“OK, Mr. Shapely, I’m going to take some radiographs, and then we’ll be able to decide how best to handle this.”
The radiographs showed a spiral mid-shaft fracture of the left femur.
“With this kind of fracture,” I explained, “it’s difficult to keep the bone ends aligned with a splint of any kind. The best way to handle this is to do an open reduction and put a stainless steel pin in the bone. After it heals, I’ll remove the pin. We’ll also put a Thomas splint on him for added protection and stability. He should do just fine.”
“Whatever it takes, Doc. He’s a good dog, and my wife loves him. She was so upset she wouldn’t even come along, afraid you were going to put him to sleep. Go ahead and fix him up.”
He cares for the dog at least as much as his wife does, maybe more.
“Will do, Mr. Shapely, I’ll start working on him right away. I expect you need to go and open your store, so I’ll call you as soon as I’m finished and let you know how things went.”
“Thanks, Doc. I appreciate that.”
The open reduction was straightforward. I hadn’t done one on my own but had assisted Dr. Smith in vet school twice. It involved dissecting down over the fracture site, removing the inevitable blood clot, pushing the pin down through the upper portion of the bone, aligning the fracture, and pushing the pin down into the lower portion until it was firmly in place. After cutting the remainder of the pin off just below the skin, I sutured the tissues over the fracture site and closed the skin. I fitted a Thomas splint, put Scamp into a cage, and called the pharmacist.
“Scamp’s out of surgery and doing well. He is awake, his color is good, his heart rate and pulse are normal, and his breathing is regular. He should be ready to go home in a couple of days.”
I saw Scamp every two weeks after he went home to repair the tape on the Thomas splint and to make certain he was doing well. After five weeks, I removed the Steinman pin and the Thomas splint, and Scamp walked out of the clinic with only the hint of a limp.
***
“Old man Jackson told me they would be in town today,” Dick told me. “He said the bull is easy to handle. He left him in the corral back of the barn, tied up. Said the bull’s been limping around for several days.”
I found the lame Hereford bull snubbed to the railing of a corral behind the barn. He was standing with just the tip of the toes of his left forefoot touching the ground. The wind kicked up swirling dried dirt and pulverized manure through the corral, and I spit some black stuff out of my mouth.
Lifting the bull’s left forefoot, I pushed on the swollen area between the toes. Pus came out. The bull flinched and jerked his foot away.
Having anticipated that foot rot was the problem, I had brought a soft cotton rope with me from the truck. I looped it over the leg, just above the sore foot, placed the rope over the bull’s back and around and under his chest. I pulled on the rope, bringing the foot up, and then tied the rope in place. I cleaned away dead tissue with a hoof knife and then poured 7 percent tincture of iodine into the wound. The bull bellowed and pulled away, fell to his knees, and scrambled up on three legs again, snorting. He looked at me with anger in his eyes.
“Sorry, old boy. It hurts like hell, I know, but it will be much better soon.”
I stuffed gauze soaked in iodine into the now open abscess and then bandaged the foot using the gauze and tape I had stuffed into the pockets of my coveralls. After the bandage was in place, I went back to the truck for some antibiotics. I slapped a sixteen-gauge, two-inch-long needle into the bull’s left rump, attached the steel and glass syringe to the hub of the needle, and injected the long-acting penicillin.
***
The day proved to be busy, and the weather got nastier, as the radio announcer had predicted. After a late lunch, I treated four mastitis cases and a retained placenta, each on a different farm. In the early evening, clouds built to the west, the wind shifted to the northwest, and for fifteen minutes, it rained mud as I drove. The last call of the day was a lame saddle horse.
I carefully observed the mare as the owner, at my direction, led her at a walk and then a trot, going away and then coming towards me. Finally, I observed from the side as the owner walked and trotted her for me to diagnose the lameness.
“Jeez, Doc,” wheezed Frank Tompkins, “I hope you’ve seen enough. I kept this mare so I wouldn’t have to use my own feet to get around.”
