One More Pregnancy

D. E. Larsen, DVM

“I wish Dr. Ball was here,” I thought to myself as I drove my left arm deeper into the rectum of this old fat cow. Dr. Ball was the chief OB instructor at Colorado State when I was in school there. He was tall and thin, and it seemed that his arms were long enough to reach his knees, and his fingers were at least 6 inches long. He could do anything in a rectal exam.

“How am I going to get this uterus retracted,” I thought as I swept my hand across the floor of her pelvis. I could just grasp the cervix; the rest of the uterus hung over the brim of the pelvis and was heavy and resisted my attempts to pull it back so I could get a better grip.

“Bob, I don’t know if I am going to be able to retract this uterus,” I said as I looked at an anxious owner. “Let’s review her history one more time.”

I pulled my arm out and removed the OB sleeve. I could do 100 pregnancy exams in a couple of hours, but this old cow had already tired my arm out. I leaned on the railing of the crowding ally, resting my arm, as I talked with Bob.

“How old is this cow?” I asked.

“She is going to be 19,” Bob answered. “She is my first and is the genetic base of my entire herd. I realize it is a big request, but I would  love to have another calf out of her.”

“When was the last time she had a calf?” I asked.

“Three years ago, probably a little over that,” Bob said.

“When was the last time you bred her?” I asked. “I mean, is there a possibility that she has a pregnancy. I have not even been able to get the uterus up where I can check for a membrane slip.”

“No, I quit wasting semen on her will over a year ago,” Bob said. “I didn’t have a bull before we moved. This young guy I have now might get a chance at her if you say go.”

“So, this is the situation,” I started to explain. “This cow is 19, very over-conditioned, fat it other words. She hasn’t been pregnant in over three years and has a uterus that is out of reach. That most likely means there is some chronic pathology in that uterus. That all adds up to a slim chance of getting her npregnant.”

“What is the first step in trying?” Bob asked.

“The first step is to retract her uterus so we can decide what might be going on inside of it,” I said, a little unsure that I had been clear enough in my explanation. “In school, we had Dr. Ball. He could retract this uterus is a heartbeat. When he wasn’t available, we had a large cervical forceps that could clamp on the cervix and provide a little additional traction to pull the uterus up where you could get ahold of it. i don’t have such a forceps. But I have a large Oschner forceps that has some teeth on it and might be able to provide a little traction. The only problem would be it could put a small tear on the cervix if it doesn’t work.”

“If that is what it takes, let’s do it,” Bob said. “This is probably the last time we have a chance of getting her pregnant.”

“Just to be clear, that chance is less than twenty-five percent,” I said. Why did I give such a figure? Never give odds to a horse owner, or probably a purebred cow breeder. They will take you up on it every time.

I tied the cows tail out of the way, tying it with a loop of twin around her neck. That way if we forgot to untie it before releasing her from the chute, we would not pull the end of her tail off. After prepping her vulva, I tied a length of gauze to the handle of my 12-inch Oschner forceps and carried the forceps into the vagina with my left hand and arm. Along with the forceps, I brought a guarded culture swab.

The cervix was large but felt relatively healthy and was tightly closed. I advanced the guarded swab to the cervical opening and pushed the swab into the uterus. I pulled the swab back into the guard, pulled that out with my right hand, and handed it to Bob.

“Hold onto this for a minute,” I said.

Then, back inside, I clamped the forceps on a stout external ring of the cervix at the top. Then I tested the gauze with a firm pull. The forceps held, and the cervix did retract a little. I withdrew my hand and made sure the gauze followed and hung outside the vulva.

“Bob, do you know if this cow cycles normally?” I asked.

“Yes, she cycles as regular as can be,” Bob said. “You can almost set your calendar on her every 21 days.”

“Do you know when she due to cycle?” I asked.

“She should cycle in the next few days,” Bob said.

I changed sleeves on my left arm. I pulled the fingers of an OB sleeve and pulled it on my arm, then stretched on a latex exam glove. Finally, covering it again with another OB sleeve with the fingers removed. The would provide much better sensitivity in my fingertips.

“This is the plan,” I started. “If this uterus feels like it is salvageable at all, I will infuse it today with an antibiotic. Then if she cycles, you go ahead and breed her with the bull and call me. We will infuse her again, 24 hours after breeding.”

“I would rather breed her with AI semen, and save the bull for the last resort,” Bob said.

“Okay, I just want to try on this cycle, just in case we get lucky,” I said. “We will have the culture results back by next week and be able to make an antibiotic selection based on that culture. If she doesn’t get pregnant, we will go through a series of infusions. We might be working on her for several months.”

