by Gillian Hick
‘I’ll ring as soon as I’m finished. Try not to worry,’ I reassured her. If only I could follow my own advice.
Although sedated, Gemma thumped her tail softly as I injected the anaesthetic into her vein. Her head slumped on the table as the drug took effect. Soon she lay, clipped and prepped, under the green surgical drapes. I couldn’t help but imagine the faces of three anxious little girls as I sliced into the smooth skin. Thick wads of fat covered the midline and had to be separated before I could incise into the abdomen. At least now I would know what exactly the problem was.
I stared in disbelief as I examined the coils of intestine; the colour ranged from healthy pink to congested red, to purple and, in parts, to the blackish colour that every vet dreads. As I carefully manipulated the loops of inflamed tissue, I could get an impression of a hard, irregular substance filling several sections of gut. In between, the loops were bloated with gas. I was well aware of the correct technique of ‘milking’ the foreign body to a piece of healthy intestine and incising into that loop to remove the offending article. But in this case, it wasn’t possible as the obstruction was in not one but several portions of the intestine and seemed to be well trapped in the thickened muscular rings.
Starting with the biggest section, I cut through the muscle wall and could feel the sharp point of the scalpel blade scrape off a metal-like substance. Picking up a forceps, I grasped the edge of the foreign body and tried to ease out the irregular, elongated mass. I winced as the sharp edges snagged the delicate lining of the gut. Having pulled out a piece approximately ten centimetres long, I unravelled it to find out what it was: the shredded remains of a Chinese takeaway container. If this had been the only section of the gut to be damaged, I could have just removed the damaged necrotic section and rejoined the healthy ends, but it was nowhere near that simple. Gently, I manipulated the next portion of damaged gut out of the abdomen and carried on easing out loop after loop of intestine, in varying degrees of necrosis. By the time it was all spread out over the sterile laparotomy sponges, it was clear that there was precious little healthy intestine left. I wondered how on earth Gemma could have looked so well and shown so few clinical signs with the extensive damage inside.
Without remembering the exact detail, I could recall a study from college days where dogs had survived with large portions of their intestine removed. However, the damage to Gemma’s intestine was so extensive that I wasn’t confident that she could survive if I were to remove it all in one piece. My only alternative was to remove each section separately. I began the painstaking job of repairing the damaged gut as best I could. I struggled trying to decide which pieces to remove and which to retain. I sweated as I made long incisions into the damaged tissue, as there was no way I could pull out the metallic container without tearing the gut. I vaguely remembered from my surgical lectures how an incision should never be more than … was it one and a half times the diameter of the gut?
My fingers ached as I rejoined lengths of gut where I had had to remove a dead section. It seemed to take hours as I fiddled with the tiny lengths of suture material. My back ached and my eyes were blurring by the time I had finally finished. I flushed large volumes of warmed saline through the abdomen, hoping to remove any intestinal fluid that might have leaked out. With the last syringeful, I added some soluble antibiotic. Carefully, I wrapped all the repaired sections in the glistening omentum, the supportive sling that cradles the internal organs. I hoped it would do its job and soak up any leakage from the rejoined sections. Soon, all that remained visible of my work was a neat row of sutures in the skin. I shuddered to think of the horrors that lay hidden beneath.
While waiting for Gemma to wake up, I rang Teresa. The phone was answered on the first ring. I recognised the babyish tones of Kate.
‘Is my dog better now? Mummy told me you’re going to cut out the bad bits.’
‘Gillian, I’m sorry about that.’ Teresa sounded flustered. ‘How is she?’
I paused. ‘I’m sorry, Teresa, but it’s not looking good.’ As painlessly as I knew how, I explained my worries.
Teresa couldn’t hold back the tears as I told her what the culprit was and she remembered. ‘We had a Chinese on Wednesday night. When the container was gone the next morning, I assumed Frank had thrown it out. I should have known better. How could I be so stupid? It’s just the sort of thing she’d go for.’
