The Poll Presentation

 D. E. Larsen, DVM

I was cleaning up at Robert’s place in Brownsville when his wife came out of the house at a trot.

“Doc, your office is on the phone and would like to talk with you,” Alice said. “We have an extension near the back door that you could use now without removing your boots.”

I headed around the house, and Alice with waiting at the back door with the phone receiver in her hand.

“Hello, what’s up?” I asked.

“Elaine is at a place just over the hill on Mountain Home Drive,” Ruth said. “She has a mare in labor, and there is a problem. She was hoping I could catch you. She would like you to stop by and give her a hand.”

When Elaine joined the practice, it gave me the opportunity to step aside from working with horses. Now, I am being pulled back in to help. 

“I know the place,” I said. “If she calls back, tell her I am done here and will head that way as soon as I clean up a bit. I should be there within fifteen minutes.”

“I don’t think she will call back,” Ruth said. “She sounded pretty exhausted, and I think she is having problems with this mare.”

I hurried, cleaned up, got everything in the truck, and headed to Mountain Home Drive.

Difficult deliveries in the mare were extremely rare and my worst nightmare. The contractions are so powerful the foal is usually delivered rapidly. Difficulties are hard to deal with because of those contractions. War stories abound. Veterinarians get their arm broken when it is between the foal and mare’s pelvis during a contraction. Stories of having to anesthetize the mare to make any manipulations of the foal’s position or placing a stomach tube into the trachea of the mare to reduce her ability to do an abdominal push. 

I had once asked a horse veterinarian how he handled difficult deliveries.

“I call one of you cow doctors,” he had replied. “You’re the ones who do all the delivery work. I see a problem once every five years.”

I could only imagine what Elaine was dealing with today, but I wasn’t looking forward to helping her.

Elaine was waiting outside the old garage by the edge of the driveway. I could see the mare down inside the old garage.

“What do you have going on?” I asked.

“She has been in labor since sometime during the night,” Elaine said. “I think she has just about had it. The foal is in a poll presentation, and its head and neck are stuffed into the birth canal so hard I can’t budge it. She strains so hard against my efforts to push the head back. I thought you might have a little more strength and be able to correct this presentation.”

“I would assume the foal is dead,” I said.

“I think so, but I don’t know how to be certain,” Elaine said.

“We should be able to reach an eye,” I said. “You stick a finger in his eye, and if he is alive, he will react to that with a contraction of the eyelids or something. You check that while I get my coveralls and boots.”

When I was ready and scrubbed up, I knelt beside Elaine behind the mare.

“There was no response when I stuck a finger in his eye. He is probably long dead,” Elaine said.

“Let me get in there and see if I can move this head,” I said, reaching my left arm into the mare’s vagina.

The foal’s front legs were in the birth canal in normal position, and the top of the head was the next thing I encountered. The bridge of the nose was impacted against the brim of the mare’s pelvis. I pushed with all strength on the foal’s head. The mare stained, and the head hardly moved.

“In the cow, I would push this head back alongside the calf, put the leg back into the uterus, and then pull the head back to normal position. It would be simple to get the leg back up to normal position and deliver the calf. But I can budge this foal’s head.”

“What do you think? Should we sedate the mare and try?” Elaine asked.

“When we have a dead fetus, my training says we make decisions that are easiest for the mother,” I said. “I think we should cut the head off.”

“I know you do fetotomies all the time on cattle, but I have been told they are dangerous in the mare,” Elaine said.

“The concern in the mare is the exposed sharp bone lacerating the birth canal,” I said. “I can cut the head off with a fetatome and cover the exposed bone with my hand. She will spit this foal out with one or two contractions.”

Elaine took a deep breath. “Okay, let’s get it done,” she said.

While Elaine was putting the fetatome together, I threaded a length of OB wire between the foal’s head and neck. This would cinch down and make a clean cut right at the base of the skull. We threaded the wire into the fetatome, and we were ready to go.

“I will hold the fetatome in position, and you work the saw,” I said. “When the cut is complete, I will pull the head out and then place my hand over the exposed neck bone. That will be a rapid move because once that head is out, this old gal will be pushing.”

I placed the head of the fetatome against the side of the foal’s head and had Elaine take up the slack in the OB wire. I double-checked the position of the wire.

