Over on Animal Science Review, Austin J. Bouck just posted his paper, Do organic animal operations encourage management decisions that negatively impact animal welfare? Personally, I do tend to buy organic dairy products when I can in hopes that I’m contributing to improved animal welfare, even though deep in my heart I suspect I’m doing no such thing. In veterinary school, classmates told me they avoided buying organic because of things they had seen on organic farms. I’ve argued before that the best way to ensure the welfare of the animals whose products you consume is to make your purchases at a local farmer’s market, but of course not everyone has access to those. So this question of whether organic is good for animal welfare or not is a pressing one.
Austin starts out with a discussion of terminology. The word “organic” has a legal meaning, but many producers also use terms like “natural” and “free-range,” which don’t. What do these terms mean to producers and what do they mean to consumers? I have heard veterinarians dismiss these terms as meaningless, but Austin describes a tendency among organic producers to view their ecocentric model of farm management as a way of managing their animals “naturally.” In an ecocentric model, overall sustainability of the farm and interactions with the environment take priority over individual health.
If that’s the case, what are the consequences to individual health of prioritizing the environment over the individual? Austin uses as his examples dairy cows, focusing on the use of antibiotics to treat infected udders, and chickens, focusing on the use of medication for parasite infection. In both cases, he describes the strong incentives for organic farmers to withhold treatment for disease, as once an animal has been treated with an antibiotic or antiparasitic, its products (milk, meat, or eggs) can no longer be considered organic. Austin explores alternative treatments and concludes that none are effective. He notes that in Europe, use of antibiotics and antiparasitics to treat clinical disease is legal in organic production; only preventive use is banned. He advocates a change in U.S. regulations to imitate the European model, on the reasonable theory that if incentive to withhold treatment is removed, then more sick animals will be treated.
I agree! I would have been very interested to hear some statistics about how many animals go untreated on organic farms, or how far illness on these farms might be allowed to progress before animals are treated, compared farms using conventional methods. Austin doesn’t say, and I think this is because no one really knows. It would be an interesting line of research, and possibly a necessary one if we want to get the American public fired up to support change in the current regulations. If a video of a sick cow being moved by a forklift was invigorating to the animal welfare community, maybe some videos of untreated sick animals on organic farms would be as well.
Check out the paper. It’s an interesting read.
Showing posts with label food animal medicine. Show all posts
Showing posts with label food animal medicine. Show all posts
Thursday, June 21, 2012
Thursday, May 24, 2012
Antimicrobial oversight in veterinary news
Antibiotic resistance is growing, and we’ve all heard that doctors should prescribe fewer antibiotics. But the bulk of antibiotic use in the United States is in food animals. Producers feed antibiotics not only to sick animals, but to promote growth. This is a potential issue for human health, but the solution isn’t immediately clear. Which antibiotics specifically should be limited? Where exactly should we draw the line between use to prevent disease and use to promote growth?
A news article in the June 1 issue of the Journal of the American Veterinary Medical Association (JAVMA), “Proposal calls for changes in antimicrobial use,” (not open access) describes guidance documents published by the Food and Drug Administration about the use of antibiotics in food animals. The FDA’s plan for managing antibiotic use in livestock involves:
What’s good here is veterinary involvement, though I’m biased in that area. Veterinarians are the group who best understand the implications of the use of particular antibiotics, both from the perspective of benefits to human health when antibiotic use is reduced, as well as benefits to animal health and producer finances when it is increased. Veterinarians will be able to make decisions more flexibly about how and when to use antimicrobials in the absence of regulations. As our understanding of appropriate use changes, changes in practice will not be delayed by the syrup-slow process of changing regulations.
What’s disappointing, but not surprising, is the failure of the JAVMA article to discuss a reduction in the need for antibiotic use in food animals to reduce disease. Conventional food animal husbandry, in my opinion, can be highly stressful for animals, with crowded housing and long-distance transportation. Antibiotics are useful to keep these highly stressed animals from succumbing to disease, but shouldn’t we also be talking about reducing their stress to reduce their susceptibility in the first place?
What’s worrisome about the proposed guidelines, of course, is obvious: will producers and pharmaceutical companies voluntarily comply? The FDA proposes a three year window to see if they do. After that, it seems likely that they will pursue a regulatory solution. I very much hope that the voluntary solution works. As I said above, I believe it’s a more agile solution, able to adapt more flexibly to changes in our understanding of antibiotic use in food animals. However, I hope the FDA is not overly optimistic about human nature by making the guidelines entirely voluntary.
A news article in the June 1 issue of the Journal of the American Veterinary Medical Association (JAVMA), “Proposal calls for changes in antimicrobial use,” (not open access) describes guidance documents published by the Food and Drug Administration about the use of antibiotics in food animals. The FDA’s plan for managing antibiotic use in livestock involves:
- voluntary compliance by producers and pharmaceutical companies
- cessation of use of antibiotics for growth
- “judicious” use of antibiotics for prevention and treatment of disease
- involvement of veterinarians in the decisions to use or not use antibtiotics in particular cases
What’s good here is veterinary involvement, though I’m biased in that area. Veterinarians are the group who best understand the implications of the use of particular antibiotics, both from the perspective of benefits to human health when antibiotic use is reduced, as well as benefits to animal health and producer finances when it is increased. Veterinarians will be able to make decisions more flexibly about how and when to use antimicrobials in the absence of regulations. As our understanding of appropriate use changes, changes in practice will not be delayed by the syrup-slow process of changing regulations.
What’s disappointing, but not surprising, is the failure of the JAVMA article to discuss a reduction in the need for antibiotic use in food animals to reduce disease. Conventional food animal husbandry, in my opinion, can be highly stressful for animals, with crowded housing and long-distance transportation. Antibiotics are useful to keep these highly stressed animals from succumbing to disease, but shouldn’t we also be talking about reducing their stress to reduce their susceptibility in the first place?
What’s worrisome about the proposed guidelines, of course, is obvious: will producers and pharmaceutical companies voluntarily comply? The FDA proposes a three year window to see if they do. After that, it seems likely that they will pursue a regulatory solution. I very much hope that the voluntary solution works. As I said above, I believe it’s a more agile solution, able to adapt more flexibly to changes in our understanding of antibiotic use in food animals. However, I hope the FDA is not overly optimistic about human nature by making the guidelines entirely voluntary.
June 1, 2012, Vol. 240, No. 11, Pages 1266-1277
doi: 10.2460/javma.240.11.1266
Friday, September 30, 2011
Being a food animal veterinarian, day 8
Day 8 was not like the other days. My rotation-mate Delilah and I signed up to spend the day assisting with embryo collection at a farm that works with my school to preserve heritage breeds. The farm acquires (usually on loan) individuals from heritage breeds of sheep, cows, and goats. They superovulate and breed the females, then collect the embryos and cryogenically store them. Del and I kept asking what the plans were for the embryos. No plans! We are just storing them in case they are needed some day when these breeds are extinct.
The facility was beyond lovely, a 1920s folly farm that looked like a crazy cross between a medieval castle and a Mexican mansion. Biosecurity was a big concern there, so we had to cross a little bridge with a foot wash on the way in, and multiple signs about the premises said things like “This is private property. Please go away immediately.” The grounds were so immaculately clean that it was hard to believe there were animals there, but there were, beautifully cared for (with lots of pasture!). The farm was restored and updated, so you would for example pass through a stone archway into a modern cryogenic storage facility. Also, it had the cleanest bathroom I had encountered on a farm yet, but then again, that is not saying much. Most farms have bathrooms that rival the worst truckstop bathrooms, so that the vets who drive the trucks will say things like “hang on, we’re passing by a gas station in less than an hour” when you ask about facilities.
Del and I traded off assisting on surgeries and running anesthesia for three ewes. We premedicated, intubated, and maintained each ewe under anesthesia on gas. Then we helped Dr. Thery go in laparoscopically to make sure she had in fact successfully been superovulated. Ideally the ovary would look like a bunch of grapes. We would count the post-ovulatory structures on each ovary. Then we would laparasopically find and grasp the uterus, and pull it out of a small incision. Once it was exteriorized, we flushed it to get all the embryos out of it. The embryos were carried over to the lab, and we watched on video as they were identified, counted, and graded (the more vs less viable ones selected out). We closed up the ewes and recovered them. Each ewe would be kept for two surgeries, then returned to her owner.
It was a lovely day, and of course the surgery experience was a fun bonus. Del and I had some interesting conversations about whether this effort to preserve heritage breeds was worth the investment. Whether or not it is, it was a beautiful facility, and nice to see how a farm can be run when money is essentially not a factor.
The facility was beyond lovely, a 1920s folly farm that looked like a crazy cross between a medieval castle and a Mexican mansion. Biosecurity was a big concern there, so we had to cross a little bridge with a foot wash on the way in, and multiple signs about the premises said things like “This is private property. Please go away immediately.” The grounds were so immaculately clean that it was hard to believe there were animals there, but there were, beautifully cared for (with lots of pasture!). The farm was restored and updated, so you would for example pass through a stone archway into a modern cryogenic storage facility. Also, it had the cleanest bathroom I had encountered on a farm yet, but then again, that is not saying much. Most farms have bathrooms that rival the worst truckstop bathrooms, so that the vets who drive the trucks will say things like “hang on, we’re passing by a gas station in less than an hour” when you ask about facilities.
Del and I traded off assisting on surgeries and running anesthesia for three ewes. We premedicated, intubated, and maintained each ewe under anesthesia on gas. Then we helped Dr. Thery go in laparoscopically to make sure she had in fact successfully been superovulated. Ideally the ovary would look like a bunch of grapes. We would count the post-ovulatory structures on each ovary. Then we would laparasopically find and grasp the uterus, and pull it out of a small incision. Once it was exteriorized, we flushed it to get all the embryos out of it. The embryos were carried over to the lab, and we watched on video as they were identified, counted, and graded (the more vs less viable ones selected out). We closed up the ewes and recovered them. Each ewe would be kept for two surgeries, then returned to her owner.
It was a lovely day, and of course the surgery experience was a fun bonus. Del and I had some interesting conversations about whether this effort to preserve heritage breeds was worth the investment. Whether or not it is, it was a beautiful facility, and nice to see how a farm can be run when money is essentially not a factor.
Sunday, September 25, 2011
Being a food animal veterinarian, day 7
Day 7. Just me and Dr. Gray (my favorite doctor to ride with). He blasted out of the clinic at high speed, announcing that we were extremely late and that we were going to check on a herd which had a problem with cystic ovaries. He tossed me a copy of Merck’s Veterinary Manual and said, “Let’s get smart about cystic ovaries.”
He and I at least knew what cystic ovaries are, but I am betting you do not. What you want an ovary to do is to grow a bunch of follicles, and then have one follicle decide it is the queen follicle and ovulate an egg. You probably know what happens from there. If this process is stymied at some point so that the follicle just hangs out and doesn’t develop, but becomes a bump on the ovary full of liquid, it is a cyst. The cow may recover from this and return to a normal reproductive cycle, or her system may become confused by the particular mix of hormones circulating and get hung up. The a veterinarian has to figure out what is going on. The most common explanation is that the cows are not eating well enough, so we came prepared to look into that.
We pulled up at a lovely little farm. This was a hobby farm in the sense that the owner had income from elsewhere, but a real farm in the sense that he was trying to make a profit on selling milk. He actually had a farm store where you could buy milk from that farm (unheard of!) and ice cream made from the milk (even better!). I purchased both, since the cows were out on grass, which made me happy. (The milk later spilled in Dr. Gray’s truck and went bad so that he became cranky with me, but that is a different story.)
