Run Oskee, Run!

Run Oskee, Run!

Thursday, June 4, 2015

I have the BEST! job!!

I truly love my job. Yes, there are days I don't want to get out of bed, and there are nights I just don't want to go on another call but there are the days that make me smile from ear to ear and remind me why I chose this profession. Those are the days you live for and look forward to, and those are the days that keep you going and keep looking forward to the next adventure!

Well for me, I had one of those days last Friday. It started out a little nerve racking and busy but for the most part it was going smoothly. I had walked up front for just a brief moment when one of the receptionist kindly let me know that one of our clients was on their way with a cow calving. Now, most calvings are no big deal. You may have to work at it a little but generally the calf comes out the back end eventually. I was told the cow had arrived and when I went to the back the vet tech had the cow in the chute and ready to go. I had my coveralls and boots on, I sleeved both arms and lubed up. Immediately I could feel the feet. The calf was coming backwards and he (I did not know at this moment the calf in fact was a he, that info came later) seemed a little twisted but I could feel him try to kick my hand away as I grabbed his feet. I wasn't sure he would fit through the pelvis, the feet seemed a little big, but I thought I would give it a shot. I mean, no doctor wants to jump straight into a C-section! I was able to secure the chains (When I say chains it sounds so harsh, but generally if you position them correctly, chains are very easy on the calf's legs and do not cause any harm) to the calf's feet easily. I then attached the chains to the come along (a device to help slowly pulled the calf out when arm strength just isn't enough) and we started to crank. The feet started to emerge from the backside but I quickly realized this wasn't working. There was no way this calf was going to fit through his mama's pelvis. The cow would deliver via cesarean.

I asked the tech to release the come along to loosen the line attached to the calf's legs. I could hear her trying to get the come along to release but nothing was happening. When I looked back I could tell there was a problem! We COULDN'T get it released! Quickly panic starts to set in as we cannot release the line connected to the calf's legs!!! I didn't know how much time we had before we lost the calf! I tried to help, the farmer tried to help...but still no release! I started to run up the the front to see if someone up there could get this thing to release! I stepped out of the chute running! Some of the lube I had put on my sleeves earlier had fallen on the concrete making it extremely slippery. The Lube in combination with my no traction rubber boots caused me to go heals over on the the hard concrete as I tried running to the front for help! With a few curse words I popped right up and continued running to the front as everyone watching me gasped, too stunned to laugh or say anything. If it had not been such a serious moment I'm sure everyone would have had a good laugh (as I am now as I recall the events of this day...hehe).  But anyway...After what seemed like an eternity, I finally decided to release the cows head...she would back up and we could remove the chains from the come along. Oh GOOD! The cow was free and the tension was released on the calf! Now the work really began. 

You may or may not know, but c-sections on cows are performed standing, well for the most part. You can do them on their back or laying down on their side but I prefer it when they are standing. For the most part they do quite well. You shave their side from ribs to hooks (The boney part of their pelvis that sticks out.) Lidocaine is injected into the skin and muscle for pain control, the surgical area is scrubbed and an incision is made!   

The cow was doing great as I made my incision. Once into to abdomen I could feel the calf inside the uterus. At this point I could appreciate just how big of a calf we were dealing with I knew this was going to be an uphill battle. Arm deep inside the cow, I could feel the front legs of the calf...all the way on the other side of the cow. As I tried to grab the feet and pull them toward my incision the cow decided to push. With that push, a large portion of her rumen (the largest part of the cow's stomach) popped out of my incision. I quickly tried to push it back through the incision but she kept pushing. I was using my whole body to keep the innards in while trying to get the calf out. I asked Dr. Bill to quickly give an epidural. I was thinking that the epidural would help stop the severity of the contractions, which it did...a little. I continued to try get the calf in a good position to make an incision into the uterus. Dr. Bill sleeved up and tried to move the calf, but it was hopeless. The only solution now was to make an incision into the uterus blindly. (Side note: one of the instruments we use to make and incision in the uterus is a letter opener. Yes, like the plastic ones you can almost always get from a grain elevator. I used one that was actually shaped like and ear of corn.  They are usually sharp,(usually, but have an extra just incase) and the way they are designed protects the calf and the organs on the outside of the uterus).

