Don't Turn Your Back in the Barn (Adventures of a Country Vet)

by Perrin, Dr. Dave

  When I warmed enough to move my fingers, I milked the heifer and fed the meagre ration of colostrum to the calf by stomach tube. She would probably need the next few meals that way, but her tongue should return to normal size within a day and allow her to suck on her own. Her mother still looked rough but, unless I missed my guess, she'd be up and around in a few days.

  This had been a difficult day from the start. Most of the appointments on the book this morning had yet to be done! Doris was doing her best to pacify clients but, as the emergencies stacked up, she was becoming frustrated. Luckily, two of the appointments were in-hospital surgeries that we could do at our leisure—contingent, of course, on there being leisure time before the day was over.

  I had just cleaned up from the caesarian and sedated a rambunctious little spaniel for neutering, when the phone interrupted again. Doris was struggling to pack up the large-animal instruments, but she wasn't making much headway. I watched her expression as she talked on the phone and surmised that our day was not getting any smoother. Adjusting her glasses, she took a deep breath and turned to me.

  "Dan Hurford's on the phone. He has a cow he's really worried about. Do you want to take the call now, or would you rather phone him back?"

  "I'll take it now. How about holding Jake for me?" Yes, this was going to be one of those days!

  "Hi Dan, what's up?"

  "Number 202 looked a bit off this morning at milking. I wasn't too concerned about her at the time; just jotted her number down for you to look at her tomorrow. I walked through the barn a few minutes ago to check for heats and found her stretched out in a stall. She looks terrible! I had a heck of a time getting her up. When I did, she staggered and dragged her hind feet all the way to the sick pen."

  "How long's she been milking?" I was going through a mental checklist of possibilities.

  "She's fresh about three and a half weeks now and was really coming into her own for milk until today. She's squirting out manure like water, and her eyes are terribly sunken. If you don't get here soon, we'll be doing a postmortem on her for sure!"

  "I'll head out right away. Doesn't sound like we can waste any time!"

  It was raining when I left the office, not heavily, but steadily—the type of rain that over twenty-four hours is a real soaker. I started the car and turned up the radio. The CBC was interviewing the outgoing president of the British Columbia College of Physicians and Surgeons. They were discussing cutbacks in the medical field—how Canadian standards of care were on the decline.

  The good doctor went on at length about the difficult conditions that his colleagues were forced to work under, about the inadequacies of both surgical facilities and emergency rooms. According to him, they were dealing with a true crisis, and the poor physicians were struggling to cope. I thought of this morning's experience and wondered how he would view his own working conditions if he had the opportunity of kneeling next to me on that soggy hillside, a fine drizzle falling onto his surgical field. I couldn't help but feel that a day with me might change his perspective considerably.

  By the time I drove across the flats and turned down the lane to the Hurford farm, the rain had become slush, and a residue of ice was building up under the wiper blades. This time of year, the weather couldn't quite make up its mind, and an hour one way or the other made the difference between rain, or sleet, or snow.

  I reluctantly stepped out of the car into heavy wind. Sleet whipped against my face, and I had to close my eyes to slits in order to see. I shivered as cold inched its way to the bone; I took a moment to adjust my scarf to cover my neck. Facing the wind, I stumbled to the milking room door and heaved it open. Dan was waiting for me in the coffee room, a bucket of water ready to go.

  A few years younger than I, Dan was a dynamo. He was lithe and handsome, energetic, and determined to make their family farm one of the finest in the valley. Along with his brother, David, he did his best to keep up with the night life and often returned from a party just in time to fire up the compressors for the morning milking.

  "Can't understand what's going on with this cow," Dan groused, as we walked to the sick pen. Shaking his head in disgust, he fumbled with the twine that held the side door closed. "I swear her eyes are sinking more by the minute!"

  A big Holstein lay at the far end of the pen, her head stretched out in front of her. Her tongue protruded slightly, and she emitted a faint grunt with each breath. Her hair stood up in a disheveled fashion. Her tail was wet from diarrhea, and the straw beneath was covered with dark, undigested particles of stool.

  "Do you think she'll be able to stand?" I asked.

