Consequences of a Popular Street Drug 

D. E. Larsen, DVM

Prologue:

I have told this story before with a little different format. That story was titled ‘The Elk Hunt.’ This story adds content and discusses current concerns about popular street drugs.

***

Frank and I waited in the truck while we watched the small elk herd make its way down to the apples we had scattered on the ground.

Every year, for the last several years, I had sedated Frank’s bull elk to saw his antlers off. If left with his antlers, he would kill the much smaller sika deer bucks during the rut.

I was anxious to see how a new capture drug would work this year. In previous years, I had just used Rompun. It did a good job for the most part, but it could all excited animals to take sudden defensive movements. I was constantly worried that I would end up like one of the little sika bucks with an antler through my chest.

Frank stepped out of the trunk when the bull was comfortable eating the apples we had scattered on the ground.

“I hope this drug works as well as you claim,” Frank said in a hushed voice.

He stepped in front of the truck and waited for the bull to turn broadside to us. Frank raised the capture gun to his shoulder, aimed, and fired all in rapid succession. 

Whop! The dart stuck in the hind leg, a perfect shot. Frank returned to the truck, and we waited. The drug took effect quickly. The bull stumbled about a bit and then went down on his knees. He settled to the ground slowly and rested on his sternum briefly before flopping onto his side.

With the elk on the ground, I grabbed my bag and hurried over to him. I didn’t know how long I would have to work. I cut a four-foot piece of OB wire and hooked it to the handles. With long rapid strokes, I sawed through both antlers in a short period of time. The smell reminded me of the old slow-speed dental drills.

With the main job done, I drew a couple of tubes of blood for routine testing. I applied nearly an entire tube of ophthalmic ointment to his eyes for protection against drying. This class of anesthetic drug reduced the blink reflex. Then finally, I gave him a dose of the dewormer, Levasol.

Ten minutes after I was done, the bull elk righted himself onto his sternum, rested momentarily, and sprang to his feet. He was confused for a few minutes but quickly returned to normal and headed up the hill to join the group of cows.

“That was just about perfect,” Frank said. “It’s nice to have a drug that works so well.”

“Yes, I would have liked a little longer duration, but I would guess we could control that with a little Rompun or some addition Sernalyn,” I said.

I got my things back in the truck and headed for the clinic. I was pleased with the results and figured this would be a very useful drug for me in large animal anesthesia.

*** 

A couple of years later, Fred Briggs, the drug salesman, stopped by the clinic at the end of the day.

Fred always tried to arrive at the end of the day. That way, I usually had time to talk with him, and he lived in Albany, so it was a good way for him to wind up his day on the road.

“I have bad news for you today, Doc,” Fred said. “I know you have been using Sernalyn for several years.”

“Yes, it’s almost a perfect drug for the capture gun and has some use in large animal anesthesia,” I said.

“Ketamine has become a popular drug on the street,” Fred said. “And Sernalyn is twenty times more concentrated than ketamine. It is very valuable on the street, and the good old DEA and FDA are going to discontinue the drug.”

“When is this going to happen?” I asked.

“It has happened,” Fred said. “They are not recalling any product, and you can use what is on the shelf, but we can’t order any of it. We can sell our inventory, but then that’s it. I can sell you one last bottle today if you want it.”

“I guess I’m not keen on stocking discontinued drugs,” I said. “If they are going to be gone, you just as well learn how to get along without them. But I will talk with Frank and see what he wants to do.”

***

Sernalyn was gone, and we were back to using Rompun alone. Then, out of the blue, the DEA changed M-99 to a Class 2 drug, and this would allow for clinical use. I called Frank.

“Frank, they have changed M-99’s classification,” I said. “It is available for clinical use now. Are you still interested in ordering it?”

“I worry about this elk escaping, and we would have trouble capturing him,” Frank said. “It would be nice to have a dose or two available. I will pay to put it on the shelf.