Herd check. Why did the cows have cysts? The usual veterinarian for the herd was present; we had been called out as consultants basically because we had an ultrasound machine to help us better see what was going on inside the cows. We checked cow after cow. Some follicles (excellent), some post ovulation structures (also excellent). No cysts. It turned out that what had appeared to be cysts were actually normal structures. The cows were in fact somewhat skinny, so we also did some education about how to body condition score a cow. This was a learning experience for me; it is more complicated than with a dog, involving a flow chart. We also gave advice about how to synchronize the cows so that the farmer would know when to breed them. Without a solid synchronization program (or a bull, which most people find dangerous to keep around), you just have to watch the cows to see when they might be in heat. They are in heat for such a short period of time, less than a day, that it is very easy to miss. Best to know ahead of time when it’s going to happen.
We got back in the truck. I ate my ice cream sandwich for lunch. It was a good lunch.
The next farm was very different. Instead of the welcoming committee of three people who had received us at the first farm, we were left to find the sick cows on our own. Eventually one of the employees handed us a list of numbers: three cows with possible twisted stomachs (displaced abomasums) and one that might have a dead calf inside her. Usually farmers catch the cows up for us and have them in headlocks, but not here. Go find them!
The sick pen had dozens of cows in it. Dr. Gray and I wandered through until we found our girls, then chased them into a small side area where we could put them into the single head lock one by one. The cow with the presumed dead calf was pretty sick, so Dr. Gray dealt with her while I checked TPRs (temperature, pulse, respiration) and gave physical exams to the other three. I couldn’t see him, as he was behind a barrier from me, so I was on my own.
First cow: already in the head lock thanks to Dr. Gray. Normal TPR. No pings (the sound they make when you thwack your finger against their belly and they have a twisted something or other inside there). Looked bright and alert and not dehydrated. I relayed this to Dr. Gray, he came over and double checked, said we would just recommend some oral fluids, and I should move on to the next cow.
Second cow: obviously not in the head lock. I released the first cow and tried to get the second cow in. They will move away from you, so you can basically chase them into where you want, but she would not actually put her head in the lock. They weigh a lot more than you; sometimes you can shove on the back end and they will be nice about it, but there was no way this girl was cutting me a break. It was a little embarrassing, but I did my TPR while she was loose.
This time Dr. Gray came back with blood on his arm up to his shoulder, looking stressed. He checked over the cow (who he also failed to get into the head lock), gave her a rectal exam (this was all with a bare arm — iew), gave her the same diagnosis as the first cow, and went back to what he was doing. I walked back to watch as he shot the sick cow with the dead calf inside her in the head with a captive bolt gun, standard euthanasia technique on farm for a cow who cannot make it on to a truck to be shipped to slaughter.
Dr. Gray explained that the cow had had a dead calf in her for several days, and had a large rip in her uterus, which she could not recover from. I will save you from some of the gorier details. He was clearly somewhat bothered by the fact that the calf had died at least four days before and she had not gotten medical attention before then. “To be fair,” he said, “the calf wasn’t in the birth canal so she probably didn’t show any signs of labor for them to notice.” I said, “Is this maybe a case where on a smaller farm, someone would have realized something was going on with the cow which was supposed to have freshened a few days ago?” He allowed as to how that was probably the case.
Then we checked out the fourth cow, the one which was also supposed to have a displaced abomasum. Amusingly, this cow stuck her head into the head lock enthusiastically. We were running late, so Dr. Gray did this exam himself, and did find a problem. He is a fan of a toggle procedure to fix displaced abomasums, so that is what we did, instead of the surgical procedure I had seen previously. With the help of a farm hand, we sedated the cow, put ropes around her, pulled her over on her side, and rolled her on to her back. Once she was on her back, her stomach floated into the correct place. Dr. Gray put two pins into her belly, puncturing through the skin and into the stomach. He used the pins to secure the stomach in place. The cow was allowed to stand up and was good to go (with dextrose, steroids, oral fluids, oral calcium, and B vitamins to help her out).
Then we washed off in a bucket. There was a lot of scrubbing to be done. And that was day seven.
He and I at least knew what cystic ovaries are, but I am betting you do not. What you want an ovary to do is to grow a bunch of follicles, and then have one follicle decide it is the queen follicle and ovulate an egg. You probably know what happens from there. If this process is stymied at some point so that the follicle just hangs out and doesn’t develop, but becomes a bump on the ovary full of liquid, it is a cyst. The cow may recover from this and return to a normal reproductive cycle, or her system may become confused by the particular mix of hormones circulating and get hung up. The a veterinarian has to figure out what is going on. The most common explanation is that the cows are not eating well enough, so we came prepared to look into that.
We pulled up at a lovely little farm. This was a hobby farm in the sense that the owner had income from elsewhere, but a real farm in the sense that he was trying to make a profit on selling milk. He actually had a farm store where you could buy milk from that farm (unheard of!) and ice cream made from the milk (even better!). I purchased both, since the cows were out on grass, which made me happy. (The milk later spilled in Dr. Gray’s truck and went bad so that he became cranky with me, but that is a different story.)
Herd check. Why did the cows have cysts? The usual veterinarian for the herd was present; we had been called out as consultants basically because we had an ultrasound machine to help us better see what was going on inside the cows. We checked cow after cow. Some follicles (excellent), some post ovulation structures (also excellent). No cysts. It turned out that what had appeared to be cysts were actually normal structures. The cows were in fact somewhat skinny, so we also did some education about how to body condition score a cow. This was a learning experience for me; it is more complicated than with a dog, involving a flow chart. We also gave advice about how to synchronize the cows so that the farmer would know when to breed them. Without a solid synchronization program (or a bull, which most people find dangerous to keep around), you just have to watch the cows to see when they might be in heat. They are in heat for such a short period of time, less than a day, that it is very easy to miss. Best to know ahead of time when it’s going to happen.
We got back in the truck. I ate my ice cream sandwich for lunch. It was a good lunch.
The next farm was very different. Instead of the welcoming committee of three people who had received us at the first farm, we were left to find the sick cows on our own. Eventually one of the employees handed us a list of numbers: three cows with possible twisted stomachs (displaced abomasums) and one that might have a dead calf inside her. Usually farmers catch the cows up for us and have them in headlocks, but not here. Go find them!
The sick pen had dozens of cows in it. Dr. Gray and I wandered through until we found our girls, then chased them into a small side area where we could put them into the single head lock one by one. The cow with the presumed dead calf was pretty sick, so Dr. Gray dealt with her while I checked TPRs (temperature, pulse, respiration) and gave physical exams to the other three. I couldn’t see him, as he was behind a barrier from me, so I was on my own.
First cow: already in the head lock thanks to Dr. Gray. Normal TPR. No pings (the sound they make when you thwack your finger against their belly and they have a twisted something or other inside there). Looked bright and alert and not dehydrated. I relayed this to Dr. Gray, he came over and double checked, said we would just recommend some oral fluids, and I should move on to the next cow.
Second cow: obviously not in the head lock. I released the first cow and tried to get the second cow in. They will move away from you, so you can basically chase them into where you want, but she would not actually put her head in the lock. They weigh a lot more than you; sometimes you can shove on the back end and they will be nice about it, but there was no way this girl was cutting me a break. It was a little embarrassing, but I did my TPR while she was loose.
This time Dr. Gray came back with blood on his arm up to his shoulder, looking stressed. He checked over the cow (who he also failed to get into the head lock), gave her a rectal exam (this was all with a bare arm — iew), gave her the same diagnosis as the first cow, and went back to what he was doing. I walked back to watch as he shot the sick cow with the dead calf inside her in the head with a captive bolt gun, standard euthanasia technique on farm for a cow who cannot make it on to a truck to be shipped to slaughter.
Dr. Gray explained that the cow had had a dead calf in her for several days, and had a large rip in her uterus, which she could not recover from. I will save you from some of the gorier details. He was clearly somewhat bothered by the fact that the calf had died at least four days before and she had not gotten medical attention before then. “To be fair,” he said, “the calf wasn’t in the birth canal so she probably didn’t show any signs of labor for them to notice.” I said, “Is this maybe a case where on a smaller farm, someone would have realized something was going on with the cow which was supposed to have freshened a few days ago?” He allowed as to how that was probably the case.
Then we checked out the fourth cow, the one which was also supposed to have a displaced abomasum. Amusingly, this cow stuck her head into the head lock enthusiastically. We were running late, so Dr. Gray did this exam himself, and did find a problem. He is a fan of a toggle procedure to fix displaced abomasums, so that is what we did, instead of the surgical procedure I had seen previously. With the help of a farm hand, we sedated the cow, put ropes around her, pulled her over on her side, and rolled her on to her back. Once she was on her back, her stomach floated into the correct place. Dr. Gray put two pins into her belly, puncturing through the skin and into the stomach. He used the pins to secure the stomach in place. The cow was allowed to stand up and was good to go (with dextrose, steroids, oral fluids, oral calcium, and B vitamins to help her out).
Then we washed off in a bucket. There was a lot of scrubbing to be done. And that was day seven.
Monday, September 19, 2011
Being a food animal veterinarian, day 6
Day 6. Another herd check. It’s becoming routine. To be fair, I tend to end up riding with the clinicians who do herd checks, because I want to spend these three weeks working with cows. I have so far avoided riding with the clinician who specializes in horses, because equine medicine bores me silly. I like horses, just not horse medicine. And I really like cows, who are endlessly sweet and amusing, and I like herd health, or population medicine. Put me on a farm with a few sick cows and I am perfectly happy to spend hours talking about what is wrong with farm management which is causing these cows to get sick. Ask me to actually do procedures on an individual cow and I start wondering when we are moving on to the next farm.
So. Day 6, herd check. After all the rectal palpations there is inevitably the one or two sick cows to check on, or in this case, three. One was six weeks fresh (gave birth six weeks ago). You always, always ask how fresh a cow is, or if she is not particularly fresh, how many days in milk (how long she has been giving milk, i.e., how many days ago she gave birth — I have been told things like “this cow is 510 days in milk”). They get different diseases depending on where they are in the whole calf-milk-breeding-no milk-calf cycle. This one, being six weeks fresh, should have been past any problems with her uterus recovering from labor, but was not. Which was why we were being asked to look at her. We recommended infusing her uterus with dilute iodine to get rid of the infection.
The next cow had aborted two days previously. She still had bits of placenta hanging out. Normally retained placentas clear themselves within a day or two, but this one was hanging in there a little long, especially for having quite so many pieces still stuck in. My syllabus says it is “controversial” to “manually clean” the uterus of retained placenta (i.e., go in and pull the bits out by hand). It is usually better to let nature take care of this, as upsetting as it is to see cows walking around with pink stuff dangling out of their private parts (what small animal owners inevitably refer to as “down there” and what farmers will refreshingly refer to as “vaginas”). In this case, we manually cleaned. Well, the vet cleaned, and I watched. Good times.
Sick cow #3 had some hair loss on her heels and at the head of her tail. The clinician took one look and pronounced her as having mange. We applied a parasiticide: the vet handed me a big bottle and told me to pour it along the cow’s top line. The stuff was bright purple. Now the cow was bright purple. More fun than cleaning placentas.
Farm two. A big farm, but a well run one. They were having a diarrhea problem with many of their calves (“calf scours”). We drew blood on some four day old calves to check to see if they had gotten enough antibodies from their dams in the colostrum (milk full of antibodies) that they drank in their first few hours of life. (Back at the clinic, the answer was that two of them were fine, and two of them were borderline for not having enough antibodies.) This was a great example of a herd health problem. Why were these calves getting sick? It seemed to be some management problem, but where exactly was the farm going wrong? If the calves weren’t getting enough colostrum, why not? The guy in charge of calf management spent a long time talking to the vet to try to figure it out. So far, we still have no answer. I hope they manage to find one.