  Dan slipped a rope halter over her head and tightened the sliding knot under her chin. "She wasn't very steady when I put her in here a half hour ago, but she's always been strong-willed. She's one of those cows that works hard without attracting much attention."

  Dan moved to her side and made a few quick plunges, driving the point of his knees into her rib cage. "Come on girl! Come on! Get up! Get up!" He slapped her sides with the flat of his hands as he shouted. Number 202 made a half-hearted effort to rise, shifting herself only a few inches from the ground.

  "Yeah! Come on, girl! Give it a try!" Dan urged, as she settled back to the straw. This time her effort was more determined, and she struggled to an erect position. Shaking violently and shifting unsteadily from one leg to the next, she appeared ready to fold at our feet. We stood one on either side of her to help keep her from collapsing sideways. Finally, she planted her feet and stood resolutely.

  "Just can't believe how quickly this cow has gone downhill!" Dan shook his head in dismay. "She was milking close to a hundred pounds a day and looked fine at milking last night."

  I began a methodical examination, as Dan stood by her hind end waiting to steady her if she moved. The cow's udder was devoid of milk, but felt completely normal as far as the texture was concerned. I struggled to get enough milk from each quarter to do a mastitis test and wasn't surprised when it tested clear.

  Grabbing the fetid tail as close to the base as possible, I inserted the thermometer into her rectum and waited patiently. I had no sooner removed it than she sent a jet of watery, foul-smelling stool over her tail onto the straw-covered floor. Her temperature was only

  37.3 degrees Celsius—more than a degree below normal. I took a quick listen to her chest. Her lung sounds were normal and, although her heart was pounding rapidly, I could hear nothing unusual. There were no sounds of rumen contraction on the left side, but no evidence of anything else out of the ordinary.

  As soon as I moved the stethoscope head to the right side and flicked the rib cage, I heard it—the deep, resonant, high-pitched, ringing sound of an extremely distended organ. The textbook described it as the sound of a coin dropping into a metal milk can.

  No wonder she was going downhill so rapidly! The cow's main stomach, the abomasum, was twisted off so that, although fluid could accumulate, it couldn't leave to be reabsorbed lower in the bowel. She was literally taking fluid from her bloodstream and depositing it in the gut.

  "She's got a torsion of the stomach, Dan. We'll have to do surgery right away."

  "How's that different from a displaced abomasum? We've had lots of cows with that, but I've never seen one this sick."

  "That's because the circulation's still fairly normal when the abomasum's just displaced. It's more a problem of discomfort and the stomach contents not moving along normally. With a torsion, the circulation's cut off completely, and the cow goes into shock and dies in a matter of hours."

  While Dan clipped the hair from 202's right flank, I ran a couple of bottles of dextrose and some dexamethasone into her jugular vein to help her failing circulation. I scrubbed her side, then went on to administer the injections that would leave her surgery site free from pain. I poked aggressively at the skin where my incision would go. Blood trickled from the series of puncture holes, but the cow gave no indication that my actions were causing discomfort.

  Stri
pping to the waist, I began scrubbing my arms from the shoulders down. I hadn't warmed up from this morning's episode; repeating it now just didn't seem fair. What a shame to leave those warm clothes in a heap on the straw.

  The only bright spot of undressing in cold weather was that farmers invariably sympathized with me. As he watched me scrub, Dan zipped up his sweater and pulled down his toque. He helped me don the surgery gown and gloves. Although little more than a thin layer of cotton and a thinner layer of latex, the covering made me feel better on some ephemeral psychological level.

  I quickly made my incision. A pencil-thin red line leaked a fine stream of blood down the cow's side and onto the straw. I clamped a disposable drape to her side and was about to resume cutting, when she started sinking.

  "No you don't, 202!" Dan hollered, giving her a jab in the ribs. "Stay up now, girl! Stay up!"

  The cow hovered in a couched position then, with a bit of a struggle, planted her feet, locked her hocks, and stood firm.

  "Good girl, good girl. Just stay on your feet. Boy, we're gonna be lucky to get this one done before she goes down."

