Cowboy Education

D. E. Larsen, DVM

During the fall of my junior year in vet school, I worked part-time for Monforts of Colorado. At the time I worked for them, they ran two feedlots with about 100,000 head of cattle in each lot. My job was to work in the hospital during the weekends. This was an excellent opportunity for me. I was able to see a lot of management of a large feedlot and a lot of feedlot medicine. I also learned that education happens in more places than in the classroom.

The hospital for the Greeley feedlot was small but well laid out. There was a crowding pen that led to the treatment chute. The cattle that stayed for multiple days were held in a series of small holding pens, arranged according to the treatment group they were assigned. Treatment protocols were established by the feedlot veterinarian. As a hospital technician, I just did the daily treatments called for by the established protocol.

For example, the pneumonia protocol (the most common) called for 5 days in the hospital with IV antibiotics each morning and often some supportive medication if needed. Steers were treated, and the treatment was recorded on their record. They were returned to the treatment pen after they were treated. Any steers with unsatisfactory progress were put into another treatment group, and the protocol was intensified.

Each morning the cowboys would meet in the hospital and get ready for their day. While they drank their coffee, they would assign the pens that each group would check. In the central feedlot, the steers were held in large pens of approximately 500 head each. Two cowboys would ride through each pen each morning and check for sick or injured steers. During these morning sessions, they would make sure everyone knew if there were questionable steers from the previous day’s ride that needed to be double-checked. It was also time for them to kid the young ‘doctors’ working on the weekends. I was a little older than most of the guys who worked in the hospital, and I could hold my own most of the time.

After the cowboys mounted their horses and started out for their assigned pens, we would start with the daily treatment schedules. Our goal was to get all the hospital treatments completed before the cowboys were back with the new steers for diagnosis and treatment.

During the ride through the pens, if they found any steers needing treatment, they would cut him out of the large pen and put him in a holding pen until they had a group of 10 to 12 steers. These steers were then herded to the hospital by a couple of the cowboys. They would help us get them into the crowding pen, and they would relay any particular information to us that would help with the diagnosis. They also took the time to make sure the young doctors were teased a little.

This one morning in November was a bright, cold late fall morning in Northern Colorado. It was frigid, and the hospital was the only warm place available to anyone. We had the doors closed, and the electric ceiling heater was turned up full blast. 

I was herding the last steer back to the hospital pens when the first group of new steers arrived from the central feedlot. The cowboys herded them into the crowding pen. When I got back to the hospital and warmed myself by standing under the heater blowing warm air, Eli Hernandez already had a steer in the treatment chute. Eli was the lead cowboy. He was a large Hispanic man, he towered over me. I considered him an old man in those days, that means he was probably in his early 50’s. His worn face told of his years of working in the sun. His large belly suggested that he drank a beer or two. I am sure his horse was enjoying the morning break.

Eli was anxious for me to look at this steer. “Doc,” he said, “what do you think about that mass on this steer?”

This was a test, and I understood that it was a test. Eli was really going to find out what kind of a cow doctor this kid was. I was going to have to make some thoughtful comments. This was a massive swelling on the right side of the abdomen. I had no idea what it could be, maybe a hernia, or could be a tumor. One thing I had been taught was it is okay to admit you don’t know something as long as you could illustrate a plan to find out what was wrong.

“I have no idea, Eli. We will probably have to stick a needle into it and get a sample under the microscope.” I replied.

Eli listened as he was cleaning his fingernails with a large pocket knife.

“Yeah, Doc, you get your needle ready, I have got to get back to the pens,” he said, half chuckling under his breath.

He looked down on me with a broad smile as he turned for the door. As he walked by the chute, he made a quick swipe at the bulging mass on the side of the steer. His knife was obviously very sharp, and it sliced through the skin like butter, opening a large gash in the belly of the steer.

The pus poured out of the swelling like you were pouring milk from a large pail. Eli made more look back at me as he opened the door. He still had a big smile, but there was no malice in his glance. Just like a professor who had provided a good lesson.

There was limited circulation of air in the hospital when it was buttoned up against the cold outside. The odor was suddenly overwhelming. Steam rose from the growing puddle of pus on the floor. There must be 5 gallons of pus on the floor, and it was reaching the drain very slowly. I headed for the garage door that had been closed all morning and pulled it open. The air was cold, but at least you could take a deep breath. Then I grabbed the hose and washed the bulk of the pus down the drain.

That taken care of, I turned to the steer. Eli had probably seen this type of abscess many times before and knew that drainage was the first line of treatment. The gash that he had made was maybe 6 inches long. That was good. This abscess needed adequate drainage to allow for the healing of the tissues on the inside of the abscess. This could take a couple of weeks.

