D E Larsen DVM
Editor’s note: This article contains some explicit biological terminology.
It was a late spring day with mostly blue sky, but some heavy dark clouds.
Walt was waiting when Ruth and I pulled into his barnyard. Ruth was short with dark hair. She had worked for me for a couple of years and although not a farm girl, she really enjoyed the farms we visited.
Walt’s farm had offered a variety we didn’t often see: draft horses, along with the cattle.
Walt greeted us with his beaming smile and an outstretched hand, his handshake firm and sincere. I knew these men judged men they met by their handshake – something I didn’t learn in school, but I had learned long ago growing up around men who earned their living working with their hands.
The little steer calf was standing in the loafing shed, twitching his tail and stomping his hind feet. When I moved a little closer, he pressed against his mother’s hind leg. Mamma shook her head at me and moved into the corner of the shed.
“He is pretty uncomfortable,” I said to Walt. “How did you recognize him out in the pasture?”
Walt was a tall, thin man with a broad smile on his face most of the time. Lean does not mean that he was not strong. Slim, wiry, and tough as nails, Walt could work most men into the ground.
He had a team of draft horses, Belgians, that he used to put up his hay in the field that was next to the highway. I am sure that many people would observe him and fail to realize how rare the spectacle was today. I always enjoyed watching the horses work and would often take the back road so I could stop and watch for a time.
“The little guy was not moving around at all,” Walt said, his obvious concern betrayed by a fading smile. “I noticed him and his mamma standing over in the corner of the pasture, all by themselves. With all this stomping and tail twitching, I figured something must be wrong.”
“He is pretty young for a urinary stone,” I said, “but this is what they act like early on in the course of things. We don’t see this much around here, but it was common in Colorado where I went to school.”
Urinary stones were uncommon in beef cattle in the Willamette Valley, meaning that I would see a case once or maybe twice a year at the most, often going several years between patients.
I was surprised that Walt would recognize the stomping and tail twitching as enough of an issue to call me early. It demonstrated how some of these old farmers were so in touch with their animals that they knew when there was a significant problem.
“It is early yet, and he is uncomfortable because of his distended bladder. In a little while, one of two things will happen; either his bladder breaks or his urethra breaks. When that happens, the pain goes away, but the problem becomes much more difficult to fix. It is a good thing that you called early.”
The calf was easy to catch, and we tied his head and then ran the mamma cow outside. I was sure of my diagnosis, but completed a quick exam. His temperature was normal, and his chest was normal.
On the rectal exam, I laid my fingertip on his pelvic urethra. It was continually pulsating. This guy had a stone blocking his urethra for sure.
I took a second rope and tied a loop in the middle of the bite of the rope. I slipped the loop over his neck with the knot lying between his front legs. The rope ends crossed in the middle of his back, ran down his sides, and came out between his hind legs. This was called a “flying W” and is a standard method to throw a cow. It was generally not used on a small calf, but we would have to tie him down for surgery.
I grabbed the two ends of the rope and pulled. The calf stiffened and fell on his side. We rolled him up on his back, flexed his hind legs, and tied each leg with the ropes in a manner that when he kicked, it would put more pressure on his back and add more restraint.
Once restrained, I got on my knees so I could palpate the length of his penis. Stones generally lodge at the point of the attachment of the retractor penis muscle in the sigmoid flexure of the penis. I grasped this portion of the penis with my left hand to stabilize it.
With my right hand, I could easily palpate the stone.
“This is going to be easy,” I said to Walt. He was watching closely. Most of these guys had not watched a calf thrown so easily before.
“So far, you make it look easy,” Walt said.
We clipped and prepped the surgery site, and Ruth opened the surgery pack while I put on gloves. This was barnyard surgery at its best. There was fresh straw down, but the ground’s softness under my knees told me we were on top of a foot or more of straw and manure.
The surgery was brief, as I had promised. I injected the area with Lidocaine for local anesthesia, grasped the penis to stabilize it, palpated the stone, and made about a 2-inch incision over the stone. I bluntly divided the tissues with a pair of forceps to expose the urethra with the bulge where the stone was located.
Once this was exposed, I ele-vated the penis. I drove a scissors under the penis and out the other side to maintain the exposure and stable urethra and free up my left hand. I palpated the stone again, then carefully incised the urethra, feeling the stone’s grit as the scalpel pulled across it. I grabbed the stone and pulled it out of the urethra with forceps. I placed it on the surgery pack. I took a urinary catheter and ran it up the urethra toward the bladder. It was just long enough to reach the bladder. We relaxed as urine drained out of the catheter.
I could imagine that the calf was feeling some relief at this point. When the urine stopped, I removed the catheter. I then ran it the other direction to ensure the rest of the urethra was open.
Now we had a decision to make: to close or not to close the incisions. I had the option of leaving the incisions open. I sort of favored this because there might be more stones in the bladder and they would have the chance of passing out the incision if it were left open.
Barnyard surgery is not the best in the world, and closing the incision always gave the possibility of infection. And closing the urethra on such a small calf could lead to a narrow spot that might cause problems later. The only problem with leaving the incisions open was that urine would flow out of the incision for a week or so until there was enough healing to allow normal flow.
I was getting ready to discuss all this with Walt when the calf kicked. He got one hind leg free from the restraint. He kicked again, and the surgery pack went flying. The decision was made by the calf.
I grabbed the scissors, releasing the penis to return to its normal position. Ruth started gathering instruments that were scattered through the straw.
Walt was crawling across the straw on his hands and knees, concentrating on one spot. He ran his hand across the straw a couple of times. Then with a beaming smile raised his hand, he had found the stone.
“This is going on my mantle,” he said, still smiling.
We let the calf up, sprayed for flies, and I explained the urine flow issue to Walt.
Things turned out OK.
And I will never know how Walt could keep track of that stone in all that commotion.
– David Larsen is a retired veterinarian who practiced 40 years in Sweet Home. More of his stories are available on his blog at docsmemoirs.com.