A Yorkshire Vet Through the Seasons
Page 18
Later that afternoon, I received a phone call. It was Gary from the lab again, full of the excitement that I had come to expect from this pathologist when he was on the trail of a diagnosis.
‘Hello, Julian!’ he said cheerfully. ‘It looks like acute pasteurellosis! The lungs are purple with haemorrhage. Have these lambs had any vaccines?’
I confirmed that yes – they had received the correct vaccinations, at the correct time. Wayne was as diligent as any farmer I knew.
‘Hmm, well.’ This had put a slight damper on Gary’s excitement. ‘Sometimes disease can break through against a vaccinal titre. It has been awful weather recently. I think I might have developed pneumonia if I’d been out in weather like this! We’re running some more tests, just to confirm. I’ll keep you posted … Oh, another thing – the livers were all clear. Not a trace of fluke, so we’re clear on that one!’
I wasn’t convinced by the diagnosis of pasteurellosis, although Gary clearly was. He had seen the lungs though, and that was his job, after all. I called Wayne to check the vaccine history again. He confirmed that not only had the vaccines been done, as always, at the correct time, but the sheep had also received an extra dose only three weeks previously, in anticipation of the weather. This ‘back end’ had been a wet one so far! I advised him to give a precautionary course of antibiotics to any sheep that looked poorly and also to move them onto another pasture. The second part of this advice was risky – moving sheep from place to place can precipitate disease crises through stress. Pasteurellosis – our ‘working’ diagnosis – could even be triggered by moving sheep from one field to another. Wayne also knew this, but we both agreed it would be sensible, just in case the grazing itself was the cause of the problem.
Three days later, Wayne had done all he had been advised. He had moved the lambs and injected about a hundred sheep with antibiotics in a bid to prevent them from getting any worse, but there had still been more deaths. We had been in contact twice a day by telephone, while we awaited the final test results from the lab. The phone call came halfway through Monday morning, and changed our diagnosis immediately.
‘It’s lead poisoning! Definitely lead,’ explained Gary.
Toxicological testing on the kidneys and liver had revealed dangerously high levels of the heavy metal in the organs of each of the three lambs sent in. The fax confirming this quickly followed the phone call. Despite the relief of having a definitive diagnosis, the gloomy headings on the top of each page did nothing to lighten my mood.
Lamb 1: Lead poisoning with secondary pneumonia.
Lamb 2: Lead poisoning, minimal secondary pneumonia and
nephrosis.
Lamb 3: Lead poisoning, mild secondary nephrosis.
Diagnosis: LEAD POISONING.
How had these lambs, grazing the fertile fields alongside the Swale, been exposed to lead? I did some more research before calling Wayne with the news, and what I discovered was more a lesson in geology than in veterinary epidemiology. In years gone by, the landscape of parts of the Dales was not only rural but also industrial. The scattered ruins of lead mines can still be seen in many places. The recent heavy rain had resulted in large quantities of water washing through the lead seams of upper Swaledale, from where the River Swale originated. This water, contaminated by high levels of the toxic mineral, in the form of silt containing lead ore, ran off the hills and into the river. As the river burst its banks further downstream, the silt that had been held in the current was deposited onto the fields where Wayne’s sheep had been grazing. The hungry lambs, cropping the grass short and therefore taking in silt as well, had eaten sufficient quantities to damage their internal organs and destroy their blood cells.
Wayne immediately made sure all his lambs were safely inside, away from the dangerous grass. There was no practical cure that could be administered to the lambs. The only drug that might have been helpful needed to be injected intravenously every day, into every sheep, for about five days, which was completely unfeasible given the size of the flock. Wayne and his lambs would just have to sit it out and wait for the lead to leach out of both the lambs and the grass.
The disaster had been contained, although it took many more tests and was quite some time before the lambs were safe for human consumption. The farm next to the River Swale would not be grazing sheep on recently flooded fields again.
* * *
It did not take long before I was drawing upon my newfound knowledge elsewhere. Only two miles downstream and two weeks later, I found another case of lead poisoning, this time in a herd of Simmental cattle.
