The Doctors Voss

I need to preface this little story. Dr. Voss was a Equine Ambulatory Veterinary at Colorado State University during my years as a student at that school, (1971 – 1975). He was an excellent instructor and veterinarian and very well liked by all the students. He went on to become Dean of that school and was held in such esteem that the new teaching hospital was named after him. This story is of a young instructor, adored by his students, and should be taken only to add to his esteem.

D. E. Larsen, DVM

When I was in Veterinary School, there were two doctors in town with the name of Voss. The older Dr. Voss was a well respected OB/GYN doctor; the younger Dr. Voss was a horse doctor.  He was in his mid 40’s and very well liked by all the students at the Veterinary School. 

  The young Dr. Voss was known to be quite a storyteller in the classroom or on farm calls.  He told stories to keep the atmosphere light, but he also used stories to drive home a point he was trying to make to the students.  

  One of his favorite classroom stories he used was to make a point about double checking yourself before administering a medication.  He always said, look at the bottle when you pick it up, look at it when you are drawing up the dose and then look at it again when you set it down.  That’s a good point, but students learn better with a story to illustrate the point.

  Dr. Voss had a story to go with that bit of instruction.  It was about a call for a horse with colic.  Doing a rectal exam on the horse, he could determine there was an obstruction at the colonic flexure.  He had administered mineral oil via a stomach tube and given a dose of pain medication.  Now he was planning to give a dose of medication to relax the contractions of the gut, allowing the mineral oil to work through the gut and loosen the obstruction.

  Dr. Voss continued the story: he grabbed the bottle of medication from the truck and drew 10cc into the syringe.  He walked over and administered the dose via the jugular vein.  When he returned to the truck to put the bottle away, he realized that it was the wrong medication.  Instead of relaxing the contractions of the gut it would cause strong contractions.  In the horse with an obstructed colon, this would most likely cause a rupture of the colon and a dead horse.  

  Realizing his mistake, he returns to talk to the owner.  “I think this horse is in a lot worse shape than I originally thought,” he says.  “I think this horse is probably going to be dead by morning. Not much more that we can do at this time.”

  The owner calls the hospital the next morning and reports that indeed the horse is dead.  Then he concludes,  “That Dr. Voss is the best veterinarian we have ever had on the farm. He predicted that death exactly.”

  The class roars at the story. The point is made and will be remembered by everyone for the next 50 years. And they didn’t have to make a single note.  It conflicted with the philosophy of honesty and transparency in treatment and medical records, but the critical point is there.  Was the story true?  Probably not, Dr. Voss was far too good of a doctor to make such an error, but nobody asked that question.

  The young Dr. Voss regularly hosted a large group of senior students at his house for poker parties.  Not a lot of money involved because most of us had very limited funds, but penny ante poker, a beer or two and good times.  On one such evening, the phone rang. 

  Dr. Voss answered the phone, “Hello, this is Dr. Voss, how can help you?”

The call gives everyone an early lesson on how the telephone was going to dominate our lives in the years to come.

  “Yes, this is Dr. Voss, what can I help you with Kathy?” he repeated into the phone.  The room was silent with all attention to the phone call.  The night crew at the veterinary hospital would take care of any emergencies, so this must be a unique client.

  After a brief silence Dr. Voss exclaims, “Oh, I see!”

A long silence this time, then another comment “Oh my!”

Then a more extended silence, “Oh, my gosh.”

Another long silence, everyone is straining to hear the call.  Dr. Voss finally speaks, “Well Kathy, I don’t know, but I can’t be of much help to you. You see, I am Dr. Voss, the horse doctor.”

 There is a brief moment of silence and then a loud ‘click’ that can be heard across the room as the Kathy slams the phone down.

  Dr. Voss hangs up his phone and beams with a broad smile, “I guess she wanted the other Dr. Voss,” he says.

  The room erupts in chaos as everyone tries to pump Dr. Voss for details.  What an evening. 

On a Thanksgiving Eve

D. E. Larsen,DVM

The barn was cold, but there was steam rising from the back of young heifer. A dusting of snow on her back was melting fast.  Bill and Connie Wolfenbarger had called with a heifer in labor.  They were not regular large animal clients but did visit the clinic with their small dogs.  I had been to their place several times to treat cows belonging to the Gilbert’s.