So. Day 6, herd check. After all the rectal palpations there is inevitably the one or two sick cows to check on, or in this case, three. One was six weeks fresh (gave birth six weeks ago). You always, always ask how fresh a cow is, or if she is not particularly fresh, how many days in milk (how long she has been giving milk, i.e., how many days ago she gave birth — I have been told things like “this cow is 510 days in milk”). They get different diseases depending on where they are in the whole calf-milk-breeding-no milk-calf cycle. This one, being six weeks fresh, should have been past any problems with her uterus recovering from labor, but was not. Which was why we were being asked to look at her. We recommended infusing her uterus with dilute iodine to get rid of the infection.
The next cow had aborted two days previously. She still had bits of placenta hanging out. Normally retained placentas clear themselves within a day or two, but this one was hanging in there a little long, especially for having quite so many pieces still stuck in. My syllabus says it is “controversial” to “manually clean” the uterus of retained placenta (i.e., go in and pull the bits out by hand). It is usually better to let nature take care of this, as upsetting as it is to see cows walking around with pink stuff dangling out of their private parts (what small animal owners inevitably refer to as “down there” and what farmers will refreshingly refer to as “vaginas”). In this case, we manually cleaned. Well, the vet cleaned, and I watched. Good times.
Sick cow #3 had some hair loss on her heels and at the head of her tail. The clinician took one look and pronounced her as having mange. We applied a parasiticide: the vet handed me a big bottle and told me to pour it along the cow’s top line. The stuff was bright purple. Now the cow was bright purple. More fun than cleaning placentas.
Farm two. A big farm, but a well run one. They were having a diarrhea problem with many of their calves (“calf scours”). We drew blood on some four day old calves to check to see if they had gotten enough antibodies from their dams in the colostrum (milk full of antibodies) that they drank in their first few hours of life. (Back at the clinic, the answer was that two of them were fine, and two of them were borderline for not having enough antibodies.) This was a great example of a herd health problem. Why were these calves getting sick? It seemed to be some management problem, but where exactly was the farm going wrong? If the calves weren’t getting enough colostrum, why not? The guy in charge of calf management spent a long time talking to the vet to try to figure it out. So far, we still have no answer. I hope they manage to find one.
Saturday, September 17, 2011
Being a food animal veterinarian, day 5
Day 5. I was refreshed after a weekend of sleeping 13 hours a night (still catching up after my exhausting small animal surgery rotation the previous month). I signed up to ride with Dr. Gray and my classmates Will and Anna.
Farm one. A largish farm for a family farm, but run by people who clearly really cared about their cows, a mom and daughter team. Anna performed a castration; Dr. Gray said I could show her how since I had done one before (making me an expert, clearly). There was a long discussion about whether to use lidocaine (a painkiller) or not, as there always is when calf castration is discussed. Since this is something I’ve thought about a lot, I was able to present the usual pro and con arguments to my rotation mates. We used lidocaine. The calf was a lot bigger than the one I had done before. My advice: do them younger. The restraint is a lot easier.
Then we did the usual herd check. One cow had had a forced extraction recently, a difficult birth ending in having the baby pulled out of her using chains. Dr. Gray did a vaginal exam, which is more uncomfortable for the cow than a rectal exam, such that students are not allowed to follow after and do their own exam. She had multiple internal lacerations, so Dr. Gray recommended antibiotics and pain killers. This was one of those sticky situations where pain killers weren’t absolutely necessary, just indicated for the cow’s comfort. He thought the farmer wouldn’t want to give them and considered not even suggesting them, but in the end did suggest them (“if you wanted to give some banamine, it wouldn’t be wrong”) and the farmer promptly agreed. I had thought she would, since she seemed to really care about her cows. Veterinarians, it is not wrong to just suggest the best care, even if you think your client will say no! You just have to find a way to do it in a way that won’t make your client feel uncomfortable if they do feel they can’t afford it.
Overall, I mostly liked how these cows were kept; the health of the cows was clearly a high priority on this farm. I am still not happy that the industry standard keeps cows on slippery concrete where they are bound to develop foot problems (10% of a herd is expected to be lame on any given day), walking in manure so that they are caked with it up their legs, and not getting to eat the grass that they evolved to eat.
Second farm of the day: we preg checked (pregnancy checked, rectally) about 100 cows. PHEW. Luckily there were three of us. As the herd check started winding to a close, Dr. Gray put Will and me on the task of giving the cows the injections that they needed. When a cow was preg checked and found to be open (not pregnant), with structures on her ovary to indicate that she had recently ovulated, she got an L written on her side in orange chalk. When she was pregnant she got a P. Otherwise she got nothing. I injected all the P cows with a multiple vaccine. Early pregnancy is a good time to vaccinate so that the mom will pass on the antibodies to the baby in her colostrum after birth. Will injected the L cows with Lutalyse. This is a hormone (prostaglandin F 2α) which causes them to reset their estrual cycle so that they will ovulate in the next three days and can be bred again. In general the female vet students avoid handling Lutalyse, because if it gets in our system we get very bad cramps. I was glad to have Will there to give those injections.
Farm one. A largish farm for a family farm, but run by people who clearly really cared about their cows, a mom and daughter team. Anna performed a castration; Dr. Gray said I could show her how since I had done one before (making me an expert, clearly). There was a long discussion about whether to use lidocaine (a painkiller) or not, as there always is when calf castration is discussed. Since this is something I’ve thought about a lot, I was able to present the usual pro and con arguments to my rotation mates. We used lidocaine. The calf was a lot bigger than the one I had done before. My advice: do them younger. The restraint is a lot easier.
Then we did the usual herd check. One cow had had a forced extraction recently, a difficult birth ending in having the baby pulled out of her using chains. Dr. Gray did a vaginal exam, which is more uncomfortable for the cow than a rectal exam, such that students are not allowed to follow after and do their own exam. She had multiple internal lacerations, so Dr. Gray recommended antibiotics and pain killers. This was one of those sticky situations where pain killers weren’t absolutely necessary, just indicated for the cow’s comfort. He thought the farmer wouldn’t want to give them and considered not even suggesting them, but in the end did suggest them (“if you wanted to give some banamine, it wouldn’t be wrong”) and the farmer promptly agreed. I had thought she would, since she seemed to really care about her cows. Veterinarians, it is not wrong to just suggest the best care, even if you think your client will say no! You just have to find a way to do it in a way that won’t make your client feel uncomfortable if they do feel they can’t afford it.
Overall, I mostly liked how these cows were kept; the health of the cows was clearly a high priority on this farm. I am still not happy that the industry standard keeps cows on slippery concrete where they are bound to develop foot problems (10% of a herd is expected to be lame on any given day), walking in manure so that they are caked with it up their legs, and not getting to eat the grass that they evolved to eat.
Second farm of the day: we preg checked (pregnancy checked, rectally) about 100 cows. PHEW. Luckily there were three of us. As the herd check started winding to a close, Dr. Gray put Will and me on the task of giving the cows the injections that they needed. When a cow was preg checked and found to be open (not pregnant), with structures on her ovary to indicate that she had recently ovulated, she got an L written on her side in orange chalk. When she was pregnant she got a P. Otherwise she got nothing. I injected all the P cows with a multiple vaccine. Early pregnancy is a good time to vaccinate so that the mom will pass on the antibodies to the baby in her colostrum after birth. Will injected the L cows with Lutalyse. This is a hormone (prostaglandin F 2α) which causes them to reset their estrual cycle so that they will ovulate in the next three days and can be bred again. In general the female vet students avoid handling Lutalyse, because if it gets in our system we get very bad cramps. I was glad to have Will there to give those injections.
Monday, September 12, 2011
Being a food animal veterinarian, day 4
Day 4. Friday! I was hugely looking forward to having an actual weekend off, with no responsibilities in the hospital for the first time in 5 weeks.
I was one of the first students in to the clinic. Dr. Cole caught me and my classmate Will as I was coming in and told us that a client had just pulled in. She was bringing her extremely elderly and sick dog in to the clinic for euthanasia. The clinic technically doesn’t handle small animals at all, but Dr. Cole was willing to help out the client in this case. We euthanized the dog in the back of the truck, lying comfortably on his blanket. Will and Dr. Cole handled the actual euthanasia, while I talked to the owner about her dog, what he was like.
I rode with Dr. Thery that day. We went out to a small farm which produces artisanal raw cheese for sale in New York city and directly to restaurants in the area. I loved this farm. The cows were all out on grass all summer. The barn was old but very well maintained, not overly dirty. The cows were extremely friendly; even the calves were not head shy at all. We did a herd check, popped an abscess on a cow’s flank, and vaccinated and TB tested a mess of heifers (about to be sold across state lines) and calves.
I kept ducking out of doing the actual medicine to go talk to the farmer about how she makes grass feeding work. Grass feeding is the norm for beef cattle before they go into feedlots, but for dairy cows, conventional wisdom is that they have to be handled too much to make it work. What a pain to have to round up all your cows twice a day for milking! But the farmer shrugged that off. The cows want to be milked, because their udders get uncomfortably full. They come back in to the barn voluntarily. Once they know the routine, it’s no problem.
I wish all farms could be like this one. I know that’s a pipe dream, but I still really want to find a way to support farms like this one, to make it just a little easier for farmers to do what I consider to be the right thing by their animals.
I was one of the first students in to the clinic. Dr. Cole caught me and my classmate Will as I was coming in and told us that a client had just pulled in. She was bringing her extremely elderly and sick dog in to the clinic for euthanasia. The clinic technically doesn’t handle small animals at all, but Dr. Cole was willing to help out the client in this case. We euthanized the dog in the back of the truck, lying comfortably on his blanket. Will and Dr. Cole handled the actual euthanasia, while I talked to the owner about her dog, what he was like.
I rode with Dr. Thery that day. We went out to a small farm which produces artisanal raw cheese for sale in New York city and directly to restaurants in the area. I loved this farm. The cows were all out on grass all summer. The barn was old but very well maintained, not overly dirty. The cows were extremely friendly; even the calves were not head shy at all. We did a herd check, popped an abscess on a cow’s flank, and vaccinated and TB tested a mess of heifers (about to be sold across state lines) and calves.
I kept ducking out of doing the actual medicine to go talk to the farmer about how she makes grass feeding work. Grass feeding is the norm for beef cattle before they go into feedlots, but for dairy cows, conventional wisdom is that they have to be handled too much to make it work. What a pain to have to round up all your cows twice a day for milking! But the farmer shrugged that off. The cows want to be milked, because their udders get uncomfortably full. They come back in to the barn voluntarily. Once they know the routine, it’s no problem.
I wish all farms could be like this one. I know that’s a pipe dream, but I still really want to find a way to support farms like this one, to make it just a little easier for farmers to do what I consider to be the right thing by their animals.
Sunday, September 11, 2011
Surgery rotation vs ambulatory rotation
Surgery: Get yelled at if you hold your hands below your waist, even for half a second, while you are sterile
Ambulatory: Perform surgeries on manure-encrusted surfaces
Surgery: Why would people who are in the operating room just to observe want chairs?
Ambulatory: Spend 1/3 of your day sitting in a comfy truck seat
Surgery: Discover that it rained when you see wet ground upon leaving for the day
Ambulatory: Discover that it is raining when you have to change into your coveralls standing under the open sky
Surgery: Your patients have names like “Sweetie-Boo”
Ambulatory: Most of your patients are addressed as “Boss” or “Girl,” except for one who acquires the name “The Cow We Had to Take to the Vet Clinic”
Surgery: Special room to scrub in, covered in signs with complicated procedures for doing so
Ambulatory: Scrub in using soapy water in a bucket
Surgery: Dress is business casual
Ambulatory: I consider most of my t-shirts too nice to wear (you have to be prepared to get poop on everything)
Surgery: You think your patient has developed feline idiopathic cystitis? Don’t worry about it. We don’t do internal medicine, just surgery
Ambulatory: We do internal medicine, surgery, theriogenology (reproductive medicine), dermatology, cardiology, neurology, ophthalmology, population medicine, public health
Ambulatory: Perform surgeries on manure-encrusted surfaces
Surgery: Why would people who are in the operating room just to observe want chairs?
