by JULIAN EARL
Most caesareans on cows are laborious, time-consuming jobs. Many have to be performed in the middle of the night and it is great to work on a well-prepared farm where the staff know to have plenty of warm water available, something ready to use as a table for laying down all of the surgical instruments, and a cow that is well restrained. Trying to do difficult surgery standing a metre or so in front of a cow’s back leg, just in the correct place to be kicked badly, can be risky. If the cow is lying down she has more difficulty connecting her foot to your leg or body, but sometimes will still try vigorously. Using a ten-or fifteen-centimetre needle to perform what is called paravertebral anaesthesia of the nerves as they exit the spine is not always appreciated by the victim – I mean the patient. The most difficult caesareans can easily take a couple of hours, but the quickest and easiest was undoubtedly a thirteen-month-old heifer that had mistakenly been made pregnant when merely four months old. Because she was still very small at the time of birth, a caesarean was unavoidable, but as she was lying obligingly calmly on her right-hand side, the operation was as quick and easy a caesarean as I have ever done and took less than forty minutes. The wound was fairly small and therefore quick to repair. The calf inside was only half the usual size and easy to lift out, and because the heifer was lying down, she was unable to jump around during the procedure. In contrast, I operated on a large beef cow lying on her right side, and when I reached inside to lift the calf out (which means lifting vertically), the calf was so heavy I thought it had to be an elephant. Even the three of us – farmer, vet and nurse – had great difficulty lifting the calf out on this occasion. Although we didn’t weigh this calf, it measured nearly two metres from nose to tip of the tail – rather big! Other caesareans have been a pleasant surprise. Driving forty miles early on a freezing Christmas morning to a caesarean tends to spoil the festive mood, especially for one’s family, but on arrival everything was ready and prepared. Even the cow had the Christmas spirit; she was perfectly behaved, not moving a muscle during the procedure and then the calf was alive and well after a very efficient operation. We all got our turkey dinner after all.
Caesareans in cows are best regarded as a salvage procedure to try to rescue something from a very difficult situation. They are not performed in sterile operating theatres but in barns with straw, dirt and cow faeces far closer to the wound than you would choose. The risk of complications, especially infection, is high, but cows are incredible animals sometimes. I have performed a caesarean on a cow standing in a yard with deep straw, with plenty of the aforementioned excretions from the rear end of the cows scattered around. She misbehaved, she jumped around, tried to kick, tried to escape and eventually – just at the point when I had opened up her side properly and so exposed her internal organs, with the uterus ready to incise in order to reach the calf – she decided to throw herself on the ground. She rolled over on to her back then completely over on to the side with the open wound, collecting straw, cow poo, and assorted debris all over my nice surgical wound and her internal organs. Desperate times need desperate measures, so after encouraging her to stand again and performing thorough and vigorous flushing and drenching of the wound with a bucket of warm tap water, the contaminated organs at least looked clean. The tap water wasn’t sterile but I’m sure it was a lot cleaner than the straw and dung that had been spread over the wound. Having seen other cow caesarean wounds swell dramatically after apparently non-contaminated surgery, both I and the farmer were very surprised – I think gobsmacked is the more appropriate word – that there was no post-operative swelling and no trace of wound infection, despite the gross contamination.
Some caesareans have to be performed outside and I did one on a big beef cow in a December while it was snowing hard. Although the inside of a cow is very warm, when it reached the point of stitching her back together, my wet hands had started losing sensation. I manfully continued because I had no choice. Cow caesareans are always performed through their left-hand side for anatomical reasons. The wound is stitched in layers: the uterus, the muscle of the body wall, the fat layer under the skin, and finally the skin. I had brushed the snow from the wound, managed to stitch the multiple layers of muscle without stabbing my frozen fingers too often, but as cows sometimes do, she continued to strain as though trying to push another calf out the normal way even after the actual calf had already gone. To push like this involves a cow tensing all the muscles of the body wall and, to my dismay, I was standing back as I heard a sound similar to a row of press-studs being ripped open. Every single one of my lovely neat stitches popped undone along the whole length of the wound. I would have sworn but my face was too cold for me to speak. ‘Mmm … Noo!’ was all I could manage and back I went to the start of the stitching process. This was probably the closest I’ve been to hypothermia when operating. The hot tea provided by the farmer, good old Mr L, was the most welcome cuppa I had ever drunk.
Chapter 14
Great escapees
Shut that door!
One cardinal rule at a veterinary practice is to always, always, always, keep windows and doors shut when patients are in the room. I have seen cats leap for any space or gap that might give them an opportunity to escape. Many have jumped against a closed window that they thought was open. Cats, in particular, are animal Houdinis that will try to go out through any gap if they have the opportunity. If a cat does get out, your chances of recapture are not very good.