‘Don’t blame yourself,’ I consoled her. ‘It can happen so easily. But right now it’s up to Gemma. She’s a strong dog. She may just pull through. I’ll let you know how she is tonight.’
‘Of course, and listen, thanks so much for everything. You sound absolutely exhausted.’
I sincerely hoped she would have something to thank me for. A niggling doubt in my mind kept asking if I should have operated sooner.
By Tuesday night when the Kennys returned, Gemma was ready to go home. I had been in touch with them a few times a day and I had reassured them that everything was going as well as could be expected. Despite my cautious warnings, Teresa became more enthusiastic with every passing hour.
‘I just know she’ll pull through,’ she kept saying.
I didn’t like to put a damper on her hopes, but I couldn’t forget the mess of intestine beneath the neat row of stitches.
When Teresa and the gang arrived to collect Gemma, the enormous bouquet of flowers almost hid the three small girls as Sarah and Kate struggled to carry them. Mary brought up the rear with a card not unlike the one Gemma had got.
‘We love you. Thank you for making our dog better. From Sarah, Mary and Kate.’
While thanking them profusely, I cautioned Teresa. ‘It’s not all over yet. It takes at least five days for the wound to heal. There’s an awful lot of damage inside.’
‘I know, but just look at her. She looks so well.’
I said nothing but hoped, as I had never hoped before, that my doubts were mislaid.
I heard nothing for two days.
I was just beginning to relax when on Friday morning, I opened the waiting room door to see Teresa, Gemma and the girls inside. I quickly ushered the kids off to Roger with the promise of a lollipop if they didn’t try to kidnap him.
‘She’s been in absolutely brilliant form, better than ever before. But she didn’t eat very well this morning. I thought you’d like to see her.’
I cursed to myself as I read her temperature. One hundred and three. This was just what I had been dreading. Gemma winced as I palpated her abdomen. I could just imagine the contaminating fluids leaking from the sieve-like gut into the abdomen, and the resultant peritonitis. I shook my head slowly at Teresa.
‘This is what I was afraid of. We’ll have to keep her in again.’
The lollipops consoled the three girls enormously when I explained to them that Gemma would have to stay with me again.
‘She must like you an awful lot,’ said Kate nodding her head wisely.
I hoped they would still like me when this was over.
I rang an older and more experienced colleague to look for advice.
‘Should I try opening her up again?’
‘Good Lord, no. There’s nothing more you can do than what you’re doing already. By the sounds of it, the whole thing was a disaster from the start. I think you’ll lose her, but still, you never know …’
I wished I hadn’t rung him.
I seemed to spend the next three days either with Gemma or on the phone to Teresa. Gemma was getting steadily worse.
‘If she’s no better by tomorrow, we’ll have to start thinking if it’s fair to let her go on much longer,’ I said quietly to Teresa.
She wasn’t able to answer me.
The next morning, Gemma was dead.
I couldn’t believe it as I stared at what remained of the once majestic animal, the ‘big sister’ to three bright and happy young girls.
I broke down when I rang Teresa to tell her.
‘I’m so sorry,’ I said, so aware of the inadequacy of t
he words.
I never saw Teresa or her three little girls again. I don’t know if they ever got another dog or if they had lost faith in me – either way, I couldn’t blame them.