Ambulatory: Spend 1/3 of your day sitting in a comfy truck seat
Surgery: Discover that it rained when you see wet ground upon leaving for the day
Ambulatory: Discover that it is raining when you have to change into your coveralls standing under the open sky
Surgery: Your patients have names like “Sweetie-Boo”
Ambulatory: Most of your patients are addressed as “Boss” or “Girl,” except for one who acquires the name “The Cow We Had to Take to the Vet Clinic”
Surgery: Special room to scrub in, covered in signs with complicated procedures for doing so
Ambulatory: Scrub in using soapy water in a bucket
Surgery: Dress is business casual
Ambulatory: I consider most of my t-shirts too nice to wear (you have to be prepared to get poop on everything)
Surgery: You think your patient has developed feline idiopathic cystitis? Don’t worry about it. We don’t do internal medicine, just surgery
Ambulatory: We do internal medicine, surgery, theriogenology (reproductive medicine), dermatology, cardiology, neurology, ophthalmology, population medicine, public health
Saturday, September 10, 2011
Being a food animal veterinarian, day 3
Day 3. I signed up to ride with Dr. Cripi, just him and me. I was hopeful that I would get to do more hands on stuff when I was not competing with other students for opportunities.
I expected to get right in the truck and head out, but Dr. Cripi said that a cow was being brought to us this morning. Some farms are so far outside the clinic’s usual area that they are only worth visiting if there is some other work in the same region. These farms can be our clients, but have to let us schedule our visits to groups of them on the same day. When they have emergencies, they have to bring their animals to us. This was why the cow was coming to us now.
She got off the truck nicely and we put her in the stocks so that she was restrained and could easily be examined. Dr. Cripi noted that her eyes were sunken, indicating dehydration. Some other students were standing around as well, and we all got to examine her. A large part of examining a cow is trying to identify problems with its complicated GI system. If part of the GI is displaced to somewhere it shouldn’t be (a fairly common problem, especially in cows that are fed too little roughage in their diets, e.g., are not out on pasture or fed mostly hay) then that part of the GI will start filling up with gas. You can “ping” the cow to hear this. You snap a finger hard against her side while listening with your stethoscope. This was the first ping I had ever heard, as I had never before examined a cow with a displacement. It sounded like a basketball bouncing on a metal floor. I referred to the ping as “gorgeous,” which amused the farmer no end.
This cow had an RDA, or right displaced abomasum. This means that the cow’s true stomach, or abomasum, had floated up on the right side of the cow. (Normal location: right side, but a lot more ventral, e.g., closer to the ground). We performed standing surgery on the cow to fix the problem. We did not sedate her, as she was so sick that Dr. Cripi thought sedation would make her lie down, which would make the surgery much more difficult. We did give her a local block in the area where we would be cutting. Then she was shaved and prepped (aseptically scrubbed) over her right side.
First we scrubbed in. This was hilariously different from scrubbing in to surgery in the small animal hospital, which I had done a lot of on my surgery rotation over the previous month. A cow holding area is going to be inherently dirty. We scrubbed our arms off with iodine and put on long surgical gloves (they have to go up to your shoulder, because you’re going to be reaching deep inside a big animal), then normal sterile gloves on top of that.
Then Dr. Cripi made a maybe 5 inch incision in the cow’s side. She didn’t seem to notice; hurray for local anesthetics. He pointed: “See? Her abomasum is right there. That’s huge!” The abomasum was hugely distended with gas and floating right under the surgical incision. Dr. Cripi put a needle into it, attached to a long tube, and let a lot of the gas out. He had all the students smell the gas: a sort of sweet smell, much nicer than rumen smell. (The rumen is the largest and possibly most important part of the cow’s complicated four chamber stomach, the part that feed first falls into to ferment.) The farmer declined to take a sniff, and made a face.
Once the abomasum was somewhat deflated, Dr. Cripi tacked it to the body wall with tacking sutures. Then he closed the incision’s lower layers with the biggest needle I have ever seen in my life. Then he showed me how to close the last layer, the skin. I have done my share of small animal skin closures, and this was really different: that cow’s skin was insanely thick and tough. If you’ve sewn leather, you know what it’s like. I had to really put my back into it to get the needle through.
Then we dosed the cow with a liter of intravenous fluids plus dextrose, and a liter of electrolyte solution. I got to hold the fluids up “as high as you can!” If it is going to make your arm tired, it is the student’s job.
Then the cow walked politely back on her truck and went home.
We got in our truck and headed off to our first farm, with Dr. Cripi angsting about how late we were the whole way. En route, we talked about our lives. Some ambulatory vets use the ride as a teaching opportunity (Dr. Mulain); some ride in silence (Dr. Thery); some just want to chat (Drs. Cole and Cripi). Dr. Cripi had a pretty interesting life, it turned out, spending five years just traveling the world before realizing he wanted to work with food animals as a veterinarian.
Farm number one: a herd check. Checking cows in a herd for pregnancy seems to be the bread and butter of the practice. It was a typical concrete floor, feces-covered barn, but with a particularly open design that I really liked, basically just a roof over the cows, no walls. I asked about their plans for winter (this was a brand new structure). They intend to put up some cover then, but nothing permanent. We worked with a fantastic view of rolling Connecticut hills. It was a lovely scene to look at while putting one’s arm up a cow’s butt.
This farm’s staff included a scrawny kid just out of his teenage years who noticed that a female had arrived and immediately took off his shirt. This became even more hilarious when I was told that it was my job to castrate a bull calf and that the kid would help restrain. I later asked Dr. Cripi if the kid took off his shirt every time a female vet student appeared. Dr. Cripi rolled his eyes and said yes.
How to castrate a bull calf: the vet will draw a diagram for you on a paper towel, hand you a scalpel, and send you on your way. I asked if we used lidocaine for analgesia; he said I could if I wanted to. I said yes please. (The debate in use of lidocaine for a local block in castration is that arguably it is more unpleasant to have a needle shoved into multiple spots in your scrotum and have something that burns injected than just to have the stuff ripped off real quick. Personally I think pain meds are mandatory, but even more so if the job is being done by someone who’s never done it before.) I gave the calf lidocaine injections at various locations around his scrotum and waited five minutes for it to take effect.
My experience in castrating dogs and cats was helpful. I cut off the tip of the scrotum, squeezed the testicles out. They are slippery and don’t like to come out, but I had done this before on a smaller scale and knew how to squeeze. Then I grabbed them and pulled until they came off. (The hardest part was getting a grip. In small animal medicine one uses little four by four pads to hold on to them, not your hands.) The kid asked why we didn’t just cut them off. I said that Dr. Cripi hadn’t said, but my guess was that the bleeding would be worse if you cut; ripping provides some hemostasis.
Farm number two. En route, the sun came out. My spirits immediately lifted. It is amazing what a difference some blue sky makes. At this farm we had a sick cow who was two weeks fresh. This means she gave birth two weeks ago and has been being milked for two weeks. The stress of parturition means that many of these fresh cows are at risk for a variety of diseases, like a displaced abomasum such as we’d seen earlier that morning. In this case, she seemed to have some nerve injury from when the baby passed over the obturator nerve along the pelvis. We prescribed rest, TLC, and anti-inflammatories (banamine is what you give to cows).
Farm number three. Another hobby farm, but a somewhat bigger one. This farmer had quit her previous job to just be a cow farmer, and her husband’s income was presumably supporting the operation. The cows were out on grass in a truly lovely setting (we drove over a little covered bridge across what I have to describe as a sparkling brook on the way in). The cows were spotlessly clean. Normally you sort of hesitate to pet them because of all the manure all over them (at least until you have manure on your hands, which inevitably happens). These cows were so clean that I actually sniffed one and discovered that natural (manure free) cow smell is a lot like horse smell. The farmer had put the sick cow into a holding area, which had a concrete floor which was also spotlessly clean. No huge masses of spider webs! No dead birds in the rafters! Crazy! The farmer actually hovered with a bucket to catch the urine when the cows peed, which is farther than I would go in her place, but I really did appreciate the cleanliness. As Dr. Cripi pointed out, these cows were basically pets.
This cow had a left displaced abomasum (same problem as the first patient of the day, different side). LDAs are actually a lot more common than RDAs, which is too bad, as you still have to cut on the right side of the cow (the rumen covers everything on the left side) and as you then have to reach across the inside of the cow to get to the abomasum on the other side, it becomes quite a process. This cow was dry (no longer being milked) and due to freshen (give birth) in a few weeks. Dr. Cripi was amazed that she had an LDA. Dry cows almost never get displaced abomasums; it is a disease of fresh cows. Cows out on grass also almost never get this disease. This particular cow also turned out to have pneumonia, so maybe the stress of that had caused the displacement. Weird.
So, same surgery, except that Dr. Cripi had to reach through the cow this time instead of having the abomasum pop right up under his incision. I did not get to close, as I had inadvertently contaminated myself on the cow’s side while trying to prevent the drape from falling off of her.
Last farm of the day: again, a horse owner. Her horse needed his yearly vaccines. He was 31 years old! He was a super nice horse. Dr. Cripi sat down and handed me the vaccine bottles. I drew them up and injected them into the horse’s neck. He never flinched. Old patients can be the easiest ones to handle.
End of day 3: less wet, more confident, starting to have fun.
I expected to get right in the truck and head out, but Dr. Cripi said that a cow was being brought to us this morning. Some farms are so far outside the clinic’s usual area that they are only worth visiting if there is some other work in the same region. These farms can be our clients, but have to let us schedule our visits to groups of them on the same day. When they have emergencies, they have to bring their animals to us. This was why the cow was coming to us now.
She got off the truck nicely and we put her in the stocks so that she was restrained and could easily be examined. Dr. Cripi noted that her eyes were sunken, indicating dehydration. Some other students were standing around as well, and we all got to examine her. A large part of examining a cow is trying to identify problems with its complicated GI system. If part of the GI is displaced to somewhere it shouldn’t be (a fairly common problem, especially in cows that are fed too little roughage in their diets, e.g., are not out on pasture or fed mostly hay) then that part of the GI will start filling up with gas. You can “ping” the cow to hear this. You snap a finger hard against her side while listening with your stethoscope. This was the first ping I had ever heard, as I had never before examined a cow with a displacement. It sounded like a basketball bouncing on a metal floor. I referred to the ping as “gorgeous,” which amused the farmer no end.
This cow had an RDA, or right displaced abomasum. This means that the cow’s true stomach, or abomasum, had floated up on the right side of the cow. (Normal location: right side, but a lot more ventral, e.g., closer to the ground). We performed standing surgery on the cow to fix the problem. We did not sedate her, as she was so sick that Dr. Cripi thought sedation would make her lie down, which would make the surgery much more difficult. We did give her a local block in the area where we would be cutting. Then she was shaved and prepped (aseptically scrubbed) over her right side.
First we scrubbed in. This was hilariously different from scrubbing in to surgery in the small animal hospital, which I had done a lot of on my surgery rotation over the previous month. A cow holding area is going to be inherently dirty. We scrubbed our arms off with iodine and put on long surgical gloves (they have to go up to your shoulder, because you’re going to be reaching deep inside a big animal), then normal sterile gloves on top of that.