The problem was the gallon of pus at the bottom of the abscess, below the gash. I shaved the area around the gash and down the abdomen so I could open the abscess at its lowest margin. I scrubbed the area with Betadine Surgical Scrub. Then injected some lidocaine into the gash and into the area of the planned opening. That done, I used a scalpel to open the abscess on its ventral margin. This time I caught the pus in a bucket. The smell still filled the room, but it was easier to clean up.  The open garage door provided some air circulation. With the drainage complete, I threaded a large Penrose drain through the upper gash and out the lower incision. I tied the drain in a loop so it would stay in place for as long as it was needed.

Next, I flushed the abscess with a bottle of Hydrogen Peroxide. This made a lot of foam and probably provided some mechanical cleaning. I followed the Peroxide with dilute Betadine. The large gash was large enough to allow me to reach my gloved hand and arm into the abscess. I removed several large chunks of consolidated pus and explored the body wall to ensure it was intact. Then I found the culprit, a large splinter laying in the bottom of the abscess. Probably from a fence rail or a feed bunk. This abscess grew so large before it was detected because the steer would act normal until the size of the swelling started to interfere with his function. When looking at 500 steers, the cowboys look for steers acting less than normal.

Next, I gave a hefty dose of Combiotic, a Penicillin/Streptomycin combination, an antibiotic combination in use at that time.  No worry about flies in this weather. This steer would be in the hospital for a week or two.

The diagnosis was an obvious abscess. This would be a common problem for me in the years to come. The size of the thing was what was exceptional. Turns out to be one of those once in a lifetime diagnoses. In over 40 years of practice, I have never seen anything to come close to the size of this abscess.

D. E. Larsen, DVM

It was hard to see in the night with this heavy rain. I was glad that I had put my rain pants and boots on when I left the house.  I pulled on my raincoat as I stepped out of the truck.  I was wet before I got the jacket on, the rain was drenching. I peered at a blank wall of small fir trees and brush. Ayers McElfresh had said to come to this corner of his place when he called this morning. 

Finally, I could see two shadowy figures move out from under a fir tree.  They were hunched, in heavy rain gear and wide brim hats.  Sort of looked like a scene out of a Jesse James movie.  

The phone had shocked me awake from a sound sleep, the clock said 3:00 AM. It was Ayers on the phone. Ayers McElfresh was an old logger with a small farm on Scott Mountain. He had lost an eye in the woods, and I always had trouble making eye contact with his good eye rather than his glass eye.

“Doc, I have a cow down up on the hill, she is in bad shape.  Glenn Hill and I have been looking for her all night.”  I hung up the phone and pulled myself out of bed and quickly dressed. The truck was cold at first but started to warm as I headed down the hill to the highway through Sweet Home.

The rain seemed heavier as I turned up Scott Mountain Road.  Ayers had reminded me not to come to the house. “They would meet me at the upper corner of his place.  The cow was close to that corner.”  I slowed the truck as I turned the corner, straining through the night and heavy rain to get a glimpse of Ayers.  There they were, a couple of shadowy figures moving out from under a large tree. Dressed in rain gear and both wearing wide brim hats, they looked like something out of a Jesse James movie.

I waved as I stepped around the back of the truck.  Ayers and Glenn Hill, a neighbor, both waved back.  “Bring your stuff, and we will spread the wire so you can get through the fence.”

Spreading the fence wire for me was quite an honor. My grandfather would have tanned our hides if he had seen any of us kids stretching the fence wire when we were growing up.

“This is that half Holstein cow.  I raised her from a calf.  She is about 5 or 6 years old.  Calved yesterday, we have been looking for her all night.  She rolled down the hill into a big old patch of Himalayan berry vines.  One hell of a fix, she is flat out Doc.”

I grabbed the bucket filled with supplies and headed across the ditch full of runoff and ducked through the barbed wire that Ayers and Glenn were holding apart for me.  I peered into the tunnel in the brier patch.  Ayers shined his flashlight down into the tunnel, maybe 30 feet down the hill, you could see the cow.  She was lucky her head was uphill, probably why she was still alive.

“How the hell did you find her?” I asked.

“Let me tell you, it wasn’t easy.”  “We looked all night in this damn rain, almost gave up but finally worked our way up to this corner.  Glenn is the one who noticed this hole in the brush.  I was surprised to see her down there.” 

With a deep breath, I squatted down, and sort of duck walked down the tunnel of briers to the cow.   Her head was up, allowing the rumen gas to escape.  If it were downhill, she would be dead already.  

    The rain clothes provided protection from more than constant rain.  There was minimal room, and every stray movement was met with a tangle of berry vines.  My exam was very cursory.  I had already made my diagnosis of milk fever, I just wanted to make sure I wasn’t going to miss something obvious.  

    The temperature was low, 98°,  her udder normal, no vaginal discharge, rectal exam shows firm dry stool.  All this was consistent with the diagnosis.  Response to treatment will be the last confirmation.

