PeeWee

D. E. Larsen, DVM

It was early Sunday morning when the phone rang. We were not out of bed yet. We didn’t have any firm plans for the day, but we had discussed going up the Calapooia River to swim. The weather had been warm and dry, and we wanted to take advantage of the river while it was still running full and clear.

“Good morning, Doc, This is Oscar. I hope I didn’t wake you up, but I wanted to catch you before you headed to go fishing or something. I bought this little wiener dog the other day. Cute little guy, he is about 6 weeks old. I fed him a pork chop bone last night. Boy did he like that, he attacked that bone like it was alive. But Doc, this morning, he ain’t feeling too good. In fact, he is pretty darn uncomfortable. I think maybe that bone got stuck.”

“Good morning, Oscar, we were just laying here thinking we didn’t have a thing to do on this beautiful Sunday morning.”

Otto had been in the clinic a few times. Oscar was a large man, with broad shoulders and a muscular build, white hair that he wore in a crewcut. He was gruff to most people but well-liked by everyone. I could picture this massive man with large rough and calloused hands carrying a little 6-week old Dachshund puppy into the clinic. I always found it odd when big men selected small dogs, but it seemed pretty typical.

“I know Doc, it is a nice morning. I suppose you have kids wanting to go swimming or something. But Doc, I’m afraid this little guy won’t wait till Monday morning.” 

“Okay, Oscar, I will meet you at the clinic in an hour,” I said. “That will give me enough time to get up and dressed and help with breakfast for the kids.”

Oscar was waiting at the door when I pulled up to the front of the clinic. He had the little pup tucked in the crook of his arm. If you didn’t look close, you would miss him. Oscar followed me through the door, and we went right to the exam room. 

It was apparent the little guy was in distress. He stood on the table, trying not to move, with his head and neck extended.

“I call him PeeWee,” Oscar said. “I am not sure why we got him, but he is a cute little guy, and he really likes me.”

PeeWee’s exam was unremarkable except for his discomfort. I had not been in practice too many years, but I had already learned the bone in the throat presentation was never a bone in the throat.

“How big was this pork chop bone, Oscar?” I asked.

“Well, I don’t know, it wasn’t too big, maybe the size of my thumb,” Oscar replied.

Oscar’s hands were massive. The size of his thumb would make two of most other men.

“Are you sure he swallowed it?” I asked.

“He was sure chewing on it. And I looked everywhere, under the kitchen table and everywhere. It was nowhere to be found.”

“Will, let’s take an x-ray and see if it is in his stomach,” I said. “It could have just scratched up his gullet going down.”

I took PeeWee back to the x-ray room. Getting an x-ray on Sunday morning was no problem. The problem was waiting for the developer to warm up so it could be developed.

PeeWee was uncomfortable enough that he laid on the x-ray table without any restraint. I quickly snapped two views for the chest and abdomen. One lateral with him on is side and ventral-dorsal with him on his back.

Oscar and I chatted a little as we waited for the developer to reach a temperature that would be functional. I had watched Oscar at the bowling ally, often wondering if they had needed special bits to drill the holes in his bowling ball. 

When the x-ray was finally on the viewer, my heart sank. There it was, a massive bone compared to the small chest of a six-week-old Dachshund, lodged in his esophagus right at the base of the heart. I was unsure that it could be removed by an endoscope. Endoscopes were new things in veterinary medicine in those years. It would mean a referral to a specialty clinic to even have someone try to remove it. And in the 1970s, that meant a trip to a teaching hospital either in Davis California or Pullman Washington.

“Oscar, this is a bad as it can be,” I explained. “This bone is lodged at the base of the heart, right in the middle of his chest. The best way to get it out is to go to a veterinary teaching hospital and see if they can remove it.”

“Doc, that isn’t going to happen,” Oscar said. “I am setting here wonder how the hell I am going to pay you, there is no way I can go somewhere else. It is going to be fixed here, or we will just have to put the poor little guy to sleep.”

