Poor Planning 

D. E. Larsen, DVM

Darrell was waiting at the gate when I pulled up. I hadn’t met Darrel before. When Darrell called, he told Sandy that he had just bought this place and it needed a lot of work, but he had bought a herd of cows to run on it.

“Hi, Doc,” Darrell said as I pulled through the gate. “You can just pull out over there to park.”

I got out of the truck and surveyed the landscape quickly. There was no house, no barn, no cross fences, nothing. I didn’t even see any cows.

“Hi, Darrell,” I said as I extended my hand. “This is nice looking pasture. The gals in the office said you had a cow with a sore foot.”

“Yes, she is carrying one of her front feet,” Darrell said. “I was hoping you could help me out with her.”

I looked around again. There was no sign of any cows. I probably couldn’t see the entire property, but I didn’t have a good feeling about how this call would turn out.

“How long have you been on this place, Darrell?” I asked.

“I just moved here from California last week,” Darrell said. “I bought this place when I came to town. I know it needs a lot of stuff done, but that is what I was looking for when I moved.”

“There are no buildings here,” I said. “Where are you living?” 

“I’m at the motel for now,” Darrell said. “But I had a contractor out here yesterday. He has some house plans and thinks he can get things started right away.”

“You know, you have to make sure you have water and that you can get septic approval before you build a house,” I said.

“Well, the contractor never mentioned those things,” Darrell said. “But water shouldn’t be a problem. I have a creek over this rise, and it has plenty of water.”

“It is not safe to use surface water in the house these days,” I said. “And a lot of these little creeks are seasonal. They run full in the winter and spring, but they dry up when summer and fall come around.”

“Well, I will have to talk to the contractor about those things,” Darrell said. “Maybe we should go get a look at the cow with a problem. That’s what I called you for.”

“Where are your cows?” I asked.

“I am not sure. They move around a bit,” Darrell said. “They are probably over the rise and down by the creek.”

“And where is your corral?” I asked.

“I don’t have any of that stuff built yet,” Darrell said. “I plan to build a barn and a corral system up the hill from the house. But that will probably not happen until I get the house built.”

“What are you going to do with your cows next winter?” I asked.

“I haven’t given it much thought,” Darrell said. “Can’t they pretty much take care of themselves?”

“We will need to talk about the needs of your cows this winter after I look at this cow,” I said. “You want to get in my truck, and we can drive out there.”

“I would rather have you walk,” Darrell said. “I really don’t want to tear up the grass by driving out there.”

“You understand that my fees are based on time,” I said. “We are going to stroll out there where you figure the cows might be, and there is not going to be any way to get ahold of this cow once we get there.”

“These cows are tame,” Darrell said. “I can walk right up to them.” 

“I can guarantee you that when they see a stranger coming, they will run off,” I said. “And walking up to a cow is a little different from lifting up a foot to look at it.”

“Doc, you’re not sounding like you want to look at this cow,” Darrell said.

“Darrell, I don’t know what your expectations are, but you have to have some way to catch a cow and handle her after you catch her. We could chase your cows around these twenty acres for several hours and never lay a hand on them.”

“What do you think I should do?” Darrell asked.

“I think you go down to the farm store and buy a portable corral system and set it up over there in the corner of the pasture,” I said. “Then, if you start feeding the cows in the corral, they will get used to going in there. Right now, you have put the cart before the horse. You have cows, but you have no infrastructure to care for them. By the middle of winter, you are going to have dead cows. And your neighbors will be reporting you to the sheriff.”

“You make things sound pretty bad,” Darrell said.

“Darrell, it is like anything else,” I said. “I understand your excitement with your change of life, but before you can make a massive change, you have to do the planning and have the infrastructure in place. Otherwise, you just end up with a big mess. And Darrell, that applies to almost any big change, not just cattle.”

“So, can you help me out with this cow?” Darrell asked.

“Get in the truck,” I said. “We will drive out there and at least eyeball her. I can get you some antibiotics to put in the feed or water.”

We drove over the rise, and there was Darrell’s herd. Five Angus cross cows, bedded down by the small creek, already running low for late spring.

As soon as the truck got close, the cows were up and headed for the far corner of the place. I could see the cow Darrell was concerned about. She was limping a bit but not bad.