    I grasped the nostrils with the nose tongs and pulled her head back, tying the tongs to the hock with a quick release knot.  I opened a bottle of Cal Dextro2 and secured the IV set to the top.  Everything was sterile, but that was sort of joke at this point.  The rain was still heavy, but the vines caught the downpour and converted it to large heavy drops.  Mud and rain, couldn’t keep things clean.  

    I took the needle out of the autoclaved pouch and leaned against her neck to further stabilize her.  Holding the jugular vein with my left hand, needle in my right hand, held by thumb and forefinger.  I struck the jugular with the heel of my right hand twice in a rapid motion and then turned my hand and seated the needle into the vein on the third stroke.  Releasing my grip on the needle as it passed through the skin kept it from piercing through the vein.  Then I quickly threaded it down the vein.  I learned this technique when I worked in the feedlots while in school.

    Hooking the IV set to the needle, I started the infusion at a rapid rate for the first bottle.  Giving it too fast could cause a cardiac arrest (dead cow).  Seldom happened to a cow this far advanced, her blood calcium could be below 4.0. 

    I leaned back and rested a little, looked at Ayers.  He was concerned, hadn’t said a word, just held the flashlight and watched.

    “Milk fever!” I said.  “Not an uncommon condition in older dairy cows.  She would have been dead in the morning, good thing you found her.”

    “Is she going be okay?”

    “I think you will be surprised.  Might take a couple of bottles here and a little time but there is a good chance she will walk out of here.”

    When the first bottle was done, she was a little more alert but not struggling against the restraint.  I started the second bottle a little slower.  I couldn’t decide what was worse, the torrential downpour or the constant large drops.  

    By the time the second bottle was done, she was struggling against the nose tongs.  I pulled the needle out and put everything back into the bucket.  I moved around to her side and pulled the free end of the rope, this released her nose.  Her head swung around and almost knocked me down.  I was able to pull the nose tongs out of her nose.  She kicked and righted herself to her sternum.  Then in one motion, sprung to her feet and raced up the hill and out the tunnel.  Glenn who was watching from the entrance had to jump out of her way.  Ayers went flying one direction, and I went the other.  The bucket and its contents were scattered.

When I got off my back, Ayers was still unhooking himself from the briers. 

    “Damn glad I was dressed for the rain.”  He said as he gathered the light and started to give me a hand.

    I grabbed the bucket, a little bent now, and started putting things back into it.  Everything was there, except the needle.  Before me was a mire of mud, cow tracks, and footprints.  I swept my hands across the wet ground.     

    “What are you looking for? 

    “I lost the needle.  Should be here somewhere.”

    Ayers helped me look for a minute or so then looked at me with his one good eye and asked, “Is it valuable?” His eyebrow over his good eye raised up a little for emphasis.

    “No, not valuable, just not the kind of thing you don’t want to leave behind.”

    “Look Doc, it’s 3:00 in the damn morning, raining like hell.  Here we are in the middle of large brier patch at the far corner of my place.  There isn’t going to be anybody in here for the next 100 years.  Just leave it.”

    Made sense to me, besides I had a full day ahead of me.  So I left the needle.  We crawled up the tunnel and into the drenching rain.  It felt good to stand up straight again.

    Glenn was still standing there, looking somewhat like a drowned rat.  “That was some show.  What did you give her Doc?  I might need some of that stuff.” 

    I crawled back through the fence and stuffed things into the truck.  I will have a chore cleaning things up in the morning.  I peeled my raincoat off, just about as wet inside as outside.  

    I pulled myself into the truck and shut the door.  Dry at last.  Will be a short night tonight, I thought as I started up the hill looking for a spot to turn around.

The sun was hot, dust stuck to the back of your throat.  It was one of those August days in the Willamette. Valley that made one wish Fall would come early.  I leaned over the low gate to get a better look at the horn on the old ram, trying not to disrupt his interest in the alfalfa in the feed rack.  Every movement stirred up more dust.

    Flies were gathered around an ugly spot on the side of his head where the tip of his horn was buried into the skin.  A full curl plus some, this old ram would be a trophy in the wild. 

    Ayers had called worried about his ram.  Arthritic enough that he probably had problems getting around to service the ewes. It was late in the day before we had been able to work him in.  The good part was I could go home after this, the sad part was it was the hottest time of the day.

      Ayers had been a little embarrassed about having me look at the old guy. 

“He probably ain’t worth the cost of the call, poor old guy probably should just put him out of his misery,”  Ayers had said when called.

