Tuesday, April 15, 2008

enough with the cows already

i don't know why but of all the animals with which i have "played" cows manage time and time again to be the most disgusting.

in case you missed it - this is another gross and possibly offensive post about cows.

ECC has been steadily busy. we've had an emergency every night save one (monday). 4 of the 7 have undergone general anesthesia, which is no small task in large animal medicine. so it's been hopping around here - what with surgeries and a barn full of horses, cows, llamas, crias, pigs, goats, and 1 lonely karakul sheep to attend to on the hour.

at any rate, when this dairy cow presented for a dystocia (what is it with me and dystocias?) i figured it would be a run-of-the-mill calf pulling or c-section. you'd think i'd learn at some point. this cow had been in labor for 12 hours, with no evidence of the calf appearing. she weighed a whopping 1800 pounds and barely fit into the chute. after everyone and the homeless guy from down the road palpated her - it was determined that she had premature placental separation. that's exactly what it sounds like. the calf was dead. and big. and way way way down in the abdomen. so far down that there was no way the calf was coming out via the birth canal. F-A-B-U-L-O-U-S. to surgery we went.

cow c-sections are done in a standing position, so after prepping her - we draped the area and began. on opening the abdomen, we couldn't immediately locate the uterus. it was deep within the sizeable belly of this cow. all was going -- ok enough -- when the surgeon stepped away for a second, leaving me staring into the muscles and viscera of a very large, very belligerent, very NON-RESPONSIVE to pain medications cow. at that precise second the cow elected to cough. for no good reason that i could determine, small intestines came spraying out of the incision, missing my wide-opened eyes by a hairsbreadth. stunned but still trying to think quickly, i grabbed the misdirected loops of jejunum and frantically started stuffing them back into the cow (where they belonged). the cow herself turned to look at me because (i imagine) it feels strange to have ones intestines outside of ones body - and handled so roughly. again, she coughed - and again jejunum sprayed out, bringing with it a healthy dose of mesentery. i tried to keep the panic out of my voice when i hollered for the surgeon, who came back at a run - just as wonder-cow honked again - and more intestine slithered into my overfull hands. the surgeon screamed up and shoved her arms into the cow, attempting to hold the guts in while simultaneously yelling for another surgeon to scrub in - all very animal ER.

the other surgeon did indeed join us shortly - after her mandatory 5 minute scrub. while i and the resident held the unruly guts inside the cow, she patiently located the uterus. it was - as i said - deep within the cow. there was no simple exteriorizing of the uterus. nope, not happening. instead, the surgeon located a hock or a tail or some other extremity of the calf and made the uterine incision somewhat blindly. that part went well enough - and lo and behold a large dead calf popped out. since the resident and i were both somewhat preoccupied with holding the entire gastrointestinal tract inside the cow - we couldn't catch the calf. it popped out and slithered to the floor -where the skull cracked loudly on the concrete. luckily, it was already dead.

the rest of the surgery proceeded uneventfully, although the cow seemed to have an incredibly high tolerance for lidocaine. despite receiving massive doses, she continued to rock and plunge from side to side in the already overstrained chute. it was all we could do to suture her without poking ourselves in the eye/hand/arm. you'd think a dairy cow that's handled twice daily would have some manners.

after all of that, we let her out of the roundabout and herded her back to the stall. on checking on her a half an hour later, we were dismayed to see the bottom half of her incision hanging open to the world. it was only the skin suture that failed- the jejunum had elected to stay inside the body this time. depressed at our bad luck, we again placed her in the too small chute and proceeded to re-suture her skin incision.

this time - it stayed.

after graduation, i will never touch a cow again. if it isn't dead and rotting calves, it's unbelievably poorly behaved intestines that have no business being outside of the body...

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