I once dated a guy - let's just call him "Farmer MacDonald" - who subsequently owned a farm and subsequently - lots of animals of the bovine type. Knowing that I was a Labor and Delivery RN, he thought he would show off his skills in the delivery area.
I should have known better.
He told me that he had a mother cow in the barn obviously in labor for several hours.
"You came just at the right time" he shouted over his shoulder. "Let's go!" He strutted off in the direction of the barn and pompously ordered about a few of the Hispanic workers for good measure. (yes, he was a bit of an ass...)
I followed him into the barn and stayed my safe distance on the other side of the corral fence, ready to watch the show. Having once owned 4 Morgan horses, I tend to steer clear of ginormous animals with feet that could be weapons. Especially ginormous animals with weaponous** feet in pain.
The poor cow was mooing and moaning......Farmer Mac reached inside her up to his elbow and pulled, trying to help the calf out. Apparently she had been in labor for a while, and he was impatient to get it over and done with. (sound familiar?)
Anyway, it seems that the calf was "stuck" and he needed help getting it out. He got out a rope and tied it around the leg of the calf. Pulled. Nothing. Yanked on the feet. Nada.
By this time several more farm workers gathered around, trying to help him out. The poor cow, by this time was bawling away, creating a restlessness among the other cows in the barn. She was in obvious distress, and the group of men around her were making her extremely jumpy.
Chains with handles were secured around the two front feet visible and Farmer Mac pulled on them with all his might (not unlike some OBs I have seen do, only without the chains....)
The poor cow shied away and rammed up against the fence and I jumped out of the way. Shouting and pushing ensued....and the workers scrambled to get a foothold..... (not unlike what I have seen happen in some deliveries)
A bar was placed between the parallel fence boards and under the cow's abdomen and the farmer pushed down hard on the end of the bar on the outer side of the fence, trying to use leverage to move the calf up and out (supra pubic pressure anyone?)
Finally, after approximately an hour of scuffling around and still just the legs hanging out and no head to be seen....it was determined that the calf was dead. Apparently, the nose, which usually follows the front feet with delivery, was twisted so it pointed toward the feet. A malpresentation. At this point, Farmer Mac was clearly pissed off, and continued to bark orders in the direction of the migrant workers.... (again -sound familiar??)
A wire appeared from his "Vet cupboard". He looped around the calf's head in utero and Farmer Mac proceeded to saw OFF the head with the wire and remove the calf in bits and pieces.
When it was all over and done with he said "Well, I guess you really didn't need to see that, did you". Matter of factly.
Me: slightly in shock. ( ya think??)
"Ummmm.....well....it definitely isn't the way we do it......." I stated, rolling my eyes.
The guy had too much of an attitude ( like many of the OBs that I had worked with in the past.....) and his total disregard and lack of respect for animals (in general) spoke volumes to me.
I punted him soon thereafter.
>>>>>>>>
This is, btw, the way it is supposed to happen.
This is what he was trying to do. (although the actual way is to alternate pressure on each leg to walk it out)
Sometimes they use "forceps" - or a "rocker" in farm language. :(
Look who comes in to help resuscitate....!
Applying support to the perineum in an odd way.
**is this a word?? :)
16 comments:
First: this is an excellent example of why fewer and fewer veterinarians work on production animals: the farmers aren't willing to pay us for our professional services.
Second: In cattle, if a cow has been pushing for more than about three hours, she needs help (this is a species difference; cats and dogs can go much longer). Dystocia for disproportion is very common in cattle (think: large bull, small heifer). Dystocia for malposition (think: long-legged calves) is also common.
Veterinarians tend to utilize epidurals to prevent the cow from straining while untangling the calf. We also perform caesareans in the field if it's not possible to untangle the calf. Of course, we have sedation and pain control available for dystocias.
Because a fetotomy is less traumatic to the cow than a caesarean, it's not uncommon to remove a dead calf in pieces. It looks terrible but it's more humane to the cow. Sometimes the calf comes out several-days-dead and partially decomposed (think: range beef cattle).
There are some major species differences re: birth. I'm an equine veterinarian and do no cattle work at this time. Dystocia in mares is generally fatal to the foal; if the mare has been pushing for more than 20 minutes, the foal is almost certainly dead. Additionally, we don't perform caesareans in mares in the field; these are all shipped immediately to a surgical facility.