    Ayers was an old logger who ran a few sheep and cows on a forty-acre ranch out in Liberty.  He had lost one eye when a broken cable had recoiled and struck him on the right side of his head.  Probably lucky that it didn’t take his head off.  Ayers was a big raw bone Scotsman, well over 6 feet with broad shoulder and a sturdy frame.  His calloused hands and course complexion told of many years of hard work and exposure to the elements.  He was tough as nails but had a soft heart when it came to his animals.  

    “Sure enough, the tip of that horn is buried in the skin.  We probably don’t want to take the whole horn off, that would be pretty hard on a ram this old.  I should be able just to trim the end and solve the problem for a couple of years”.

    “Couple of years?  This guy will be lucky to survive the winter.”

    We put a halter on the ram with a little struggle and snubbed his chin to the upper corner of the stall.  I retrieved a short piece of OB wire from my bag and threaded it around the tip of the horn.  Then I clamped a handle on each end.  Positioned the wire saw about one inch from the skin.  Leaning back to apply my weight to the wire I started long slow strokes to get the wire embedded.  At that point, I quickened the pace.  Smoke rose from the horn.  Makes the smell on the old dentist drill seems like nothing.  Only took a few seconds and the tip of the horn flew over my left shoulder as I fought to regain my balance.  Checking the horn where the tip had been, and there was no blood.  A good thing about the wire saw, the heat generated usually cauterized any vessels.  

I used a prep blade to shave the wool away from the wound.  A few maggots had already hatched and were scurrying to avoid the Betadine.  The horn had left hole almost to the bone.  It would do well after I cleaned the wound and applied Betadine ointment and Screw worm spray.  Long-acting Penicillin injection completed the treatment.  I released his head, removed the halter and opened the gate.  The ram looked at us like we were crazy, he returned to the alfalfa in the feed rack.

“This must be your last call? ”  Ayers asked, knowing full well that I wouldn’t have anything scheduled after 5:30 on a Friday afternoon.  He had asked to have a drink with him on each visit for the last 6 months.  I had always had the excuse of having more to do.  

“Yes, this is my last call today.”

“I have a new bottle of Pinch, best scotch that I know.  Come on up the house and have a drink.  You can wash up there.”

“Sure, I’ll put things away and pull the truck up there.”

Ayers was holding the door for me when I got there.  

“New bar of soap right there at the sink, a clean towel is hanging on the hook.”

After washing Ayers lead me to the dining room table.  His wife was sitting at the kitchen table and did not respond to us.  I knew that she was suffering from Alzheimer’s.  Her care had really confined Ayers in recent months.  Ayers grabbed a couple of large drinking glasses as we entered the dining room.  New bottle of Pinch was on the table.  I think he had planned this visit.  

“Just a moment, I have a new bottle of Soda, don’t want to ruin good scotch with an old bottle of Soda.”  

Ayers returned from the kitchen with ice and a new bottle of Schweppes Club Soda.  He added a few ice cubes to each glass.  Opened the Pinch and poured first 2 fingers then 3 into each glass.  Filled the glasses with Soda and sat down with a noticeable sigh.  

“Love this stuff, about the only thing I have anymore.  She doesn’t remember anything now,” nodding his head toward his wife, “makes things pretty tough.”

I wasn’t quite ready for a counseling session and never was very good at small talk.  Taking a sip of the drink, I was a little surprised that it was pretty good.  I hadn’t drunk scotch since early in my army days at Fort Devens.  This was maybe going to be easier than I thought.

“Must be difficult, do you have anybody to help?”

“Lady comes in the mornings, helps to get her up and through the bathroom and shower.  Fixes breakfast and cleans the house a little.  When she leaves she just sits there in the kitchen until bedtime.”

We continued to talk, mostly about Ayers’ early days in the woods before he lost his eye, then about the developing cataract in his only remaining eye.  Cataract surgery was advanced enough that most people when through it without a thought or worry.  It would be different if you only had one eye.  That low complication rate doesn’t mean much if you are the one with the complication.

     “Do you remember that night that you lost that needle up in that brier patch 4 or 5 years ago??”

“Do I remember?  That was quite a night, pretty hard to forget.”

    “Well, a couple of months ago I decided to clear some brush up in that corner.  Don’t know why sure don’t need any more land.  I can’t do as much as I used to do.  I was working along, and damned if I didn’t step right on that needle!  It went through the sole of my boot, through my foot and poked out the top of my boot.  Damn that hurt!  I sat down and pulled it out, that hurt like hell too.”

    “I was a real mess for a while.  Limped around for better than a week.  I was going to go to the doctor and get a tetanus shot but started to feel better, so I forgot about that.   Must have been okay, I’m still alive.  Maybe because that was a sterile needle?’

    “I don’t know, Ayers, that needle couldn’t have been too sterile, laying in the mud and dirt for the last few years.”

    “Well, no matter now.  I was the one who wanted you to leave it so I could get back to bed.”

    Not much else to say, they don’t make them like Ayers anymore.

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