In the few years I had been in Sweet Home, I had learned that price was often a limiting factor to medical decisions. If you could fix it for a hundred dollars, that was fine. If it was going to be more, then there was a serious discussion of putting the critter to sleep.

“The only way I can get that bone out of this pup is with surgery,” I said. “That means opening his chest and opening his esophagus to remove the bone. The book says not to do that if you can avoid it, and it is a surgery that will be very difficult for me with one pair of hands. By very difficult, I mean it is over my head in this clinic. We could lose PeeWee in surgery or after surgery.”

“Doc, if there is a chance you can fix him, go for it,” Oscar said as he stood up, towering over me.

“I don’t know what it will have to cost, Oscar,” I said. “You could be paying several hundred dollars for a dead dog.”

“You do what you can, I will just have to come up with the money,” Oscar said. “Do you want me to sign something?”

“Your handshake is good enough for me,” I said, extending my hand as I gathered PeeWee in my left arm. Oscar’s hand engulfed mine, but I shook as firmly as I could. “I will do this today and give you a call when we are out of surgery. He is going to have to stay overnight, maybe two or three nights.”

I gave Sandy a call, telling her I was going to need a hand with surgery. That meant that the kids would have to entertain themselves at the clinic, hopefully, not for the entire day.

While I was waiting for Sandy, I began setting up for surgery. Any thoracotomy for me was major surgery. I was thankful that I had the foresight when I made my equipment purchase to include a ventilator. The problem with that was the size of this patient. I was worried I would have trouble setting the volume of the breath low enough to accommodate this little guy. 

When we got going, the first part of things was pretty standard. I induced anesthesia with Pentathol and then placed an endotracheal tube. With gas anesthesia, I ran a high flow semi-open system that was sort of autopilot. That changed when the chest was opened.

I prepped the left side of the chest and did a local block at the fifth intercostal space using lidocaine. 

Then with a deep breath and a glance at Sandy, I made my incision. When I opened the chest, we started the ventilator. It worked great, and Sandy could pause it as I needed. I turned off the Halothane to prevent getting the pup too deep in anesthesia. I would turn it back on only as needed.

Moving as quickly as I could, I spread the ribs with a retractor and pushed the lung lobes aside. There was the bulge of the bone in the esophagus. I dissected to the esophagus between the Vagus and the Phrenic nerves. Then carefully packed off the area with moist sponges. I incised the esophagus longitudinally, using as short of an incision as I could. I grasped the bone with forceps, and it slipped out, expanding the small incision only slightly. 

I used a two-layer closure of the esophagus with 3-0 Maxon. Being careful to ensure the endothelial layer was securely closed. I place a couple of sutures in the soft tissues between the nerves and then removed the packing. Then we carefully inflated the collapsed lung lobes.

I placed a chest drain and used a Heimlich flutter value on the drain tube. Then I closed the chest by pulling the ribs together with two sutures of 2-0 Maxon encircling the ribs on each side of the incision. When I closed the soft tissues between the ribs, it sealed the chest.

We overinflated the lungs to help evacuate the residual air from the chest. Closed the skin and secured the flutter valve to the chest wall. This valve was nearly as long as the chest. It was definitely not designed for a 6-week-old Dachshund puppy. It sort of looked like a muffler on PeeWee’s side.

After a small dose of Innovar for pain, we woke up PeeWee. Waiting as long as we could before removing the endotracheal tube, just in case we had some respiratory issues. I think PeeWee felt so good with that bone out of his esophagus that he was not bothered by the pain of the chest incision.

PeeWee’s recovery was remarkable. He was bouncing around, looking for breakfast in the morning. I think he was disappointed with his liquid diet. By the end of the day on Monday, I was able to pull his chest tube, and we sent him home. Strict liquid diet for a week, and then it depended on the recheck. 

Oscar was a happy man when he picked him up. I cautioned him again about not feeding bones and to be strict on the liquid diet. He pulled out three hundred dollar bills from his pocket and pressed them into my hand. Never asking what the bill was going to be, he shook my hand vigorously and walked out the door with PeeWee licking his face. I was happy with the three hundred dollars.  