I drew an infusion of Furcin solution and Neomycin into a 60 cc syringe and attached an infusion pipette to the syringe. I handed this to Bob, and I took the culture swab and set it aside. That done, I lubed my left hand and arm and pushed as deep into the rectum as I could. I grabbed the cervix and, at the same time, with my right hand, pulled on the gauze attached to the forceps. The cervix and uterine body retracted into the pelvis. I reached forward and flipped the entire uterus back into the pelvis — sort of amazed myself.

“This uterus is the size of a uterus with a 90-day pregnancy,” I said.

Out of habit, I checked for a membrane slip; there was no pregnancy. The uterus was thick and dough-like, with no significant fluid present. Probably just a case of very chronic uterine infection, endometritis, I thought. The ovaries were active and felt normal with a receding corpus luteum on one ovary.

“Okay, hand me that syringe,” I said.

Holding the cervix, I worked the pipette tip through the cervical rings and made the infusion. Then I allowed the uterus to return to its position. I pulled my arm out and removed the sleeve, carefully turning it inside out. I prepped the vulva again. Then with a new sleeve, I retrieved the forceps for the vagina.

And so it began, a months-long battle with an old, chronically infected uterus, trying to bring about a pregnancy. I went through a week of antibiotic infusions based on culture results. We used post-breeding infusions after every breeding attempt. We used artificial insemination, and we bred her with the bull. She continued to cycle regularly. At least she didn’t raise any hopes by missing a heat period.

I was at wit’s end, and then I remembered a conversation with Don in Enumclaw, on our way back to the clinic, from doing some pregnancy exams. Don enjoyed picking my mind. We had gone to different schools, and sometimes our views on how to do things were completely different. We both modified our thinking in small ways from our discussions.

“I want to tell you,” Don started, “if you ever get in a situation where you want to get a cow pregnant, I mean, if you have tried everything and you really want her pregnant. You infuse her with dilute Logul’s.  

“That is probably the only absolute ‘never do’ that Dr. Ball told us,” I said. “That is supposed to do far more harm than good.”

“I am just saying,” Don repeated, “if you really want to get that cow pregnant, use an infusion of dilute Logul’s. It works, maybe not every time, but it works.”

“I don’t know,” I replied, somewhat skeptical of the advice.

“You do an infusion; the cow will cycle in 6 – 8 days, skip that cycle and breed her on the next cycle. You can do a post-breeding infusion if you like. You will have a 70 or 80% conception rate on that breeding. And most important, you will have a very happy client. I know what the literature says. And I know how you were taught, but in this case, my experience trumps all of that. Just file it away in your mind and try it if the need arises.”

On my next trip to check the cow, the uterus was improved. After all the treatment it sort of felt like a normal uterus now. I could retract it into the pelvis in a pretty standard manner now. So things were improved, but still, no pregnancy resulted.

“Bob, I have one more trick we could try,” I started as I explained the new plan. “There is a treatment that I was taught in school never to use, but the guy I practiced with when I was in Enumclaw, swore by the results in just this situation. We have pretty much exhausted the book. We have worked through everything, and the uterus is better. You can probably remember the difficulty I had during her first exam. But today the exam goes easy. 

What I suggest is an old-time treatment. I do an infusion with dilute Logul’s.  This infusion wipes out the lining of the uterus. And then the lining of the uterus is regenerated from a few remaining cells.”

“Sort of like a chemical D&C,” Bob said.

“Yes, I guess that is a good way to look at it,” I said.

“It doesn’t look like we have any other choice,” Bob said. “Let’s do it.”

It took me almost a week to get a bottle of Logul’s. It was not something in the regular supply line. When it came, I had no recipe for mixing a dilute solution. I sort of went by the old Port Wine formula that I used for Betadine. I mixed a solution, and we gave Bob a call and set up a visit.

The infusion was no problem. The old cow was used to the chute now. I noticed that when we turned her out of the chute and started discussing the breeding schedule, she was hunched up a little. There must have been some significant discomfort with the infusion.

“Expect her to cycle in 8 days or less,” I said. “Don’t breed her on this cycle but breed her on the following cycle. We should plan a post-breeding infusion just to on the safe side.”

Her cycles went right by the book, eight days, and 21 days after that. Bob called when he had bred her. I had hoped he would use the bull, but he used artificial insemination. He probably figured he had gone through all this trouble; he wanted a good calf. 

I marked my calendar for her next expected cycle. The date came and went, and there was no call from Bob. Too early to celebrate, I thought, but just maybe, she is pregnant. At 42 days after breeding, Bob called.

“She still hasn’t cycled,” Bob said with some excitement in his voice. “When do you want to check her?”

We waited until 50 days, with her uterus being larger than most, I didn’t want to be in a situation where there was a question with the exam.

When 50 days came, the exam was brief. The uterus felt the best that I had seen in this old girl, and a 50-day pregnancy was present based on a membrane slip and palpation of the amnion. 

