A Yorkshire Vet Through the Seasons
Page 14
Eventually though I managed to get rid of it all, which allowed me to feel further up to try and find the cause of Trevor’s colic. This added yet another degree of risk, because I was more likely to touch a sensitive part of the intestines. Stretched bands of mesentery or distended loops of bowel would be very sore and if I touched them there would be an instant spasm of pain. Furthermore, the deeper in I examined, the harder it became to pull my arm out quickly. Should Trevor twist or drop suddenly, my arm would be broken. It was time for another deep breath. Trevor fidgeted and his front feet danced as I went in past my elbow. There was no pelvic flexure impaction and I could not feel any displaced intestines. As I reached further forwards, towards the nephrosplenic space, Trevor suddenly became very agitated and his head, as well as his front legs started to go upwards. I could see Lady Anne becoming just as anxious, and I pulled out my arm just in time, as Trevor started to spin round, pivoting around the old lady.
Lady Anne let go of the horse as he went down again and started to roll. My examination had obviously upset his painful bowels, but I was fairly confident that there was nothing too serious going on. I got back hold of the lead rope and encouraged him back to his feet. His intestines were still very noisy and his heart rate had gone up to sixty-eight beats per minute.
What should I do next? More tests or should I make a presumptive diagnosis of spasmodic colic?
As I watched Trevor trying to escape from Lady Anne’s hold for the umpteenth time, I decided to opt for the latter. I explained that we should give him a spasmolytic injection. This would stop the spasmodic contractions, which were surely the source of his pain.
Trevor realized that the injection meant the end to his ordeal and the minute I stepped away after administering the medication, he jumped in the air and promptly galloped off, still with his head collar and lead rope attached.
‘Oh well, never mind,’ sighed Lady Anne. ‘Let’s have a cup of tea.’
I helped the old lady with the kettle, which was thick with limescale, and I filled up the teapot. It was heavy and I did not want the final part of my visit to end in disaster because of a mishap with boiling water.
I found somewhere to sit amongst the clutter that took up most of the spare space in the living room. The cup of tea tasted pretty terrible, but Lady Anne was clearly feeling happier and it was nice to talk to her and listen to some of the stories about her life. She had been a successful point-to-pointer when she was younger and fitter and the faded pictures on the walls and in frames on the mantelpiece and sideboards showed her in all her former glory.
As the leaves of tea became visible at the bottom of my chipped cup, I knew it was time to bring up the difficult subject of payment. I had been given strict instructions not to leave without a cheque in payment both for today’s visit and towards the outstanding balance on the account.
‘Lady Anne, would it be possible to have a cheque to pay something off your account, please?’ I tried to be as sympathetic as I could.
‘Oh dear. I’ll see what I can do,’ she winced and shuffled across the room towards the bureau in the corner and rummaged inside. When she found the chequebook, it was evident by its size that it was not from a normal, high-street bank. I tried to disguise the widening of my eyes. I had heard about cheques like these, from private banks like Coutts, but I had never seen one before. Suddenly I had less sympathy for the financial plight of the old lady, but Lady Anne went on to explain, as she found a chewed Biro with which to fill out the details of a payment, ‘It’s very difficult, you see. The rest of my family has all the money. They live on a large estate in Derbyshire, with staff and everything. My sister was really the apple of my mother’s eye and she got it all. I haven’t really got very much, you know. The stud fees are huge and feed and bedding in the winter is a real burden for me.’
It was so sad. I felt like saying that it was not a problem and that the cheque could wait until another day, but I could imagine how this would go down, back at the practice. I just sat in my chair, shuffling uncomfortably and looking alternately at my feet and the horse pictures on the walls.
It took quite a while for Lady Anne to fill out the cheque. With shaking hands, she handed it over, asking me to complete the ‘payee’ details on the top line. I realized she hadn’t asked me how much she owed. Thirty pounds read the spidery writing along the central line of the massive cheque.
‘Oh, well. At least I’ve tried,’ I thought, but I knew I would be in trouble. Thirty pounds didn’t even cover the cost of the drugs that I had injected into Trevor, let alone the hour or so of veterinary time, fuel costs and so on. It was woefully inadequate, but I didn’t feel it was fair to ask for any more. I bade farewell to Lady Anne, promising to visit again later in the day to check that Trevor was responding as I hoped.