Bison Calves on High Mountain Ranch

D. E. Larsen, DVM

Ruben and Mae Wilde owned High Mountain Ranch on Ames Creek in 1976. Ruben had made his money in the construction business. He bought the ranch and was now in the process of becoming a hobby rancher. He did not need the farm to produce a livelihood, but he needed something to keep him busy. 

Ruben’s answer was to do things a little differently from his neighbors. He would raise bison. Not many people around knew much about raising bison. There were not many bison around. That was Ruben’s first problem, where was he going to get these bison. Then Ruben was going to learn that the assumption that they were like raising cattle was false.

My first visit to High Mountain Ranch was to look at a bison calf the had puss draining from his hind leg. The previous owner had repaired a fracture on this leg before Ruben had purchased the calf. Ruben had purchased this bull calf and a female calf, both about six months of age, from an orthopedic doctor in Eugene. 

“Who repaired the fracture?” I asked as I was getting out of the truck.

“The doctor did it, with a cast, I believe,” Ruben answered.

I had not been in practice too long at this time. Still, I was already aware that some of the worst veterinarians were medical doctors. They would not accept any advice from a veterinarian because they knew everything. Their education gave them little appreciation of the variability of species. You could put a cast on a person and tell them not to bear weight for six weeks. Try doing that with a three-month-old bison.

“Bison are pretty hard to handle in a chute, but if we can get him restrained well enough, I might be able to get an x-ray of the leg. Then we will know if this infection has affected the bone. That is going to be a difficult task.”

“I have them both in the barn right now. I was hoping you could rope the little guy, and we could do it in there.”

“I have never had a rope on a bison calf, Ruben. That doesn’t sound like a viable plan, but let’s look at what we have,” I said as I sat things down and head toward the barn with Ruben trying to keep up with me. He had one leg shorter than the other and had about a three insole sole on his one boot.

The barn was old, probably built in the 1920s. Heavy timbers formed the supporting structure. Long 1 x 12 boards enclosed the building and interior walls, probably cut from number one peelers. Not a visible knot anywhere. Not painted, the wood had seasoned to steel gray. The wood was likely more valuable than the barn. 

Ruben lead me through the side door of the barn. This barn was more of a workshop than a stock barn. We threaded our way through this large workroom, cluttered with old farm equipment. Most of the items probable came with the place. I doubt if Ruben knew what they were. It did not look like he had moved anything in years.

“I have them in the haymow,” Ruben said as he pushed open the door just enough for us to squeeze through.

Ruben had the calves in the barn, but they were far from restrained. We were standing in a large empty room with a few traces of old hay. The floor was of heavy planks. There were no fences or pens, just a large room about 60 feet long and 30 feet wide. The calves stood side by side in the middle of this haymow, staring at us and getting more agitated by the second.

Before I could even begin to tell Ruben that there was no way we were going to get a handle on that calf, the calves started a slow jog around the haymow. I pushed my shoulders against the wall as they brushed past us. There was nowhere to go except back out the door. The calves picked up speed on their second lap around the room. 

“Ruben, there is no way we are going to get ahold of that calf. You will at least need to get them in the chute.”

“I couldn’t get them anywhere near the corral,” Joe answered.

The calves were at full speed on their third lap. I was alarmed for our safety and pressed myself back against the wall as they brushed past us, too close for comfort. I reached for the door. Ruben was right behind me. The calves didn’t do a full lap on their fourth turn, they cut the lap short and squared themselves up with the far wall of the barn. Going full speed, they hit the wall together. The wall never slowed them a bit. Boards flew in all directions. They knocked a hole in the side of the barn four planks wide. 

I looked at Ruben, and he was standing with his mouth open in disbelief. We walked over to the gaping hole in the side of the barn. I leaned out the new opening in the barn and surveyed the area, the siding boards were torn off in their full length. The calves had torn through the old fence just like they went through the side of the barn. They were across the first pasture, still going full speed toward the far corner of the place. “

Hopefully, they will slow down when they reach your line fence,” I said to Ruben.

“Ruben, I would call that doctor up and have him come to get those calves, there is no way you are going to be able to treat the infection in that leg.”

