What are the Odds, From the Archives

D. E. Larsen, DVM

The young heifer strained hard as I tried to explore the four feet presented at her vulva. I slid my arm into the vagina alongside the legs. I could determine that these were two front legs and two hind legs, but were they from two different calves?

“She has been straining like that all morning, Doc,” Ole said.

We are in a small barn, just out of Enumclaw. I had been out of school for a couple of months. “A complex delivery like this is not fair,” I think to myself.

“She doesn’t look big enough for this to be twins,” I said. “This has to be an abnormal calf. I am going to push it back into the uterus a little, that will allow me to explore it a little better.”

Ole did not reply, I am sure he is second-guessing his request for me to check the cow. All the Norwegians seemed to want Dr. Larsen these days.

I pushed on the feet with both hands. Slow, steady pressure was needed to push the calf back out of the birth canal. I knew there was a risk of rupturing the uterus if I was too aggressive.

Finally, the calf was out of the birth canal, and I could feel the entire calf. Confused for a moment, but then I was able to define this calf. The four feet surrounded the head, and there was somewhat of an apron of skin surrounding the feet and head. Reaching over this apron, I ran into the exposed intestines of the calf. And I could feel a severely contorted spinal column.

“Ole, this is a mess,” I said. “This is a schistosomus reflexus calf. That is a fetal monster. This calf is sort of inside out. He has an open abdomen and chest, and his back is bent backward. The good thing is he is small, I should be able to cut him into a couple of pieces and get him out.”

“That sounds pretty gruesome,” Ole said. “Have you done that before?”

“I have done a lot of fetotomies, but never on a calf like this,” I said. “This is one of those things that a veterinarian is supposed to see once in a lifetime. What are the odds of me having one this early in my career? Seems like it is not fair for me to have to deal with it in my first few months of practice.”

I am sure I can recall that a fetotomy on a schistosomus reflexus calf was supposed to be complicated. It probably depends on the cow and the calf and the situation. This proved easy, I dropped an OB chain over the back of the calf and was able to pull it up between all the legs and pull the OB wire around the calf. With a fetotome, I was able to saw the calf into two pieces in short order. With a little luck, this one cut also severed the head. I was able to extract the three sections with hand traction.

“That looked awful easy,” Ole said. “I thought you said it was going to be a mess.”

“I think we got a little lucky,” I said. “She is a small heifer, it was a small calf, and only one cut was necessary. It could have been a lot worse.”

“It could have been a lot worse,” I thought to myself. Here I am, some thirty years later, and it is a lot worse.

I stand on my tip-toes to reach a little deeper into the cow. When I reach a little deeper, I find intestines. This is a large cow in a muddy pasture, and it is going to be dark soon. This has to be a schistosomus reflexus, but the fetus is not fully reflexed. This would be an impossible fetotomy, even for me when I was a young man. This is going to be a C-section, and it will be best to be done over at the vet school, where there will be more than one set of hands.

“George, this is a mess,” I said. “She has an abnormal calf in her. It is called a schistosomus reflexus. The calf sort of bends in two, backward, and the belly and chest are open. This one does not feel like it is fully bent backward, it feels sort of spread out flat. I am not confident that I can get it out. The best option would be to take her over to college and let them do it.”

Convinced that I am done working on the cow, I clean up as George and Sharon discuss the referral option.

“Okay,” George says. “Let’s go ahead and take her over there.” 

“Let me give them a call and make sure they will be waiting for you,” I said.

We called and made the arrangements, and George and Sharon loaded the cow up in their stock trailer and headed for Corvallis.

The school concurred with my diagnosis and elected to do a C-section. They used general anesthesia, which is risky in cows that have not been held off of food and water for an adequate time.

They were successful in getting the abnormal fetus out. George described the calf as a spider calf, one heck of a looking thing. 

Unfortunately, the cow died during the night. I never got any paperwork on the referral, probably because the referral was done on an emergency basis, and no paperwork was involved. My guess was that it was a death associated with the anesthesia. Still, I am sure the surgery would have been a difficult one. So, who knows. 