I knew it would be difficult to fix up another visit in work time, because I would incur the wrath of Jean in accounts if I added more work to a bill that had an almost zero chance of being paid. So I came up with a cunning plan. The days are long in June in Thirsk and I decided to call back at Sutton Stables after I’d finished work for the day. I needed to take my dog, Paddy, for a walk and it was a perfect opportunity to visit the beautiful lake called Gormire that sits, nestled under the white stone escarpment, surrounded by ancient woodland. The road to Gormire took me right past the field where Trevor had been rolling around and I knew I could check him from the other side of the fence – a safe distance away. As long as I could see that he was grazing happily, I would know he was healthy and that my injections had worked. If he was lying down, as he had been when I first saw him today, it would be a very short or non-existent dog walk that evening and I would have to dice with danger again.
Luckily for me, for Trevor, for my dog and for Lady Anne’s chequebook, when I peered over the fence into Trevor’s field it appeared that the colt had been completely cured. He was standing with his fellow youngsters, happily nibbling grass and showing no signs of any abdominal pain at all. I could enjoy my evening dog walk in perfect peace. I followed the path to the lake, winding through the beech trees, covered in their vibrant lime-green summer foliage. It was a good way to end another busy, if slightly stressful, day.
Miscellaneous Creatures
Over the last twenty years or so, the range and type of animals that we treat in our mixed practice has changed considerably. Once, our daily routine would involve mostly dairy cows and beef suckler cows and their calves, sheep to lamb and horses with colic. Dogs and cats made up a much smaller percentage of our caseload than they do today. As farming practices have changed, the number of traditional farms with livestock in the area has dwindled, but there has been a significant increase in so-called ‘hobby farming’. The mixture of work that we do has correspondingly slowly but surely shifted. It is not uncommon for a round of visits to include a sick goat, an alpaca that has stopped eating or a miniature donkey that needs to be castrated. Even though the commercial imperative of getting a dairy cow back to full milk has largely disappeared from the majority of work in a mixed practice like ours, the role of the veterinary surgeon is just as important, arguably even more so, as people come into farming without prior experience, or branch out into unusual breeds. We treat the pet goat or pet alpaca as exactly that – a pet, a member of the family in just the same way as a rabbit is now considered part of the family, as much as a cat or a dog.
One of our farmers flatly refuses to send her old ‘cull’ ewes to market as most other farmers would do, maximizing their profit by selling elderly sheep to the mutton trade. She asks me to visit to euthanase her ‘old girls’ by injection. She can’t bear the idea that they would be sent for meat, after all they have done for her over the years. Many farmers and even some veterinary surgeons would consider this a sentimental approach, but it is not our place to pass judgement.
Some vets shy away from this kind of large animal work – it’s not exactly the premier league of vet practice but, to me, it is actually incredibly rewardi
ng. I am asked to the farm to treat the animal because it is sick, not because it has ceased to be productive. It is purely for the animal’s benefit and has nothing to do with economics. A keeper of backyard chickens wants her favourite, egg-bound chicken cured, not so that she gets back to her full egg-laying productivity, but because she wants her chicken to be happy and healthy again. To me, it doesn’t matter if the patient is a goat, an alpaca, a ferret or a chicken. Any sick animal deserves to have the benefit of veterinary help.
This gradual change in philosophy has certainly been part of the reason for the change in array of our daily patients.
* * *
The message in the daybook wasn’t very helpful. It simply said, ‘Julian, please phone Mr Nichols’ and gave his telephone number. This kind of cryptic message always makes for an entertaining phone call. It was around the time when we were in the midst of the Channel 5 series, The Yorkshire Vet, and we were getting used to a miscellaneous selection of phone requests. A call might be to congratulate us upon the latest episode, to point out a mistake we’d made on screen (‘It was a merlin, not a juvenile sparrow hawk!’), or to make a request that I talk at the local WI meeting (‘I’d love to, if I can fit it in. How many people will be attending? … Oh, about six or eight. Very good, it will be quite informal then? … I’ll see if I can fit it in. We are quite busy with this sort of thing at the moment’).