The sight in Gordon’s fold yard was a sorry one. It was full of about forty year-old store cattle. Gordon had purchased them from nearby hill farms, where they had been overwintered on barley. He fattened these animals on the plentiful grass in the fields around the confluence of Cod Beck with the Swale. The cattle, which were usually a picture of health, with white and deep tan markings, did not look so good. Gordon pointed out about six who were standing, ears down, staring into space and not moving at all. It was otherwise a beautiful autumn afternoon. The sun was doing its best to provide some end-of-season warmth before it slipped out of sight. Gordon explained all, pre-empting my questions. The Simmentals had arrived about three weeks before. The weather was still good and, in the autumn sun, the land nearby his farm had dried out after the recent flooding. The cattle had enjoyed an Indian summer – admittedly one punctuated by an Indian-style monsoon – finishing off the last of the grass. They had obviously tucked into it with some enthusiasm as it would have been vastly superior to anything they had experienced before, coming as they did from upland farms.
‘It was just this morning that I didn’t think they looked quite right. So I spent an hour or so getting ’em all in, so I could have a closer look.’ Gordon was tense. ‘It’s just those six really. I’d be hard pushed to say that there is much wrong with the others. I thought you’d better come and have a look. You’re the vet, you should know what’s up wi’ ’em. I don’t want to lose any – they cost me a fortune. Stores like this are not ten a penny. If I lose any, well, it’s my profit gone, you see.’
The more Gordon spoke, the more I felt the pressure rising. I thought I had better interject.
‘Where exactly were they grazing, Gordon?’
I hoped that he would point to a field right next to the river.
‘Well, everywhere really. All those fields down there.’ As we stood on a mound just outside the farmhouse, Gordon pointed out the extent of the grazing which, luckily for me and my diagnosis, included large tracts of land right along the banks of the river. And yes, they too, had been completely flooded about four weeks before.
‘The flooding’s been bad here,’ he explained. ‘You see, where Cod Beck joins the Swale, the water sort of backs up and it goes everywhere. Especially if it’s been over-wet in the Hambleton Hills as well as the Dales.’
We went back inside to have a closer look at the sick animals. In contrast to lead poisoning in sheep, which usually manifests itself as sudden death, in cattle the disease progresses more slowly. The affected animals develop neurological signs, most frequently characterized by loss of vision. Sure enough, on close examination, these Simmentals were following the textbook perfectly. They were all blind. I confidently pronounced my diagnosis of lead poisoning. It did not impress Gordon as much as I had hoped. The farmer was sceptical.
‘Well, we’ve had this farm for generations and I’ve never heard of anything like this before. Could it not be pneumonia?’
I explained the signs and my theory, as we examined each blind animal. There was nothing to suggest it might be pneumonia, but there was also no definitive test, other than post mortem examination, to confirm that it was lead poisoning. There were no suitable candidates for post mortem at the moment, and to wait until there was one might be leaving it too late for the possibility of curing the others. Gordon’s mood and his confidence in my diagnosis were lifted slightly when I explained
that treatment might be feasible for this small number of beasts, if we gave it straight away. We would need to inject a drug called calcium edetate intravenously, every day for about five days. Gordon’s demeanour drooped again. Five daily visits from the vet and probably lots of bottles of medicine sounded expensive. I felt somewhat despondent. I had made a pretty good diagnosis (without the need for any expensive lab tests), offered a treatment that would very likely save the lives of all his animals (which he had already pointed out were very valuable and that he couldn’t afford to lose) and I had offered to treat them every day until they were cured. I didn’t know what more I could do.
I explained it all again and Gordon wandered off into the corner of the fold yard to contemplate the situation. After what seemed like an hour, he stomped back to the cattle crush where I was waiting, and nodded his head.
‘You’d better get on with it then. I don’t want ’em to die.’
And so I sprung into action, injecting the life-saving medicine into each of the stricken animals. This was what being a vet was all about for me – making a diagnosis and administering a cure. I was in my element. It was so much better than falling into a sheep dip!
