A Disastrous Delivery

     I mentioned earlier that many of my memories from practice involve cases that had bad outcomes. I think that is because good outcomes were usually expected, and when things go as expected, they are not memorable to me. But the bad ones are strongly embedded, and they come to mind as I write about my career.

     Jim called to our office to say that he had a cow in labor, and that she would require a cesarean surgery to deliver the calf. That message was relayed to me, and as I began traveling to Jim’s farm I wondered what circumstances had led Jim to that opinion. I learned the answer soon after arriving at the farm.

     Jim explained that the cow in labor was carrying a calf that had been implanted as an embryo into her womb nine months earlier. Genetically, the embryo was from a far superior cow that the one that was now carrying the calf. The calf was extremely valuable, financially worth far more than the cow in labor. Because the cow had not delivered the calf on her own in a timely manner, Jim thought that a cesarean section was the most certain way to get a live calf delivered.

     I thought it was at least worth evaluating the position and size of the calf before doing surgery and expressed that to Jim. He agreed, but once again emphasized the value of the calf. My examination revealed that the calf was of normal size, and that it was positioned correctly for birth. I was confident that mild traction on the front legs would yield the birth of a live, healthy calf within a few minutes. I suggested we try this, and Jim reluctantly agreed.  

     Because of the presence of fetal fluids on the legs of the calf, they tend to be slippery. To get good traction, a small stainless steel chain was usually attached to each leg. To avoid excessive pressure in one spot, a “double-loop” was utilized, with one loop above the fetlock and one below it (the fetock of a calf’s let is equivalent to the last knuckle of our fingers). If the double loop is not used, and if hard traction is applied, the pressure would sometimes be enough to fracture the leg.

     I used the double loop in attaching the chains to the calf’s legs, still located deep in the cow’s birth canal. Then Jim and I began to pull, and soon saw the feet emerge, with the tip of the nose also visible. So far, so good. I was confident we would be successful. Then I noticed that the second part of my double loop on one leg had slipped off the end of the foot. A quick decision was needed. Should I take the time to reapply the second loop, or just continue? Because the calf was coming easily, I decided the danger of a fracture was very small, and chose to continue pulling. This was the wrong decision. A few seconds later Jim and I both saw the sickening sight of the bone above the fetlock snapping under the pressure of the single loop of chain.

     By now the calf was half-way out, and Jim and I simply grabbed both front legs above the elbows and finished the delivery. So we now had a healthy calf in every way except for one broken leg. Jim was surprisingly calm. Despite being embarrassed and very disappointed, I was still quite confident that I could salvage the situation. Fractures in young animals usually heal quickly. I knew that I could apply a splint to stabilize the leg, and fully expected the calf would recover completely. 

     My biggest concern was that the skin had torn when the bone broke, exposing the fracture sight to germs. I cleaned the wound thoroughly, disinfected the area, and sutured the small laceration. Then I applied the splint. I also administered antibiotics to further minimize the chance of infection. Jim remained calm and pleasant, but he must have been rather frustrated that I had not done the cesarean section that he had emphatically requested.

     I stopped by the farm a few days later to find the calf doing very well. Of course, with three healthy legs, the presence of a splint on the fourth one did little to impair her. She was bright and alert and eating well. Her temperature and vital signs were all good. I was very relieved. Jim seemed fine. My plan now was to change the splint every two weeks and expected the bone to be fully healed by six weeks.

     When I returned to the farm for the first splint change, I was glad to see that the calf was very active. Jim reported that she was eating well. However, as I began removing the splint, I began to detect the unpleasant odor of infection. Removing the last bit of wrapping revealed pus oozing from the laceration. This was very bad, as it implied infection of the bone, and did not bode well for full recovery.

     I explained all of this to Jim and suggested that he take the calf to the veterinary college at New Bolton Center for further evaluation and possible treatment. He did so, and later that day called to tell me that x-rays had shown extensive bone infection. Prognosis for recovery was now very poor. The doctors there recommended euthanasia, and Jim authorized them to do it. Remarkably, Jim did not blame me or complain.

     My disappointment was huge. I wondered if I should offer to pay Jim something. Yet I knew that I had acted responsibly in my approach to the original situation. Sometimes, despite our best efforts, things simply go poorly. I continued to work with Jim until I left practice, and over-all I gave him excellent service, yet my memory of Jim will always be tainted with the memory of the disastrous delivery.