When I phoned Mr Nichols, he was quick to get to the point.
‘Well, I have this donkey. It’s a Miniature Mediterranean Donkey. It’s got a retained testicle, apparently. My vet says he can’t deal with such things. I’ve seen you lot on the telly and I know that you are the testicle experts. Can I bring it for you to have a look at?’
We do a fair few horse and donkey castrations and they are not so taxing. But the removal of an internal testicle is more complicated altogether. The job usually falls to equine vets who have the facilities to perform a full general anaesthetic and have a fully equipped equine operating theatre. My first thought was that this should be the course of action here and I started to explain this to Mr Nichols. As I was talking, though, I realized that I had never seen a Miniature Mediterranean Donkey. I imagined it would probably be quite small, especially at just six months old, as this one was. I asked about his size.
‘Oh, he’s about as big as my Labrador, that’s all. I can pick him up. I thought I would bring him over to you in my car boot, if that’s all right?’
Mr Nichols had thought it all through.
‘We live in Beverley, but I don’t mind fetching him over.’
This being the case, our small animal operating theatre would be the perfect place to perform the procedure. It would be not very much different to doing the same operation on a Great Dane.
And so we made arrangements for ‘Archie’ the teenage (in donkey terms) Miniature Mediterranean Donkey to come in. Sure enough, a week later, he was lifted out of the straw-filled boot of Mr Nichols’ car, to take his place in the kennels, next to the dogs, cats and rabbits. As he stood in the x-ray room, waiting in the dim light for his sedative to take effect, he was oblivious to the ridiculousness of his situation. Everyone who walked past had to do a double-take when they realized the creature had enormous ears and a head collar instead of a collar and lead.
Everything went very smoothly. Within half an hour, Archie’s small but elongated testicles were lying in a metal kidney dish and he was beginning to come round from his anaesthetic. Mr and Mrs Nichols had enjoyed a brief foray into Thirsk for a coffee, but were now back in the waiting room, anxious to take the little man home. Archie could just about totter out to the car park from his kennel (again heads turned) but needed a helping hand into the boot. It had been an unusual morning. Mr and Mrs Nichols were very happy. I think Archie was happy too, but it was hard to tell. His face gave nothing away!
* * *
The first alpacas to appear around Thirsk in significant numbers came in 2002, the year after the foot and mouth disease outbreak that decimated the nation’s cattle and sheep population. Thirsk was badly hit, and many farmers lost all their stock. After this terrible trauma, and after the prescribed time had elapsed before restocking was allowed, farmers turned their thoughts to what to do next. Some saw it as an opportunity to do something new. Ed and Linda, dairy farmers who had lost all their animals in the cull, had taken the opportunity, while they had no twice-daily commitment to the udders of their cows, to enjoy a holiday in South America. It is easy to imagine what happened next. Fields that once were home to over a hundred black and white cows were filled with elegant, long-legged and long-necked creatures whose eyelashes rivalled those of their bovine predecessors and whose fleeces were many times softer than those of the sheep whose fields they adjoined. When visits came through to the practice to see these unusual animals, all the other vets suddenly – or so it seemed – had very important paperwork to do or really urgent dentals to perform, and it was not long before I became the ‘alpaca man’.
At this stage I had no specialist knowledge of alpacas. I had established that they were very broadly similar to sheep (although this is a gross oversimplification, as they have numerous subtle and not-so-subtle differences in terms of both the diseases they face and the personality and behaviour they display), but as time went on, I realized that to get to know this type of camelid was to fall in love with them. On my first visit, I found that, quite unlike sheep, which would immediately tend towards fear and flight, these curious animals would come up and investigate whatever was going on. They had no malice and radiated a calm serenity, both in their demeanour and also the gentle noises they made. Standing in a field of alpacas, I discovered, was a calming, tranquil experience.