CHAPTER FOUR
A HELPING HAND
I am fully convinced that to the day I die I will be absolutely useless at dehorning cattle. From the time I first qualified, it seemed that the simple act of detaching cattle from their horns was not for me. After a few hopeless attempts high up in the Dublin mountains during my first year in practice, I wasn’t too concerned at my seeming lack of natural aptitude for the job – after all, at the time I didn’t seem to have a natural aptitude for anything veterinary related! But, as time passed, I gradually found myself becoming less useless at certain jobs, and on certain occasions I really thought I was becoming in some way competent. But with dehorning cattle – or ‘skulling’ as it was known – I seemed to make little progress. Within a short time, I became proficient at injecting the local anaesthetic to numb the nerve supply to the horn. I enjoyed carefully inserting the needle in under the ridge of bone knowing that any further resentment on the part of the animal would be purely due to being handled and not due to any pain. After that, however, everything would start to go wrong. For a whole month I used nothing but the crange – a large metal guillotine-type instrument. Strong yearlings and two-week old calves alike, I towered over them brandishing the huge blades and, yes, it did work fine on the small calves, apart from a slight difficulty in balancing the enormous instrument on the 3cm-long stumps that would one day become horns. Meanwhile, anything with a decent-sized blood vessel would bleed profusely the instant the heavy blades met.
‘It’s the angle you have wrong,’ assured one of the vets I had seen practice with. ‘Get it at more of a slope and you won’t get bleeders.’
But, no. I still got bleeders.
‘You want to get further down the horn, right in tight to the skull,’ said another. ‘But be careful,’ he added, ‘I remember once I went too tight and I cracked her skull. She ended up in the factory.’
So then I tried the embryotomy wire – a heavy-duty, sharpened metal wire attached to two metal handles which was looped around the base of the horn, allowing the horn to be sawn off. Apart from the fact that every time I dehorned a beast it was like having a work-out in the gym, I thought I was getting there. Yes, they still bled a little bit, but it didn’t look quite so gruesome. However, one particularly hardy bullock destroyed my progress. The first horn was tough going and my face went from various shades of pink to red, to beetroot, to purple as I valiantly sawed, thrashing around in unison with the furious animal, but eventually the offending horn did drop to the ground. Resisting the urge to retch, I flopped at the side of the crush until the shaking in my shoulders and wrists had subsided enough to have a go at the second side. Off I went again, sawing and sawing, but the more I went on, the less progress I seemed to make. Back and forth I sawed, until the wire stopped, trapped deep in the horny tissue. With a bit of assistance from the farmer, who seemed sympathetic enough to my plight, I managed to release the wire as he pushed against the cut edge of the horn. Only a few strokes in, the same thing happened, but this time nothing would budge the wire. It was as though the heat created by the burning had welded the wire into the horn.
Too exhausted to be embarrassed, I went back to the jeep to get the crange to finish off the job. The temptation to drive away and never come back was almost irresistible. As the wire was wedged in the horn just exactly where I wanted to place the crange, I knew that this was going to be yet another botched job. The torrents of blood that shot out at all angles as soon as I had cut off the offending horn was like none before, and despite my best efforts, poking and prodding with a forceps, the unfortunate beast was still bleeding heavily by the time I had finished. I wearily picked up a strand of baling twine and tied it tightly around the base where the horn had once been, until the bleeding stopped. It would have looked absurd enough, but with the length of wire still firmly wedged at the base of the horn it looked ludicrous. The twine was removed the next day by the farmer and the bullock suffered no ill-effects, but to this day, if he is still alive, that strand of wire is still stuck in the remnant of his horn.
By this time, I was into my next season and some of the farmers were ringing to complain that some of the ones I had dehorned the previous season had started to grow horns back again as my cautious nipping off of the top did not remove the base of the growing horn.
Now I changed tack and, having given up on my own skills, I tried the animal welfare issue. No sooner would a calf I had safely delivered drop to the floor than I would begin a lengthy lecture to the farmer on the merits of early debudding: by burning the developing bud of horn at a young age any further horn growth would be prevented.
‘You can’t beat it,’ I would plead with them. ‘Do it now and it will save all the hassle and expense later on. You won’t believe how much they will thrive,’ I would plead. ‘You won’t set them back at all in the autumn time.’
Farmers that I would meet in passing at the local mart or in the co-op would equally be awarded one of my lectures. I was convinced I had gone too far, however, when after a tough caesarean at three o’clock one morning, I earnestly delivered my speech to the bewildered farmer, who was obviously too polite to point out that the calf was a polled breed and never would grown horns anyway!