“Okay, Darrell, I can give you some powdered antibiotic you can mix with a little grain and give to that cow once a day. If that doesn’t take care of the problem, then we will need to get her into a corral when we can get her looked at and examine that foot.”

“What are you thinking is wrong with her, Doc?” Darrell asked.

“I am guessing that she has foot rot,” I said. “If I am right, the antibiotics will take care of the problem. If it doesn’t get better, we need to look closer.”

We drove the truck back to the gate, and Darrell didn’t have anything to say the entire time. I got out and retrieved several packages of powdered antibiotics from the back of the truck.

“Give her a half of the package mixed with a little grain once a day,” I said. “If the other cows get some of it, it won’t hurt them, but it will reduce the dose the sore footed cow is getting.”

“What do you think I should be doing with this place, Doc?” Darrell finally asked.

“You have to slow down and make a plan,” I said. “If your contractor didn’t talk to you about a well and septic system, you need to get a few others out here to give you a bid. You either need to build some sort of a shed for these cows for winter or send the cows back to the sale. It doesn’t need to be a barn, but it needs to store some hay and give the cows protection from the rain and the cold. Then you need to get a well driller out here and get a good water supply. You get that done, then stop by the office, and I can discuss your plans for a barn and corral system with you. Then you can build your house.”

“You sound like you think I am way ahead of myself,” Darrell said.

“Darrell, I have just seen too many wrecks in the middle of winter where it is the cows that suffer,” I said. “To be frank, I see a Californian who probably sold out in California and has a pot of gold by Oregon standards. Many folks around here will help you spend it, and you just have to slow down enough to ensure those folks have your best interest at heart.”

“You think I should sell those cows, don’t you?” Darrell asked.

“Yes, I think you are not set up for cows right now,” I said. “Get your well drilled, your house and barn built, and get some fences and a corral built. Then get someone to help you pick out a good set of cows. Know the cow’s pregnancy status and have their winter feed in the barn. I can help you with things if you want. If you do all that, your life as an Oregon rancher or hobby farmer will be much better.”

“What should I do with this grass if I sell the cows?” Darrell asked.

“Stop in to the office, and I can hook you up with Sudi,” I said. “She will be happy to make hay for you. Probably for a fee if you want to keep the hay. And if you aren’t set up to keep it, she would take it, maybe even pay you a few dollars.”

“I guess I could probably just stack it here,” Darrell said.

“This is not Colorado or Eastern Oregon,” I said. “We get far too much rain to store hay outside.”

“Okay, I think what you say has some merit,” Darrell said. “I will give that cow some antibiotics and find somebody to help me take these cows back to the sale barn. I never even thought about their pregnancy status when I bought them. They probably took advantage of me there also.”

“If you talk with the sale barn, they can probably get someone to come to pick up the cows for you,” I said. “Just make sure you tell them they will need to have some panels with them because you don’t have a corral or holding pen.”

“Okay, Doc, I will get things going on the right track, and when I have things all planned out, I will come by your office and go over things with you,” Darrell said.

As things turned out, Darrell did okay. He was appreciative of my advice. That first contractor was hoping to take him to the cleaners, but he got that straightened out. 

The following spring, his place was set up, and Darrell came up with a good herd of cows. And he remained an excellent client.

Photo by Andrew Hall on Unsplash.

The Winos

D. E. Larsen, DVM

Our first weeks in Enumclaw, Washington, were busy. Our move from Colorado had been an experience, but that was in the past. I was busy establishing myself in a busy veterinary practice. Sandy was active with the girls, trying to make the house a home.

After just finishing school on borrowed money, our funds were somewhere between limited and nonexistent. And it was another two weeks before my first paycheck. But Sandy was doing well managing the meager funds, and it looked like we would not starve. 

“I asked Jack for an advance on our first paycheck,” I said as I was changing out of my clinic clothes.

“What did he say?” Sandy asked. “We really need to go to the grocery store. My shopping list is getting pretty long.”

“He just handed me a couple of hundred dollar bills and said he would try to remember them when they did payroll,” I said. “They are in my wallet on the bed.”