So, I placed an order for M-99 and didn’t give it much thought. Then, when I returned to the office after lunch a few days later, two gentlemen dressed in suits and ties were waiting for me.

“You must be Doctor Larsen,” the first gentleman said. “We are from the DEA, and we are here to check out your facility for the use of M-99.”

“You changed it to a Class 2 drug,” I said. “I figured it was no different than any other Class 2 drug.”

“It is a thousand times more potent than morphine,” the second gentleman said. “That makes it very valuable on the street.”

“I have this client with a number of exotic animals,” I said. “He worries that we would have trouble capturing them if they escaped. We just ordered one vial to have on hand for an emergency.”

“Okay, that sounds reasonable,” the first gentleman said. “Now we need to look at your inventory sheet and then check your Class I safe.”

“I don’t have an inventory sheet,” I said. “I just placed the order.”

“In that case, your inventory sheet should read zero,” the second gentleman said.

“And what is a Class I safe?” I asked. 

“It is like the safe that would be in that bank across the street,” the first gentleman said.

“Well, I have a safe deposit box in that bank across the street,” I said.

“That would work just fine,” the second gentleman said. “You could store the M-99 in your safe deposit box.”

“But if it is in that vault, I wouldn’t have access to it during an emergency when that bank is closed,” I said.

“I guess not, but that is the storage requirement,” the first gentleman said.

“Well, I won’t mess with the order then,” I said. “If I can’t access it, there is no reason to go to the expense of putting it on the shelf.”

That ended the discussion. The DEA downgraded the drug, but they still considered it required special handling. And Frank and I were stuck with using Rompun.

***

Epilogue:

Currently, in 2023, this country is seeing a new craze for street drugs. Rompun, xylazine, is combined with many drugs, fentanyl, heroin, and others.

The news media is doing a great job directing those interested in acquiring the drug to any small veterinary clinic where a simple burglary would yield the desired product.

When I practiced in Enumclaw, Washington, in 1975, there was a rumor of a guy who broke into a veterinary clinic in Seattle and stole some Rompun. They found him not far away, flat out in the street, unable to move. I have no first-hand knowledge of that event, but it was repeated often at every veterinary meeting of the time.

This new problem with “Tranq” threatens the availability of a long-standing drug in everyday use in veterinary medicine. 

https://en.wikipedia.org/wiki/Xylazine

https://abc7.com/tranq-xylazine-zombie-drug-fentanyl/12895509/

Photo by Jonathan Cooper on Pexels.

Egor, From the Archives

D. E. Larsen, DVM

Egor was a large mix breed dog.. He was large enough that he could have had some Saint Bernard in that mix. His massive head sat on a body with a broad flat back that reminded one of an aircraft carrier’s flight deck. He weighed over 110 pounds and was generally treated on the floor of apparent reasons.

Joe first called for me to see Egor in September of 1976. I was doing house calls, then as the clinic was still several months from completion. Egor was 9 years old at that time, and he was beginning to show his age.

“Good morning, this is Joe, I was hoping you could look at my dog, Egor. He has a torn toenail.”

Joe and Kathyrn lived in a small house. The living room was cluttered with knickknacks, mostly old clocks, and antiques. Then, when you put a couch and two chairs in the small room, there was little room to work on a large dog. We moved to the front yard.

“This toenail is broken back into the quick,” I explained. “This is going to be painful for a couple of days, even after I clip it. We are going to have to do a nerve block on this toe, and that might be painful also. Hopefully, Egor is going to let me do this.”

“Egor is a tough dog,” Joe said, breathing hard from the short walk to the front yard. “You can do anything to him, and he won’t move.”

I had Egor sit and picked up his paw. When I inserted the needle in each side of his toe and injected a good dose of Lidocaine for a nerve block, he did not even flench. We waited a few minutes to make sure the nail was numb. Joe’s breathing was improved with the short rest, but you could still hear every breath as he struggled to exhale. 