    When they discovered a tail hanging from the heifer’s vulva, they knew they had a problem. This meant the calf was in a true breech presentation and almost certainly dead. In a true breech position, the calf does not engage the cervix, and the cow doesn’t go into hard labor.  Most people will not notice a problem until the calf has been dead for a day or two.

    Tomorrow was Thanksgiving, I would miss some of the prep for the family dinner. The evening snowfall was light but continuing. Hopefully, I could make it home before the roads became a problem. Sandy’s folks were already at the house, so we didn’t have to worry about anybody traveling tomorrow.

    I tied the tail out of the way and started to wash the heifer’s rear end. The hair on the tail would come off with the slightest touch. I pulled on a plastic OB sleeve onto my left arm. With a little lube on my hand, I eased into her vulva to explore the birth canal. She strained hard when I reached the butt of the calf. No fluid was expelled with the strain. I pushed the rear of the calf with a couple of fingers. There was a spongy consistency under the skin and some crackling like I was popping air bubbles. The calf filled the entire birth canal, I could not advance my hand into the uterus, and I could not move the calf, it was wedged solidly into the birth canal.  I withdrew my hand, the sleeve was covered with hair from the calf and the odor was slightly pungent.

    “This calf has been dead for over a week,” I said as I removed the sleeve. “It is emphysematous, blown up with gas, I am not sure I am going to be able to get it out of her.”

    “What are our options?” Bill asked.  I knew their daughter was a small animal veterinarian, maybe in California. I did not know her, but I would assume they would be a little more knowledgeable than most clients.

    “Options are not many, the calf is in a breech position. That means its’ hind legs are retained and only the rump is presented. It is blown up so much that I cannot even insert my hand into the uterus. We are not going to be able to deliver this calf vaginally. I try not to do a C-Section on a dead calf, but with all the emphysema I won’t be able to do a fetotomy.  That leaves us with two viable options. Option one is a C-Section, which will be with risk and will be difficult.”

    “And the second option?” Bill asked.

    “The second option is to get your rifle and shot her now. It would not be fair to her to leave her in this situation,” I said.

    “Let’s do the C-Section,” Bill said.

    I double checked her halter to make sure she would not be choked if she went down. Then I change the tail, tying it to the right side. I placed a rope around her neck with a bowline and ran it along her side and tied it to ally fence, holding her against the fence. With her in a reasonably secure position, I clipped a wide area on her left flank, from her dorsal midline to her bottom of her flank.

   I prepped her flank with Betadine Surgical Scrub. The with 90 ccs of 2% Lidocaine, I did a large inverted ‘L’ block of her left flank. I blocked a wider area than usual because I may need to make a longer incision than is usually required. This was not going to an easy procedure. I repeated the prep after the block.

    After laying out the surgical pack and supplies, I pulled on a pair of surgical gloves, more to keep my hands clean than to pretend that this was going to be a sterile procedure.

    “We have a couple of major risks with this surgery,” I explained as I prepared to make my incision.  “The first one is that it is going be difficult to pull this uterus to the incision and second when I open the uterus, there is going to be no way to prevent the contamination of the incision and the abdomen. We are just going to have to depend on antibiotics.”

    Bill nodded, and I made a long incision down her flank, starting a few inches below her transverse processes and extending about 15 inches down her flank. The skin and subcutaneous tissues parted easily. This I incised the muscles of the flank, they quivered as the blade divided them.  When I incised the peritoneum, the abdominal content did not sink away from the incision with a characteristic rush of air into the abdomen. The distended uterus filled the entire abdomen. There was no trouble finding it or worry about moving the rumen to externalize the uterus. The abdomen was filled with the uterus. 

    I reached into the abdomen to the tip of the uterus. Cupping my hand around the tip of the uterine horn, I pulled. The uterus did not move. I tried to rock the uterus in the abdomen. Sometimes you could swing the uterus enough to make it easier to bring it to the incision. This uterus did not budge. Again and again, I tried to bring the uterus to the incision.  I searched and found a hoof, I could not move the hoof.  

    I pulled out, stretched and changed gloves. It this cold barn, I was sweating profusely.

    “Do you think I could give you a hand?” Bill asked.

    “We might try that, if we could both get a hand under the end of the uterus, we might be able to make it move,” I replied.