“Great!” Sandy said as she absconded with the two bills. “You can go with me and the girls when we go shopping after dinner. They have a nice hometown grocery store on the far edge of town. We were there earlier today, but I didn’t have enough money to buy much.”

Dinner in our house was still a time for everyone to sit down together and talk about the day’s events. But the dinner was a little skimpy, from my view. Sandy was doing a masterful job of stretching a near-empty pantry. Tonight, we had spaghetti with just a bit of hamburger in the sauce.

“We are down to our last pound of hamburger,” Sandy said. “So I planned to use half of it tonight in the spaghetti sauce and the other half tomorrow with a box of hamburger helper. Then, before you came home with some cash, we would be down to tuna casserole.”

“If we pick up ten pounds of burger tonight, we should be able to stretch it out to payday,” I said.

After dinner, we washed the dishes, and I called Ralph from the field behind the house. All I had to do was shake the jar of Pet-Tabs, and he would come running. 

Amy gave him his Pet-Tab, and I spooned his last bit of canned cat food into his dish. I took a whiff of the can before depositing it in the garbage.

“If things get bad enough, we could always resort to cat food,” I said. “This doesn’t smell too bad.”

“We are not going to raise these girls on cat food,” Sandy said.

We loaded the girls into our station wagon and drove through Enumclaw’s downtown to the grocery store. The kids had their routine down already when we arrived at the store. Dee rode in the shopping cart seat, Amy hung on the front of the cart, and Brenda helped direct it down the aisles.

“Can we each pick out a box of cereal like you said this morning?” Brenda asked.

“Yes, we can buy cereal tonight, and it’s a good thing,” Sandy said. “I don’t think that last box of frosted flakes would fill all the bowls in the morning.”

After the cereal aisle, we turned the corner and ran into Ed.

“Hi, Ed,” I said. “Do you work here?”

“Oh, hi, Doctor Larsen,” Ed said. “Yes, I am the assistant manager.” 

“That’s great, but what are you hanging around in the aisles for, aren’t you supposed to be doing more important stuff?” I asked.

“These two old guys rip us off for a couple of bottles of wine every time they come in here,” Ed said, motioning to a couple of old bums looking over the wine collection. “I call them Red, the one with red hair, and the skinny one, Skelton.”

“If you’re watching them, they surely can’t steal anything, can they?” I asked.

“It doesn’t seem to matter how close we watch them. They always manage to stuff a bottle into those trench coats they wear.”

We left Ed to his surveillance and pushed the cart past Red and Skelton. It was apparent that they spent more time with the wine bottle than in the shower.

Sandy went down every aisle, filling the cart to almost overflowing.

“You know we have to make those two hundred dollars last for another couple of weeks,” I said.

“We are fine. This won’t even take one of those bills,” Sandy said.

As we were leaving the checkout counter after spending eighty-four dollars, Ed was upfront watching Red and Skelton as they walked across the parking lot.

“Ed, just a suggestion, but if you put a coat rack at the door and require those two to hang up their trench coats when they come into the store, it might solve your problem,” I said.

“That’s a good idea,” Ed said. “I will bounce that off the manager in the morning.”

We loaded the girls into the car first then I placed the grocery bags in the back.

“How do you know Ed?” Sandy asked.

“He was in the clinic with a puppy yesterday,” I said. “He seems like a nice young man.”

“Can we have a puppy?” Brenda asked.

“You will have to do with Ralph for now,” Sandy said.

***

A couple of weeks later, Ed came to the clinic for a couple of things for his puppy.

“Say, Doc, I want to thank you for suggesting the coat rack,” Ed said. “Red and Skelton grumbled at first, but they hang their coats up now, and our losses from the wine inventory moved to zero almost overnight.”

“That sounds great,” I said. “Probably makes your job a lot easier.”

“Oh, yes, I was spending five or six hours a week just watching those two,” Ed said.

***

A week later, I was in the grocery store with Sandy and the girls, doing some shopping. We were standing at the checkout, waiting our turn. The lady ahead of us was buying three bottles of wine.

The light was just right for me to get a good look at the bottles. One of the bottles was only half full. I pointed to the bottle.

“Did you notice this?” I asked the lady.

“Did I notice what?” she asked. 