I wiggled the broken portion of the toenail, watching Egor closely. If he felt anything, he was not showing it. I took my nail scissors and snipped off the broken portion of the nail. The blood flow was enough that I was glad we were outside. I held a cotton gauze on the bleeding nail for a moment and then put a silver nitrate stick on the point of bleeding. It took a couple of minutes, but finally, the bleeding stopped.

“What if that starts to bleed after you are gone?” Joe asked.

“All bleeding stops, eventually, one way or the other,” I replied. Joe did not understand the comment, or he didn’t think it answered his question.

“If it starts bleeding, you give me a call, and I will come back, I am not too busy yet, and I live just a little way up Ames Creek,” I replied.

That was the first of many visits with Joe and Egor. It was always a sight to see Egor coming to the clinic door with Joe hanging onto the leash, struggling to keep up. They would come through the door, and Joe would grab a chair, entirely out of breath. Egor would be wagging his tail as he went into the exam room. Joe always waited in the chair.

In April of 1978, Egor developed acute kidney failure. His prognosis was poor.

“He means the world to me, Doc,” Joe said. “I can’t give up on him. If you can do whatever is possible to save him, I will find a way to pay you.”

“He is a huge dog, Joe,” I said. “There is less than a 50% chance he can survive, and treatment is going to be expensive.”

“My wife has all sorts of antique clocks,” Joe said. “You can have your pick of the collection.”

“Okay, Joe, we will do as much as we can. But you must know, there are no promises. Sometimes, all the money in the world cannot buy a cure.”

“I understand that, Doc,” Joe said. “But without Egor, I won’t last a week.”

“We will keep him, at least 3 days, probably more likely a week,” I said. “I will keep you posted on Egor’s progress.”

“I can’t take him home at night?” Joe asked.

“I am going to be running IV fluids around the clock,” I said. “He is going to need to stay if we are going to have any chance of saving him.”

Egor was a great patient. He was very ill, had IV tubes hanging everywhere, and we were coming at him with needles for a blood draw or an injection multiple times a day. His tail always wagged. He hated the bland food he was allowed, but he would lick your hand when the bowl was put in the kennel. 

After three days, he greeted me with a bark and a bounce when I came into the kennel room. He was feeling better. His kidney numbers edged back toward normal. When I called Joe, I tried to instill only cautious optimism.

“Good morning, Joe,” I said into the phone when he answered, only allowing a single ring. “Egor is improved this morning. His kidney numbers are close to normal this morning, and his urine has some concentration to it. He is not well, but much to my surprise, he is improved.”

“Does that mean I can take him home?” Joe asked. “I have been worried to death that he is going to die down there, Doc. I know we all have to go some time, I would just like to be with him when it is his time.”

“I would like to keep him one more night,” I said. “I will take him off the IVs, and we will see if his kidneys can maintain him on just water.”

Egor bounced out of the clinic the next day. He almost knocked Joe over, he was so happy to see him. Joe had no understanding about how incredibly lucky we were to be seeing Egor go home. We loaded him down with a case of kidney diet food and oral antibiotics. I was not confident that Joe would have the strength to keep Egor on the special diet for an extended time, but for today, everybody was happy.

“You and your wife come by the house this evening and pick out a clock,” Joe said as he and Egor went out the door.

“Do you think they have a clock that is worth enough to cover this bill?” Judy asked.

“I guess the value of an antique is based on perceived worth,” I said. “Seeing those two go out the door together, is a pretty precious event in its self.”  

Sandy and I dropped by Joe’s house that evening. Egor greeted us at the door as if he hadn’t seen us in weeks. Sandy and Kathryn looked over the clocks as I sat and talked with Joe and Egor.

Sandy selected a modest mantle clock. Kathryn had some large clocks that she felt had a higher value and tried to get Sandy to make a better selection. We had discussed our needs before we stopped, and we needed a clock that we could display, not one that took up a lot of space.

