But I have to admit, I do see a regular deflection that occurs about 2 or 3 times a minute. I think Henry is in very deep hibernation. I doubt is he will wake up from it.”

“Just what are you saying, young man,” Matt asked.

“I think Henry is near death,” Dr. Snow said. “I don’t think he is going to wake up. I think he will be dead by this time tomorrow.”

“So, I guess I should plan to bury him tomorrow,” Matt said.

“But what if you are wrong, Doctor,” Hazel.

“The other thing to do is to take Henry home, make him comfortable on the kitchen counter, and if he starts to smell, you can feel better about burying him,” Dr. Snow said.

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The Angry Awn

D. E. Larsen, DVM

I glanced up the hill 100 yards, where Derek was moving through some high grass. There was a chill in the early morning of October air. This was the first weekend that I was free to hunt. We were carefully covering my favorite clearcut on the backside of Buck Mountain.

As I watched, Derek suddenly grabbed his face and buckled to the ground. It took me a couple of minutes to climb the hill to where he was on his knees, with his hand over his eye.

“What’s wrong,” I asked as I approached through the chest-high dry grass.

“Aw, I have something in my eye,” Derek said.

I pulled his hand away to look at his eye. It was tearing heavily and was mostly closed from the pain, and the pupil was pinpoint. The culprit was already on his cheek. A grass awn laid on his cheek an inch below his left eye.

“You had a grass seed in your eye,” I said as wiped the seed off his cheek. 

“It really hurts,” Derek said.

I was starting to wonder if I was going have to pack him out of here. That would be no easy task. There was a steep hill up to the road. 

“I have a first aid kit in the truck, and it has some eye ointment and an eye patch in it,” I said. “Do you want me to go get it, or do you want to try to walk out of here?”

Derek was quiet for a moment. “I think I can walk out of here with a little help,” He finally said.

I slung both rifles over my shoulder and helped Derek to his feet. 

“Keep that eye closed, and it will feel better,” I said.

We were some distance from the truck, but Derek did fine once we were moving. We got through the high grass and cut across the clear cut to the cat road that went up the hill. I had to provide some support on his arm as we climbed the hill to the truck.

I got Derek into the truck and then opened the first aid pack. I carried more of a first aid pack than what you would find on the drug store shelf. I was prepared for lacerations, fractures, and penetrating wounds. But I was a little limited on eye injuries.

I did have a small tube of eye ointment. It was a triple antibiotic ointment, but I figured it should be okay for this situation. After I squeezed it into his eye, the pain was alleviated somewhat.

It was a long drive back to town, not in miles but in time. The logging roads were not highways, and speed was not an option.

We were lucky that Saturday morning when the local Optometrist was still in his office, and he accommodated us with an emergency exam.

“There are a couple of tiny little scratches on his cornea,” the doctor said. “It should feel fine if we keep it lubricated with some ointment for a day or two.”

It was just a few days later when Mike came through the door with Bob. Bob was wagging his tail stub. He always seemed happy in the clinic. Bob was a Springer Spaniel who lived for the fall bird hunting.

“Good morning, Doc,” Mike said. “Bob has a sore eye. I would like you to look at this morning if you have time.”

I glanced at Bob, and his right eye was half-closed, and the side of his face was wet with tears. Other than the eye, he looked like nothing was wrong.

“This eye started bothering him a few days ago,” Mike said. “We hunted on Saturday, and everything seemed fine. On Sunday morning, I noticed he was squinting his eye a little.”

“Let’s get him up on the exam table where I can get a look at it,” I said.

Mike was a big, muscular young guy who cut trees for a living and spent most of his spare time hunting or fishing. Bob was his constant companion when he was hunting or fishing.

Mike lifted Bob onto the table for me, and I placed a couple of drops of topical anesthetic into his right eye. I thought that maybe I should put some of this in the first aid kit after Derek’s near incapacitation.

“We will give that a couple of minutes to soak in, and then I will be able to look at this eye a little better,” I said. “Where were you guys hunting?”

“We were up Canyon Creek,” Mike said. “There is a lot of quail up there. I miss a lot them, but Bob has a grand time. He is not much of a pointer, but he flushes the hell of them. Keeps me in shape just trying to keep up with him.”

I spread the eyelids wide on Bob’s eye. I could see there was an extensive ulcer on the surface of the cornea. I ran a blunt forceps under the upper and lower eyelids to make sure there was no foreign body. Then I grasped the third eyelid with the forceps and lifted it away from the corner of Bob’s eye. There it was, a large grass seed awn stuck under the third eyelid. I grabbed it with the forceps and pulled it out. 

“This is the problem,” I said as I held the seed up to show Mike. “Now, I need to put a little dye into this eye so we can see how much of the cornea is damaged.”

A drop of dye and a blue light from the ophthalmoscope and over half of the cornea’s surface glowed green.

“Look at how much the cornea is ulcerated,” I said.

“What do we need to do now?” Mike asked.

“I need to hang onto Bob for a couple of hours,” I said. “We need to suture his third eyelid up over his eye to serve as a patch. We will send him home on some medication, and things should heal just fine. We will take the sutures out in a week and expect the eye to be healed.”

Suturing the third eyelid was an easy procedure. With Bob under brief anesthesia, I placed a couple of mattress sutures through the upper eyelid. I used a small piece of rubber-band to serve as a stint so the sutures would not cut into the eyelid.

When Mike came to pick him up, Bob bounced out of the kennel like a new dog.

“He looks like he is feeling a little better,” Mike said.

“I will tell you a little story,” I said. “Last Saturday, I was hunting with my son up on Buck Mountain. My son got a grass seed in his eye. By the time a got over to him, the seed was already on his cheek. Now I’m telling you, he was so painful, I thought I would have to carry him out. When we got to the doctor, he had a couple of tiny scratches on his cornea. Bob comes in here wagging his tail, and over half of his cornea is ulcerated, and the grass seed is still there.”

“What does that say about how tough this dog is?” Mike said.

“Most dogs are pretty tough, and maybe people are just pansies,” I said. “Eye pain might be more intense in people because eyesight is more important to us. I don’t know, but there is definitely a big difference.” 


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