    Bill stripped down to his waist and washed his hands and arms thoroughly.  I stood on the head side of the incision and ran my left hand down to the tip of the uterus. Bill on the other side of the incision inserted his right arm.  I guided his hand to the correct position.  We pulled, we pushed, we tried almost every maneuver. The uterus did not budge.

    Bill and I were almost nose to nose.  Bill had sweat on his brow and sweat dripping off the tip of his nose. He looked me square in the eye.

    “A woman couldn’t this,” he said.

    I smiled, “If you haven’t noticed, I haven’t got it done myself, yet.”

    We pulled out, and I rethought the situation.

    “I am going to try one more thing,” I explained. “I am going to open the uterus up here without externalizing it. I will then try to get a hold of the calf’s hoof and turn it up to the incision.  The risks in doing this are many. I could spill content into the abdomen, I could tear the uterus, and even with a grip on a foot, I might not be able to budge this uterus.”

    “And then, if this fails, we are going back to option two. We will get your rifle and put this girl out of her misery.”

    That said, I incised the uterus in the middle of the flank incision. With a surgical glove and an OB sleeve on, I ran by right hand down the inside of the uterus. There was a front foot, I grabbed the leg just above the hoof and pulled as hard as I could.  The uterus rolled and the hoof popped out of the incision. With my left hand, I incised the uterus over the hoof, then slipped an OB strap onto the hoof.  I handed the strap to Bill and told him to keep it there.

    Pulling my arm out of the upper incision, I enlarged the incision over the exposed hoof. Bill was able to pull the entire front leg out of the incision.  I reached in and found the other leg. It came out quickly, and we attached it to the other end of the OB strap.

    With both front legs out, I enlarged both the flank incision and the uterine incision. Now I was able to pull the head out of the incision. Then putting things down, I helped Bill put a hard pull on the calf. It was sort like pulling a basketball through a knothole but when gas-filled abdomen of the calf finally cleared the incision both Bill and I almost fell as the rest of the calf followed with a swoosh.

    The membranes and the calf landed on the barn floor in a splat. Then the odor hit us. Bill and Connie both gagged and had to turn back to the side door.  When they opened that door, things were better, or maybe we were just adjusted.  Bill grabbed the OB strap and pulled the calf out the barn door, and I returned my attention back to closing up this mess.

    I washed and changed gloves. I put 5 grams of Tetracycline powder into the uterus and pulled the open incision to the outside. This was a long incision in the uterus, and then there was the small incision higher on the horn.  I elected to close the upper incision first, just in case the uterus would start to involute, and I would not be able to reach this incision.  I closed It with a simple continuous suture of #2 Dexon.

    The larger incision I closed with my standard Utrecht closure using #2 Dexon. After closing, I returned the uterus to the abdomen. I was concerned that there was probably a lot of leakage into the abdomen and pondered how best to deal with that event. There was no option to lavage the abdomen in the middle of this barn, so I just dumped another 5 grams of Tetracycline powder into the abdomen.

    I closed the flank incision with 4 layers, all the deep layers with #2 Dexon. I used simple continuous in the peritoneum, interrupted mattress in the muscles and simple continuous in the subcutaneous tissues. I used #4 Vetafil in the skin with an interrupted mattress pattern.  No need to spray for flies in this weather.

    The heifer had to feel tremendous relief getting that mess out of her. She was going to need some additional antibiotics to keep her incision from falling apart. The easiest thing was to use some long-acting sulfa boluses.  I gave her 4 boluses of Albon SR. That would give her 5 days of protection.  

    I untied her tail rope and the sideline. She was as calm as could be expected.  I loosened the halter and slipped it over her head. She turned slowly and headed to the door, sniffing the floor a little as she passed.

    “She should be okay for tomorrow, but I will check with you on Friday,” I said to Bill as I was cleaning myself up.

    “She will be just fine,” Connie said.  “Our daughter will be home for a week or two.  She can check her tomorrow.  We will let you know how she is doing. You go home and rest for dinner tomorrow.”

    At least I was going to have a few days to rest up with the holiday.  I stopped at the clinic and cleaned all the equipment.  I would be a real mess if I left it for the girls on Monday.  I stripped down to the waist and washed thoroughly. The one mistake I made with the clinic was not putting in a shower. I thought I would wash here and go home for a shower.  Then probably have to start working on dinner for tomorrow.