I picked up the half-empty bottle and handed it to her. Her mouth fell open.

“Oh my gosh!” she said. “How did that happen?”

The clerk looked at the bottle.

“Just a moment, and I will get Ed,” the clerk said.

Ed came and picked up the bottle. He looked at me, shaking his head. 

“Red and Skelton,” Ed said.

“I like to watch Red Skelton, but what does he have to do with my half-empty wine bottle?” the lady asked.

“That is s private joke,” Ed said. “We need to get you another bottle. And I need to check the inventory.”

I went with Ed to the wine aisle. Looking through the bottles, they seemed okay until we looked at the bottles on the back of the shelf. Bottle after bottle had been opened and partially consumed.

“Those two bastards,” Ed said. “We stop watching them, and they just come in here and drink the wine in the store. No wonder they don’t complain about the coat rack anymore.”

We took the lady her bottle of wine, and Sandy finished checking out.

“I hope you can solve that problem,” I said to Ed as he passed with a cart full of half-empty wine bottles. Some with only a little missing, but most were half full.

“I’m afraid what the final count will be,” Ed said. “The manager will hit the roof when he sees this in the morning.”

Ed dropped by the clinic in the morning to thank me for finding the problem and update me on the situation.

“We got the chief of police to ban them from the store,” Ed said. “The manager wants to take them to court, but you can’t get blood from a turnip. I think he is going to be satisfied with the ban. The thing I worry about is how many bottles did we sell before the problem was noticed. I pulled three shopping carts full off the shelf last night. We emptied the shelves and checked every bottle. How could they drink that much wine and still walk out of the store?”

“Practice, I would guess,” I said. “A lot of practice.”

Photo by Rana M on Pexels.

The Stone’s Story, From the Archives

D. E. Larsen, DVM

Raymond came through the door with little Sophie cradled in the crook of his arm. Sophie was a really small Chihuahua, and Raymond, her owner, was a large man. It was one of the things that I always found a little odd. Some of the largest men were attached to these tiny dogs.

After he stretched a towel out on the exam table, Raymond placed Sophie in the middle of the towel. Sophie, at four and a half pounds, was overweight. Her spindly legs looked undersized for her round body.

“She has blood in her urine, Doc,” Raymond said. “And she pees a little puddle every 5 or 10 minutes. The wife is getting upset with all the cleaning up after her.”

I looked at Sophie, her gray muzzle told she was past middle age. She should probably weigh two and a half pounds, not four and a half. Her membranes were normal, with normal capillary refill time. Heavy tartar on her teeth and some chronic periodontal disease suggested that she was a good candidate for a heart murmur. That was confirmed when I placed the stethoscope on her chest.

Chronic periodontal disease leaks bacteria into the bloodstream. These circulating bacteria take up residence on the heart valves, in the kidneys, and the liver. Poor dental hygiene, most common in small dogs on pampered diets, leads to all sorts of significant health complications.

She was heavy enough that it was difficult to palpate her abdomen accurately. But when my fingers reached the posterior abdomen, I bumped a hard firm bladder. Sophie immediately squatted and peed a small puddle of bloody urine onto the towel.

“Raymond, we are going to have to pick up the towel so I can get some urine off the tabletop,” I said as I lifted Sophie up so Raymond could remove the towel.

I sat Sophie down and felt her bladder again, more carefully this time. There was a large stone in the bladder. I could feel some movement in the stone, probably a couple of stones. They were large, making the bladder feel full, but there was little room for urine. Sophie squatted again, depositing a small puddle of bloody urine on the exam table.

I drew the urine into a syringe and placed a small drop on a microscope slide. A quick look at the slide under the microscope showed the blood but also many bacteria and struvite crystals.

Struvite stones were the most common type of bladder stones in the dog at that time. Struvite stones in the dog are caused by a urinary tract infection that leads to acidity changes in the urine, crystal formation, and then the development of stones. These stones grow with time. In male dogs, they often cause urinary tract obstruction as the small stones try to pass down the urethra. That seldom happens in the female.

Today there are diets that can dissolve struvite stones in the bladder. That was not the case in the 1970s and 80s. Stones as large as Sophie’s, are best removed by surgery, even today.