Then Dr. Cripi made a maybe 5 inch incision in the cow’s side. She didn’t seem to notice; hurray for local anesthetics. He pointed: “See? Her abomasum is right there. That’s huge!” The abomasum was hugely distended with gas and floating right under the surgical incision. Dr. Cripi put a needle into it, attached to a long tube, and let a lot of the gas out. He had all the students smell the gas: a sort of sweet smell, much nicer than rumen smell. (The rumen is the largest and possibly most important part of the cow’s complicated four chamber stomach, the part that feed first falls into to ferment.) The farmer declined to take a sniff, and made a face.
Once the abomasum was somewhat deflated, Dr. Cripi tacked it to the body wall with tacking sutures. Then he closed the incision’s lower layers with the biggest needle I have ever seen in my life. Then he showed me how to close the last layer, the skin. I have done my share of small animal skin closures, and this was really different: that cow’s skin was insanely thick and tough. If you’ve sewn leather, you know what it’s like. I had to really put my back into it to get the needle through.
Then we dosed the cow with a liter of intravenous fluids plus dextrose, and a liter of electrolyte solution. I got to hold the fluids up “as high as you can!” If it is going to make your arm tired, it is the student’s job.
Then the cow walked politely back on her truck and went home.
We got in our truck and headed off to our first farm, with Dr. Cripi angsting about how late we were the whole way. En route, we talked about our lives. Some ambulatory vets use the ride as a teaching opportunity (Dr. Mulain); some ride in silence (Dr. Thery); some just want to chat (Drs. Cole and Cripi). Dr. Cripi had a pretty interesting life, it turned out, spending five years just traveling the world before realizing he wanted to work with food animals as a veterinarian.
Farm number one: a herd check. Checking cows in a herd for pregnancy seems to be the bread and butter of the practice. It was a typical concrete floor, feces-covered barn, but with a particularly open design that I really liked, basically just a roof over the cows, no walls. I asked about their plans for winter (this was a brand new structure). They intend to put up some cover then, but nothing permanent. We worked with a fantastic view of rolling Connecticut hills. It was a lovely scene to look at while putting one’s arm up a cow’s butt.
This farm’s staff included a scrawny kid just out of his teenage years who noticed that a female had arrived and immediately took off his shirt. This became even more hilarious when I was told that it was my job to castrate a bull calf and that the kid would help restrain. I later asked Dr. Cripi if the kid took off his shirt every time a female vet student appeared. Dr. Cripi rolled his eyes and said yes.
How to castrate a bull calf: the vet will draw a diagram for you on a paper towel, hand you a scalpel, and send you on your way. I asked if we used lidocaine for analgesia; he said I could if I wanted to. I said yes please. (The debate in use of lidocaine for a local block in castration is that arguably it is more unpleasant to have a needle shoved into multiple spots in your scrotum and have something that burns injected than just to have the stuff ripped off real quick. Personally I think pain meds are mandatory, but even more so if the job is being done by someone who’s never done it before.) I gave the calf lidocaine injections at various locations around his scrotum and waited five minutes for it to take effect.
My experience in castrating dogs and cats was helpful. I cut off the tip of the scrotum, squeezed the testicles out. They are slippery and don’t like to come out, but I had done this before on a smaller scale and knew how to squeeze. Then I grabbed them and pulled until they came off. (The hardest part was getting a grip. In small animal medicine one uses little four by four pads to hold on to them, not your hands.) The kid asked why we didn’t just cut them off. I said that Dr. Cripi hadn’t said, but my guess was that the bleeding would be worse if you cut; ripping provides some hemostasis.
Farm number two. En route, the sun came out. My spirits immediately lifted. It is amazing what a difference some blue sky makes. At this farm we had a sick cow who was two weeks fresh. This means she gave birth two weeks ago and has been being milked for two weeks. The stress of parturition means that many of these fresh cows are at risk for a variety of diseases, like a displaced abomasum such as we’d seen earlier that morning. In this case, she seemed to have some nerve injury from when the baby passed over the obturator nerve along the pelvis. We prescribed rest, TLC, and anti-inflammatories (banamine is what you give to cows).
Farm number three. Another hobby farm, but a somewhat bigger one. This farmer had quit her previous job to just be a cow farmer, and her husband’s income was presumably supporting the operation. The cows were out on grass in a truly lovely setting (we drove over a little covered bridge across what I have to describe as a sparkling brook on the way in). The cows were spotlessly clean. Normally you sort of hesitate to pet them because of all the manure all over them (at least until you have manure on your hands, which inevitably happens). These cows were so clean that I actually sniffed one and discovered that natural (manure free) cow smell is a lot like horse smell. The farmer had put the sick cow into a holding area, which had a concrete floor which was also spotlessly clean. No huge masses of spider webs! No dead birds in the rafters! Crazy! The farmer actually hovered with a bucket to catch the urine when the cows peed, which is farther than I would go in her place, but I really did appreciate the cleanliness. As Dr. Cripi pointed out, these cows were basically pets.
This cow had a left displaced abomasum (same problem as the first patient of the day, different side). LDAs are actually a lot more common than RDAs, which is too bad, as you still have to cut on the right side of the cow (the rumen covers everything on the left side) and as you then have to reach across the inside of the cow to get to the abomasum on the other side, it becomes quite a process. This cow was dry (no longer being milked) and due to freshen (give birth) in a few weeks. Dr. Cripi was amazed that she had an LDA. Dry cows almost never get displaced abomasums; it is a disease of fresh cows. Cows out on grass also almost never get this disease. This particular cow also turned out to have pneumonia, so maybe the stress of that had caused the displacement. Weird.
So, same surgery, except that Dr. Cripi had to reach through the cow this time instead of having the abomasum pop right up under his incision. I did not get to close, as I had inadvertently contaminated myself on the cow’s side while trying to prevent the drape from falling off of her.
Last farm of the day: again, a horse owner. Her horse needed his yearly vaccines. He was 31 years old! He was a super nice horse. Dr. Cripi sat down and handed me the vaccine bottles. I drew them up and injected them into the horse’s neck. He never flinched. Old patients can be the easiest ones to handle.
End of day 3: less wet, more confident, starting to have fun.
Friday, September 9, 2011
Being a food animal veterinarian, day 2
Day 2 of my Ambulatory rotation. Still raining. I rode with Dr. Cole and one other student.
First we visited a lovely hobby farm, meaning a farm which is not expected to bring in enough revenue to support the owner. These owners bred and showed registered Ayershire cows, and sold their milk as a sideline. They had full time jobs elsewhere. This was a tiny barn, milking around just 20 cows, very clean relative to other barns (I never had to wade through an ankle-deep sea of manure, which is more than I can say for some other farms we visited), and the cows seemed very healthy.
Next we did a herd check at another, larger farm. More rectal palpations. I complained to Dr. Cole that I had no idea what I was doing when I put my arm in there. He walked us through a guide of how we should approach the situation, complete with an actual size model of a cow uterus. Awesome! Here are his instructions, because I know you are desperate to know:
Next stop was another farm for a herd check, 2 rabies vaccines, and 2 health certificates for some calves that were being taken to the fair. We’ve actually done a fair number of health certificates this week. Autumn is town and county fair season, so the kids are all taking their cows out to show them. At this farm I got to see one cow being prepped for the trip by being buzzed down smooth with some clippers.
The last farm was a herd check, 3 calves to dehorn, and 3 lame cows to check on. We tied each lame cow to a post by the head, then lifted the problem foot by means of a complicated rope pulley system that I supposedly learned in my Clinical Skills class but which I certainly could not duplicate on my own. (“Throw a half-hitch here... That’s not a half hitch! Well, do you at least remember how to do a quick release knot?”) The cows would then kick and freak out, so someone had to tail jack them to keep them distracted. Tail jacking means holding the cow’s tail straight up. To do this you have to stand very close to the cow and lean into the tail. She won’t kick you once you’re close, because they kick out to the side, not back. But getting close can be tricky. I learned: get in and tail jack her before they lift her leg and she starts hopping around and kicking. That works much better. (Trim feet down so you can see the problem. Declare the problem to be hairy heel warts. Yes, that’s an actual disease, caused by a species of bacteria. Apply powder antibiotic and bandage the foot. Done.)
Day 2 done. Still cold. Still wet. Starting to feel more like I know what I’m doing.
First we visited a lovely hobby farm, meaning a farm which is not expected to bring in enough revenue to support the owner. These owners bred and showed registered Ayershire cows, and sold their milk as a sideline. They had full time jobs elsewhere. This was a tiny barn, milking around just 20 cows, very clean relative to other barns (I never had to wade through an ankle-deep sea of manure, which is more than I can say for some other farms we visited), and the cows seemed very healthy.
Next we did a herd check at another, larger farm. More rectal palpations. I complained to Dr. Cole that I had no idea what I was doing when I put my arm in there. He walked us through a guide of how we should approach the situation, complete with an actual size model of a cow uterus. Awesome! Here are his instructions, because I know you are desperate to know:
- First you feel for the vaginal canal and/or the cervix. These are fairly caudal (the direction of the cow away from the head) so don’t overshoot them.
- Follow the cervix cranially (forward). Behold the body of the uterus.
- The body of the uterus may have fallen off the floor of the pelvis into the abdomen. If so, grab it and pull it back up onto the pelvis so you can handle it.
- Follow the uterus to the right. Ovary! Not necessarily round. It may be more elongated. Often golf ball sized.
- Do the same on the left.
Next stop was another farm for a herd check, 2 rabies vaccines, and 2 health certificates for some calves that were being taken to the fair. We’ve actually done a fair number of health certificates this week. Autumn is town and county fair season, so the kids are all taking their cows out to show them. At this farm I got to see one cow being prepped for the trip by being buzzed down smooth with some clippers.
The last farm was a herd check, 3 calves to dehorn, and 3 lame cows to check on. We tied each lame cow to a post by the head, then lifted the problem foot by means of a complicated rope pulley system that I supposedly learned in my Clinical Skills class but which I certainly could not duplicate on my own. (“Throw a half-hitch here... That’s not a half hitch! Well, do you at least remember how to do a quick release knot?”) The cows would then kick and freak out, so someone had to tail jack them to keep them distracted. Tail jacking means holding the cow’s tail straight up. To do this you have to stand very close to the cow and lean into the tail. She won’t kick you once you’re close, because they kick out to the side, not back. But getting close can be tricky. I learned: get in and tail jack her before they lift her leg and she starts hopping around and kicking. That works much better. (Trim feet down so you can see the problem. Declare the problem to be hairy heel warts. Yes, that’s an actual disease, caused by a species of bacteria. Apply powder antibiotic and bandage the foot. Done.)
Day 2 done. Still cold. Still wet. Starting to feel more like I know what I’m doing.
Thursday, September 8, 2011
Being a food animal veterinarian, day 1
The first day of my ambulatory (food animal medicine) rotation, I got horribly lost on the way to the clinic, which is about an hour from my home. I came in late and missed half of the orientation. Ambulatory is so called because its vets go to the clients rather than vice versa. There are eight students on the rotation right now, but we break up into groups of one to three and ride along with individual vets.
Day one, three students, Dr. Mulain.
Farm one: herd check! Lots of rectal palpations to discover the pregnancy status of cows. If not pregnant, they would get an injection of a medication to reboot their reproductive cycle, so that their owner would know when they were going to come back into heat and therefore when to breed them. Dr. Mulain palpated first and we followed after, one student per cow. Mostly I put my arm in and waved it around aimlessly, hoping to randomly encounter a uterus.
We also dehorned some baby calves at this farm, and checked up on a lame cow who had had a claw (half her foot) removed a few weeks ago. Her bandage was removed and the clients were told to clean her foot regularly. We checked another lame cow, trimmed back her foot, and cleaned out a sore on it.
Farm two: a steer had been hit by a car! The barn had been broken into by thieves the night before and the inhabitants had escaped. The steer was covered in road rash, which we cleaned. His tail was mangled, and we amputated it. His biggest problem was a dislocated hip. We provided anti-inflammatories and advice that he was unlikely to be able to live with a dislocated hip, but that there was a small chance it would heal.