I suspect the issues in large animal calving/foaling are actually quite different from those in human birth. Most of the veterinarians and good producers I know don't bother animals having normal births beyond ensuring that it is, indeed, a normal birth. Furthermore, there are major physiological and anatomical species differences. As I mentioned earlier, foals rarely survive a dystocia unless the foaling is attended - which is why serious breeding farms generally attend every foaling (every horse is observed every 30 minutes, around the clock, or devices such as FoalAlerts are used).
Really not the same as in humans, though I understand why your personal experiences may have caused you to be disturbed by the calving you described (I'm disturbed, too, but for very different reasons!).
By my sarcastic comments in parenthesis (and rolling of the eyes)you can tell that it was mainly his attitude that disturbed me...(plus note the "punted" at the end!) :)
The guy was pretending he was a Vet and wanted to show off his skills...the guy was a jerk.
I know that human delivery is different than animal although by what you are saying (large bull, small heifer – same thing happens in humans/ dystocias – also happens in humans/ human fetuses removed that have been long dead and not expelled-not always in great shape). I was told once, when we had our 4 Morgans that it was the centuries of breeding and assisting etc of the horses that created a lot of the problems with delivery. You might want to comment on that... :)
My gf's husband is a large animal Veterinarian and I have heard a few stories :) so I hear you about the production animals and their owners...
With the Youtube links - I tried to show the parallels between humans and cattle....some of the things that might be comparable... :)
The same farmer guy would also neuter his male cats with an ordinary sharp (or not) knife and no anesthesia and nothing for pain. He was a creep. Thus the comment at the end (and the reason for the punting)
by the way Outrider...I have a lot of respect for Veterinarians - they do the same thing as MDs but it is more difficult because you have patients that can't tell you what is going on with them.... :)
Thanks for your enlightening comment! :)
Re: assisted deliveries in horses = more problems... only in that horses who are at higher risk for dystocia may now survive rather than die while foaling, thus leading to a higher overall rate of dystocias via thwarted natural selection. You can comment on whether this phenomenon occurs in humans if you'd like. :-)
The fact is, most births in valuable horses are attended, and most attendants hope they have nothing to do but observe. Attendants ensure the foal nurses (horses, unlike humans, must absorb colostrum within 12 hours to avoid death by sepsis - another species difference), and in certain cases, ensure the mare doesn't reject or attack the foal. I really hope women don't attack newborns immediately following birth, but it's probably not unknown.
It's actually rare for dystocia in horses to be caused by disproportion. It's usually due to malpositioning or fetal malformation (contracted limbs in a fetal monster, for example). For cattle, it's just the opposite. Why? Cattle producers prefer to breed young and develop calves quickly, thus, heifers + large bulls (via AI) = dystocias. Not so for horses. Dystocia is actually relatively rare in horses, though it can be a devastating emergency for those who aren't prepared
It is my understanding that the importance of maternal/fetal disproportion in humans is exaggerated and a justification for the current high rate of caesareans. Correct me if I'm wrong.
Your jerk farmer pal is not alone. Piglets and calves are routinely castrated with no anesthesia (cost and drug residues). I also know of horses (yearlings and even 2-year-olds!) castrated with a pocket knife under rope restraint by breeders/trainers, no anesthesia. Don't get me started...
Well, that makes sense. Breeding in cats have also done the same: created subspecies that have multiple medical problems. As for humans...I am thinking that there are equivalents - we are saving babies that used to die - and therefore are creating medical weaknesses in that way, although that doesn't necessarily mean they aren't productive members of our society....ethical issue here. :)
Interestingly enough, I worked with an OB that wrote a discussion paper on frequent incidence of dystocia in Asians when they move to America due to change in diet...not sure it was accepted by the College... ;)
There is a teeny bit of a parallel with the colostrum thing. Immunities are passed on to the human baby....however - mothers attacking a baby is another whole ball of wax which I won't get into here, totally unrelated to the non-consumption of colostrum! But have seen it happen. :(
I believe you are correct about the exaggerated dx of disproportion leading to increased c/s in humans.... nowadays everyone wants a perfect baby and if there is any hint at that not being the case...the c/s is brought in "to the rescue"...whether it comes from the MD or perceived by the mom/dad. There is a whole HUGE discussion on this also - and as you say " Don't get me started"!!