Ruben looked at the hole in the side of the barn and shook his head. “I guess you are right. He has a young bison bull. I could probably trade him these calves for the bull.”

“You need to get your fences in better shape and get your corral set up to catch a bison before you get another one. These are not funny looking cows. When I was in school, we were vaccinating a bison herd in Wyoming. I saw a bison almost kick a guy over the fence in a crowding ally. You might be better off raising llamas.”

I had hoped Ruben had learned a lesson on that day. Those hopes were trashed when I got a call from him a couple of months later.

“Doc, I have a real mess up here,” Ruben said, obviously short of breath. “This damn young Buffalo bull has just gored my pregnant sow. She has one hell of a gash on her side.”

“I have some time, Ruben, I can run up there right now. Where is this gash on the sow?”

“It is on the side of her belly. I hope it is just skin and muscle, I don’t see guts.”

“I’ll be right up.”

“Doc, if you are coming anyway, could you castrate this guy for me, and dehorn him at the same time?”

“We will have to hurry if we are going to do all of that. It will depend on how bad the injury is to the gilt. We will do the gilt first and do the bull if we have time. We can always schedule the bull another time.”

“I suppose so, but I don’t want to take a chance. If you have time, we need to do it today,” Ruben said with some finality.

“Will, if we are going to do it today, you need to have him in the chute before I get there. And I am leaving here in just a few minutes.”

The drive up Ames Creek was a short one from the clinic. It went by the house, if I was lucky, I could have time to stop for lunch with the kids on my way back to the clinic. The kids will enjoy that, maybe I can bring them a buffalo horn.

I was a little surprised to see the young bull buffalo in the chute as I pulled into the barnyard. Ruben was waiting anxiously. He wiped his brow as I was getting out of the truck and motioned to the pig laying in the shade of small shed. Actually a young sow, a gilt, with a large belly from a pregnancy. She had a jagged gash on the side of her abdomen, maybe 6 inches long.

“She has just been laying there the whole time since he attacked her,” Ruben said. “I think she is okay. She is sort of a gentle little thing, tame as a pet.”

I knelt beside the sow and patted her behind her ear. She shook her head and grunted a little.  I swiped the wound with a Betadine swab. I then started injecting lidocaine into the tissues along each side of the injury.

When the wound was deadened, I scrubbed it and the skin around it with Betadine. I explored it both with my finger and visually as best I could. It was deep but did not get into the abdomen. I applied a small amount of Furacin powder for some local antibiotic benefits. The placed a half-inch Penrose drain in the deepest portion of the wound, giving it an exit port through the skin below the injury. 

The closure was relatively quick. I used #2 Dexon in the muscle layers in a simple continuous pattern and repeated that for closing the subcutaneous tissues. Then I closed the skin with #2 Nylon. 

With the wound taken care of, I injected her with a hefty dose of Polyflex for the antibiotic. Then I gave a standard dose of dexamethasone for the shock. I sprayed the wound for flies, even though we were probably early for that problem.

True to Ruben’s word, when I stood up, she rolled up on the chest and stood up also. Almost as if I had told her she was okay to go. She shook her whole body, grunted again, and walked out toward the pasture.

I drew up a couple of doses of Polyfex for Ruben and instructed him on how to give them.

“You need to monitor the wound for a couple of weeks,” I said. “I will be back in a few days to check the wound and remove the drain.”

“That will be good,” Ruben said. “I can take the sutures out after that.”

“Yes, that will be okay,” I said. “But don’t get in a hurry. If everything is okay, we will leave those in a full 2 weeks.”

“Now, let’s take care of this fellow,” Ruben said, motioning to the young buffalo bull in the chute.

We went over to the chute, and I leaned on the bar to tighten the squeeze as tight as I could get it. The problem with bison in the squeeze chute is their size is all in the shoulders. It doesn’t matter how hard you squeeze them, their hips are free to move somewhat.

Standing on the right side of the chute, I put a strong tail crank on the bull. Pulling the tail back up over his back. I instructed Ruben to hold in that position from the far side of the chute.