I was quickly in at the deep end and it was fortunate for me, as well as the herd, that I was fascinated by alpacas, right from the very start. After a handful of missed diagnoses, I started to feel that I knew what I was doing, until one sunny afternoon, when I was called to an alpaca that was struggling to give birth. These animals have enormously long necks and even longer limbs, so if things go wrong at a birth (called by those in the know ‘unpacking’), then things go badly wrong. My first ‘unpacking’ was probably one of the most difficult I could have faced. It was a sunny afternoon in the school holidays and my son Jack, who must have been about seven years old, had come with me to work. As I drove onto the farm, I was ushered straight up to the field where the stricken female had been corralled into an outdoor pen. I put on a glove and felt inside to try to establish the cause of her difficulty. I’d done this procedure thousands of times before in sheep, but this was the first time in a camelid.
Jack had a grandstand view from his car seat and as he peered out, my face must have been a picture of confusion as I tried to work out what I was feeling. Then it dawned on me – the alpaca had a uterine torsion. This is a condition where the uterus twists through 180 degrees. The effect it has on the birth canal is the same as that achieved by twisting the top of a bag or the ends of a sweet wrapper – it closes it off completely. The only solution was to perform a caesarian section.
Jack was not the only spectator. Ed, his wife Linda, their son (plus his girlfriend), their daughter and Linda’s father, Trevor, were also watching. Trevor was an enthusiast with a hand-held video camera and he had rushed to start filming the action as soon as Ed and Linda had realized there was a problem with the alpaca. He captured every moment. I was used to this, because one of Trevor’s first (and my first, for that matter) forays into filming was of me operating on a cow with a twisted stomach. I think he has a large archive of various vets from Skeldale, cutting into all manner of animals on his farm!
With seven onlookers, one with a video camera, the pressure was on, especially as I was in uncharted territory. This was my first ‘unpacking’ and my first caesarian on an alpaca, but one caesarian is much like another, and I decided to treat the operation as somewhere between a sheep caesarian and the same procedure on a cow, both of which I had perform
ed hundreds of times before. The gentle alpaca remained impeccably behaved throughout and, mercifully, everything went extremely smoothly.
Trevor decided to send his video footage to the local television news, such was the novelty of the event, and a reporter appeared at the surgery to conduct an interview. Linda was so enthusiastic about sharing anything out of the ordinary, and so keen on alpacas, that the next thing I knew there were pictures of me in all the alpaca magazines as well.
By strange coincidence, my second difficult ‘unpacking’ was also recorded on camera. This time the camera was altogether more fancy and was operated by David, one of the producer-directors of The Yorkshire Vet.
On this occasion the practice had received a call from Jackie, who farms a herd of about a hundred breeding alpacas. Jackie is extremely experienced and whenever I get a call from her, I know it is going to be something challenging.
‘Julian, it’s Cinderella. She’s trying to give birth, but I’m really worried that something’s wrong. She started in the middle of the night and she’s just walking around in the field, with her tail in the air. She’s definitely not right.’
This was an emergency. I put all other work on hold and whizzed out of the car park with David sitting next to me, camera poised to record. As we drove to the farm, David asked questions about what was happening, where we were going and what we might see when we got there. I explained to the camera that alpacas normally give birth with ease and that whenever a problem arises it is usually serious. As we rushed along the winding lanes to Jackie’s farm I told David all about the twisted uterus and I could see he was excited – he sensed he was onto a great story to film.
He was not wrong. As I carefully felt inside Cinderella’s birth canal, the problem was immediately obvious. All I could feel was a tail. The cria (which is the name for a baby alpaca) was in a breech presentation; that is, it was coming backside first with both back legs pointing forwards, towards the mother’s head. This was a very difficult mal-presentation as I would need to manipulate both back legs so they were pointing backwards, towards the way out. In this way I would then be able to deliver the cria, although it would still be coming out backwards rather than forwards. Of all the animals we deal with, alpacas have the longest legs for their body size and this would make the job extremely tricky. There is a real danger, when trying to hook the back legs up and back, that a sharp little hoof will tear the wall of the uterus. In a lamb or calf it is usually possible to cup the hoof in your hand, to protect the delicate tissue, but with such long spindly legs, there was a strong possibility I wouldn’t be able to get my hand far enough forwards to do this. Jackie was worried and David honed his focus to capture all the excitement on camera. It could not have been a more tense twenty minutes.