Tompkins, the famous rodeo and Wild West show cowboy, had raised wheat and cattle on the high plains twenty-five miles north and west of town. He was now eighty-two, he told me, a widower for five years. His son had graduated from the University of Montana and come back to help his dad operate the ranch. After turning sixty-six, Tompkins had turned the ranching operation over to his son, leasing him the land and selling him the cattle herd. Frank and his wife had spent winters in Arizona and the rest of the year on the ranch; their house was just a hundred yards away from the home his son had built for his own family.
The son died after a six-month fight against pancreatic cancer. Tompkins’s wife lived only one year after their son died. Their daughter, who had also finished college, was married, had her own family, and lived in Denver. After his son died, Frank resumed the ranch operations, taking care of his son’s young family as best he could, but it got to be too much for him. His daughter-in-law and grandchildren moved back to be with her family in Billings where she started a new life.
Frank sold the ranch and moved to the house he had purchased when his children were going to high school. While they had been in school, his wife had stayed with the two children in town during the school week, so they would not have to drive in every day from the ranch. After his daughter had finished high school, they had kept the town place as a rental. Renters hadn’t taken care of the house or the barn, and the five-acre place had been in sad shape when he had moved in, but he was gradually restoring it.
We moved into the barn to get out of the wind and blowing dust. Frank had started his renovation projects with the barn to make things comfortable for his animals before taking care of the house and his own needs. There were three renovated stalls. He had converted the fourth stall into a well-organized workshop. There were a lot of antique but well-cared-for carpentry tools, organized according to purpose. I noticed new paint and a new roof on the barn as I walked over and took a ripsaw off its peg on the wall. It was sharp, covered with a protective seal of beeswax. A wood-handled chisel was as sharp as a razor.
“I see you take very good care of your tools, Mr. Tompkins. My granddad was a carpenter, and he always talked about how important that was.”
“Well, a man can’t do good work without good tools, and this mare was one of the tools of my trade. Some jobs just need doing on horseback. This mare is one of the best cow horses I had over the years. It’s a little hard for me to get around these days, but when I get up on her, I feel like I’m doing something worthwhile again.”
“You miss the ranch then?”
“Oh yeah, but it was too much for me, too many things to be done. When my boy died and I had to take over again, I realized that and my heart wasn’t in it. Nobody to leave it to.”
We were standing in the wide alley of the barn. I continued my evaluation of the mare. “Right foreleg, it seems,” I murmured. I used a hoof tester to rule out soreness in the hoof. When I palpated up the leg, I thought I felt some heat in the region of the sesamoid bones.
“I’ll need some radiographs before I can make a diagnosis or give a prognosis. If you’ll call the hospital, you can make arrangements with Dick Mathes for a time to bring her in for the X-rays. Do you have a trailer to bring her in?”
“Yeah, I’ve still got one out at the ranch. Haven’t bothered to bring it in, didn’t think I would need to haul her anyplace. I can go get it.”
“Does she load easy?”
“Oh yeah, she’ll load right up, no problem.”
“Well, I don’t think it’s anything too serious, but we have to
rule out a fractured sesamoid bone. If it’s just the bad strain I think it is, three or four weeks of stall rest and some liniment rubbed on each day should take care of it.”
“Sounds good to me,” Tompkins said. “Taking care of her is more important to me than riding her these days.”
Chapter 24: My Son, the Doctor
Hank Randall retired as the editor of in-house publications at the Allis Chalmers Company. During his career at Allis Chalmers, he was also a free-lance cartoonist, selling cartoons to trade magazines. After retirement, he continued free-lance cartooning but spent most of his time doing serious paintings, acrylics on mason board. Most of his paintings were colorful western themes featuring stylized caricatures of people, buildings, and animals.
He was a quiet, regular man. During the week, he worked from eight in the morning until noon. When he broke for lunch, Emily, his wife of forty-some years, would have a tuna and mayonnaise sandwich and one sweet pickle ready and waiting for him. At twelve-thirty, he was back in his converted garage studio, hard at work. At five in the evening, he stopped what he was working on, cleaned his brushes and other paraphernalia, returned to the house, showered, and helped Emily prepare dinner.