The bull jumped a little when I grabbed his testicles and squeezed them into the bottom of his scrotum. After that initial jump and with the tail crank, he settled down pretty well. With my scalpel, I made a quick slice down each side of the scrotum.  The incision was deep enough to cut through the tunic and into the testicle. There was no response from the bull.

I expressed both testicles out of the scrotum and grabbed them with my right hand. I pulled them down, stretching the cords until I could fell the cremaster muscles break. Now the testicles dangled several inches below the scrotum. One at a time, I applied the White’s Emasculator to each cord, nut to nut, and squeezed with both hands. This severed the cord and crushed the vessels all in one motion. I held the squeeze for 20 seconds or so.

I held the testicles up for Ruben to see. They were smaller than I would expect. A bovine bull this age would have testicles twice this size. Maybe this was one reason for the relatively low fertility in the bison population compared to cattle.

“You want these for breakfast?” I asked Ruben.

“You have to be kidding,” he replied.

I tossed them out toward Ruben’s two dogs. They were unsure what was coming at them and jumped out of the way. Then they slowly returned to the testicles on the ground, carefully sniffing, then each grabbing one and moving in different directions. Pleased with the morsel.

I continued the scrotal incision through the bottom of the scrotum, so there would be no pocket to catch any drainage. Then I sprayed the scrotum with Furacin spray and the whole area with fly spray. When Ruben released the tail, I sprayed the tail switch liberally with fly spray.

I went up to the head and looked at the horns. These were a real set of horns. I had dehorned older bovine bulls with horns that did not come close to these, especially the size of the base of the horn. 

“Are you sure you want this done,” I asked Ruben. “This is going to leave massive holes into the frontal sinuses.”

“Will they heal,” Ruben asked.

“Yes, they will heal,” I said. “It is just going to surprise you.”

“I don’t want to deal with a goring again,” Ruben said with a sense of finality in his voice.

I tried to put nose tongs on the young Bison bull, but he was not going to let that happen. He was squeezed tight enough that his head was pretty secure. I pulled my cordless clippers from my bag and started shaving the hair around the base of the horns. This hair was dense and long. When I had the hair cut from around the horns, they looked even larger than before. They must have been at least five inches in diameter. I scrubbed the base of the horns with Betadine Scrub and then injected the primary nerves with a large dose of lidocaine. I injected four nerves on each horn, at the top and bottom, and each side of the horns.

When the horns were numb, I pulled a six-foot length of OB wire saw out of its container. I attached saw handles on each end and seated the wire snuggly around the base of the horn. I took the handles in hand and leaned back to apply pressure to the wire saw and started with long slow strokes. As the saw passed through the skin and soft tissues and engaged the bone, I quickened my pace. Smoke rose from the site and an odor that would put the old-time dental drills to shame. 

“Ruben, grab the tip that horn,” I instructed as I made the last few strokes.

The wire saw came free of the tissues, almost white-hot from the friction, and Ruben had the horn in his hand. Ruben looked at the massive hole into the frontal sinus and gasped.

“I see what you were trying to warn me about,” he said.

There was no bleeding. The heat of the wire sealed the ends of the arteries. The large artery at the bottom of the hole was pulsating. It would be spurting six or eight feet in the air if not sealed by the heat, and any rub could break that seal. I grasped this large artery with my forceps and gently stretched it out, one inch, a little more, then it broke, and snapped back into the tissues. A small amount of blood came from the hole. This allowed a firm clot to form deep in the soft tissues so there would be no significant blood loss. I repeated the process with the lesser arteries around the base of the horn. I powdered the gaping wound with Furcin powder and trimmed a piece of filter paper to cover the wound, attaching it with a couple of dots of back-tag glue.

With the first horn done, the second was completed the same with a new piece of wire saw. The wire saw could often be used on each side, but the amount of bone being cut made it dull enough to warrant a new length of saw wire.

When the horns were both done, I sprayed the head with fly spray. Then I went and got a single injection of Dual Pen for antibiotics and a dose seven-way blackleg vaccine.  