:)
Dystocia in cats is very rare, in my experience. Even when one considers the variety of breeds, cats, unlike dogs, are all about the same size, though, and kittens have stubby little limbs that generally squeeze through in any direction. As for health problems... yes, that's true, any time a breeder selects for traits not directly related to survival (brachycephalism aka smushed face, color, etc.).
As for extreme preemies... yeah, that's a whole ethical discussion. I'd tend to pick my battles but then again, that's why I'm a veterinarian, DEFINITELY not a NICU clinician.
Re: dystocias in North American Asians... I wonder if this depends upon the rate of marriage of Asian women to Caucasian men. Tiny Vietnamese woman + Huge Swedish man = higher likelihood of trouble, at least from my veterinary perspective. I wouldn't expect as many problems with women producing children with men of the same ethnic background. (For an interesting discussion of this very issue, check out The Spirit Catches You and You Fall Down by Fadiman).
Of course I know human infants should, optimally, receive colostrum, but this is an absolute necessity for survival in foals. We transfuse foals who don't receive colostrum within twelve hours because otherwise, they will inevitably die of sepsis within days. The explanation is the type of placentation in horses (vs. primates), which is also the reason foals are dead only 20 minutes after a mare starts pushing in a dystocia.
What an interesting post...and a more interesting dialogue between you two. I learned a thing or two today.
Thanks for your enlightenment! how interesting! The more i read...the more i see how lucky we were to have a live foal.... :(
As for cats....I have always gotten mine spayed immediately, so never have seen the birth of any...usually I get older cats from the local SPCA...
Re: Asian women, I am thinking it was just the diet the OB was looking at (ie from mostly rice to fats and other american type foods), but having a larger partner would have the added size discrepancy thing in addition to....
*sigh*
Sometimes I wish I went into the animal field. It's not considered *quite* so bad when you have a kitten that is a little brain damaged...
oh! just recalled what the OB paper stated... (can u tell I am getting OLD - deterioration of grey matter here!)... I believe his hypothesis was that Asians, within their culture over the centuries have no longer needed the pelvic proportions required to deliver due to their diet and "evolved" to the "size needed" and when a dramatic change came about with diet change when in a society that eats differently (lots of fats) ....I am going to have to do some research on that...because I have seen lots of obese women giving birth to teeny babies and vice versa. But, then, one or two anomalies does not a fact make....
Thanks Wild! It's been an interesting conversation.... lots of info I didn't know either! :) I am thinking Outrider needs a blog........ :) please? :)
oops, should have said "pelvic proportions required to deliver BIG BABIES"
Re: live, healthy Morgans... yes, I'd say a healthy foal always requires a little luck. True in any species. :-)
As for "slightly damaged" kittens: well, usually we euthanize them, or they die when the mother cat rejects them. Or eats them (I really hope humans don't do that?)
Slightly damaged foals? In a valuable mare, this can be almost as bad as a damaged human infant. When the breeder paid hundreds of thousands of dollars just for the stud fee, well, it's not good when the foal dies of sepsis or is born with a limb deformity. Interestingly, neonatal maladjustment aka "dummy" foals are usually okay as athletes if they survive. Sometimes it's good for a performance horse to be a little stupid. Kinda like football and hockey players (boo hiss - I know!).
Veterinarians, especially large animal veterinarians, are taught to evaluate QUALITY of life, not necessarily quantity, and definitely not just "life" (I foresee eventual conflict with human healthcare providers, BTW). There are no quadriplegic horses (we euthanize them). What we call catastrophic fractures are generally fatal injuries. Ruptured bowel, in a horse, is a death sentence.
As a veterinarian, I want my patients to live and have a good quality of life just as much as any human physician wants her patients to live. Even though I recognize human life ranks above animal life, horses aren't "lesser", as patients, to me. If animals were "lesser" to me, why become a veterinarian?
Re: veterinary profession - I take my work very seriously, but I also euthanize my patients. That can result in enormous internal conflict, especially when the decision NOT to treat is not mine, because animals are their owners' property. One recent article on veterinary suicides (our rate is double that for physicians) mentioned that we see death five times more frequently than human healthcare workers.
I do not have a blog. Way too much commitment... how do you folks find the time to write about interesting stuff on a regular basis? I am writing a book. Winter is my slow time, so I'm hoping to make real progress.