“Okay, let’s go, long, slow strokes to start, then pick up the speed,” I said. “This will be an easy cut. You will be done before you know it.”

Elaine started the saw, and the wire sliced through the foal’s neck in a half dozen strokes.

I grabbed the head by an ear and pulled it out of the mare, immediately putting my hand back in to cover the exposed bone of the foal’s neck.

The mare made a strong contraction, pushing the foal into the birth canal. The exposed bone popped out of the vulva. I grabbed the foal’s legs and gave a tug, and the mare pushed again. The rest of the colt was out, followed by all the membranes.

“Wow! That was some fast action,” Elaine said. 

We stood up, and the mare rolled up onto her sternum, and then she stood up. She turned to look at the foal but Jose, the owner was already pulling it out of the garage.

“What do you think we should do for her now?” Elaine asked. 

“I will put some antibiotic powder in her uterus and check for any damage to the birth canal,” I said. “I think giving her some IV antibiotics, maybe a dose of dexamethasone and oxytocin, would be a good idea. Whatever you think.”

I placed five grams of tetracycline powder into the mare’s uterus and did a thorough exam of the uterus, vagina, and vulva. There were no birthing injuries. This mare should be in good shape for breeding in the future.

“Okay, Elaine, you finish up here, and I will run back to the office and get things caught up there,” I said. “I think this gal is fine and should have no problems, but I would suggest some antibiotics for a few days at least.”

I was thinking of how good it felt not to deal with the mare and the owner following the delivery. People always feel like they are on the losing end of things when the foal doesn’t survive. They don’t understand how close they were to lose the mare also.

This mare did well following the delivery and lived to have at least a couple of foals in the future with no problems.

Photo by Faris Hamza on Pexels.

The High Price of New Drugs 

D. E. Larsen, DVM

Dolores pushed the door open and walked into a crowded pharmacy. She held Gary a little tighter as she squeezed her way through the people. It was a little unusual to see so many people in Sempert’s Drugstore in the middle of the morning.

When she got to the counter, she handed the prescription to the clerk behind the counter.

“The doctor said this might be expensive,” Dolores said. “I guess I need to know how much it will cost before filling it.”

“Sure, just a moment, and I will have Frank check it out for you,” the young clerk said.

A couple of minutes later, Frank, the pharmacist, came up to the counter.

“Good morning, Deacon. How are you today?” Frank asked.

“I am fine, but this little guy is not doing so well,” Dolores said. “The doctor said he has tonsillitis. He also said this new drug would work like magic to make him well.”

“Yes, it seems to work like magic, alright,” Frank said. “but it is a little expensive.”

“That is what the doctor said,” Dolores said. “I just need to know how much it will cost before I have you fill it.”

Frank looked around the crowded store. Several ladies were listening to their conversation now. Frank wrote the figure on a slip of paper and pushed it across the counter to Deacon.

“There is the cost, Deacon,” Frank said. “I wish it was less. If it is a problem, we could put it on an account for you so you could pay it over several months.”

Dolores picked up the slip of paper and looked at it. Her mouth fell open, and she looked at Frank with a questioning expression. Tears were welling up in her eyes.

“Yes, Deacon,” Frank said. “These new drugs are expensive.”

“But this is a month’s wages for my Frank,” Dolores said.

“Like I said, I can put it on an account for you,” Frank said.

“No, Frank wouldn’t like to do that,” Dolores said. “I will go talk with Mom and Dad and see if they can help us out with this. Frank won’t like that either, but I can’t let Gary suffer if this will make him well.”

“Okay, but I am going to fill this anyway,” Frank said. “If your folks can’t help, we will just put it on a card in my file, and your Frank won’t have to know a thing about it.”

“I will be back in an hour or less,” Dolores said as she pushed through the thong of people behind her. A tear fell down her cheek as she opened the doors to the open air.

“Deacon, what in the world is wrong?” Lila, her sister, asked as they passed on the sidewalk. “My Lord, I don’t know how long it has been since I have seen you with a tear on your face.”

“Gary has tonsillitis, and the doctor prescribed a new drug for him,” Dolores said. “It is going to cost a month’s wages. I don’t know what we are going to do to pay for it.”

“Heaven forbid,” Lila said. “How can a drug cost that much? These are just crazy times.”

“I’m going to run out to the folks and see if they can help us pay for it,” Deacon said. “Frank won’t like that, but I don’t know what else to do.”