“I don’t often use antibiotics following castration and dehorning, but you would probably have trouble getting this guy back in a chute,” I said to Ruben.

“Yes, I doubt that he would be fooled with some grain next time,” Ruben said.

I picked up the horns as I headed back to the truck. “Do you want these?” I asked.

“No, you can take them if you want,” Ruben replied.

If the kids are interested, the dog will have a new chew toy, I thought.

Photo by christie greene on Unsplash

Charlie

 D. E. Larsen, DVM

  It was a bright sunny afternoon in early June when I pulled up to the gate of the McCubbins’ farm. Frank had a llama with a vaginal prolapse, and she was close to her delivery date. When I got out to open the gate, I noticed a feral momma cat with a litter of 4 kittens. The kittens looked to be about 5 – 6 weeks old. The remarkable thing about the litter was there was one Siamese cross kitten with long hair. My kids would love that kitten, but the whole group scattered when I tried to approach them.

  I continued on to the barn after closing the gate. Frank and his grandson were waiting for me at the barn. I casually mentioned the litter of kittens as I was collecting my things to deal with this llama. Vaginal prolapses are simple to deal with when they occur following delivery but are always tricky before delivery. One has to replace the prolapse and secure it in place without obstructing the birth canal. Careful monitoring is one option if the vulva is sutured closed. That is always unreliable, and if the vulva is sutured closed, the baby will die in a short time if it is stuck in the birth canal.

  Today I was going to try a trick not taught in my schooling but relayed to me over dinner at a local veterinary association meeting by on old veterinarian over twice my age. After carefully washing the prolapsed tissue, I lubricated the mass and carefully pushed it back in place. She did some straining, and it was evident that she would push things out again. 

  Now for the trick. I washed a wine bottle one last time and rinsed it with betadine and lubricated it with KY jelly. I carefully inserted the bottle into the vagina, blunt end first. It would serve as a pessary, preventing the vagina from prolapsing again. When the cervix dilated, and the baby entered the birth canal, the bottle would be easily pushed out and followed by the baby. This was a trick from the 1930s, or maybe before. The results were expected to be far better than any of the modern methods.

  Frank and I were talking while I was cleaning up and putting things away. He was intrigued by the story of how professional information was passed from one generation to the other. Often information from older generations never made it to the textbooks but still prove to be very functional. 

While we are standing there, Frank’s grandson approaches with the Siamese cross kitten in his hand. I asked what he was going to do with him as I carefully checked him over. The kitten was covered with ringworm.  

  “I’m going to keep him.” he replied.

  I told them that was fine but to be careful of the ringworm. I told Frank I would be happy to take the kitten if the ringworm became a problem.

  It was probably 2 weeks later when Frank called the office.

  “Are you still interested in taking that kitten?” he asked. “I have a grandson who is covered with ringworm.”

  Frank was happy to deliver the kitten to the clinic. We started with an anti-fungal bath and topical treatment. Naming him Charlie, he was an irresistible kitten. Even with careful treatment and stern warnings, our kids also developed a few ringworm lesions before Charlie’s skin was clear.

  Charlie proved to be a super cat. He grew large, measuring nearly 3 feet from the tip of his nose to the tip of his tail. He was a ferocious hunter. There was nothing safe in the back of our property. We had many molehills when Charlie arrived; by the beginning of Charlie’s second summer, he had eliminated the entire mole population.

  I would leave the bedroom window open and unscreened during the night, and Charlie would come and go as he desired. It was common for him to bring his trophies and leave them at the foot of our bed. Mice and bats were standard fares. One night I heard him come through the window, and he jumped up on the bed. This was something he did not do on any regular basis. Next thing I knew, he dropped a mouse on my neck. Thankfully it was dead.

  During Charlie’s 5th year, he went hunting one evening and never returned. There was nothing, Charlie just didn’t come home. Probably caught by a coyote. Or maybe by the great horned owl who hung out on the creek side of the hill.

  Charlie was missed by the whole family. But the return of the molehills was most disturbing.

Photo by Alena Vertinskava on Unsplash 

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