The Clock is still on our mantle.

Egor did well over the next months. Not perfect, but pretty well. The bland, low protein, diet required in Egor’s long term management did not appeal to either Joe or Egor. My guess was that Joe tried but likely cheated some.

Egor was losing a lot of protein in his urine and losing weight. His kidney numbers continued to hoover close to normal, and he maintained his high spirits. But when he would drag Joe into the clinic, it was evident that neither one of them were their old selves.

Joe died in October of 1979. The family decided that Egor was too ill, and too lonely without Joe, to go on. They brought Egor to the clinic for the last time a couple of days following Joe’s death. We were busy that day, and Egor was left in a kennel for a short time before I could find a few minutes for him. This should have been nothing for Egor.  He had been in this very kennel for days at a time in the past.  

Egor sat in the kennel and howled a loud, mournful howl, as I have never heard a dog howl before or since.

If ever a dog knew his fate, Egor knew!

Photo by Jozef Fehér from Pexels

The Powers That Be

 D. E. Larsen, DVM

I always hated looking at a group of cattle for someone I did not know. They often wanted you to look over the fence and give them a diagnosis rather than running them through a chute for an individual diagnosis.

Just looking over the fence for the diagnosis was risky in the best situations. But with herds that I worked with on a regular basis, I would occasionally provide that service for simple things.

I mulled over the situation as I was driving to a herd of heifers that had recently arrived from Montana, and one heifer had aborted. The possibilities were endless, all the way from travel stress and trauma to infectious disease.

I was relieved when I pulled up to the corral, and there was a heifer in the chute.

George met me when I stepped out of the truck. We shook hands. I had heard of George, but this was our first meeting. He was professional, with a practice in Eugene. He had a small ranch here in Brownsville and ran a small herd of cattle, probably as an investment. More for land speculation than making money from cattle. But most of these guys had all the answers before they asked the questions.

“This truckload of heifers came in last night from Montana,” George said. “This heifer aborted during the night. I just thought we should do some diagnostics on her. I mean, I don’t want something that will go through the entire bunch.”

“What do you know about the place they came from?” I asked.

“I guess I don’t know much,” George said. “The whole deal was done over the phone. I do know a guy who knows the guy who owned the heifers.”

I glanced at the heifer in the chute. She had ear tags, like the rest of the group, and she had a brucellosis tag. She also had membranes hanging from her vulva.

“Let me look at their health certificate,” I said.

“We didn’t do a health certificate,” George said. “The guy said he ships cattle into Oregon all the time without a certificate.”

“Do you have a brand inspection?” I asked.

“No brand inspection either,” George said.

“George, how do you know these heifers were not rustled?” I asked.

George was quiet after that question. I don’t think the possibility had entered his mind.

“The guy sounded honest, and he has a ranch,” George said.

“You might want to think about the ownership thing,” I said. “I am sure that Montana considers a brand inspection a big deal. Here in the valley, it is a pain in the butt because we don’t have any range animals. I am not sure what Oregon will say about no health certificate and no permit.”

“The state shouldn’t know anything about it,” George said.

“If you want some testing done, I will send samples to Oregon State Diagnostic Lab,” I said. “Several abortion diseases are reportable. Once I send the samples, it is completely out of my control. I will probably be a little at risk if I don’t quarantine this entire group. But if you can assure me they are not going anywhere, I will wait until we get lab results.”

“I would be pissed at a quarantine,” George said.

“Then you should be following the rules,” I said. “If you just received the shipment, you are probably not at fault. The shipper would be the one in violation.”

“Would they do anything with the cattle?” George asked.

“They should, but I doubt they would do anything,” I said. “The state veterinarian doesn’t have any police powers. So if it was considered a problem, he would have to go through the sheriff. I doubt that would happen unless there was a major outbreak. The rules are set up to protect all the producers in the area. If someone imports a disease into the area, everyone here could suffer. If it was bad enough, the entire state could suffer.”