Gus and the Manure Pile

D. E. Larsen, DVM

Manure piles were (and still are to some extent) standard fare on Oregon farms.  They were located around the barn somewhere and served multiple uses.  They came in many shapes and sizes.  Smaller places had a simple pile outside a doorway where the barn was cleaned.  Larger farms had more elaborate piles.  In my experience their edges were the easiest place to collect a can of worms for a day’s fishing.  They also were used to dispose of small animals that were casualties during the year on the farm.  They were the ultimate compost piles.

Gus was a typical barn cat.  Well past middle age when I first met him when I came to Sweet Home in 1976.  Gus was lucky to have been neutered early in his life, but still had his share of scraps defending his turf.  He was nothing special, gray tabby in color and not large, maybe 8 pounds.  He lived with his extended family on a small acreage on a hill outside of Sweet Home.  Grandma and Grandpa lived on the “farm”.  Not much of a farm, but enough for a few cows and sheep and a small barn.  The son and his family lived about a quarter mile up the road on a neighboring taxlot.  When Gus came to the clinic he came with Carol, the daughter-in-law.

Over the first few years of practice in Sweet Home Gus was approaching his golden year.  In those times I didn’t see neutered male cats over 15 years of age.  This was before the advent of the feline leukemia vaccine, and diets did not address urinary tract and heart issues.  For barns cats to reach that age was truly exceptional.

One cold winter morning Grandpa hurried into his pickup truck in the carport on the side of the barn.   It was cold and he was anxious to get the truck started.  “Thump, thump” came from under the hood.  Gus had sought the warmest spot he knew of to sleep the night before.  The warm engine block was one of his favorites.  Usually able to scramble out before the engine started, this morning it didn’t work.

Grandpa knew what the noise meant, he had seen more than one cat caught in a fan belt on cold mornings.  He was disappointed when he found Gus, he had been such a good cat.  Gus was a mess, broken leg with bone poking out, left eye hanging out of the socket, several large lacerations and bleeding from his mouth.  In Grandpa’s mind there was only one thing to do.  Picking up a hammer, he made a quick whack to the back of Gus’ head.  Disposal was easy.  Gus’ final resting place was the manure pile on the other side of the barn.

In most cases that would be the end of the story, but remember, cats have 9 lives.  Gus had already used several of his just surviving to this advanced age.  Now he would need to cash in all the others.

Carol had noticed that Gus had not been to his dish on the back porch for several days.  She mentioned his unusual absence to Grandpa.  Grandpa was quiet, knowing the she would have rushed Gus to clinic and spent a lot of money on an old cat.

The next morning, she heard a noise on the porch.  She opened the door and was aghast at the scene.  There was Gus.  Covered with manure, left eye hanging out, broken and torn.  How had he managed to make it to the door? How had he known which door was the one to provide him help? She carefully boxed Gus and headed for the clinic.  Grandpa was outside as she drove by so she stopped to show him what she had found.  Grandpa had no choice but to confess.  He said that the vet could do a better job than him, assuming that Gus would be put to sleep.  In those years, in Sweet Home, if a cat couldn’t be fixed for $100.00 it probably was not going to be fixed.  Gus would surely be well over that figure.

Carol laid Gus on the exam table and related the story.  Gus looked hopeless to me.  She wanted to know her options. Gus was a pitiful sight as he lay on the table, looking cautiously at me out of his one good eye. 

“What are your options, Gus?”  I thought to myself as I pondered the situation.

My initial thought that Grandpa had Gus’ best interest at heart, he just didn’t do the job very well.  I’m not sure that was what his owner wanted to hear.

“We have a lot problems here” I started.  “Contaminated compound fracture of the tibia, fracture of mandible, eye that needs to be removed, broken teeth and multiple lacerations that are very contaminated.  The first question we need to discuss is do we want to put him through all this over the next few weeks?”

Carol was quick to respond, “We are not going to put him to sleep, not until we don’t have any other option.  I don’t care what it costs. If we have to, Grandpa can log a few trees.  That’s the least he can do after what he did to this cat.”

I knew Grandpa.  He would log his trees for his family or for the Grandkids.  I wasn’t so sure about a cat.

Now we were on to option number 2.  Referral was out of the question. There were no specialty clinics around at that period of time.  If Gus was going to survive it was going to be by my hands only.

“We have several things to do, first we need to sedate him and get him cleaned up, get him on some fluids and antibiotics.”