“Raymond, Sophie has a large stone, or more likely 2 or 3 large stones in her bladder,” I said. “These are caused by an infection in the urinary tract. She has a lot of bacteria in her urine. We need to do several things. We need to do a culture on her urine, and while we are waiting for the culture results, we will get her started on a good broad-spectrum antibiotic. We need to get an x-ray, so we can see how many stones we are dealing with, if there are stones in the kidneys, or a bunch of little stones also. We need to do some blood work to make sure Sophie’s kidney function is normal. These stones are going to have to be removed with surgery.”

“Doc, you sound like you are talking about a lot of money,” Raymond said. “I don’t have a lot of money. Are there some short cuts we can take.”

“We can shortcut some of the things if that is what you want to do,” I said. “You need to understand, shortcuts are great if everything works out fine. But if things don’t go just right, we end up spending more money than we would have doing things right in the first place.”

“What kind of things are you talking about, Doc?” Raymond asked.

“Looking at her urine, her kidney function is probably okay,” I said. But if it isn’t, and a random urine sample is not the best indicator of kidney function, we might be delayed in finding that out, and we could lose her. If she happens to have an infection that requires a particular antibiotic, we might not know that without a culture. If we have a bunch of little stones along with the big ones I can feel, we could leave a stone behind and have to do a second surgery.”

“She is sort of long in the tooth, Doc,” Raymond said. “Let’s put her on some antibiotics and do the surgery. If things don’t work out, at least we tried.”

“That is fine, just as long as you remember this conversation,” I said as I shook Raymond’s hand.

“Will I be able to take her home tonight?” Raymond asked.

“We are early enough that she should be able to go home tonight,” I said. “We will have her on c/d diet for a time. That will be important, nothing else.”

“You are going to ruin her life and make mine miserable,” Raymond said.

“You know, you are killing her slowly with kindness, don’t you,” I said.

“What do you mean, Doc?” Raymond asked.

“Look at her, Raymond,” I said. “She weighs twice what she should, her teeth are a mess. She should have those cleaned, and there will be many teeth that are not savable. The infection in that mouth could have been what started this bladder thing, and her heart valves are leaking a little. She needs to be eating dog food, period. But we can work on those things after we get this bladder thing fixed.”

I gave Sophie an injection of Amoxicillin and Gentocin. I planned to send her home on Clavamox. We gave her 80 ccs of fluids by subcutaneous injection and placed her in a kennel while we got the surgery room ready. Sophie was unhappy in the kennel, how dare we treat her like a dog.

After anesthesia was induced and the abdomen was prepped for the last time, I draped the incision site, first with towels and then a surgery drape. I made a short incision over the bulge in the posterior abdomen caused by the large stones in the bladder. I was able to squeeze the bladder out of the incision. It was the size of a full bladder but hard as a rock. 

I placed a couple of stay sutures to hold the bladder in position when I incised it and removed the stones. Then I made an incision into the bladder. The bladder wall was thickened from the chronic infection and the mechanical damage from the stones.

I popped the first stone out, then the next. Amazingly large stones for such a small dog. The bladder lining was burgundy red and almost bubbly from the chronic inflammation. I flushed the urethra in both directions and carefully explored the bladder to make sure no small stones were hiding.

Then I closed the bladder in two layers with Maxon and returned it to normal position. I was careful to remove a couple of drops of urine from the incision and flushed the area liberally. Then the abdomen was closed with a standard 3 layer closure.

Sophie recovered quickly and was probably more comfortable than she had been in months. Raymond was pleased with how lively she was when he picked her up.

“I want to see her in a couple of days, just to check the incision and feel her bladder,” I said. “If you get a chance, try to get a look at her urine in the morning. Mainly to see is the blood is cleared up. And Raymond, you have to be strong, c/d diet only for 3 weeks. No bacon off the breakfast table. You understand, we have come this far, don’t ruin it by being weak when she begs.”

“I will do my very best, Doc,” Raymond said.

“I can guarantee you, Doc,” Sue, Raymond’s wife, said. “He has spent our summer trip to the coast, and he will finish the job if he knows what is good for him.”

Photo Credit: d.e.larsen.dvm@peak.org

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