One Twist Deserves Another, From the Archives

D. E. Larsen, DVM

I ran my hand into Rosie’s vagina a second time. It still ran into a blind pouch. Rosie was a prized Jersey cow that supplied milk to a lot of neighbors.

“What the heck is going on?” I asked myself. “I had never had a dystocia in a Jersey before unless it was associated with milk fever.”

I explored the pouch with my fingertips. Then the light finally flashed on. This was a full uterine torsion. Partial torsions were common. In fact, I sort of prided myself at being able to untwist a uterus that was half rotated. 

I used my left arm’s strength, I would rock the calf a little, and then, with a strong flip, I would turn it upright. The narrowed twisted vagina would open completely, and delivery would be a snap after the correction. This was a full 360-degree torsion. The vagina was twisted closed like the top of a plastic bag. I tried to advance my hand through the twisted vagina, to no avail.

My thought was to get my hand into the uterus with a detorsion rod and hook the feet to the rod. Then with a bar through the other end of the detorsion rod, I could untwist the uterus with a strong crank. But that wasn’t going to happen. I could not begin to advance my hand through the twisted vagina.

“Carol, there is full 360-degree uterine torsion,” I said. “I can’t get my hand through it. That means we are probably going to have to do a C-Section.”

There was a gathering crowd in this small backyard barn lot. It seemed that half of Crawfordsville was watching.

“Is that the only option,” John asked.

I started to reply, but the question had started the wheels turning in my memory bank.

“I am sort of short on tricks,” I said. “But there is one that we could try. I have never done it. In fact, I have never seen it done. It might be worth a try. I will need 2 by 12 plank, about 12 feet long.”

“We just happen to have one of those,” Carol said. “Over in that lumber pile.”

A couple of guys pulled the plank out of the lumber pile and had it beside Rosie in no time. I had everyone’s full attention now. Nobody had any idea what I was up to.

“This is the plan,” I explained. “We lay Rosie on her side, lay this plank across her belly, with the plank’s midpoint on her belly. Then we roll Rosie to her other side while some brave soul stands on the plank. The plank holds the calf while the Rosie turns, thus undoing the uterine torsion. The only trick is to make sure you roll her the right way.”

“And just how are you going to lay her down on her side?” Bill asked. “I suppose you just ask her.”

“That’s another trick that I use all the time,” I said. “It’s called the Flying W. If you haven’t seen it, you will be impressed.”

I got my large cotton rope and placed the middle of the rope over Rosie’s neck. I crossed the rope between her front legs and brought it up each side, crossing again in the middle of her back. Then I bring both ends out between her hind legs, on each side of her udder, the application was complete. A slight pull, and Rosie fell to her right side.

“I’ll be darned,” Bill said.

I positioned the plank across Rosie’s belly. With the midpoint in the middle of Rosie’s belly. This would be enough plank to make a full turn for Rosie. The plank was at about a 45-degree angle with the ground. It might take an agile person to ride it for the entire arc.

I looked around at the crowd.

“I can stand on the plank,” Carol said. “She is my cow, and there was a day that I was somewhat of a gymnast.”

I positioned Carol on the plank, about four feet up the plank from the ground. I had a couple of guys on each rope tied to both the front and hind feet.

“Now, we are going to go very slow,” I said. “I need to have my hand in her vagina to make sure we are turning the correct way. I tend to be a little dyslexic, and I have trouble figuring this out.”

With my hand in the vagina, I had the guys start lifting on the feet. Sure enough, the twist was tightening.

“Okay, all stop,” I said. “We are going the wrong way. We have to start all over with Rosie on her left side.”

It only took a couple of minutes to untie Rosie’s feet and remove the plank. I didn’t have to do much. The whole crew knew what was up and what needed to be done.

With Rosie on her feet, Bill quickly grabbed the ends of the ropes on the Flying W. He wanted to feel just how easy it worked.

“Now, we want her to fall on the left side,” I said. “So when you pull, you want to lean left and put all the pressure in that direction.”