Except on Fridays. On those days, he stopped working at four o’clock. At five, Alex Washburn, the owner of Freddy’s would take out three bottles of Blatz beer and line them up on the end of the bar closest to the wall. On the wall was a hand-lettered sign saying “Hank’s stool, Friday evenings.” If anyone were occupying the stool on Friday at five fifteen, Alex would shoo him or her off.
At five thirty, Emily would drive up, and Hank would get out of the car and walk through the bar’s door. Alex would pop the top on the beer bottle closest to the wall. Hank would assume his position on the stool and take a long drink from the opened bottle.
During the evening, a succession of regulars would join Hank on the stool to his left engaging in spirited, thirsty conversation. When he finished a bottle, Hank would stand on the runners of his stool and put the bottle in the open cardboard case Alex had placed within reach behind the bar for that purpose. That was the signal for Alex to place a fresh bottle in line, next to the remaining two and open the one closest to the wall. When Hank had enough, he would leave the empty on the bar. At midnight, Emily would arrive, honk the car horn once, and Hank would be gone for another week.
Years before our arrival, Hank had earned this special attention and the six to eight beers he drank each Friday evening by decorating the walls of Freddy’s with life-sized caricatures of the regulars engaged in either their favorite pastimes or occupations. Alex had told me about the sign, the stool, and Hank’s routine when I had stopped for a cold beer on a particularly hot afternoon.
Hank and Emily owned a wirehaired-terrier mix, Sparky. I met Sparky and Hank when his master brought the dog in for his annual rabies shot. I met Emily when I went to their place to give her pinto mare, Patches, encephalitis and tetanus vaccinations late that spring.
Emily’s face was etched with permanent smile wrinkles. She bubbled, especially so when riding or taking care of her mare. Patches’s personality matched Hank’s, calm, steady, taciturn. Sparky was more like Emily.
***
Rosalie and I were just starting to get ready for bed a little after eleven in the evening when the phone rang.
“Doc,” Dick said, “Hank Randall just called. His wife’s mare is colicky.”
“OK, call and tell them I’m on my way. Did you tell them to keep her up and walking?”
“Of course.” He sounded a little irritated that I had asked.
Colic is another name for a bellyache. It can have many causes and is a serious emergency in horses because horses manifest abdominal pain by rolling. They get to the ground, sometimes falling heavily, and roll to their back and side-to-side. Because of the manner in which the bowel is suspended in the abdomen of horses, when the animal rolls with abdominal pain, the intestinal tract can twist on itself, roll on itself, or sometimes telescope into itself. When any of these happen, the blood supply to the affected portion of the bowel is interrupted, and that portion of the bowel dies. Once this happens, if not surgically corrected, the lesion is fatal.
In the early 1960s, there were very few veterinary hospitals prepared and experienced in doing abdominal surgery in horses. The Sidney Animal Hospital was not one of them.
The emergency treatment for colic is to keep the horse on its feet by forcing it to walk until the veterinarian arrives. Once the veterinarian is on site, it is necessary to make a diagnosis of the cause and treat accordingly. In many, if not the majority, of cases, the exact cause is not readily apparent, and the standard treatment in the early 1960s was to dose the animal via stomach tube with mineral oil, adding a degassing or surface-tension-reducing agent, and to administer an analgesic agent. Today we have available many more choices of antispasmodic and analgesic drugs for this still serious emergency.
A more societal aspect of colic in horses, depending upon the neighborhood and time of year, is the colic block party. Hank and Emily lived in an eclectic area just outside of town, characterized by five- and ten-acre plots of land and a wide variety of housing. There were mobile homes still on wheels, manufactured homes on solid foundations, modest frame houses, and some expensive custom homes. A similar mix of barns and corrals accompanied the houses and reflected the financial resources of the owners. It was summer, hot, dry, shirtsleeve weather, perfect conditions for a colic block party.
