Dr. Colleen Lewis / March 6, 2017
Written from the cow perspective, but pertains to all ruminants, large and small.
Raising livestock isn’t always glamorous and fun, but you can be assured that it will be unpredictable. Planning for an emergency has to start before the emergency occurs. Do not get caught flat footed and ill prepared for the inevitable.
Dystocia is defined as calving difficulties or failure to progress through the normal stages of calving. There are three main categories that constitute a calving/post-calving emergency:
1. Failure to initiate calving while STUCK IN STAGE 1
The dam may offer very few symptoms that anything is wrong. The cervix is usually dilated and effaced, yet the neonate never makes it up into the vaginal vault. Typically, the cow, never engages into active labor. The longer a calf stays in the uterus with the early contractions, the more she is subjected to lack of oxygen (hypoxemia) and dropping of blood pH (acidemia). The newborn, due to length of time in stage one, has a dramatically increased rate of morbidity and mortality. Over 50% of stillborn calves are considered statistics of a prolonged stage 1.
2. Starting the second stage of labor, but NOT PROGRESSING
We would all like to see stage two last for 30 minutes to an hour in mature cows and less than two hours for heifers. Calves in a prolonged delivery are subject to the same risks of hypoxemia and acidosis as calves stuck in stage one; increasing their morbidity and mortality rates.
3. Incomplete stage 3 with a RETAINED PLACENTA
A retained placenta can create a toxic cesspool of infection. Color/consistency (changing to thin and brown) and smell (wow!) will tip you off to the beginning of the end. Do not let these cows progress to anorexia and ketosis. Prompt care is important!
A good history and examination will help to diagnose and treat down or lethargic animals. I cannot stress the benefit of bloodwork enough. Once an animal has been down for more than three days, their prognosis starts to fall off dramatically. Once a cow has been down for 5 days, the odds of her ever rising again are very small. Getting serious about a down cow early to prevent her demise can be very rewarding. Many reasons why cows are down can be readdressed through management and nutrition. Tweaking protocols can prevent other cows from enduring the same problems in the future. Waiting five days to call your veterinarian can put these cases at an incredible disadvantage.
An arterial bleed that involves bright red pumping, squirting or non-stop blood flow needs immediate attention. At the site of any breeding injury apply pressure using gauze or something made of fabric. Materials with texture will facilitate clotting by providing a little lattice to build on. Keep the first layer of material that you apply firmly in place as the blood begins to form a soft clot. Leaving the first layer in place allows the network of clotting ample time to build and take hold. Once soaked with blood, you can add another layer of absorbent material on top. Pulling the first layer off will start the clotting system all over again, so avoid removing the first layer when possible. If immediate, local pressure isn’t enough, look for a way to slow or stop the bleeding by either applying a tourniquet or applying immediate pressure to the artery or vein supplying the injured area. Adding a cold pack on top of your initial application may also help; the blood vessels will naturally constrict to reduce blood flow.
The blood supply to and from the udder is formidable. The milk vein is often readily recognizable externally as it leaves the fore udders and disappears through the body wall as it courses to the liver. The fact that the milk vein is so exposed with only the skin and hair to protect it makes it vulnerable to injury. Even though this vein is not under as much pressure as an artery, the volume is tremendous. Since the direction of the blood flow is from the udder, apply firm pressure along the entire route of the vein as well as direct pressure until help arrives.
Every full thickness skin injury is different, yet all share the need for attention. Prompt repair of skin wounds, within 12 hours, will minimize pain, infection, and severity of scar tissue formation. Lacerations that are promptly surgically repaired will usually require less long term wound care than untreated wounds. Even if it looks like some skin is missing, many surgical closure techniques can decrease and even eliminate large gaps and holes. The skin is very pliable and can often be stretched or released: a technique used to spread the skin over a larger area to cover deficits.
A “closed” wound is sutured completely closed, skin to skin, with no gaps, holes or drains. Staples and tissue adhesives can also be used depending on skin thickness and tension. Sutures are generally removed in 10 to 14 days and little more than monitoring is required during the healing phase. An “open” wound is not sutured or reduced at all. Wounds left open to heal are meant to heal by second intention. Second intention wounds may require daily cleaning and copious flushing. Areas with devitalized tissue may require debriding; depending on location, a wound may require extensive bandaging as well. Open wounds typically heal in two to four weeks, but may take longer if massive damage or infection are present. A “partially open” wound will be reduced with some form of skin to skin contact, but holes or gaps may remain. A drain or multiple drains may be placed in any type of open wound to assist in keeping the wound open and draining as it heals from the inside out. Parts of the open areas will then heal with second intention. Once the wound is completely closed up around the drain, the drain is pulled and the remaining tracts are monitored and treated as needed until healed.
Old lacerations can still be treated as open or partially open with or without drain placement; the more tissue we can cover with a natural skin bandage, the faster wound healing can get underway. Any pockets or dead spaces that are created by the injury as it pulls the skin away from the underlying connective tissue can become contaminated. Pockets that are not oriented to drain naturally will pool fluid and create a cesspool of infection. Exploring the wound for pockets or secondary abscesses is an important part of wound care. If a fluid pocket develops below a wound, bacteria can start to produce toxins. These toxins will be absorbed into the bloodstream and cause grave illness that can lead to death. Pockets can appear even weeks after the initial injury as some bacteria are slower to replicate or produce toxins. Bite wounds are guaranteed to create a pocket. Opening up pockets to allow complete drainage as infectious fluids are produced is paramount.
Non-weight bearing cattle need immediate attention. While shoulder dislocations are rare, fractures below the knee are not. Bones that are fractured and displaced are manipulated most easily in the first few hours prior to development of excessive inflammation. Leaving a non-displaced fracture without support or splinting can also lead to further displacement and possible advanced nerve or tissue damage. Stabilize both open and closed fractures. Casting is a simple fix in some lower limb fractures, especially in young stock. Open (broken skin) or compound (exposed bone) fractures are a great risk for contamination and require immediate attention to prevent bone infection. Copiously clean open wounds and bandage well above and below the potential fracture site for support while waiting for further care. If transporting is necessary, load the animal with the affected limb toward the rear of the trailer; a probable front foot fracture would require tying a heifer in the trailer in a rear-facing position. This places the stress of trailer braking onto the uninjured rear limbs.
Gas distention that is new or uncomfortable can be very serious. When coupled with reduced feed intake or failure to eat, it can be a disaster. Grain overload and acidosis are extremely common. Keep a close eye on changes in feed, even subtle changes in the quality of the hay fed can have a major impact on gastrointestinal health. Early diagnosis can help to distinguish between individual animal problems or impending herd issues.
Stocking a few first aid supplies in your arsenal will come in handy for the many emergencies that are possible on the farm. This list will change depending on your species and type of operation.
About the Author
Dr. Colleen Lewis is a 1996 graduate of Kansas State University, College of Veterinary Medicine. Her career has taken her to many places as a practice owner, consultant, embryologist, and mentor. She enjoys mixed animal practice, teaching, traveling, farming and high school sports with her husband, Andrew and their three boys.
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