I was relieved and happy. Bob was happy. And I am sure the old cow would enjoy not being run through the chute every few days. And the bottle of Lugol’s probably sat on my shelf for the next 20 years before I discarded it.

Photo by Harry Cunningham on Unsplash

Old Mister Nielson

D. E. Larsen, DVM

Old Mr. Nielsen sat on a stump by the head of the squeeze chute, watching me closely as I cut a length of OB wire and attached handles to each end. He was s short, stout Norwegian. He covered his thinning gray hair with a tattered old ball cap that sat a little crooked on his head. His weathered face and hands told of uncounted hours of labor in the outdoors. Mr. Nielsen had milked cows for years but now used his farm to raise replacement heifers.

“How do you spell your name, Doc?” He asked. Of all his questions, this was the most important one for him.

“I spell it with an ‘en,’ Larsen,” I replied. “My Grandfather was a Norwegian sea captain who sailed lumber ships on the West Coast.”

That satisfied his curiosity. I was new to Enumclaw, and I was surprised at how ethnic the community was around here. Dr. Larsen could mean Norway, Denmark, or Sweden. Now I would be in solid with the Norwegians.

“What are you going to do with that wire, Doc?” was his next question.

The old veterinarian in the practice, Jack, dehorned these older heifers with the old fashioned guillotine type dehorners. These were almost a medieval instrument, and I had no intention of using them. Four foot long wooden handles attached to a cutting head that was positioned over the base of the horn. When the handles were closed, the guillotine blade half cut and half crushed the horn off. Local anesthesia didn’t help much. Blood would fly, and the heifer would bellower. It did a terrible job, and partial regrowth of the horn was common due to the incomplete removal of the base of the horn.

“This is what I use to remove the horns. It is a wire saw. I think you will be impressed,” I replied.

I think he was less than convinced as we loaded the first heifer into the chute. We had a dozen heifers to dehorn today. They were all yearlings, I hoped I would hold up to this number, but I was young and robust and calculated that I could get the job done. With the head secured with nose tongs, I injected each horn base with Lidocaine for local anesthesia. I seated the OB wire at the base of the horn. Then I started with long, rapid strokes. Smoke rose from the horn as the wire engaged the bone. It smelled like the old, slow dental drills. The process was brief, there was no apparent pain, and no blood as the hot wire seared the vessels. I grasped the exposed arteries with a forceps and pulled them slowly until they broke deep in the tissues and snapped back. This would allow a secure clot to form, and there would be almost no bleeding.

I repeated the process on the second horn. Then I applied some antibiotic powder on the wounds and into the open frontal sinus. The open frontal sinus made an impressive wound that alarmed the neophytes, but Mr. Nielsen had seen it many times before. After applying a good spray for flies, I released the nose tongs. Then I went back and sprayed the switch of her tail. Out of the chute, she ran, no pain, only a drop of blood and standing out in front of the chute like nothing had happened.

     “That is a pretty neat wire you have there. I think I like it, and that heifer acts like nothing happened,” Mr. Nielsen added. Obviously pleased with the job.

“Why did you spray her tail?” Mr. Nielsen asked. 

“Just to make it a little more effective against the flies,” I said.

The other heifers that followed were completed with an identical procedure. I changed the wire saw after every heifer to ensure the speed of the cut was not slowed by a dull wire. The last couple of heifers bled a little more as my strokes became a little slower, and the OB wire failed to sear the arteries. Even then, the bleeding was quickly controlled when the arteries were pulled. 

“This is so much better of a job than what that big old lopper does,” Mr. Nielsen said. 

After cleaning things up, I headed back to the clinic.

When Don, the other veterinarian in the practice, came in that afternoon, he had already heard the story of my dehorning job.

“I think you are going to be doing our dehorning from now on. Old Mr. Nielsen has told almost everyone about the job you did this morning,” Don said. “And your Grandfather’s story didn’t fall on deaf ears either. I think all the Norwegians will be lined up at the front door pretty soon.”

Photo by Lomig on Unsplash

Buck and the Colt

D. E. Larsen, DVM

Buck was resting under the giant oak tree on the corner of his barnyard. He was chewing on the remains of the trimmings from the horses’ hooves that he had gathered yesterday when Dale, the farrier, had visited his farm. This was a perfect June morning with bright sunshine and a cooling breeze coming up the creek.

He looked up with a start when he heard his favorite truck in the distance. It would be visible coming down the road shortly. This was Doc’s truck, and it usually meant that there would be better treats that these old hooves. Buck started down to the barnyard. Doc’s truck was still not visible on the road, but he wanted to be there to meet him when he pulled into the yard. Buck had suspected that something was going to happen when Ellen had him bring in the calves this morning. He loved to herd his calves, even better than the cows because they would never challenge him. It was his job, and he lived for it.

Ellen came out of the house as Doc was pulling into the barnyard.