“I’ll follow you out there,” Lila said. “I can watch Gary for you while you return and pick up the medicine.”

It was a short drive out to her folks. Lilia tended to drive faster than Deacon, and she followed close behind.

“Mom, I took Gary to the doctor this morning. He has tonsillitis, and the doctor prescribed some medicine that is supposed to work like magic.”

“That’s good that they have something that works good,” her mother said. “Kids are miserable with that stuff.”

“The problem is it is very expensive,” Deacon said. “I hate to ask, and don’t tell Frank, but could you help us out a little?”

“How expensive are you talking about?” her father asked.

“It’s a month’s wages for Frank,” Deacon said. “I don’t know how long it will take us to pay for this medicine.”

“I’ll write you a check, and don’t worry about paying us back,” her father said. “No grandson of mine is going to suffer for want of a few dollars. And Frank doesn’t need to know anything about it.”

“I don’t know how to thank you,” Deacon said. “Lila will watch Gary while I run and pick up the prescription.”

Dolores handed the check to the pharmacist and clutched the sack to her chest.

“Deacon, this formulation is brand new, and I had to reformulate it a bit for Gary,” Frank said. “This only comes in a capsule, and I doubt you could get a capsule down him. This liquid doesn’t taste very well, and you might struggle to get it down him. You can mix it with some fruit, like a mashed-up banana. Anything like that should work.”

Back at the house, and with the help of Lila and her mother, Dolores prepared a dose of the new medicine.

“The druggist said it tastes terrible,” Deacon said. “Do you have a banana I can mash up and mix with it.?”

“Yes, I’ll grab a banana for you and mix some chocolate milk,” her mother said.

“How do you think we should do this?” Deacon asked.

“Maybe give it in several small bites,” Lila suggested.

“If it tastes bad, you will never get the second bite into him,” her father said. “He is a finicky little guy.”

Dolores put the quarter teaspoon of medicine into a small spoonful of mashed banana.

“Here, Gary, take a sip of chocolate milk,” Grandma said as she held the class for the little guy.

Dolores quickly followed with a spoonful of doctored mashed banana. Gary took the dose without problem but made a face as he swallowed it. Grandma quickly handed him the glass of chocolate milk.

After dinner, Dolores related the events of the day to Frank. 

“The medicine is expensive, but Gary is almost well after just one dose this morning,” Deacon said. “We need to get another dose into him this evening.”

“Expensive; what do you mean by expensive, Deacon?” Frank asked.

“It cost forty-three dollars,” Deacon said.

“Forty-three dollars, we can’t afford that,” Frank said. “Where did you get the money to pay for it? You didn’t put in on one of the cards that Frank Henry keeps in his box, did you? “

“Dad wrote a check for me,” Deacon said. “He doesn’t want us to pay him back.”

“How can they charge that much for a little bottle of medicine?” Frank said. “I have to work weeks for that much money.”

“They said it is brand new, and before now, it has only been available for the military,” Deacon said. “I guess it costs a lot to make.”


The year was 1945, and the drug was Penicillin. Just months earlier, it was only available for the military and for civilians with extreme emergencies. It was first formulated for oral use in February 1945.

My mother was named Dolores, but her childhood nickname, Deacon, given her by the Felsher kids, had stuck and was used by friends and family for her entire life. I never heard my father call her by any other name.

My brother, Gary, struggled with tonsillitis for some time before having them removed.

The median annual income in 1945 was $1400. A logger was probably on the short end of that figure. I have no data on Dad’s monthly wage, but Mom always said the $43 figure was a month’s wage.

Photo by Ron Lach on Pexels.

My First Foal Delivery, From the Archives

D. E. Larsen, DVM

“Doc, this is Sid, Stan’s brother,” Sid said into the phone. “I have to go to work, but I have a mare down in the middle of the field, just over the little creek. She has a foal stuck. I don’t know how long she has been at it, I just noticed her as I was leaving the house. I would sure be grateful if you could get out here and take care of her. My place is on Wiley Creek, the first driveway past Whiskey Butte. I don’t think you will have any problems with her since she is down. She is a gentle old gal. I will stop by your office when I get off this afternoon.”

I hated these 5:00 AM phone calls. I didn’t know Sid, but if he was Stan’s brother, he was probably okay.