This farm also produced a calf who had injured her eye a few days before. The eye was not salvageable. We put the calf under general anesthesia with an injection and laid her down on the barn floor, then removed the eye. It was an odd experience for me, as I had just finished my small animal surgery rotation. The levels of cleanliness vary tremendously between the two rotations, to say the least.
Farm three: a house with two elderly horses in a tiny barn out back. One had been suffering from neurologic disease for years and was now increasingly lame. We cleaned out an abscess on his hoof and put on medication and a bandage. The horse looked like he was minutes from expiring, but the vet told us that he always looked like that and always pulls through.
So ended my first day of ambulatory, cold and wet. I trust that the weather will improve, though. September in New England is always lovely.
Day one, three students, Dr. Mulain.
Farm one: herd check! Lots of rectal palpations to discover the pregnancy status of cows. If not pregnant, they would get an injection of a medication to reboot their reproductive cycle, so that their owner would know when they were going to come back into heat and therefore when to breed them. Dr. Mulain palpated first and we followed after, one student per cow. Mostly I put my arm in and waved it around aimlessly, hoping to randomly encounter a uterus.
We also dehorned some baby calves at this farm, and checked up on a lame cow who had had a claw (half her foot) removed a few weeks ago. Her bandage was removed and the clients were told to clean her foot regularly. We checked another lame cow, trimmed back her foot, and cleaned out a sore on it.
Farm two: a steer had been hit by a car! The barn had been broken into by thieves the night before and the inhabitants had escaped. The steer was covered in road rash, which we cleaned. His tail was mangled, and we amputated it. His biggest problem was a dislocated hip. We provided anti-inflammatories and advice that he was unlikely to be able to live with a dislocated hip, but that there was a small chance it would heal.
This farm also produced a calf who had injured her eye a few days before. The eye was not salvageable. We put the calf under general anesthesia with an injection and laid her down on the barn floor, then removed the eye. It was an odd experience for me, as I had just finished my small animal surgery rotation. The levels of cleanliness vary tremendously between the two rotations, to say the least.
Farm three: a house with two elderly horses in a tiny barn out back. One had been suffering from neurologic disease for years and was now increasingly lame. We cleaned out an abscess on his hoof and put on medication and a bandage. The horse looked like he was minutes from expiring, but the vet told us that he always looked like that and always pulls through.
So ended my first day of ambulatory, cold and wet. I trust that the weather will improve, though. September in New England is always lovely.
Tuesday, March 29, 2011
The Dairy Welfare Farm Tour, part 2: growing calves
(Continued from The Dairy Welfare Farm Tour, part 1.)
We pulled up at the farm where Dr. Mulain performs a weekly herd check every Tuesday morning, checking a bunch of potentially pregnant cows to determine if they are in fact knocked up. Lots of rectals! While we were sticking our arms inside of cows, Dr. Mulain pointed out that we can tell a lot about how cows are handled by how they respond to us. When you are in the middle of a herd of cows, do they panic and run away? They have probably not had great experiences with humans in the past. Do they come up to you, sniff you, lick you, follow you around, and generally make pains of themselves? It is likely they have had good experiences with humans in the past. These cows were like mosquitoes; I was literally batting them away. When I yelled “Shoo!” and waved my arms at them, they stared at me blankly. They had clearly been handled gently by the farm workers.
After the herd check was over, we visited the calves in their hutches. This farm used the conventional method of raising calves: separate them from their mothers immediately and raise them in tiny hutches that look like plastic igloos. The hutches are typically clustered together in a little village, but must be far enough apart that the calves can't touch each other. Calves typically live in individual hutches like this from birth until shortly after weaning.
Although the little village of hutches is adorable, something in me rebels at the idea of raising social animals in isolation like this, where they cannot touch another member of their species. Why do we do it? We raise them separately to keep them cleaner. Calves inevitably have diarrhea, and if you raise them together, that will be the method of transmission of all sorts of (sometimes fatal) diseases. So it is safer for them to keep them separate until their immune systems mature. Also, taking them away from their mothers leaves more milk for sale (they are most often raised on milk replacer, which costs less than the real stuff).
This method of raising calves is the conventionally accepted one in the industry, and is what we were taught about in our large animal medicine class. But Dr. Mulain told us about a new method that some farmers are trying, and took us to see it in practice on other farms. You can apparently raise healthy calves in groups if you free feed them, in other words, let them consume as much milk, or replacer, as they want. With the extra nutrition, their immune systems are more robust. The calves grow faster, too.
Dr. Mulain said wryly, “Remember, this isn't abnormally fast growth. This is normal growth.” His perspective is that the dairy industry has been feeding calves smaller amounts to cut costs, but this has resulted in weakened immune systems and smaller calves. With time, we have come to see these weakened immune systems as normal, but they are not.
We saw one farm in which calves had access to a big bucket of milk replacer. They were living in a group of just a few calves. Another farm had turned about ten calves in with three lactating cows. Cows chosen for nanny duty were the low producing cows — the ones later in their lactation cycles who produce less milk. It is amazing that we have bred cows to produce so much milk that a low producing cow can easily support three calves! The calves didn’t bond with a particular cow, but just partook of the nearest milk bar. Because these were low producing cows, they were by definition late in their lactation cycle, so it is unlikely that any of the calves were actually theirs.
This approach to raising calves feels emotionally better to me. I don’t like to see babies of social species raised out of physical contact with other social animals. So the approach to raising calves in groups is appealing. Time will tell if it works well, producing healthy calves and saving farmers money.
We pulled up at the farm where Dr. Mulain performs a weekly herd check every Tuesday morning, checking a bunch of potentially pregnant cows to determine if they are in fact knocked up. Lots of rectals! While we were sticking our arms inside of cows, Dr. Mulain pointed out that we can tell a lot about how cows are handled by how they respond to us. When you are in the middle of a herd of cows, do they panic and run away? They have probably not had great experiences with humans in the past. Do they come up to you, sniff you, lick you, follow you around, and generally make pains of themselves? It is likely they have had good experiences with humans in the past. These cows were like mosquitoes; I was literally batting them away. When I yelled “Shoo!” and waved my arms at them, they stared at me blankly. They had clearly been handled gently by the farm workers.
After the herd check was over, we visited the calves in their hutches. This farm used the conventional method of raising calves: separate them from their mothers immediately and raise them in tiny hutches that look like plastic igloos. The hutches are typically clustered together in a little village, but must be far enough apart that the calves can't touch each other. Calves typically live in individual hutches like this from birth until shortly after weaning.
Although the little village of hutches is adorable, something in me rebels at the idea of raising social animals in isolation like this, where they cannot touch another member of their species. Why do we do it? We raise them separately to keep them cleaner. Calves inevitably have diarrhea, and if you raise them together, that will be the method of transmission of all sorts of (sometimes fatal) diseases. So it is safer for them to keep them separate until their immune systems mature. Also, taking them away from their mothers leaves more milk for sale (they are most often raised on milk replacer, which costs less than the real stuff).
This method of raising calves is the conventionally accepted one in the industry, and is what we were taught about in our large animal medicine class. But Dr. Mulain told us about a new method that some farmers are trying, and took us to see it in practice on other farms. You can apparently raise healthy calves in groups if you free feed them, in other words, let them consume as much milk, or replacer, as they want. With the extra nutrition, their immune systems are more robust. The calves grow faster, too.
Dr. Mulain said wryly, “Remember, this isn't abnormally fast growth. This is normal growth.” His perspective is that the dairy industry has been feeding calves smaller amounts to cut costs, but this has resulted in weakened immune systems and smaller calves. With time, we have come to see these weakened immune systems as normal, but they are not.
We saw one farm in which calves had access to a big bucket of milk replacer. They were living in a group of just a few calves. Another farm had turned about ten calves in with three lactating cows. Cows chosen for nanny duty were the low producing cows — the ones later in their lactation cycles who produce less milk. It is amazing that we have bred cows to produce so much milk that a low producing cow can easily support three calves! The calves didn’t bond with a particular cow, but just partook of the nearest milk bar. Because these were low producing cows, they were by definition late in their lactation cycle, so it is unlikely that any of the calves were actually theirs.
This approach to raising calves feels emotionally better to me. I don’t like to see babies of social species raised out of physical contact with other social animals. So the approach to raising calves in groups is appealing. Time will tell if it works well, producing healthy calves and saving farmers money.
Tuesday, March 15, 2011
The Dairy Welfare Farm Tour, part 1: humane handling certification
I woke up at 6 am, and it felt luxuriously late after my 5:30 am wake up the previous morning. This was the morning of the second of my two electives during third year elective week. The day before I had spent the day in a small animal emergency room. Today, I would ride with a cow vet and some other students, seeing different farms and comparing how they care for their cows. It was chilly, but warmer than it had been, and the weather site I checked suggested a warm afternoon. I dithered between my insulated coveralls and the regular ones, before opting for the regular ones.
Two other students met me at my house, and we made the hour’s drive to the Ambulatory clinic together, where we met the fourth member of our little group. At the clinic, we hovered somewhat aimlessly in the break room and made small talk with the fourth year students there who were on a week of Ambulatory rotation. After a few minutes, Dr. Maolain, who was running the farm tour, walked through and asked us if we all had our boots. We were scornful. Did he really think we would have shown up for a day on farm without boots? (The boots are of course much appreciated when you are walking through a soup of cow manure. They are also more scrubbable than street shoes — easier to hose off and soap before leaving a farm, so that you do not carry infectious disease to the next farm you visit.)
We piled into Dr. Maolain’s truck, a tight fit, and headed out. We had a forty minute drive to our first stop, during which time Dr. Maolain taught us, via a mixture of the Socratic method and long rambles, about the state of third party certification for humane handling of dairy cows.
I have written about this before, but here is the situation in a nutshell: consumers want to buy milk from producers who treat their cows well. Some consumers purchase organic milk for this reason. However, organic certification in no way guarantees cow welfare. Currently, the only way to be sure you’re supporting a producer who treats his cows well is to buy the milk directly from an individual farmer whose practices you know. This is impractical, to say the least, especially for the average consumer who may not know enough about dairy practices to be able to identify those which result in good cow welfare.
One solution to this problem could be third party certification. An organization like American Humane offers certification to farmers for a fee. Consumers then buy milk from producers who are certified by this third party.
Unfortunately, this doesn’t work either! There is no system in place to allow individual producers to have their milk pasteurized and marketed separately. The milk truck collects milk from multiple farms before delivery to the processing plant: if one farmer is certified and another is not, the milk nevertheless mixes together on the truck and in the plant. There is no way to process certified milk separately so that it can be marketed separately.
What’s the solution to that? More processing plants? Maybe, but they are expensive to build, and I don’t know all the relevant issues involved in their funding and construction. It is an interesting problem. I know the public has an interest in milk from humanely raised cows, and it frustrates me that the market systems are not in place to deliver it to them.
(More to come...)
Two other students met me at my house, and we made the hour’s drive to the Ambulatory clinic together, where we met the fourth member of our little group. At the clinic, we hovered somewhat aimlessly in the break room and made small talk with the fourth year students there who were on a week of Ambulatory rotation. After a few minutes, Dr. Maolain, who was running the farm tour, walked through and asked us if we all had our boots. We were scornful. Did he really think we would have shown up for a day on farm without boots? (The boots are of course much appreciated when you are walking through a soup of cow manure. They are also more scrubbable than street shoes — easier to hose off and soap before leaving a farm, so that you do not carry infectious disease to the next farm you visit.)
We piled into Dr. Maolain’s truck, a tight fit, and headed out. We had a forty minute drive to our first stop, during which time Dr. Maolain taught us, via a mixture of the Socratic method and long rambles, about the state of third party certification for humane handling of dairy cows.