Many years ago, when I was working as a teenage assistant at a practice, I saw a cat escape from the consultation with Mr M, the vet, via a partially open window. The cat sprinted across the lawn outside, leapt on to the high stone wall at the front of the garden and luckily stopped, poised on the wall while she considered her next action. Before she had a chance to continue across the busy main road just ahead, Mr M who had sprinted after her, managed to grab the nearest available part of the cat, her tail, to stop further progress. In a rage at being grabbed so roughly, the cat then swung around on to the vet’s chest and, with all claws and teeth, proceeded to remove flesh and blood from Mr M through his shirt. Still, that was a better outcome – for the cat at least – than if she had behaved in the usual way cats do to cross roads, that is, by closing their eyes and blindly rushing across, hoping for the best.
Having witnessed this trauma when Mr M grabbed the tail in desperation and seen how closely the cat came to being a road accident victim, I have always insisted it be a cardinal rule that windows and doors be kept shut every single time that a dog or a cat is loose in a room. I have told staff that, whilst very distressing, unexpected deaths do occur in animals just as in people, and a medical reason can often be identified. However, it is far, far more difficult to explain away how someone at a practice has inadvertently permitted a cat or dog patient to escape from a practice building. Closed windows and doors stop this from happening.
However, occasionally it is the owners who take the risk. I was called out to the surgery at midnight one December to see a poorly cat. When the lady arrived, I opened the door to the premises. She climbed out of the car, with her black cat on her shoulder and, for whatever reason, the cat decided to jump down and run across the road directly to the tall leylandii hedge on the opposite side of the road from the practice. The owner and I spent considerable time trying to identify a black cat in deep shadow under the hedge at midnight, but it was a hopeless situation. A black cat underneath a hedge at midnight is not easy to spot and, in truth, neither of us could see the cat anywhere, even with torches. The cat was perfectly camouflaged, and eventually the lady went home, and I do not think she ever saw the cat again. We both prayed that the cat’s homing instinct would lead him back home but by one year later he had not reappeared.
A friend’s cat went missing for eighteen months, only to reappear after apparently deciding that the people three houses away were not feeding him as well as my friend had fed him after all, so came home again.
Then there was Ozzie, the all-white cat. One lady client was f
eatured in the local paper after her distinctive all-white male cat had disappeared for many months, but was presented to her again six months later by some furniture removals men. They had been in the area, then returned to their base several hundred miles away and discovered Ozzie in their lorry. Ozzie had apparently wandered into the lorry while it had been parked near his home, and had had an unexpected holiday. After all this time, the men returned to work back in the same area and, having managed to look after Ozzie, took him back to the street where they thought he had probably entered the lorry. One or two local enquiries later led the men to Ozzie’s home. They managed to reunite Ozzie with one very excited and happy family. The owners had been convinced Ozzie was lying dead on the side of a road somewhere, so were understandably overjoyed to have him brought home, apparently safe and well, just six months older. The local paper heard about Ozzie’s travels and his picture made the front page. The owner thought he should be checked over, so I visited and examined him, noted that he was fine, and clearly had been well looked after while he was away. However, I did suggest to the lady owner that, if Ozzie were castrated he would be less likely to wander off again, and might well stay at home more.
‘What?’ the owner exclaimed, ‘Ozzie is castrated!’
I paused a second then replied, ‘Well, this cat isn’t. Are you sure this is Ozzie?’
It turned out it wasn’t, and an all-white cat had achieved fame in the local paper under false pretences! Where the genuine Ozzie was, we never discovered.
Anyone would think that animals do not like going to the vets – it’s not only cats that make unexpected getaways. Not very long ago, we had a chap bring his budgie down to the practice to have the overgrown beak clipped. He was transporting the budgie in a small cardboard box. He explained the nature of the problem then, on checking that all the windows were closed, I cautiously opened the box to have a look at my patient, but to my puzzlement, there was no budgie inside, just a frayed hole in the corner of the box. I checked that it wasn’t a joke on April Fools’ Day. The man insisted that his budgie had definitely been inside the box earlier. The man had travelled in a taxi, so we were sure that the budgie had not escaped to the outside world. Although the gentleman was a bit embarrassed by his absconding budgie he was happy when he later arrived home. He telephoned the practice to say that the budgie was waiting for him at home, sitting on top of its cage. It must have pecked its way out of the box before he set off. Perhaps the budgie didn’t need its beak clipping after all.