Once the incision was made I could locate and put chains on the front legs. Well, As I start to remove the calf from the abdomen her rumen and intestines started to come out. What made it worse was that the cow started to lay down. Dr. Bill, Sherri (the vet tech) and multiple assistants tried to keep her standing, as I frantically tried to replace the abdominal organs and keep everything clean. But as much as we tried the cow went down in a not so graceful fashion. I had to regroup. As Dr. Bill held her Rumen I was Able to guide the calf's head and legs out as the many assistants pulled the calf out of the abdomen! Finally we delivered a LARGE, red and white  ALIVEcalf!! I was so happy the calf was alive but I had other problems! The rumen and some intestine were still outside the body. As I put everything back inside we washed everything off with distilled water. We needed to flushed the abdomen before starting to stitch everything back together, so Dr. Bill handed the vet tech a 5 gallon bottle of five star water and we started flushing the abdomen. Once things were as clean as I could get them I started sewing everything up. Thankfully from this point on everything went smoothly. While I closed the incision the vet tech gave additional painmeds, IV fluids and antibiotics to mama as baby tried to get use to his(at this point we knew it was a boy) new world. The calf was trying to stand before it left and Mama got up and walked onto the trailer just fine! I talked with the Owner's son a few days later and he reported mama and baby were doing well.

Throughout this whole process Dr. Bill was reliving some of his most memorable C-sections, of course he said to me, "You have it much better than I did. Most of mine were done in out in a muddy field or pasture with only a garden hose to clean them up." I relish days like this! This was not scheduled appointment and our clients with appointments graciously waited as we finished this emergency.  While it was very stressful in the moment and there a millions things going through your mind, nothing can beat the feeling of a live calf and cow going home to the farm! Not every surgery turns out this way and not every c-sections leaves you with such a great feeling. But, when one of those days comes along, it just makes me say...I have the BEST Job!~

I hope you enjoyed reading this as much as I enjoyed doing this C-section. 

A special thanks to Dr. Bill, Sherri, McKayla, Sinclair, Holly, Courtney and all of the onlookers for your help and support!

Until next time,
Doc E

Monday, June 1, 2015

Fighting Blastos!

This post was written last week, but better late than never!

I had realized this morning that I had not written in quite a while so, I sat down to start and nothing came. The good thing about my job is that you never know what will walk through the door and sure enough an idea for a blog post walked in first thing this morning. 

The day after a holiday is always busy, especially when the holiday is on a Monday. Over the years we have learned to expect these busy times and schedule accordingly. We had many calls, from my cat is lethargic to my dog is vomiting, even a ferret with a wounded ear. There was one call that seemed fairly routine...a smaller cattle dog had been seen Friday for limping, today she is no better and her left eye is hazed over. The owner just wanted her looked over. When I read the appointment, I immediately had a sneaking suspicion of what this particular furry friend was fighting. On presentation she was happy and alert. She was a timid girl but only wanted to give kisses as I examined her. Her left eye was definitely hazy and the whites of her eyes were red and inflamed. She was also limping on her right front and her carpus (Wrist in human terms) seemed swollen. I went over my findings with the her owner and we agreed upon more diagnostics. Along with my assistants we were able to shoot and x-ray of her chest, get a urine sample and drain a small amount of fluid from her front leg. When looking at the fluid under the microscope I could seem some dark purple organisms, some of which were budding from each other.  I knew right away my suspicion was right! This little girl is fighting Blastomycosis. More commonly called Blasto, is a fungal organism which most commonly affects bone , eyes, lungs, lymph nodes and skin .  I sent off a test to confirm the diagnosis and ultimately she went home on antifungal medication. 

I hope this little girl does just fine but she has an uphill battle ahead of her. Unfortunately there is nothing we have that prevents this nasty fungal disease. These organisms are out in the environment. Not every dog exposed will get the disease and severity can differ between patients. I would never encourage owners to keep their pets inside just on the chance that they may contract this fungal disease, but it is something that we at least on a yearly basis. I hope this post can shed light on a disease we as veterinarians see but is not as widely know with owners.

Over that course of the next several weeks/ months we will keep in close contact with the owner and how our furry little friend is doing.