“It sounds like some significant liability could be involved,” George said. 

“With the travel history and stress involved, this abortion is probably just the luck of the draw,” I said. “Let me get some samples, and I will get them sent to the lab, and we will worry about things when we have something to worry about.”

I did a clinical exam of the heifer and collected blood and urine samples. I also removed some of the membranes from the uterus and collected a sample of histopath exam.

“Do you want all her tag numbers?” George asked.

“No, I will just use her bangle tag,” I said. “She is too young to be eligible for a brucellosis test, so I don’t need that number.”

“When will you have results?” George asked.

“I will have a currier pick up these samples when I get back to the office,” I said. “We could have some blood and urine results by late afternoon. The histopath on the placenta will take several days. To be honest with you, we seldom end up with a diagnosis on most abortions like this.”

“So, I will just wait for your call,” George said. “Do I need to do anything with this heifer?”

“I am going to give her some long-acting antibiotics and put a couple of boluses into her uterus,” I said. “Other than that, I don’t think you need to do anything with her.”

Once I got back to the clinic, it didn’t take long to package the samples and send them to the lab.

It was about four-thirty when Dr. Johns, the pathologist, called. Dr. Johns was new to the lab and fresh out of school.

“I ran the serology you requested on that heifer from Montana,” Dr. Johns said. Everything was negative, so I went ahead and ran a brucellosis titer. I showed a pretty strong positive.”

“That heifer was too young to be test eligible,” I said.

“Well, with this high titer, I have already contacted the state veterinarian,” Dr. Johns said. “It will be a few days before I get to the histopath.”

***

I had just hung up the phone after talking with Dr. Johns about the histopath results on the placenta. He had found nothing. So the diagnosis was negative except for the brucellosis titer.

Sandy brought Dr. Wilson back to talk with me. He was the field veterinarian from the state veterinarian’s office.

“I just finished looking at that heifer that aborted out in Brownsville,” Dr. Wilson said. “Why didn’t you submit the brucellosis tag and tattoo information on the test sheet?” 

“That heifer was not test eligible,” I said. “Dr. Johns did that test without a request from me. I send all my brucellosis tests to your lab in Salem.”

“Well, it turns out that the heifer was vaccinated late, she was over a year of age at vaccination, and she is still under two years of age, so she was not test eligible,” Dr. Wilson said. “That test should have never been done.”

“I sort of think that pretty much matches what I just said,” I said. 

“That is a serious oversight on your part,” Dr. Wilson said.

“Now, just a damn minute here,” I said. “I spent four years in the Army and watched how the powers that be found the easiest underling to punish for any problem that developed. Let’s review this situation. A truckload of heifers come from Montana without a health certificate and without a brand inspection certificate. I send some blood samples to the lab on a heifer who is not eligible for a brucellosis test. Still, the lab runs a brucellosis test without my request. Then you come in here and chew my ass.”

Dr. Wilson was silent for a couple of minutes. I waited for his response.

“I see your point,” Dr. Wilson said finally. “I guess your actions were not out of line.”

“I guess when a client calls and asks about a health certificate, I should tell him not to worry about it because the state office doesn’t worry about it,” I said.

“Now that’s not the case,” Dr. Wilson said.

“My point is, if you are not going enforce your rules, throw your damn book in the trash,” I said. “This BS of putting everyone through the trouble and expense of following your rules and then just shrugging your shoulders when someone ignores them is a bunch of crap.”

“What would you have me do?” Dr. Wilson asked.

“I not asking you to do anything,” I said. “l especially don’t want you to do anything to my client. He was almost a bystander. But the guy in Montana should be looked at a bit. I guess I’m just asking you to put down your coffee cup and do your damn job.”

Dr. Wilson left, I think, in a bit of a huff. Public employees always think they are overworked. But I am sure his phone hasn’t rang at three in the morning anytime in the recent past.

Photo by Sinitta Leunen on Pexels.