“The wounds are too contaminated to close; if we clean them up and remove the grossly contaminated tissues, they will heal if he lives long enough.”

“I can probably wire the jaw and remove the broken teeth.  The eye is toast and has to go.”

“The fractured tibia is too contaminated to fix, the ends of the bones are likely dead,  The leg has to go.”

Carol finally spoke, ” I want to save the leg!”

“Can’t be done.”  I responded.

Again Carol spoke, “I want to save the leg, we can try!”

“Okay, we can try, but if it happens it will be a miracle.  And the leg will be short.  We will try.  He will have to stay a few days.  I don’t know what this will cost.”

Carol left, convinced that Gus was going be back to his old self in a few days.  Might take a little longer than that, I thought.

We sedated him with a dose of Ketamine and got him under the spray nozzle in the tub.  After cleaning the manure and dirt, it looked like things were almost doable.  We got him dried off and an IV started.  Antibiotics on board and warmed up a little, he was ready for the first of several procedures.

Putting Gus on some gas anesthesia, we started cleaning wounds.  Shaving hair from the wounds. We removed contaminated tissues and packed with Furacin Ointment (the best topical antibiotic ointment I had at the time).

I worked on the tibia next.  The ends of the bone were dry and brown with debris stuffed into the ends.  I cleaned the wound as best I could.  Calculated that I would have to removed bone from both exposed fragments.  I couldn’t make myself think this was going to be anything but a waste of time. We packed the wound with antibiotic ointment and would do the repair tomorrow.

The left eye was hanging out of the socket and did not require much to remove.  Placed a single suture around the optic stalk and removed the eye.  I could deal with closing the socket later.  

The mouth was clean compared to the rest of the cat.  Gus was missing both upper canine teeth and one lower canine tooth.  His jaw was fractured on the left side and separated at the symphysis (the mid point at the front of jaw were the mandible bones join in a non movable joint).

The symphysis was repaired by passing a 20 gauge wire around the mandibles just behind the lower canine teeth, exiting on the ventral midline where I twisted the ends to tighten the ligature, cut the ends short and buried with a single suture.  The fracture of the mandible was stabilized by wiring around two teeth on each side of the fracture.  Probably will need to do more but later.

The next morning Gus was looking pretty good and actually was ready to get out of here and back to his barn.  We gave him a few laps of gruel and continued the fluids.  We were going to tackle the leg later today.  I still felt this was a waste of time.

With Gus under anesthesia, I went to work on the exposed bone.  To my surprise, I did not have to trim too much bone before I came to bleeding bone.  The marrow cavity appeared pretty clean with the superficial debris was removed.  I repaired the fracture with a threaded intramedullary pin.  Inserted at the knee and threaded down the marrow cavity to the fracture site.  Placed the ends of the exposed bone into normal position and seated the pin into the distal fragment.  This was the common repair at that time.  We will have problems due to the contamination at the fracture site.  I cleaned up the wound as best we could and closed this wound.

Gus was ready to go home for a few days before we started the next round of repair and treatment.

Both Carol and Gus were happy to see each other.  Gus was actually stepping on the fractured leg.  Cats always make surgeons look like they know what they are doing.

Over the next few weeks, Gus became a standard visitor to the surgery room.  We would clean on his open wounds, which were granulating well.  We closed his eye socket and placed an additional wire in his jaw to improve the repair.  On each visit I was more and more cautious on how the leg was healing.  The soft tissues were looking good but I was still skeptical about the bone.  Carol was in great spirits, and I think that Grandpa was getting to come out of the doghouse once in awhile.

Finally, push comes to shove.  Time to x-ray the leg to see how the repair is going.  Gus is still quite a sight.  One eye and one lower canine tooth protruding out on the outside of his upper lip.  Larges patches with no hair, but the wounds are mostly healed.  Probably as good as they would have healed had they been sutured.  He would purr and he was bearing weight on the fractured leg.

The x-rays were better than I expected.  There was some healing but not what was needed.  We would have to try something different.

So at 6 weeks from the time of injury I removed the IM pin.   There was a pretty good fibrous union of the fracture, but no boney union.  The next try was an external fixation device, 4 small pins driven into the bone, 2 above and 2 below the fracture site and bolted to an external pin to fix the bones in position.  A tall order for a cow doctor but I got it done.