“Okay, Sid, I will get out there shortly, so it doesn’t disrupt my day,” I said. “Some times, when a stranger comes, a down animal will get up and run. I am not going to chase her around a pasture if that happens.”

“That’s okay, Doc, I understand, just do what you can,” Sid said.

“Sometimes, when a mare is having some birthing problems, it is a major undertaking to get the foal out,” I said. “That could run up a large bill.”

“This is an old mare, I don’t want to have to sell the farm for her,” Sid said. “If it is going to be a big bill, you call Stan, and he can come out and shoot her.”

With that, I rolled out of bed and dressed quickly. I was hoping I could do this quick and get home for a shower before I had to be in the office. 

This is going to be the first time I have seen a mare in labor. I have been in practice for nearly 4 years. I had seen movies in school, but birthing difficulty (Dystocia) in the mare is rare. I had heard my share of war stories about disasters in the delivery of a foal. The mare’s contraction is so powerful there are stories of veterinarians breaking their arm when the mare contracted.

One night at a local veterinary meeting, I talked with one of the horse vets. I asked him what he did with a mare in difficulty.

“I call one of you cow doctors,” he said. “You guys are the ones who do a lot of delivery work.”

That gave me more confidence for this morning. I knew it would come one day. I just thought it would be for an audience. This morning will be like getting a hole in one when you are playing golf by yourself.

Sid’s place was not far from our house, one creek to the east. I knew the place, but I had not been on it before.

When I pulled up the driveway, I could see the mare out in the middle of the field.  Not even a fence post close to her.  And the ground was too wet for the truck, if she gets up, the call is over. She was a large, black mare. Probably a Percheron, just what I needed. This foal will be a big one.

I loaded everything I could think I might need in the bucket, added some water and picked up my calf jack, a Frank’s Fetal Extractor, and headed out to the mare. This was like doing a plumbing job, I will be two hundred yards from the truck, and there will be something I forgot.

Sid was correct about the mare. She raised her head to glance at me and then laid it back down. My guess was she had been pushing for some time and was exhausted.

I wrapped her tail with some VetWrap and scrubbed her rear end well. I could see a nose, and both hooves poking out of the vulva. The hooves were massive. This was a large foal.

I attached nylon OB straps on each hoof. My thinking was this guy had an elbow lock. The elbows get bunched up against the pelvic brim and prevent the mare from pushing the foal out. It is usually readily corrected. I pulled on one hoof and could feel the elbow pop up over the pelvic brim, and the leg was over a foot ahead of the other foot. I pulled the second hoof, and then we were ready to go. I hooked up the calf jack and started pulling the guy out of there. 

The head came out with no problem. I don’t know how long momma had been pushing on this guy. He was alive but not by much. A couple of more jacks on the handle and I was at the end of the bar. I don’t think I had ever been at the end of the bar when pulling a calf. And this foal has just popped his elbows out of the vulva. 

I moved the OB straps up to his elbows and started jacking again. This guy just kept coming. I was at the end of the bar again, and his hips were not through the pelvis yet. I was lucky that I had brought my long strap. I placed it around his chest and started again. Finally, his hips popped through the pelvis. 

I set the calf jack aside and pulled him the rest of the way out. What a foal, long, and as black as his mother. He was just as tired as his mother. He shook his head as I was trying to clear mucus from his nose. I would pick a calf up by their heels and swing them. There was no way I could do that with this foal. Not only was he too heavy for me to lift, but I would have to be on a stepladder to get his nose off the ground.

After treating his navel with iodine and giving him an E-Se injection, I turned my attention to the mare. I gave a soft tug on the fetal membranes, and they slipped out with no problem. They were intact, and there was no other trauma to the vulva and vagina. I gave her a dose of Oxytocin to get the uterus contracting and a dose of long-acting Penicillin. Then I removed the tail wrap.

She rolled herself up on her sternum and then jumped up. I think she was very relieved. This foal must have been a real weight to carry around. She immediately turns her attention to the foal. If I had a little help, I would try to get some milk out of her to give a mouthful to the foal. There was no way I was going to try that with a free-standing mare. 

I gathered my stuff up and headed for the shower, thinking this foal delivery stuff wasn’t so bad, after all.

At noon, I drove back to Sid’s place. The foal was up and chasing Mom around the pasture.

Photo credits to Jan Laugesen on Pexels

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