  Shifting unsteadily from one hind foot to the other, 202 swayed dangerously on several occasions. Each time Dan was there, jammed against her left hip to prevent her from toppling over.

  Resolutely, I made a stab incision through the muscle, then extended it with scissors. I snipped through the peritoneal layer and heard the air rush in to fill the contracted area of her flank. Extending the incision in both directions, I reached into her abdomen and towards her head.

  There it was, as huge and distended as an elongated beach ball. No question that it was the abomasum—there was the fatty, white mesentery around its outer edge.

  "Well, are we in the right ballpark?" Dan's voice was playfully sarcastic.

  "We certainly are!" I stood back and retracted the wound margins. "Come have a look!"

  Slowly backing away from the cow, he stood for a few seconds to make sure she wasn't going to topple over. Satisfied, he came to my side and stared attentively into the abdomen.

  "Boy, that's bigger than any we've ever had before. What about that colour? It's almost purple."

  "Yeah, if it's still the same after we deflate it, then we're in deep trouble. If it turns pink again, it means we still have circulation and she has a fighting chance."

  I drove a large needle with an attached rubber tubing through the uppermost portion of the abomasum. A hissing sound emitted from the end of the apparatus, and the acrid smell of sour gas soon filled the air.

  For the next ten minutes, we steadied the cow between us and waited patiently for the air to evacuate. Even with most of the pressure removed, poor 202 showed little sign of improvement. I reached into the abdomen and followed the contour of the fluidfilled organ to the location of the twist. The animal moaned in agony.

  "You're sure doing something she doesn't like!"

  I grasped the pendulous upper portion of the stomach and rotated it in a counter-clockwise direction. The tension suddenly relaxed, and the organ fell into its natural position.

  "Look out! She's going down!"

  As if she had been shot, 202 crumpled to her brisket. My arms inside her, I dropped to my knees in a frantic attempt to keep her abdominal contents from boiling onto the ground. Dan's efforts to hold her up forced her further in my direction, and her body flopped onto me with an oppressive force. Flailing with her hind legs, she pushed even harder towards me, literally pinning me to the ground. Jets of bowel pumped out with each bit of additional pressure.

  "Oh, my God!" Dan was trying without success to bend the cow's hind legs and get them back under her. "Are you all right?"

  "Not really!" My back and calves were screaming with pain. "Try to get her to roll the other way!"

  Pulling madly on the manure-sodden tail, Dan fought to pull her onto her other side. The effort only made the cow more determined to push with her hind legs and grind her incision into the dirt. Great mounds of bowel accumulated in the dam created by my chest and arms. I was tempted to simply push myself away and let the bowels spill out onto the straw.

  "The legs, Dan! Get the legs!" She struggled again and forced more bowel into the pile building in my arms.

  Wrestling with her, Dan battled until both hind legs were jammed under her abdomen. As I heaved on her vertebrae, Dan levered her head and pushed mightily on her right front shoulder. At first, it seemed that we were attempting the impossible but, ever so slowly, the cow gave up to crumple onto her side. I followed forward with my burden of bowel. Surprisingly, the drape and my surgery gown had protected it from being fouled with straw and manure.

  "Will you look at that mess." Dan stared at her in disgust. "Should I get the gun?"

  "Not yet." Struggling to straighten my cramped legs and balance the guts on top of her flank, I worked my hands out of her cavity and started pushing the bowel back in. Progress was slow at first, but eventually, the last of the intestine disappeared through the incision and into her abdomen.

  Grasping the abomasum again, I brought it to the incision site. It was almost pink in colour, and its wall appeared to have already contracted considerably. I located the portion of the fatty mesentery that looked very much like a pig's ear, pulled it into the incision, and began suturing it into the closure. Tacking it in the suture line was meant to hold the organ in place, preventing the possibility of a future displacement.

  Surprisingly enough, the remainder of the surgery was pretty routine. Granted, it would have gone much faster if I hadn't been soaking wet and cold from all the peritoneal fluids. The incision closed nicely, and there had been a minimum of contamination to the abdominal cavity.