Maybe this ‘back end’ wouldn’t be so bad after all!
The Farmer from the West Riding
‘There’s a man on the phone who wants to speak to you about his goats,’ called Zoe, our newly qualified veterinary nurse.
Zoe was chuckling as I hung up my coat. It was before eight thirty and I was the first vet to arrive. A call this early was either because there was a serious problem or it was an anxious farmer.
‘He keeps phoning but he’s missed you every time and he won’t leave a message,’ Zoe went on. ‘He was on the phone at least three times yesterday. I don’t think he is from round here, judging by his accent. I can’t really tell what he’s talking about, to be honest. Can you speak to him now? I think it would be good if you could. He’s very keen to speak to you and he’s very persistent.’
It looked as if my first patient of the day would have to wait until I had spoken to the goat farmer, so I took the receiver and introduced myself.
‘Argh, nar then. Thank yer fo’ coming to spake with me. I’m Rodney. Thing is, like, I need a vet who knows abart goats. And sheep and, well, to tell yer truth, I’ve seen yer on telly and I thought yer were raight up my street. What I want to ask is – will yer be me vet?’
I was taken aback by this direct approach, especially because I could pinpoint the accent of the goat farmer to within an area of about five miles. He was not from North Yorkshire, but from the West Riding where I grew up, and I could tell he hailed from somewhere slightly to the southwest of Leeds. I asked Rodney the whereabouts of his farm. At Skeldale, we try not to travel long distances to farms, preferring to offer an attentive service to our local farmers. Hours spent on the road make it difficult to guarantee we can attend an emergency promptly. Rodney’s farm, as I suspected, was between Leeds and Dewsbury. It was in one of the few remaining patches of rural greenness that hung on as stubbornly as Rodney obviously did, in the face of the urban sprawl.
‘It’s a bit far out of our normal patch, Rodney,’ I explained.
‘Aw, go on! We don’t have many call outs ’cos me and me son, Matthew, are good at lambing, yer see. I’ll bring me sheep and me goats up to you. They’ll fit in me car boot no problem.’
I couldn’t argue with this. My family lived not far from Rodney’s farm, so I knew that the journey to Thirsk would not take more than about fifty minutes. Slightly against my better judgement, I agreed to see Rodney’s animals.
‘Super,’ he said. ‘Can I bring me little goats up to see yer? They need their horn buds tekken off. I can come up anytime. Just let me know when. I love me little goats, I do. I’ve got abart twenty in all and the little uns’ll need their horn buds out and …’
It was difficult to interrupt a farmer from West Yorkshire when he was on a roll, but the waiting room was filling up with my morning appointments. I needed to bring the conversation to a close more quickly than Rodney did, so I arranged for him to bring his goats up the following week. It was to be the start of a great friendship.
He arrived at the surgery for his appointment, and bundled a riotous gang of about six or seven goat kids out of his car and into my consulting room. Goats are very sensitive to local anaesthetic, so disbudding needs to be performed under full general anaesthetic, by masking the little animals with gas and oxygen. There is a big risk involved, due to unavoidable proximity of the red-hot disbudding iron to the flow of oxygen from the anaesthetic machine. I have heard terrible stories of whole guinea pigs going up in flames when the thermocautery machine has been used too close to the gas supply. I did not want to return any of Rodney’s precious little goats with singed heads. It would not get our relationship off to a good start.
Luckily, there were no such incendiary mishaps today, although one little goat called Abi who had been hand-reared (she was Rodney’s favourite) was determined to chew through the gas pipes of the anaesthetic machine and cause general havoc. She was cute and she knew it. She tottered over to investigate each patient as they lay on a fleecy blanket, recovering from their ordeal, and would sit on the backs of each of her friends in turn, before skipping off to have a wee in the middle of the consulting room floor. Needless to say, she was the last to volunteer for the procedure!