This was one of those cases where a lot of work was done, and a lot of expense was incurred, and there was no happy ending. 

With two, once in a lifetime events, I figured I was done with these schistosomus reflexus calves. I mean, what are the odds of having three.

Then, a couple of months later, came a late-night call to look at a cow for Alex and Debbie. A large Black Angus cow was in labor and some distress with no progress. When I arrived, she was laid out flat and straining, with no evidence of any progress.

“She has been like this for the last hour, maybe a little longer, Doc,” Debbie said. 

I cleaned her up and got down behind her. Actually, for these large cows, the exam is easier when they were laid out flat. More manageable, for the exam, but it can be a little difficult to keep oneself clean and dry. Thankfully, I had a good pair of rain bibs, and she was on a good bed of straw.

It did not take long to make a diagnosis. It had only been a couple of short months since I had worked on George’s cow. The calf in this cow was close to the same, but it was fully relaxed with four feet presented to the birth canal.

“This is not good, Debbie,” I said. “This is a fetal monster. In a large cow like this, it will be difficult to section it enough to get it out. The better option would be to go to the vet school for surgery.”

“How much is that going to cost?” Alex asked. 

“I sent a cow over there a couple of months ago for the same problem,” I said. “I don’t know what the bill totaled to finally, but it was over a couple of thousand dollars, I think. And the cow died.”

“We are going to have to think about that,” Debbie said. “This is a purebred, but she is nothing special. Actually, she is not much more than a commercial cow. I don’t think a thousand dollars pencils out for her.”

“Do you think we could make hamburger out of her, Doc?” Alex asked.

“You could eat her if you were starving,” I said. “But now, I think you would find the meat unacceptable. She is under a tremendous amount of stress, and this uterus is probably infected by now. If we are not going to try to save her, we should put her out of her misery now.”

That was the decision that was made. In the end, the feelings for the cow, and relieving her pain and distress became more critical than salvaging a few dollars. Their son ran to the house and returned with a 9mm pistol.

“How do we do this?” the son asked. “Shot her between the eyes?”

“The likely hood of missing her brain is high if you shoot her between the eyes,” I said. “If you are going to shoot her there, you want to use a large caliber rifle. With this pistol, you want to shoot her behind her poll, on the back of the head. That way, if you are on the midline, you can’t miss the brain.”

With that instruction, it was done. It was probably the best outcome for the circumstances. It was definitely the best financial decision. Sometimes in food animal medicine, one has to cut your losses. What may be the best medical decision is not always the best financial decision.

Photo Credit: Photo by Chelsea Cook from Pexels

Schistosomus reflexus links (These may not be pleasant to view for some people):

https://medcraveonline.com/JDVAR/images/JDVAR-02-00045-g006&7.png

https://inpractice.bmj.com/content/inpract/14/4/204.full.pdf

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1751-0813.1996.tb09988.x

A Bat in the Bathtub 

D. E. Larsen, DVM

It looked like it was going to be another warm September day. The sun shone through the trees as I backed the truck out and headed for the clinic. Not a cloud to be seen in the sky.

Judy was already at the clinic when I arrived. It was hard for me to get there before her. Once she had Andi off to school, she would drop Bryon off at the babysitter and come to the clinic. It was difficult for me to be there first.

“Sudi is on her way with a bat,” Judy said as I walked through the door. “She sounded a little excited on the phone.”

“I’m hoping this is a dead bat,” I said.

“She didn’t say. She said she found it flopping around in her bathtub last night,”

“She is probably going to want it tested for rabies,” I said. “I guess I better call the lab and check their procedures.”

“I don’t think you need to be in a hurry,” Judy said. “She is just going to drop this thing off on the fly so she isn’t too late for her class. I don’t know why they start school so early these days?”

“They like to be out of school early,” I said. “They don’t worry about the little kindergartener up in Cascadia who has to get up five to catch the bus.”

Our conversation ended when Sudi burst through the door holding a quart jar. The bat was still fluttering in the jar.