  Before I left, I pumped ten gallons of hot electrolytes into the cow and injected antibiotics. Dan was convinced that she was a tough cow and was going to make it. I was hoping he was right.

  "For heaven's sake, Dave," Doris exclaimed, as I entered the office, "you're absolutely filthy! You'd better hurry and get cleaned up. Mrs. Reynolds'll be here any minute."

  I deposited the surgery box and my dirty coveralls on the counter in the back room. Doris rolled her eyes and shook her head as she viewed the instruments and dirty laundry. Rolling up her sleeves in disgust, she plucked out the surgery gown.

  "How did you get this so mucky? Were you rolling around on the barn floor?"

  I opened my mouth to reply, then smiled and headed upstairs to wash and change. I looked longingly at the deep, old-fashioned tub. I was tempted to run it to overflowing with hot water, then submerge myself with only my nose sticking out.

  I stripped off my clothes. My upper torso was coated with 202's blood in differing degrees of dilution. My arms were bloody and smeared with a few dollops of manure for good measure. My knees had taken on the pale green of the manure pack that I knelt on for the latter half of the surgery, and my upper thighs were covered with the same mixture of peritoneal fluid and blood that had done such a nice job of staining my undershorts.

  Kneeling in the bathtub, I splashed water onto my body. A shower would have been heavenly, but this spit bath was just going to have to do. The warm water sent paroxysms of shivering through me, and my flesh was soon covered with goosebumps. Slathering on the soap, I loosened the crusts of caked-on blood and splashed on handfuls of hot water. As good as it felt, it was only a tease; I kept visualizing the tub filled with luscious hot water.

  I thought I had done a decent job of cleaning myself up, but the colour of the towel after I dried suggested otherwise. I threw on underpants and a pair of jeans.

  As I passed the refrigerator, I flung open the door to the same uninspiring scene that had driven me to the restaurant for yesterday's meals. The lettuce had gone beyond the usual stages of wilt and was well along in the liquefaction process. I gingerly picked it up, touching only the plastic bag that contained it, and flung it into the garbage. The cheese and bread were salvageable; they were only mouldy. Mould was something that, as a bachelor, I was well sc
hooled to deal with. I trimmed off the crust and a patch of green from two pieces of whole wheat bread and was diligently carving mould from the cheese when Doris hollered up the stairs. Mrs. Reynolds was here with Gidgit, and one of the Ramseier brothers was back in about a sick cow. It was the third time one or both of them had been in this afternoon.

  Stuffing the dried-out cheese sandwich into my mouth, I pulled on a pair of socks, grabbed a shirt, and rushed downstairs. Doris was busy talking with Mrs. Reynolds about Gidgit, so I choked down a bite of my sandwich, deposited the rest on the counter, and rushed out to talk to Mr. Ramseier.

  "Yes, Doctor." Bob's gaze focused on my stocking feet. "We have this cow that seems to be lying around a lot."

  "Is she off feed as well?"

  "Well, she's been eating some..." Bob stared in fascination at my right foot. The big toe was sticking out in a rather exaggerated fashion. "The others are out there picking, and she just kind of wanders over and lays down like she's full or too tired to be bothered with eating."

  "Sorry, but I haven't had a chance to get my shoes on yet."

  "What's that?"

  "My shoes—I just got back from a surgery in the country and haven't had much time to get on track here."

  "Oh sorry, your shoes...right."

  "I'd certainly run that cow in and get her temperature, Bob. If it's over 39.5, then we better have a look at her. If it's normal, give her a day or two and see what she does."

  "Okay, I'll call you later and let you know." A funny grin crept over his face as he turned to leave. "And good luck with your toe!"

  I rushed into the back room to pull on my shoes. Mrs. Reynolds watched me run by in my stocking feet, and I wondered if she had noticed my errant toe as well. She had recently moved here from Vancouver and still seemed out of place in this rural setting. I'd never seen her when she wasn't dressed as though she had somewhere to go. Recently widowed, she had purchased Gidgit to keep her company and satisfy her nurturing instincts. She and Doris frequented the same hairdresser and, as they waited for me, they went on about Tom's latest antics.