I have written about this before, but here is the situation in a nutshell: consumers want to buy milk from producers who treat their cows well. Some consumers purchase organic milk for this reason. However, organic certification in no way guarantees cow welfare. Currently, the only way to be sure you’re supporting a producer who treats his cows well is to buy the milk directly from an individual farmer whose practices you know. This is impractical, to say the least, especially for the average consumer who may not know enough about dairy practices to be able to identify those which result in good cow welfare.
One solution to this problem could be third party certification. An organization like American Humane offers certification to farmers for a fee. Consumers then buy milk from producers who are certified by this third party.
Unfortunately, this doesn’t work either! There is no system in place to allow individual producers to have their milk pasteurized and marketed separately. The milk truck collects milk from multiple farms before delivery to the processing plant: if one farmer is certified and another is not, the milk nevertheless mixes together on the truck and in the plant. There is no way to process certified milk separately so that it can be marketed separately.
What’s the solution to that? More processing plants? Maybe, but they are expensive to build, and I don’t know all the relevant issues involved in their funding and construction. It is an interesting problem. I know the public has an interest in milk from humanely raised cows, and it frustrates me that the market systems are not in place to deliver it to them.
(More to come...)
Thursday, February 17, 2011
What vet students talk about with their boyfriends
Me: So I’m trying to schedule this dairy farm welfare elective, but the day all the interested students are free to do it, the faculty member has a herd check scheduled. He thinks it will be fine, we can use the herd check as a starting point, but you know how these things go.
The Boy: No. What’s a herd check?
Me: Rectalling a hundred cows to tell if they are pregnant.
The boy makes a face.
Me: It’s not so bad, it’s just kind of boring, and I’ll be doing plenty of that on my Ambulatory rotation, I don’t need to be doing it during my elective week.
The Boy: So all the cows get bred at once, that’s why you do a hundred?
Me: Well, it depends on how you run your farm, but no, for this particular farm, Dr. Maolain visits them every week. So he’s checking a hundred cows a week. Well, I don’t know that it’s a hundred, actually.
The Boy: So he’s checking all the cows?
Me: Just the ones who were bred recently. Actually, knowing when to breed them is a whole Thing. They come into heat every 21 days, but they are only in heat for less than a day. The best way to know when to inseminate them (which almost everyone does artificially) is to watch them to see when they are in heat. But it is a real pain to watch all your cows all the time. So you can also use hormones to sync them, and to narrow the window for when they will come into heat.
The Boy: How long after you breed them can you tell that they are pregnant?
Me: That was a test question. It was a lot of tests ago, though. I don’t remember.
But I have looked it up for you (and as a review for me). There are four positive signs of pregnancy in a cow that you can feel per rectum: fetal membrane slip (day 30), the amniotic vesicle (day 30), placentomes (day 75), and the fetus (starts at day 65, but by mid-gestation may be too deep in the abdomen to reach with your arm). If you can feel at least one, you can say that the cow is pregnant. The fetal membrane slip is supposed to feel like the seam on womens’ stockings; it is the allantois inside the uterus. The amniotic vesicle is the sac enclosing the fetus (and it is apparently not recommended for veterinary students to go poking at it, but people who know what they are doing are OK).
Placentomes are where the cow uterus connects to the placenta, and there is seriously not a Wikipedia article on it for me to point you at! Bizarre. Different kinds of animals have different ways of getting nutrients from the mom to the baby during pregnancy, and that is why cows have placentomes and we don’t. (If you want to know more about that, comment! I might could write a post on it.)
The Boy: No. What’s a herd check?
Me: Rectalling a hundred cows to tell if they are pregnant.
The boy makes a face.
Me: It’s not so bad, it’s just kind of boring, and I’ll be doing plenty of that on my Ambulatory rotation, I don’t need to be doing it during my elective week.
The Boy: So all the cows get bred at once, that’s why you do a hundred?
Me: Well, it depends on how you run your farm, but no, for this particular farm, Dr. Maolain visits them every week. So he’s checking a hundred cows a week. Well, I don’t know that it’s a hundred, actually.
The Boy: So he’s checking all the cows?
Me: Just the ones who were bred recently. Actually, knowing when to breed them is a whole Thing. They come into heat every 21 days, but they are only in heat for less than a day. The best way to know when to inseminate them (which almost everyone does artificially) is to watch them to see when they are in heat. But it is a real pain to watch all your cows all the time. So you can also use hormones to sync them, and to narrow the window for when they will come into heat.
The Boy: How long after you breed them can you tell that they are pregnant?
Me: That was a test question. It was a lot of tests ago, though. I don’t remember.
But I have looked it up for you (and as a review for me). There are four positive signs of pregnancy in a cow that you can feel per rectum: fetal membrane slip (day 30), the amniotic vesicle (day 30), placentomes (day 75), and the fetus (starts at day 65, but by mid-gestation may be too deep in the abdomen to reach with your arm). If you can feel at least one, you can say that the cow is pregnant. The fetal membrane slip is supposed to feel like the seam on womens’ stockings; it is the allantois inside the uterus. The amniotic vesicle is the sac enclosing the fetus (and it is apparently not recommended for veterinary students to go poking at it, but people who know what they are doing are OK).
Placentomes are where the cow uterus connects to the placenta, and there is seriously not a Wikipedia article on it for me to point you at! Bizarre. Different kinds of animals have different ways of getting nutrients from the mom to the baby during pregnancy, and that is why cows have placentomes and we don’t. (If you want to know more about that, comment! I might could write a post on it.)
Wednesday, February 2, 2011
Cow anesthesia
Instead of blogging, I have been shovelling snow. And sleeping off being sick. Also maybe there was some studying in there too. But I am rallying! I love New England winter! Especially when school keeps getting closed down for snow days!
Last week I had my bovine anesthesia lab. When I learned to do anesthesia on a dog, it was a precise and complicated process which took place in a hospital. The dog got pre-anesthesia medication, had a tube down her throat to help her breathe, and got post-surgical pain meds. The process is very different with a cow.
With cows, mostly you do standing surgery — surgery while the cow is awake, with local anesthesia so they don’t feel the pain. Why? Obviously, part of the reasoning is financial; farmers cannot afford to take their cows in to the hospital for surgery, and the equipment for general anesthesia is not available on the farm.
However, even if you can afford to put a cow under general anesthesia, it might not be the best thing for the cow. Putting a tube down the throat of any ruminant is somewhat more dangerous than with a dog. Ruminants are more likely to aspirate their stomach contents and get aspiration pneumonia, which is definitely something you want to avoid. More importantly, cows have these huge stomachs. The compartment called the rumen is particularly enormous, containing around 25 gallons of material. This is where all that grass (or, in today’s world, corn) marinates in a soup of saliva and bacteria, and the bacteria generate energy which the cow uses. Putting a cow on her side means that the huge rumen is lying on abdominal organs. It can make breathing very difficult.
So in bovine anesthesia lab, I injected lidocaine along specific nerves in order to block areas of the cow’s side. I have not yet seen standing surgery in a cow, but when I do, I will let you know what it is like. Reaching inside a standing animal to move things around and sew things up will definitely be an interesting thing to see.
Last week I had my bovine anesthesia lab. When I learned to do anesthesia on a dog, it was a precise and complicated process which took place in a hospital. The dog got pre-anesthesia medication, had a tube down her throat to help her breathe, and got post-surgical pain meds. The process is very different with a cow.
With cows, mostly you do standing surgery — surgery while the cow is awake, with local anesthesia so they don’t feel the pain. Why? Obviously, part of the reasoning is financial; farmers cannot afford to take their cows in to the hospital for surgery, and the equipment for general anesthesia is not available on the farm.
However, even if you can afford to put a cow under general anesthesia, it might not be the best thing for the cow. Putting a tube down the throat of any ruminant is somewhat more dangerous than with a dog. Ruminants are more likely to aspirate their stomach contents and get aspiration pneumonia, which is definitely something you want to avoid. More importantly, cows have these huge stomachs. The compartment called the rumen is particularly enormous, containing around 25 gallons of material. This is where all that grass (or, in today’s world, corn) marinates in a soup of saliva and bacteria, and the bacteria generate energy which the cow uses. Putting a cow on her side means that the huge rumen is lying on abdominal organs. It can make breathing very difficult.
So in bovine anesthesia lab, I injected lidocaine along specific nerves in order to block areas of the cow’s side. I have not yet seen standing surgery in a cow, but when I do, I will let you know what it is like. Reaching inside a standing animal to move things around and sew things up will definitely be an interesting thing to see.
Wednesday, October 27, 2010
Veterinary fact of the day: castrating lambs
I am plowing through flash cards for my upcoming large animal medicine/surgery exam. Current favorite card:
Q: Best time to castrate a lamb?
A: First 12 hours of life, after that too hard to catch
So descriptive in its brevity.
Q: Best time to castrate a lamb?
A: First 12 hours of life, after that too hard to catch
So descriptive in its brevity.
Monday, October 18, 2010
So how can we make things better for dairy cows?
Recently we had a lecture from Dr. Gray on production medicine. Before I explain what production medicine is, let me give you a feel for what Dr. Gray is like. He is probably the member of our food animal faculty with whom I agree the most about food animal welfare, although we certainly don’t see completely eye to eye. He is a hugely amusing lecturer due to his propensity to tell involved stories about something that happened on the job recently, and to write random bits of them on the whiteboard.
This particular whiteboard was such a work of art that I convinced my classmate LPS to photograph half of it, at risk of looking like a nerd in front of the class. You will note that, at one point, Dr. Gray was telling how he had made a plan with a client to meet on a particular date, and he wrote the date on the board. (I was tempted to raise my hand to ask if that would be on the test, but since I had sassed him twice in lecture on the previous day, I decided everyone would be happiest if I kept my mouth shut.) Another friend, LPK, at one point noted that Dr. Gray had erased three milk production curves from the previous day in order to draw a fourth. These were generic milk production curves, i.e., “She makes less, then she makes more, then she makes less.” He could have simply pointed to one of the previous ones. Here, in all its glory, is half of the whiteboard:
(Thanks, LPS! Also: the “countdown to clinics” is maintained by my class, not Dr. Gray. That’s a real count; I will be playing doctor in less than 171 days.)
Dr. Gray explained what production medicine is by telling a story. He was in the truck, driving to lecture a bunch of third year students, when he got a call from the manager of a farm. The owner of the farm had set some financial goals for the farm; he wanted to see them sell 75,000 lbs of milk a day. Since they were currently selling 61,000 lbs, the manager had a problem, and he was calling Dr. Gray to talk about it.
Now, if you are a dairy farmer and you want to sell more milk, you have two ways of doing it. You can milk more cows, or you can get more milk from the cows you already have. Buying or raising more cows involves some overhead costs: if you get too many more, you need to build a new barn. If you try to cram too many into the barns that you already have, they will not do well, and the result will be decreased milk production. This farm manager wanted to convince the cows he had to give him some more milk, and maybe figure out if it was safe to keep a few more cows as well.
There are a lot of factors to take into account in this game. How many cows can you fit? If you have too many, they will all be waiting in line for a long time at the milking parlor. This will eat into their daily quota of lying around chewing their cuds, which will mean poorer quality digestion and less milk. How much milk will each cow produce? This has a lot to do with what she eats. Is she eating as much as you want her to, or is something preventing her from doing so (too many cows at the feed bunk)? Is there a way you can change her diet to provide more energy for her to turn in to milk? If you provide too much energy, her rumen will acidify. At low levels (“sub-clinical rumenal acidosis”) she won’t look sick, but her life expectancy will be shortened, and, you guessed it, she will make less milk. At higher levels, she can have ulcers which eat their way through the wall of her rumen and seed her bloodstream with bacteria. The bacteria make it to her lungs, where they generate clots. And that can kill her in a fairly unpleasant manner.