I arrived just after eleven thirty. There was a lit Coleman lantern standing on an inverted fifty-five-gallon drum in the middle of the Randall’s half-acre corral. I noticed at least half a dozen neighbors sitting on cheap aluminum lawn chairs, most with a can in their hand. There was a cooler filled with cans of beer and soft drinks floating in ice water. Frank Tompkins, whose place was just down the road from the Randalls’, was leading Patches around the periphery inside the corral. Hank followed, a length of rope in his hand, occasionally flicking the mare’s rump to keep her moving.
I performed a quick physical exam on the mare. Her mucous membranes showed no sign of toxicity. Her heart rate was elevated, but her lung and heart sounds were normal. I listened over her abdomen for several minutes but heard no signs of borborygmus, the normal rumbling noises caused by the propulsion of gas and ingesta through the intestines.
Patches kept looking around at her belly. As I put my stethoscope back around my neck, she started to collapse.
“No,... up girl,” Frank shouted, pulling on her halter rope.
I slapped her hard on the rump. “I still have to do a rectal exam. Keep her up and moving, Mr. Tompkins. I’ll get what I need from the truck.”
I pulled the plastic rectal sleeve over my left hand and arm while following the two men and the mare around the corral. Still walking, I removed the plastic squeeze bottle with mineral oil out of the back pocket of my Wranglers and oiled up the sleeve.
“OK, stop and hold her, and I’ll do this,” I said. I stood on the right side of the mare and grabbed the base of her tail with my right hand pushing my left hand into her rectum. Without instruction, Frank Tompkins moved to the right side of Patches’s head. He held her with one of his hands on either side of her halter. The old cowboy knew that if the mare decided to spook she would move away from both of us. If we were not standing on the same side, someone was likely to get hurt.
I gradually worked my arm in further until I touched the transverse colon. I could feel a large fecal obstruction with a lot of gas upstream. Patches was impacted. I pulled out my arm turning the sleeve inside out.
“Well, she’s got an impaction,” I explained. “I’m going to give her some mineral oil. She’s got a lot of gas accumulating ahead of the blockage, and that’s what’s causing the pain. I’ll give her something to try to reduce the gas formation and a touch of tranquilizer to take the edge off the pain. Keep her moving while I get everything ready. We don’t want her to go down and twist a gut.”
> Both men nodded and started walking the mare while I went back to the truck. I poured a gallon jug of mineral oil into a stainless steel bucket and added a dash of the new surface-tension-reducing agent that one of the drug company detail men had recently touted. I had used it on two previous cases, and it had seemed to be effective. I put my stainless steel pump into the bucket, put a Tygon stomach tube around my neck, and pulled a dose of Acepromazine into a syringe.
I waited inside the gate until the two men brought Patches around again. I gave her the tranquilizer in the jugular vein and then carefully started the stomach tube through her left nostril while blowing gently into the other end of the tube as I advanced it. She started swallowing, a good sign that I was in the esophagus, not the trachea. I watched carefully and saw the end of the tube moving down her neck, another sign I was in the esophagus. When I felt the tube was in her stomach, I took my end of it out of my mouth and listened while watching her chest. I didn’t want to hear air moving in and out of the tube with her respirations.
Pumping mineral oil, or anything else, into the trachea or lungs, could—probably would—result in inhalation pneumonia and death. For a veterinarian to do that is negligent at best, malpractice at worst.
“OK, just hold her steady while I pump this in; won’t take but a minute.” After emptying the bucket, I kinked the tube, removed it from the pump, unkinked it, then blew into it to empty it, kinked it again, and withdrew it from the mare’s stomach and out through her nose. She snorted some mucous but no blood. This meant I hadn’t ruptured any blood vessels in the turbinate bones of her nose while getting the tube in or taking it out, a reassuring sign of moderate competence.
“OK, let’s keep her walking while I clean and put everything away. It’s going to take some time for the oil to work its way through. Until then, all we can do is prevent her from going down and rolling.”
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