Whilst I carefully removed each rubbery bud, so the goat kids would not grow horns with which to cause trouble when they were older, Rodney waited in reception, chatting to Sylvia, the receptionist. Sylvia also loved goats and would come in every so often to check how I was getting on. Rodney told her all about his farm, how he did sheepdog trials and how his favourite dog had once gathered all the sheep off a hill, when all the other dogs had failed. When I went out to tell him that everything had gone well – all buds had been removed and no goats had been set on fire – he was still deep in conversation.
‘All t’other farmers wo’ playing pop with their dogs. None on ’em had got sheep off of moor like, but our Millie, by gum, what a dog, she’d got all on ’em …’
I had to interrupt and hand over the bundle of goat kids.
‘By gum, that’s a proper job! Thank yer very much. I’m much obliged. Thing is, not all vets know abart goats, but I knew you did. I’ve seen yer on telly like …’
He was clearly delighted by our morning’s work and, as we shook hands, I knew we would be meeting again.
* * *
I had not expected our second meeting to be quite so soon. A month had passed, and Millie, Rodney’s old and faithful sheepdog about whom we had all heard, had just finished the last of her autumnal work, doing what she did best – rounding up the sheep on the hill to separate the ewes from their lambs ready for the autumn lamb sales. She had been working hard and it was clear to Rodney that age was catching up with his faithful friend. He had noticed a large and nasty lump growing around one of Millie’s teeth, about the size of a large conker. He had rushed her to the local veterinary surgeon, who had given a grave prognosis, saying that the dog had just a few weeks left to live. Rodney was mortified, reluctant to believe that his faithful companion would not see Christmas, let alone next lambing time. His son, Matthew, had urged him to get a second opinion ‘from Goat Man’.
We had another phone conversation and the next day, Millie was brought along to the surgery in the car boot that had previously been full of goat kids. She was a happy dog and wagged her tail constantly throughout my examination, resting her head on my knee as I crouched down to examine her on the floor of my consulting room. Farm dogs do not feel comfortable standing on an examination table so I have always found it better to meet them at their level.
There was a firm, boney growth invading the right side of the very front part of Millie’s lower jaw extending up and around the canine tooth. Its surface was beginning to ulcerate and I did not need a biopsy to tell me that this was an aggressive tumour. For Millie to ha
ve any chance of survival, the mass would have to be removed, along with part of her jaw, to ensure that none was left behind.
I explained to Rodney what we needed to do. It was testament to the faith he had in me at this early stage of our friendship that he agreed immediately and without question. Most owners pale at the suggestion that part of their pet’s jawbone should be removed. It sounds extremely aggressive surgery fraught with complications and post-operative problems. Indeed, it is not something to undertake lightly but, in this case, there really was no other option. We arranged a date for the operation. It meant another long journey up the A1 for Rodney with our patient, but one that he was clearly very happy to make.
As I met Rodney and Millie in the waiting room a few days later, his anxiety was palpable. I promised to phone him as soon as I was done. The operation, while somewhat gruesome, went well. Some of the nurses and the younger vets gathered to watch, grimacing as the oscillating saw cut through the bone around the tumour. When it is necessary to remove a large part of the mandible, the cut ends of the bone are simply left unattached. This is tolerated remarkably well and, amazingly, the function of the mouth is preserved, in a pain-free way. It is always a surprise to the owner that their pet is not horribly disfigured, even immediately after the operation. In Millie’s case, though, after I had removed the tumour, the two healthy ends of the bone were still sufficiently close that I could wire them back together, which was even better. Reconstructing the soft tissues of the mouth was the final part of the operation and it was not long before Millie was lifting her head, as she recovered in a warm and comfy kennel.
I called Rodney to tell him that all was well. Needless to say, he was delighted and very relieved. It was not quite plain sailing from this point, as we still needed to make sure that Millie could eat without discomfort. Would she be able to cope with only part of her jaw?
I need not have worried. Only a few short hours after the operation, in the middle of afternoon surgery, Zoe – who was getting to know Rodney and his animals as well as I was – came rushing from the kennels and knocked on my consulting room door.