“Dave, I caught this thing fluttering around in our bathtub last night,” Sudie said. “Frank thought we should have it tested for rabies. He read were Oregon’s bats carry rabies.”

“Were the kids sleeping while it was in the house?” I asked.

“Well, they weren’t sleeping when I caught the thing last night,” Sudi said. “But I have no idea where it came from or how it got in the house. I figured the cat must have brought it in and let it go.”

“Did you handle it when you put it in the jar?” I asked.

“No, I just scooped it up with the jar and put on the lid,” Sudie said. “I was going to let it suffocate, but the kids threw a fit, and I had to punch some holes in the lid.”

“Okay, I’ll get this to OSU,” I said. “You will probably have to pay for the testing, but that might be good. That way, without human exposure, you won’t have to deal with the public health folks.”

“Just let me know when you get the results,” Sudie said as she pushed open the door to leave.

After Sudi left, I called the lab for instructions. I spoke with Doctor Johnson, a new pathologist, probably a graduate student.

“I have a bat to send over rabies testing,” I said. “Are there any special instructions?”

“We can only do the testing if there has been no human exposure,” Dr. Johnson said.

“The client found the bat flopping around in her bathtub,” I said. “She didn’t handle it, just scooped it up in a quart jar. She thought the cat brought the bat into the house.”

“That sounds good,” Dr. Johnson said. “Is the bat dead?”

“No, it is still flopping around in the jar,” I said.

“It is a real hassle for us if you send it alive,” Dr. Johnson said. “We don’t have any way to euthanize it here in the lab. We have to get one of the pathologists from the necropsy side to euthanize it for us.”

“So you want me to euthanize it before I send it over,” I said. “Does that count for a human exposure?”

“You are supposed to be able to protect yourself,” Dr. Johnson said.

“Okay, I’ll figure something out,” I said. “How long will the test take if I get this bat over today?”

“This is Friday, you know. You will probably not get any results until Tuesday or Wednesday, even if you get it over here this afternoon,” Dr. Johnson said. “It is just going into our refrigerator. Getting it this afternoon will allow us to get started on it first thing Monday morning. That way, we should have results on Tuesday.”

I hung up the phone, and Dixie was looking at the bat with a frown on her face.

“What happens if this thing gets loose in the clinic?” Dixie asked.

We took the jar into the surgery room, wet a cotton ball with a few drops of Halothane, and dropped it into the jar. The bat was asleep almost instantly. 

“How long is he going to sleep?” Dixie asked.

“Your guess is as good as mine, but we don’t have to hurry,” I said. “We will let him soak in there for a few minutes while I draw up some euthanasia solution. Then I’ll dump him out of the jar outside so we all don’t get gassed. It will only take a second to get this injection into his chest. Then it is off to bus depot with him.”

***

I hadn’t given much thought to Sudie’s bat until the phone rang on Tuesday morning. It was Dr. Williams, the state public health veterinarian. 

“Dr. Larsen, that bat you submitted to OSU last week tested positive for rabies,” Dr. Williams said. “I just wanted to make sure I had the fact right.”

We went over all the facts again. Dr. Williams agreed that there had been no human exposure to the bat.

“Do you know if the cat was vaccinated for rabies?” Dr. Williams asked.

I quickly scanned Sudie’s file. Luckily for the cat, it had a current rabies vaccine.

“The cat is current on its rabies vaccine,” I said.

“That’s good. It would have to be euthanized if it wasn’t,” Dr. Williams said. “It is recommended that you booster that vaccine now,”

“How many cases of rabies in bats do you see in Oregon?” I asked.

“We only see a handful of bats that test positive,” Dr. Williams said. “But we don’t test very many bats. About ten percent of the bats that we test are positive. But that doesn’t mean much. How many people just throw the bat in the garbage. To get an idea of a population incidence, we would need to capture and test a bunch of bats from around the state. The funds for that sort of process are not available. And we would have all sorts of bat lovers down on us for doing that. So, that’s not going to happen unless we were to get into a lot of human cases.”

We sent a message to the high school to have Sudie drop by the clinic after school.