Gotta make tea and walk the dog. :-)
I suppose, when I talked about "damaged" critter - I was thinking specifically about my cat, who really is a simpleton. As a cat, she functions quite well, if she were human, she would be dependent on society. :) I am pretty sure she was a little oxygen deprived at birth or something....but i still love her!
Commitment? I would say a book is waaay more commitment...never mind that it has to be GOOD. Blogs aren't necessarily good, nor do we have to have immaculate spelling or grammatical correctness ... although I probably wouldn't continue to read a blog that was painful to wade through unless it was really riveting. We don't even have to be interesting. Most of it comes from the top of the head and is like a conversation and just gets blurted out. Some people are very serious about it. I just write because I like it and I want to get it recorded before I lose all my grey matter.... :)
Oh...re: football players...most football players here in Canada have University degrees. As for hockey players....not sure about them...never liked the sport, and ya that is a Canadian saying that.
The Hockey Night in Canada theme song still grates on me.....
Oh...btw, THANKS! "interesting stuff" wow. Complement! (although I suppose I am assuming mine is interesting because u are reading it! )
I love dialogues like this. Would love to read your book. I happen to love animals even more than people.....
Re: football players... I don't think all football players are dumb. I do, however, think it helps athletes to be a tiny bit stupid when it comes to self preservation. Especially now, with current information about the chronic effects of repeated head injuries specifically in football players.
Some of the top horses I know are a little bit stupid re: self preservation.
FWIW, I don't believe a college education necessarily equals intelligence, but that's a whole other discussion. :-)
Re: "damaged" pets... I'm assuming your kitty can walk, eat, drink, mostly use the litter box and play. She may be slow, but if she were human, she might do well in assisted living or a group home.
I see horses that live in chronic pain and develop gastric and colonic ulcers secondary to NSAID use; are neurological; choke on food and develop esophageal strictures then aspiration pneumonia; are down for much of the day and develop pressure sores - that's not okay. Some of these problems can't be fixed, or the owner can't or won't pay for appropriate definitive treatment. That's when it's time to think about the welfare of the horse.
Autumn is not easy for equine veterinarians. We kill a lot of horses this time of year, before the ground freezes.
Still, I'm grateful veterinarians have this option for our patients. I've seen relatives, friends and clients die badly, and, largely, I think their physicians let them down. I've also seen NICU graduates who are no longer babies but children and teenagers. It's not pretty, and their parents are perpetually exhausted and overwhelmed even though they love their kids.
I think every NICU physician should have to spend a full week - 24/7 - in the home of one of these teenage NICU graduates, with that kid's family and caregivers. It would be enlightening, to say the least.
"Quality of Life"....good points you make. How much should be done. My heart goes out to those parents. Also to those people caught in the web of those end-of-life issues.
Remember, "They Shoot Horses, Don't They?"
Re: my cat...she doesn't know how to play, really....but fortunate for me...she definitely uses her litter box (CatGenie! no less!)but is a lot OCD..where NOTHING can be moved, and NOTHING new can happen without her freaking out. I have to take her toys away at night so she doesn't run around the house with them screaming all the while. She HATES going for her checkups to the point where she gets extremely tachy (where the Vet gets very concerned) and I am considering paying the extra for home visits.....
...and ya, I would agree about "college/university education = intelligence, or should I say - common sense....? :)
Though I don't shoot horses, if done correctly, it's more humane and far more environmentally friendly than euthanasia solution.
End-of-life issues... URL provided; you can probably watch this streaming on line. The PBS show Frontline did a recent program on this topic. Disturbing:
http://www.pbs.org/wgbh/pages/frontline/facing-death/?utm_campaign=viewpage&utm_medium=toparea&utm_source=toparea
Thank you Outrider for the link. I finally got to watch the whole program in it's entirety. Interesting and very thought provoking.
Personally, for myself - I have no problem saying no to complex care at life's end. I would even consider saying no to cancer treatment if it is not the type that has excellent outcome. I would choose to die gracefully and live life to the fullest possible- for as long as I can - based on what I have seen myself in hospitals.
As much as technology has progressed, the ultimate in life is death....and it best be done in a quiet, unobtrusive way (such as birthing *should* be) rather than the hospital environment. I believe we have gone backwards in both spectrums of life.
Thanks once again for the link.
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