“I’m glad you could come on such short notice.” She said as she extended her hand to Doc. “Walker wanted the bull calves marked so they would be healed for sale in a couple of weeks. I’m sorry that he couldn’t be here today. Will you need any help from me?”

“I might need you to hold a tail or two, but I’m sure that Buck will herd them into the chute with no problem. There are only 3, so we should be done in a jiffy,” Doc said.

“That will be great. I wanted to be able to move the colt to the upper pasture today,” Ellen said.

“How are things going with the colt? He was sort of jumpy the last time I worked on him,” Doc asked.

“He is better, but I still have to keep a firm grip on him. He is almost more than I can handle at times,” Ellen said.

Doc had gathered his things and headed to the chute. It was a joy to work the chute with a dog like Buck. He was probably one of the best cow dogs around. It was sort of a shame that Ellen and Walker had such a small herd, Buck deserved better.

With the first bull calf in the chute, Doc grabbed the tail and bent it over his back to give a little nerve pinch for restraint and some pain control. Castration was a quick procedure on calves this size. He showed Ellen how he wanted the tail held, and she performed like a pro.

Doc grasped the scrotum and stretched it down, with one quick slice of the scalpel he removed the bottom third of the scrotum. Then grasping the ends of the two exposed testicles with a large Oschner forceps, he stretched them down until he could feel the cremaster muscles separate. He moved the forceps up to clamp across the cords at the scrotum, then retrieved the White’s emasculator from his bucket, and the testicles were quickly removed.

Doc looked at Ellen as he held the emasculator firmly. “Do you want these?” he asked as he held them up.

“No, are you kidding? You know Buck has been waiting for them all morning,” she replied.

Doc looked at Buck, he was fixated on the morsels he held. Doc threw them up in the air, and Buck followed their arc. They bounced once, and with one quick swoop, he caught them both and made a quick swallow.

Ellen released the tail and smiled. She enjoyed how Doc truly liked Buck. Doc applied fly spray to the tail switch and around the wound and on the back of the calf. Probably a little early for flies, but just insurance. The other two bulls went the same, and in no time, Doc was cleaning up and loading things back in the truck.

Buck knew the event was over. He loved the work, loved the treats, and enjoyed Doc when he was in his barnyard. He always had conflicted emotions when he went to town to see Doc.

As Doc pulled out of the barnyard, Buck went back to his resting spot under the oak tree. This was his spot, and he could survey the entire farm from this spot, and nobody would bother him here.

As soon as Doc left, Ellen headed to the barn. She had haltered the colt earlier and was anxious to get him up to the upper pasture and see him run in the open field. It had been a wet spring, and the pasture was finally dry enough to turn him out. The colt snorted as she opened the stall and led him toward the barnyard. She headed for the road; the upper pasture was about a quarter-mile up the road. She had some concern about how the colt would react to a car on the road. This time of the morning they should able to make the trip without any traffic.

Buck watched from his spot under the oak tree. He didn’t like this colt, it did not respond to him like the cows did. Buck decided that he better follow along. Ellen might need his help, he could at least bite a heel, if the colt required correction. Buck trotted to catch up and fell in line behind the young horse.

They made it to the gate of the upper pasture just in time. Ellen could see a pickup coming up the road at a pretty good speed. She hurried to open the gate but had some difficulty with the latch. The colt heard the truck also and turned his head to get a better view. He reared up a little, and Ellen took a better grip on the lead, taking a wrap around her hand.

Buck didn’t like this colt, there was no reason for him to be causing problems. If he didn’t settle down, he would bite him on the heel.

The gate finally swung open, the truck roared past them. The colt reared again, and Ellen used all her weight to control him.

Buck moved in and bit him on the heel, that should settle him down, he thought.

The colt jumped forward and lurched toward the open pasture with one motion. The lead that was wrapped around Ellen’s hand tightened and in an instant, two fingers separated from her hand and flew into the air.

She watched as her fingers tumbled in the air. Time seemed to stand still for the moment. She thought she could reach out and catch them, but she could not make herself move. She thought about life without two fingers. She thought about all the miracle things they do in surgery today, maybe they could be reattached. She watched as they began to fall. There was no pain, no blood, she just watched as they hit the ground and bounced.

Then there was a blur, it was Buck. He swooped in and caught both fingers with one motion, and they were gone with a quick swallow.

Ellen sank to the ground. Now the pain came and the blood. She held her injured hand tightly. “No, Buck! No!” she screamed. “Damn you, Buck! Damn you!”

Buck had never heard that tone of voice from Ellen. He turned and ran back to his barnyard as fast as he could go. Buck settled into his spot. He would wait here until Walker got home, he thought, as he aimless picked up a sliver of hoof trimming from the last time the colt the farrier visited the farm. Things would be okay again. He never liked that colt anyway.