My final solution was to avoid the issue at all costs. It was amazing the excuses you could come up with if you tried hard enough. It was incredible how often the blades in the crange had broken that very morning or I had just used up my last bit of embryotomy wire on a difficult calving.
‘Sure, not to worry,’ the farmer would say good-naturedly, ‘you can do them when you come back in three days’ time to read the test.’
When a call was booked specifically to dehorn, I would bargain with whichever other vet I was working with at the time.
‘Okay so, you dehorn the two bullocks and I’ll do your evening clinic for you tonight,’ I would offer, knowing that an hour and a half-long clinic would be easier. I got very ingenious, but I couldn’t get away with it forever.
* * *
I was right at the top of the Sally Gap one fateful day when I got the dreaded message – three to be dehorned in Laragh. As I was the only vet on call that day, it had to be me and I had been through every excuse in the book.
‘Listen, James,’ I said to the farmer on the phone, having introduced myself, ‘about those bullocks you have for dehorning today, it’s no problem at all to do them, but it’s just that I’m on my own today and I have a lot of calls in and it’s very busy, so is there any chance we could leave them till next week?’ I ended lamely before I started to gabble too much.
‘Sorry, Gillian, and I know I left it late, but we had a bit of trouble at home here – one of the chaps was sick in hospital. Those bullocks are due to go to the mart next week so I really need to get them done today.’
There was nothing for it; it would have to be done. As I pulled up to the yard, I noticed that it was actually a car-repair garage with a small bit of land attached. They were obviously part-time farmers, which did nothing for my impending sense of doom as I knew it meant that the handling facilities were less likely to be adequate.
Having prepared my syringes of local anaesthetic and the antibiotic powder, I pulled on the well-worn, well-washed overalls that I reserved specifically for skulling cattle.
It’ll be fine, I assured myself calmly as I made my way up to the garage. Just three small weanlings. I’ll be done in no time. I tried to remind myself of all the successful dehornings I had done in the past. That didn’t take long.
I called out around the yard, but could find no-one. The shed was empty, apart from three enormous well-horned beasts, penned in the corner.
Ah no, I thought to myself, it couldn’t be them.
It was. I couldn’t believe that these three cattle, with mature horns as thick as miniatur
e tree trunks, were to be my patients for the morning.
As I shouted into the garage, a young lad came out looking none too pleased to be disturbed.
‘Is James around at all?’ I asked, courteously.
‘No, he had to go off,’ he replied curtly, before turning away to resume his work.
‘Well, I’m here to dehorn the cattle,’ I replied, trailing lamely after him.
‘They’re in the pen for you,’ he told me, without raising his head. ‘Work away.’
My patience was beginning to fade. ‘Well, I’ll need help with it. If not, it’ll just have to be done another day.’
‘He said he needs them done today but he had to go out,’ he answered, without enthusiasm, dashing all my hopes.
‘Okay,’ I said, resignedly facing the inevitable. ‘But, I’ll need you to help, so.’
You wouldn’t have died of excitement with the monosyllabic conversation that followed between us. I just about got out of him that his name was Declan and that he lived in Dun Laoghaire. The nearest he had come to cattle, until now, was looking out the window of the garage where he was serving his apprenticeship. In his favour, he was at least six feet tall and looked as though he worked out most nights of the week. I carefully injected the local anaesthetic under the rim of bone that covered the nerve supply while he held determinedly onto the metal tongs as the bullock tried in vain to whip his head away. As I worked under Declan’s scornful gaze, I was relieved that, so far, everything seemed to going quite smoothly, considering the odds. Having waited a few minutes for the local anaesthetic to take effect, it came to the part where I placed the blades of the crange around the enormous horns. I gradually pulled the handles open as far as I could, but this came nowhere near wide enough to get anywhere near the base of the horn. I pulled again and although I managed to open them a centimetre or two wider, it was still nowhere near wide enough to do the job.