The veterinary practice has owned a few cats over the years and sadly a couple have been run over, upsetting the staff enormously. The latest replacement was a rescued little tabby whom we named Saffan after a type of anaesthetic. We decided to keep her indoors all the time to protect her from the traffic. She would wander around the building, learning to avoid dogs coming in with their owners, but otherwise happy to lounge about at reception greeting clients and being thoroughly spoilt. One Saturday night at about 2 a.m. I was called out to a calving cow. When I had completed the job, I was fairly mucky, covered in blood and gore, and needed to replace my dirty equipment in my car in case I received another calving call later on. So, after leaving the farm, I drove back to the surgery, parked at the back entrance, went through the wooden gates, and walked through the kennelling area and to the equipment store to restock my car. As I walked through, I noticed our tabby cat sitting on the table near the door. Bearing in mind the previous comments about escapees, I should point out that I had swung the door closed behind me, but apparently not well enough. On my way back out I noticed Saffan was no longer on the table. I arrived at the car, placed my clean equipment in the boot and noticed, in the dim glow of the streetlights, a tabby and white blur sprinting up the back alley between the two rows of terraced houses behind the practice. ‘Oh no’, I thought, ‘I’ll have to go and get her back’, because never having stayed outside overnight before, I thought she might be killed on the roads, and that would be followed by the nurses killing me for letting her out. So I grabbed a torch and ran after her, up the pitch-black alley. I started calling for her, shouting all the ‘Here, here, Kitty, Kitty’ stuff, miaowing at her to attract her attention and all the time trying to see where she had gone. All she had done was run away and hide underneath an old parked car. There I was, tripping over some bin bags that were lying around, crashing into dustbins in the dark, waiting for the police to be called by someone suspicious of all the clattering. I then went down on my hands and knees, not to pray, but to try to tempt her out from underneath the car. She was determined to enjoy her night out. Although she came out from under the car, she simply hid under the next car up the alley; then she hid behind various rubbish bins. As a last resort, I started to throw bits of gravel at her, hoping to scare her back towards the practice. Luckily, this tactic worked. She finally ran back down the alley, headed towards the still-open gate; but instead of going back inside, she trotted straight past the open door and the gates, and ran up the next alley along. Rightly or wrongly I thought, ‘Enough, that’s it! You’ll just have to take your chances!’
I walked back to the car to close it and then to the practice door to lock up. I went through the gates, closed the door and guess who was sitting there, inside a dog kennel, looking very smug (as only cats can) whilst curled up on nice warm bedding? Yes, it was our Saffan.
I realised that I had just spent an hour or more in the middle of the night, chasing a totally different and no doubt bewildered cat up and down the alleys. I locked Saffan in securely for the night. What the neighbours thought, I never ventured to find out. I only have myself to blame for the lost hour of sleep, but such was the strength of my concern at how much the staff would curse me if the cat had been lost as a result of my oversight.
Chapter 15
The wedding ring
Feeling lucky
There are some places where one doesn’t want to put one’s hand if at all possible, for various reasons; losing a valuable object whilst doing so is one of those reasons.
I once had to examine a Shire mare called May with colic. She had severe abdominal pain that necessitated using all means to identify the source of the pain, including an internal rectal examination to feel around the mare’s intestines to find any abnormalities. Forgetting to remove my wedding ring before I went on this house, or rather, stable call was not the best decision I made. However, it was past midnight, and the mare was twenty miles away so, in my haste, forget is what I did. When I arrived, the mare looked very sick. I proceeded to get dressed in my overalls, waterproof leggings over the overalls, and boots. Then I was ready to start the examination. May was in a large open barn with deep straw covering the whole area – about one hundred square metres or more. As was usual for the horses here, she was very friendly, and I prepared for the internal examination. I finally realised I still had my wedding ring on, and even though I was about to wear long plastic gloves, I removed the ring, placed it inside my trouser pocket, walked over, and checked May. Fortunately, the colic was not life-threatening, and pain relief was all that was required. May responded quite well but still was not completely okay, so I wandered off to have the cup of tea offered by the owner, Mr S, and to pass some time while we monitored May’s response.
While Mr S and I drank our tea, Mrs S went over to have a look at May, then returned to say that she appeared somewhat better now, which I took as my cue to start getting out of my overalls. I placed my hand in my pocket to replace my wedding ring, and I was horrified to discover that it was not there. I checked all of my other pockets and wondered if I had actually removed the ring in the first place. Perhaps, in my urgency to examine May, I had made a terrible mistake. Then, to my relief, I noticed a small hole in my overall pocket through which the ring must have dropped. I hoped it had fallen down the inside of my overalls and landed inside my left wellington boot, but no wedding ring was to be found inside my boot, nor anywhere on my person. Mr S and I walked back to May’s stable and started looking
in the night’s darkness for a gold wedding ring somewhere in the straw. Meanwhile, May had tired out and was now lying down on the straw, oblivious to our search.
We tried to retrace my steps around the yard, but to no avail. We gradually resorted to going down on our hands and knees, wondering where we could find a metal detector at this time of the night. Mr S had gone back to where May was now lying down and suddenly exclaimed very loudly ‘Got it! I’ve found it!’