I think she snuck out early because she was waiting to talk with me at three in the afternoon.

“The bat was positive for rabies,” I said. “Luckily, the cat was current on her vaccines, so the only thing we need to do is booster her rabies vaccine early. You, Frank, and the kids are fine, with no significant exposures.”

“Why were you asking about the kids being asleep?” Sudie asked.

“The public health folks consider it a rabies exposure if a bat is loose in the house with sleeping children,” I said. “If the bat is captured and tests negative, they are okay. If it tests positive, the kids have to get shots. If the bat escapes and is not tested, the kids must get shots if the public health folks know of the incident. Those shots are serious things. Some of the side effects, although very rare, can be serious. The problem is rabies is a fatal disease. So any possible exposure has to be taken seriously.”

“We had bats in the house all the time when we were kids,” Sudie said.

“So did we, Sudie,” I said. “We even kept a tennis racket in the upstairs bedroom for that reason. We were just lucky, I guess.”

Photo by Peter Scott on Pexels.

Catching Creek 

D. E. Larsen, DVM

I acquired this rendition of the Davenport portion of Catching Creek this Fourth of July. A good part of my early life occurred within the bounds of this sketch. 

If we refer to my story of Hallowed Ground, https://docsmemoirs.com/2020/05/24/hallowed-ground-prefaced/, I can explain the locations of that story.

At the time of the story, we lived on the Lundy ranch. It was off the page at the bottom. The Cow Horn field was part of the Lundy Ranch. This sketch is laid out as the creek flows from the top of the page to the bottom. Unlike most maps, the top of this sketch is west. Just over the hill at the top of Catching Creek Mountain, one goes downhill to the coast. Going down Flores Creek to Langlois.

The Hallowed Ground story starts at the cow bridge, seen crossing the creek near the top quarter of the sketch. We would have started the hunt by walking the road up to the Davenport Grove, framed by a large bend in the creek. This grove has been the setting for an annual Fourth of July celebration since 1904. The bend of the creek always held many ducks.

After hunting the grove, we followed the creek to the cow bridge. That is where the story starts and where the grouse was shot. The field across the creek had a massive myrtle tree in the center. That tree is not on the sketch.

The creek crossing, where we almost fell on the second crossing, was on a line from the cow bridge to the logging truck. The Bartlett land was located just up the creek as it disappeared off the sketch at the top of the page.

The two houses at the top of the sketch were located a little more up the creek. The first house is about where the log truck is, and the second is about where the first house is. Jim’s cabin was before my time. I had heard stories of the place but had never been to it.

We lived in the first house until I was four years old. The sketch doesn’t illustrate how the outhouse was located on a hillside behind the house. That was a difficult trip in my memory.

On our trip back down the creek, we would have crossed the cow bridge again and walked (or ran) down the middle of the field to the upper barn, where we would have returned to the road. 

The house on the driveway from the barn was Uncle Dutch’s house, and the next large house near the road was my grandparent’s house. My mother had been on ten children in their family. 

The lower barn is just across the bridge from up the creek; the other building has a garage. The outbuildings behind my grandparent’s house were the woodshed and the outhouse. Remember, they had a large family with six girls and four boys. The outhouse was an impressive three-seater.

We then ran down the road, past the Bee Tree, and around the creek to where the road left the stream at the bottom of the sketch. There were never ducks in the creek where it ran along the road. 

The cow was in the creek just above the “a” in Catching Creek at the bottom of the sketch. 

The creek was loaded with ducks from where the road left the stream, all around Horse Shoe Bend and around the tip of the Cow Horn to Camphor Creek. There were ducks from Camphor Creek down the creek, but the Catching Creek became brushy from there to the river and was hard to hunt.

Today there are no dairies on Catching and fewer cows in the pastures along the creek. The creek is brushy along most of its course. There are likely still a lot of ducks in the stream in the fall, but hunting them is almost impossible.

Davenport Grove is still a gathering place, but my generation is fading fast. Next year we will celebrate a hundred and twenty years of Fourth of July Celebrations.

Time marches on!

Sketch done by C. Vincent.