Another 4 weeks and we were done.  The leg was healed, Gus was happy, Carol was happy.  I don’t know about Grandpa.  The total dollars are lost to a clouded memory.  Anyway, it was never about the money.

The last time I saw Gus was almost a year later.  Into his golden year now, and with none of 9 lives to spare, he was truly an old cat.  He was in for routine stuff, an abscess on the side of face, (left side, he probably didn’t see the punch coming) and tapeworms.  Still defending his turf and still able to catch a mouse or two. I always wondered about his final resting place.  Was it the manure pile, again?

Brownie, 1953

Brownie, 1953 

D. E. Larsen, DVM

I woke to an empty bedroom. The sky was clear and the morning sun was out, but there was still a chill to the summer air. I laid still and tried to listen to hear my brothers downstairs. I hated to wake to an empty room. Did the monster get them when they got up, was he still waiting for me? I felt confident that I was safe if I watched them get up and dress, but now, I didn’t know.

I stood up and backed up to the far corner of the old double bed. I had to bend over a little because of the slant of the roof on the side of the bedroom. After a deep breath, I ran and jumped, hit the floor on the dead run and made a rapid turn to the open staircase. I bounded down the stairs, taking 2 or 3 steps at a time. I didn’t look back until I was at the bottom. No monster, I opened the door and entered the kitchen as if nothing had happened. Both Larry and Gary were at the table eating breakfast. I huddled up to the wood stove, the only heat in the house. It felt good after my run down the stairs.

“You need to go get dressed and get back down here for breakfast,” Mom said. “Your brothers are planning to go swimming this morning but you guys have to clean the barn first.”

“We can ride Brownie to the river and back,” Gary said. “That way you won’t have to worry about the thistles in the field.”

I hurried back upstairs and dressed. Mom had a bowl of Wheat Hearts mush waiting for me when I got back to the kitchen. I didn’t like mush but Wheat Hearts were better that Oatmeal. The warm mush felt good on a cold morning, and the large glass of milk made it easier to swallow

With the three of us the barn cleaning went fast. Larry was the oldest, and he assigned the chores. Gary scrapped any manure on the flood into the gutter. I went along behind him and used the large barn broom and swept the loose dirt on the floor into the gutter. Larry cleaned the gutter, using the shovel to scrape long sections out the door onto the manure pile. With the job done we could head to river. No need for a bath today.

Back at the house we changed into our swim trunks and slipped on a pair of thongs (flip flops). I hated to cross the lower field in these things because of the thistles. There was no good way to avoid the stickers except when we could ride Brownie.  Gary headed to the pasture to get Brownie. With a couple of whistles he came running. He probably knew he would get the whole lower pasture to himself while we swam. 

Brownie was a Jersey cross steer, solid light brown in color with a pinkish nose. This was his second summer and he was starting to get extra grain every evening. We had raised him from a calf and he was very friendly. He came when Gary whistled. I couldn’t whistle yet but I was trying.

Gary had no trouble getting onto Brownie in the middle of the field. It was a little hard for me so I would wait at the gate. We didn’t need a bridle or rope. We just tapped him on the side of the neck with a switch to tell him where to go. I jumped on and he trotted down the lane. Larry was already across the highway and in the lower field but we would catch up with him now.

The grass in the lower field was knee high. The cows were not allowed in this field until we cut hay. Dad would be a little upset with Brownie being down here but we could tell him that we were just helping to fatten him up. 

When we got to the riverbank we slid off and Brownie ran to middle of field, bucking with joy.  The sand on the riverbank was warm from the morning sun. The river was probably still cold. Larry was already in the swimming hole. He had crossed the river and was ready to dive off the old log on the far bank. I was not supposed to go over to that log but with just us boys here today, I thought I would swim over to it.

The water was really cold. It took a slow walk to get into it. I swam a little up and back. I think I will wait until it is warmer before I swim across. A couple of times up and back was enough for me.  I got out and laid down in the warm sand. It wasn’t long and everyone was ready to go back to the house.

“You go get Brownie while I dry off,” Gary said.

I ran up the riverbank. Brownie was clear across the field with his head buried in the grass. I made my best attempt and out came a weak little whistle. Brownie raised his head and looked. He had heard my whistle. Here he came on the run. This was going to be a good ride home. He came to a stop in front of me. I nuzzled up to his belly for a little warmth. I would need some help getting on him here in the field. Pretty soon Gary came up and jumped up on him with no problem.  I jumped and Larry gave me a little boost and I was on also.