Bill pulled, leaned left, and Rosie flopped to her left side. Bill had a big smile on his face.

“That was so easy, I can’t believe it,” Bill said.

“If you are throwing a big bull, or an ornery steer, it might take a couple of guys on each rope,” I said. “But I have never seen it fail.”

The rest of the crew had Rosie’s feet tied and the plank in place in no time. Carol jumped on the plank, and we rolled Rosie.

After standing Rosie up, I washed her up one more time. I ran my hand it into a normal birth canal. I didn’t let on, but I was almost as amazed as was the crowd watching. I grabbed both front feet of the calf and pulled them into the birth canal. As I turned to my bucket for my OB straps, Rosie strained, and out popped the head. One more strain, and both John and I caught the calf before it fell to the ground.

“That was easy,” John said.

“Jersey cows have the easiest deliveries of all the breeds,” I said.

We turned Rosie loose, and she turned her attentions to the little heifer calf, utterly oblivious to the crowd watching.

Photo by Tom Swinnen from Pexels

Gus and Blackie, From the Archives

D. E. Larsen, DVM

We watched as Blackie hurried across Main Street, almost in the crosswalk and with no regard for the traffic light, his long leash trailing behind him. Blackie was a Dachshund cross, solid black in color, and the structure of a Dachshund. 

Blackie was always in the lead and always seemed to know where they were going. And not too far behind, came Gus. Gus, with his narrow brimmed hat, cocked to the side of his head and sporting a grouse feather stuck in its band. 

Gus was much slower afoot than Blackie and walked with a broom. He walked a little bent over, favoring his lower back. He always gave the appearance of someone who just got out of bed and dressed quickly. Never getting everything on just right. His shirt was half tucked in, and his greying hair was sticking out from under his hat in all directions.

Blackie was at the clinic door now, patiently waiting for Gus to arrive. The leash strung out on the sidewalk behind him. This leash was Gus’ way of complying with the city’s leash law. Gus was schizophrenic. Medication keeps him functional in the community, but if he is off medication, he has problems, and he is well known to the police.

Ruth opened the door for Blackie and waited a couple of minutes for Gus.

“What are you two up to today?” she asked.

“Blackie thinks he needs to see the Doc,” Gus replied, leaning on his elbows on the counter to catch his breath.

“Come on Blackie,” Ruth says, as she gathers up his leash. “Let’s go get your file.”

Gus always played the role of being a little dense or slow. But, the reality was he was as sharp as a tack. If you wanted to know what was going on in town, all you had to do was ask Gus. He knew everything about everyone and every business. He just had difficulty articulating the facts in a manner that anyone could understand.

Blackie was due for his annual exam, vaccinations and a heartworm test. We would have mailed a card tomorrow. That is how well Gus kept track of things.

Blackie was an excellent patient on the exam table as long as you talked with him and took things slow. If you tried to zip through the exam and stick him with a needle without adequate conversation, he would get a little snappy.

“Gus, I see that Blackie is doing well,” I said. 

“He does okay, you send the bill, gal over at the DQ has a problem,” Gus stammers.

I have found that Gus will carry on 2 or 3 conversations at the same time. Giving snippets of each sentence stitched together in a manner that is almost incomprehensible if you don’t listen very carefully.

“John takes care of it, I think her boyfriend left,” Gus continues. “I will get your sidewalk, maybe she is pregnant.’

Gus kept track of all the drama in town, I never knew how he came up with his information. I think maybe people didn’t pay attention to him, thinking he was never listening.

“I ran a guy off last night, John says Blackie owes some money,” Gus continued.

“Blackie’s bill is fine,” I said. “You don’t worry about Blackie. We will take care of him.”

“They didn’t like me in that jet,” Gus said. “That guy next door doesn’t like me; in Korea, they were mad. I only moved it a little.”

Gus must have been in the Air Force, he often spoke of being in a fighter jet and taxiing it a small distance. I would guess that probably ended his military career. And there were several folks in town which he had altercations with in the past.  Those seemed to stick in his mind and come out once in a while. 