Brownie trotted toward the gate. His trot was a little rough, not like a horse, but we were used to it and had to no problem staying on his back. He stopped at the highway and waited for our heels to tell him to go. He gave a long look back to the lower field as he started up the lane toward the house.

We rode Brownie everyday that summer. He enjoyed the rides, we covered the hill on Brownie and went to river on all the good days. When we had company everyone wanted to see how well he was trained. As the summer worn on, I was able to get myself onto his back in the middle of the field. He was a better companion than a dog.

But fall came, and the second fall of all good steers would be their last. The day for Brownie’s slaughter finally came. We slaughtered on the farm. It was a common event that we were used to watching. We generally helped where we could. The steer was shot in the head and hung in the machine shed. He was gutted and skinned there. I had helped in this part in the past but today I waited in the house. Brownie was different than the other steers. After he was skinned and gutted, they would split his carcass with handsaw. Then cut him into quarters. The quarters were carried over and hung from the large cherry tree in the back yard. It would hang there in the cold fall air until the weekend when Uncle Ern would come and cut him up. Uncle Ern was an old man now but he had been a meat cutter in his younger days. He knew just how to do it.

It was hard to see Brownie hanging there in the back yard every day. In farm families, life revolves around the kitchen and the back yard. We never used the front door, and the front yard was seldom used. Finally Saturday came and with a lot of help for Uncle Ern, Brownie was in the freezer in a short time.

Dinnertime that winter became a challenge. With every meal, I would fiddle with the meat on my plate. I knew it was Brownie and I knew I had to eat it. It proved to be long, hard winter.

“Is this Brownie?” I would ask, almost every meal.

“Yes, this is Brownie,” was always the answer. “Now eat your dinner.”

“This meat is tough,” I would say.

Dad would answer, “It would be a damn sight tougher if you didn’t have it.”

Mrs. Rose

D. E. Larsen, DVM

                Mrs. Rose was our middle daughter’s first-grade teacher.  She was a little gray-haired lady who was very prim and proper. Mrs. Rose was adored by her students and by their parents.   She was an old-time teacher, very much into the three Rs. She kept a tight rein on her classroom, ruling it with a tender heart.

    Of our four kids, Amy took the most interest in the goings-on at the clinic. She liked the people and the animals and showed compassion for both. When I had an evening call for a basset hound in labor, Amy was ready to go to the clinic with me in a second.

    I took care of quite a few basset hounds for a large group of ladies who showed these dogs.  They were relatively valuable dogs, and the ladies wanted meticulous veterinary care.  This bitch (female dog) had been in labor for nearly 3 hours.  Her owner, Sandi, had been through this on multiple deliveries.  Three hours of contractions without a pup was cause for intervention, and with each passing minute, the puppies were more at risk.  The options, following an unremarkable vaginal exam, were to try some Oxytocin to stimulate contractions or to do a C-section.

    The Oxytocin injections could work magic, but it could also mean a long night.  When bassets had large litters, you could end up with a C-section for the last pup or two because the uterus ran out of strength for continued contractions.  With the extended time of labor, those remaining puppies were often lost.  I enjoyed working with Sandi on these deliveries because she would always be quick to elect a C-section. I agreed with her in most of the cases. It made for a shorter night for me and usually a more successful delivery.

    This evening was no exception.  The size of Betty’s belly said large litter. The vaginal exam was unremarkable, and no puppy was in the birth canal. I started talking about options, and Sandi cut me off short. 

    “Let’s not spend all night here.  Let’s just go to a C-section, and everyone will be better for it,” she said.

    I called Dixie, my right hand at the clinic, to come help. Sandi had a couple of friends in tow.  That would mean we had 4 gals to tend to the puppies, plus Amy.  Sounds okay, but my guess was over 10 pups, maybe 12 or 13.  We were going to be very busy for a few minutes when I started handing out puppies.

    While I was waiting for Dixie, I got the surgery room set up, drew up a dozen doses of Naloxone for morphine reversal on the pups and I was able to get Betty onto her back, so I could clip her abdomen and do a preliminary prep.  I got an IV catheter placed and started IV fluids at a slow drip. 

    As soon as Dixie arrived, we moved Betty into the surgery room and gave her a dose of IV Innovar, a morphine combination drug.  This provided strong sedation, and we secured her to the surgery table and did a surgical prep on the abdomen.  Then we used Lidocaine for local anesthesia at the incision line.  This would allow us to deliver the pups with the least depression from anesthesia and with a small dose of reversal agent they would wake rapidly.

    This all done, I prepped myself for surgery.  Speed was the keyword at this point.  After I scrubbed, gowned and gloved, I draped Betty’s abdomen.  There was going to be a lot of fluid, I sent Amy for towels to spread on the floor.  If she was excited, it did not show.  

    Starting an inch below the umbilicus, I made an incision about 5 inches long.  Then I dissected through the subcutaneous tissues and exposed the linea alba, that center line of connective tissues where all the abdominal muscles came together.  I incised through the linea alba and opened the abdomen.  Almost no blood is lost with this approach.  This abdomen is full, the very gravid uterus leaving little room for normal gut function.

    I started pulling the uterus out of the abdomen, one pup at a time.  I laid it out across the drape on moistened towels.  One puppy, then the next, and it kept coming.  Finally, I had it all out, twelve pups, 6 in each uterine horn.  This uterus, which is the size of a pencil in its non-pregnant state,  laid out on the drape and towels it was too large to stay up on the abdomen. Several puppy segments hung over the abdomen on each side, reaching the surface of the surgery table. Quite a remarkable organ, the uterus.

    The book talks about delivering pups through one incision in the body of the uterus. I always found it a better approach, and faster, to deliver pups through an incision in each uterine horn.  I made the first incision over the pup nearest the uterine body on the left uterine horn.  Then I would squeeze a pup through this incision, clamp the umbilical cord, severe the cord, clean the airway and hand the pup to Dixie.  Dixie would give a dose of reversal agent and hand the pup off to the waiting hands, Sandi was the first in line.  By this time, I had removed the placenta and pushed the next puppy out the incision.   Handing Dixie the next pup, the whole process repeated. This continues, and finally, Amy is the only set of hands, she catches the pup in a towel and follows the girls to puppy basket as if it is nothing out of the ordinary.  This was sort of an assembly line when a pup was revived and breathing there was the next pup to catch as I handed it off.  This is a rapid, chaotic time for a few minutes.  Amy was a real trooper through the whole process.  Finally, the last pup is delivered.  I double-checked the birth canal to make sure there is not a pup hiding somewhere. There was fluid covering the table, and the floor was soaked.  My tennis shoes will be retired to the work shoe shelf.  The towels that Amy laid on the floor have soaked up most of the fluid. At least nobody slipped on the floor, time to relax a little.  Twelve live pups, Sandi and her friends are pleased.

    I start Betty on some gas anesthesia via a mask, and then I change gloves.  I close the two uterine incisions with a Utrecht pattern using 00 Maxon.  Then I return the uterus to normal position in the abdomen.  Now we clean up, we remove the drapes and carefully prep the abdomen again.  I change my gown and gloves and open a new surgery pack.  I remove the drape and towels which are soaked with fluids, and then I drape the incision with a new drape. Now I can close the abdomen with as little contamination as possible. I suture the linea alba with interrupted sutures.  Once the linea alba is closed, we give Betty a dose of reversal drug, we are now on gas anesthesia only. This way, she will recover rapidly.  I finish closure of the subcutaneous tissues and skin.  We take her off the gas and clean her up the best we can.  We return her to the kennel, and she is awake before we know it.  She is an experienced mother, and she takes the pups as soon as we show them to her.

    We send Sandi, Betty, and pups home as soon and Betty can stand.  She and her puppies will do better at home under Sandi’s watchful eyes.  I relax a little and asked Amy what she thought of all of that commotion.  With a nonchalance that she probably got from me, she just shrugs it off.

    That became almost a forgotten evening until we went to a parent-teacher conference some weeks later.  Mrs. Rose went over Amy’s progress, which was exceptional, and then looked at us with a wry smile.  

    “A few weeks ago, the whole class had quite a learning experience about where puppies come from and how they get here.  Amy was very excited about her experience and very descriptive to the class.  I don’t worry about discussing the birds and the bees in my classes.  Your daughter sort of changed all of that.”  She said.

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