Gus was not allowed in any of the bars in town because if he drank, especially if he forgot his medication, he would become violent and unmanageable. It was not unusual for Gus to require a few weeks in the state hospital in Salem to get straightened out.

John related one trip he made, taking Gus to the state hospital. John said that Gus babbled all the way to Salem and then was real quiet when they were waiting to see the doctor.  John said that they saw a new, young doctor that day. When the doctor was interviewing Gus, Gus was as normal as John had ever seen him. Just when the doctor was getting ready to send Gus back home, Gus snapped back into his incomprehensible babble. John said the doctor’s eyes just popped.

But, for all his problems, Gus did pretty well. His family had provided him a small house. Gus worked every day, sweeping and cleaning up small areas. He got funds, probably SSI, and maybe some state funds from time to time. He swept sidewalks in front of businesses and looked after small things out front, like bums hanging out. I took care of Blackie. The A&W fed him lunch and dinner at times, although he usually had to eat outside. Some of the women in town would clean his house on occasion.

If everyone on public assistance did a fraction of the work that Gus did, communities would be far better off. And that segment of the population would be looked upon with better favor.

Photo by Mel Elias on Unsplash

Lambs and Crab Legs, From the Archives

Lambs and Crab Legs 

D. E. Larsen, DVM

Gus Johansen came through the clinic door in a rush. His stocking cap was in his hand, and his gray hair was sticking out in every direction. Gus was a large man who came from Norway as a young man. He was a king crab fisherman who had a small sheep ranch a little way out of Enumclaw. 

“Doc, I am glad I got you,” Gus said, almost out of breath. “I have a ewe that is ready to lamb. Her insides are pushing out. She is so large, there have to be 3 lambs in there. I have never seen a ewe so large.”

“Sounds like I should get a look at her,” I said. “I haven’t been to your place Gus, can you leave your address, and I can get out there this afternoon.”

“We brought her with us in the little trailer,” Gus said. “I hate to pressure you, Doc, but I have to leave to go fishing tomorrow. I can’t leave this problem for Ella to deal with alone.”

“Okay, pull around back, and we will unload her into one of the large dog runs,” I said. “I will be able to look at her in 20 minutes or so. I have to finish the morning treatments on a couple of dogs in the hospital here. The girls will get her cleaned up during the time.”

I sent Kathy out to help unload the ewe and get her rear end clipped and scrubbed. I was guessing he was talking about a prolapsed vagina. A ewe with large twins or triplets made it almost common for them to prolapse their vagina before delivery. They would just run out of room in their abdomen.

“Boy, your description was pretty close,” I said to Gus as I looked at the ewe. Her entire vagina was prolapsed, with the cervix bulging a little. There was content in this prolapse, maybe the bladder, some intestines, or maybe one of the lambs. 

“Gus, it looks like she is pretty close to lambing,” I said. “She is dripping milk, and the mucus plug is gone from the cervix. If we are up against a wall, time-wise, it might be better to just take these lambs with a C-Section. There is a slight risk in doing that, these lambs could be early, and we could have problems saving them.”

“I was hoping you would take them now, Doc,” Gus said. “This is one of Ella’s favorite ewes. The lambs would be nice, but the ewe is our biggest concern. And I am going to be gone for at least 2 weeks. I want to make sure Ella doesn’t have to deal with this.”

“You have my home number,” I said. “Ella can call me any time if she has problems while you are gone. She needs to know that I am okay with her calling.”

Gus went back to the car to discuss the decision with Ella. This would make a busy morning for me, but it will be better than working with a hysterical Ella at midnight.

“I think we want you to do a C-Section, Doc,” Gus said. “Can you do that now?”

“Yes, we will do it right now,” I said. “I will only use local anesthesia, so she will be able to go home just about any time after we are done. If you and Ella want to stay and watch, that is fine.”

“Oh, no, you don’t want her here,” Gus said, jerking his head toward Ella in the car. “We will go home and do a few chores and get set up for a couple of lambs. Will you be done by noon?”

“This is not going to take me very long,” I said. “And I am going to get started right away. And Gus, my guess is there are 3 lambs.”

“That will be nice,” Gus said. “She is a good momma, but we might have to bummer one them. That will keep Ella busy while I am gone.”

“So, let’s get a surgery pack, towels, and a drape, gloves, and some Lidocaine,” I said to Kathy as Gus and Ella backed the trailer around so they could leave.

We rolled the ewe on her back and clipped and prepped her belly. I planned and ventral midline incision right in front of her udder. 

It was quite a sight with her on her back. She had one large belly.

C-Sections on ewes are usually a snap. With the ventral midline approach, the lambs are within easy reach. The surgery is often brief.

With everything set up and the incision site blocked with Lidocaine, I made the incision. The incision was complicated by a large milk vein coursing its tortuous path right up the midline. I would have to dodge it through the entire procedure.

One lamb kicked me as soon as I entered the abdomen. I pulled his head up out of the incision and incised the uterus over his head. Grabbing him behind the ears, I pulled him out. He was shaking his head before I even let go of him.

I found another lamb in the same uterine horn as soon as I reached back into the uterus. I grabbed him by the hind legs and pulled him out of the same uterine incision. By now, we had all the girls from the office out to take a lamb as I handed him off.

I explored this right horn of the uterus to make sure there was not another lamb there. Sometimes I found it easier to make a second incision on the opposite uterine horn, but this time there was plenty of room to reach the left side. I immediately ran into the head of the third lamb.

“I knew there would be three of them with the size of this belly,” I said as I extracted the third lamb.

“You better check for another one,” Kathy said. “You know what happened to Dr. Jack a while back.”

I smiled as I handed off the third lamb.

“Yes, I will check, but the odds against having 4 lambs are pretty high.”

I ran my hand into the depths of the left uterine horn, trying to remove some of the membranes.  And then this guy kicked me. I looked at Kathy and smiled.

“There is another one!” She said. “Can I have it? Please! Ella will be too busy with 3. They will never suspect there were 4.”

“Kathy, you know we could never do that,” I said as I pulled the 4th lamb out of the incision. “I would never be able to talk to Gus with a straight face.”

With all the pulling and tugging on the lambs, the vaginal prolapse had corrected itself. 

“She is going to have so much room in this belly she won’t know what to do with it,” I said.

I closed the four-inch uterine incision with number 2 Dexon and the linea alba with the same suture, using a sliding mattress on the linea alba. After closing the skin, she was ready to go.

We rolled her over onto her side, and she just kept on going and landed on her feet. She immediately turned her attention to the lambs.

“You go in and give Gus a call,” I said to Kathy.

“They said they had chores to do,” Kathy said.

“That was just so they wouldn’t have to watch,” I said. “Ella will be home sitting by the phone. I bet it won’t ring twice.”

I was right, of course. Gus and Ella pulled into the driveway in less than 10 minutes. They were all smiles when they got out of the car. And then they noticed that there were 4 lambs.

“There were 4 lambs, and they are not tiny ones,” Gus said as Ella opened the gate and went in to hug the ewe and look at the lambs.

“Do you think she can raise all 4 lambs?” Ella asked. 

“I would sure let her give it a try,” I said. “You might need to supplement them with a bottle, but they will benefit from being with mom. Supplement them with a little milk replacer and get them eating some pellets early; they will do better than if you make a bummer out of one or two of them.”

“Give me a call when you get home, Gus,” I said. “I will run out then and take the sutures out of her. It might be a day or two before she passes her membranes. You have Ella give me a call if she has any concerns about how things are going.”

“Oh, we brought you a bag of a little something and a bag for the girls, also,” Ella said as she retrieved a couple of full grocery bags from the back seat.

They loaded up and headed home as one happy group.

I looked in the bags as they pulled out of the driveway, two bags stuffed full of frozen king crab legs.

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