Production medicine is all about balance. More of a particular factor will give me more milk until it starts giving me less milk. To some extent, the welfare of the cow is in sync with the welfare of the farmer’s bank account. A sick cow doesn’t give as much milk as a healthy one. But to a very large extent, this relationship does not hold true. It often makes more financial sense to sacrifice optimal cow health (accepting sub-clinical rumenal acidosis in many cows in your herd) in the name of income (increased milk production in the remaining cows due to high energy feed). At other times, farmers simply can’t afford veterinary care for every cow that needs it when she might need it.
So do I think dairy farmers are jerks who don’t care about their cows? I absolutely do not. I have a lot of sympathy for their situation, and the ones I have met have been really nice guys who clearly do like their cows. But, to give an example of a population of humans that we all know care about animals — people who love their dogs make bad management choices when they are in bad situations. And dairy farmers are, many of them, in bad situations.
I believe that if they could afford to, more farmers would have smaller farms, with more personal care of their cows, with more cows out on grass. And I believe that almost none of them would skimp on veterinary care if they could afford to give their cows the care they want. But dairy farmers are suffering from very low milk prices right now. They do not have enough income to have the luxury of doing the right thing. They are just trying to get by. They are driven to making bad choices, like packing too many cows into a barn, or sacrificing veterinary care.
Mostly, the small farmers are driven out of business, and the large farmers are taking over, because that makes more financial sense. Dr. Gray reports that a 5,000 cow dairy is the most efficient one. Are large farms worse? Well, if they are more profitable, the cows are likely to get better nutrition and better veterinary care. Other things will be better for them too — the concrete that almost all dairy cows live on will be covered in better bedding, for example.
But in my opinion, the very best farm is the small farm with enough money. On that farm, there are few enough cows that they can be put out on grass sometimes. (Imagine getting 5,000 cows out onto grass, and then onto the next pasture segment a few days later, and then onto the next pasture segment a few days after that, not to mention getting them all to the milking machine at least twice a day.) It is a farm where the farmer can know each of his cows, and notice right away when one of them is not quite right, so that she can receive medical attention promptly. It is a farm where the number of cows is small enough that infectious disease is not a big problem. Are there any farms like this left? Vanishingly few, if any. Dr. Gray opined that the big farm is the farm of the future. The small farm is on its death bed.
I raised my hand and asked Dr. Gray if he thought there was anything veterinarians could to affect this situation, to try to fight against the death of the small farm, or otherwise take steps to change the situation of dairy cows. He replied, “No.” In his opinion, no one really cares all that much about cows. There are some people who do, like a lot of the students in the class, but he suggested that we were the exception, when you look at society as a whole.
The lecture moved on, but I wasn’t done. During the break, I talked to Dr. Gray more, along with Daria, a classmate of mine who has worked on farms and is interested in food animal medicine and herd health. I pointed out that people do care about food animals; they voted “yes” on Prop 2 in California, knowing that it would almost certainly raise food prices. Daria added that consumers do have power to affect farm animal practices; there is almost no milk sold in the Northeast from cows that were given rBST (a synthetic growth hormone), and that is because there was no demand for that milk from consumers.
Dr. Gray protested that neither of those things were useful things to do. Proposition 2 enacted rules with no science behind them and may not actually make things better for animals. And science shows that rBST isn’t bad for cows or people. (I’m not going to get into whether I agree with either of those statements; they are his viewpoint.)
I replied that the point is that consumers have power. What they are lacking is information. I noted that I have always purchased organic milk in grocery stores. Until I started vet school, I was under the misapprehension that this would lead to at least somewhat improved welfare for the cows in question. I now realize that that is not true. But I have always been willing to spend more money to purchase a better life for the cow whose milk I drink. I believe that other people agree with me.
The problem is that people don’t know how to vote with their pocketbooks for a good life for cows. They don’t necessarily know whether or not dairy cows have a good life. (My opinion: it is not by any means torture. But it is unpleasant enough that since taking this class I have stopped buying milk in the grocery store.) So my answer to the question “what can veterinarians do?” is this: veterinarians can educate.
What can you do? Unfortunately, there isn’t a good answer to this question.
This particular whiteboard was such a work of art that I convinced my classmate LPS to photograph half of it, at risk of looking like a nerd in front of the class. You will note that, at one point, Dr. Gray was telling how he had made a plan with a client to meet on a particular date, and he wrote the date on the board. (I was tempted to raise my hand to ask if that would be on the test, but since I had sassed him twice in lecture on the previous day, I decided everyone would be happiest if I kept my mouth shut.) Another friend, LPK, at one point noted that Dr. Gray had erased three milk production curves from the previous day in order to draw a fourth. These were generic milk production curves, i.e., “She makes less, then she makes more, then she makes less.” He could have simply pointed to one of the previous ones. Here, in all its glory, is half of the whiteboard:
(Thanks, LPS! Also: the “countdown to clinics” is maintained by my class, not Dr. Gray. That’s a real count; I will be playing doctor in less than 171 days.)
Dr. Gray explained what production medicine is by telling a story. He was in the truck, driving to lecture a bunch of third year students, when he got a call from the manager of a farm. The owner of the farm had set some financial goals for the farm; he wanted to see them sell 75,000 lbs of milk a day. Since they were currently selling 61,000 lbs, the manager had a problem, and he was calling Dr. Gray to talk about it.
Now, if you are a dairy farmer and you want to sell more milk, you have two ways of doing it. You can milk more cows, or you can get more milk from the cows you already have. Buying or raising more cows involves some overhead costs: if you get too many more, you need to build a new barn. If you try to cram too many into the barns that you already have, they will not do well, and the result will be decreased milk production. This farm manager wanted to convince the cows he had to give him some more milk, and maybe figure out if it was safe to keep a few more cows as well.
There are a lot of factors to take into account in this game. How many cows can you fit? If you have too many, they will all be waiting in line for a long time at the milking parlor. This will eat into their daily quota of lying around chewing their cuds, which will mean poorer quality digestion and less milk. How much milk will each cow produce? This has a lot to do with what she eats. Is she eating as much as you want her to, or is something preventing her from doing so (too many cows at the feed bunk)? Is there a way you can change her diet to provide more energy for her to turn in to milk? If you provide too much energy, her rumen will acidify. At low levels (“sub-clinical rumenal acidosis”) she won’t look sick, but her life expectancy will be shortened, and, you guessed it, she will make less milk. At higher levels, she can have ulcers which eat their way through the wall of her rumen and seed her bloodstream with bacteria. The bacteria make it to her lungs, where they generate clots. And that can kill her in a fairly unpleasant manner.
Production medicine is all about balance. More of a particular factor will give me more milk until it starts giving me less milk. To some extent, the welfare of the cow is in sync with the welfare of the farmer’s bank account. A sick cow doesn’t give as much milk as a healthy one. But to a very large extent, this relationship does not hold true. It often makes more financial sense to sacrifice optimal cow health (accepting sub-clinical rumenal acidosis in many cows in your herd) in the name of income (increased milk production in the remaining cows due to high energy feed). At other times, farmers simply can’t afford veterinary care for every cow that needs it when she might need it.
So do I think dairy farmers are jerks who don’t care about their cows? I absolutely do not. I have a lot of sympathy for their situation, and the ones I have met have been really nice guys who clearly do like their cows. But, to give an example of a population of humans that we all know care about animals — people who love their dogs make bad management choices when they are in bad situations. And dairy farmers are, many of them, in bad situations.
I believe that if they could afford to, more farmers would have smaller farms, with more personal care of their cows, with more cows out on grass. And I believe that almost none of them would skimp on veterinary care if they could afford to give their cows the care they want. But dairy farmers are suffering from very low milk prices right now. They do not have enough income to have the luxury of doing the right thing. They are just trying to get by. They are driven to making bad choices, like packing too many cows into a barn, or sacrificing veterinary care.
Mostly, the small farmers are driven out of business, and the large farmers are taking over, because that makes more financial sense. Dr. Gray reports that a 5,000 cow dairy is the most efficient one. Are large farms worse? Well, if they are more profitable, the cows are likely to get better nutrition and better veterinary care. Other things will be better for them too — the concrete that almost all dairy cows live on will be covered in better bedding, for example.
But in my opinion, the very best farm is the small farm with enough money. On that farm, there are few enough cows that they can be put out on grass sometimes. (Imagine getting 5,000 cows out onto grass, and then onto the next pasture segment a few days later, and then onto the next pasture segment a few days after that, not to mention getting them all to the milking machine at least twice a day.) It is a farm where the farmer can know each of his cows, and notice right away when one of them is not quite right, so that she can receive medical attention promptly. It is a farm where the number of cows is small enough that infectious disease is not a big problem. Are there any farms like this left? Vanishingly few, if any. Dr. Gray opined that the big farm is the farm of the future. The small farm is on its death bed.
I raised my hand and asked Dr. Gray if he thought there was anything veterinarians could to affect this situation, to try to fight against the death of the small farm, or otherwise take steps to change the situation of dairy cows. He replied, “No.” In his opinion, no one really cares all that much about cows. There are some people who do, like a lot of the students in the class, but he suggested that we were the exception, when you look at society as a whole.
The lecture moved on, but I wasn’t done. During the break, I talked to Dr. Gray more, along with Daria, a classmate of mine who has worked on farms and is interested in food animal medicine and herd health. I pointed out that people do care about food animals; they voted “yes” on Prop 2 in California, knowing that it would almost certainly raise food prices. Daria added that consumers do have power to affect farm animal practices; there is almost no milk sold in the Northeast from cows that were given rBST (a synthetic growth hormone), and that is because there was no demand for that milk from consumers.
Dr. Gray protested that neither of those things were useful things to do. Proposition 2 enacted rules with no science behind them and may not actually make things better for animals. And science shows that rBST isn’t bad for cows or people. (I’m not going to get into whether I agree with either of those statements; they are his viewpoint.)
I replied that the point is that consumers have power. What they are lacking is information. I noted that I have always purchased organic milk in grocery stores. Until I started vet school, I was under the misapprehension that this would lead to at least somewhat improved welfare for the cows in question. I now realize that that is not true. But I have always been willing to spend more money to purchase a better life for the cow whose milk I drink. I believe that other people agree with me.
The problem is that people don’t know how to vote with their pocketbooks for a good life for cows. They don’t necessarily know whether or not dairy cows have a good life. (My opinion: it is not by any means torture. But it is unpleasant enough that since taking this class I have stopped buying milk in the grocery store.) So my answer to the question “what can veterinarians do?” is this: veterinarians can educate.
What can you do? Unfortunately, there isn’t a good answer to this question.
- Buy organic milk at the grocery store? This will probably not make any contribution to dairy cow welfare. Farmers who produce organic milk have an incentive to not treat sick cows, because once a cow has had any antibiotics at all, her milk is no longer considered organic, and will bring a lower price. Regulations about what is organic make no specifications about humane handling of cows.
- Buy less milk? I certainly think that Americans consume too much milk (mostly in the form of cheese). But buying less milk right now is probably going to have the immediate effect of driving more small farmers out of business, which is not the best thing from a dairy cow’s welfare standpoint.
- Buy milk from farms with grass-fed cows. This is what I am trying to do, but it is awfully hard to find farms like this! I have failed to find milk from grass-fed cows in my area, but my farmer’s market does provide me with cheese and yogurt made from milk from grass-fed cows. Check out your local farmer’s market. Does your town lack a farmer’s market? Maybe you can start one. The market in my town was started by one guy with a lot of enthusiasm a few years ago. Does your town’s farmer’s market not have milk, cheese, or yogurt from grass-fed cows? Let the organizers know that you’d like it to. Or maybe you can set up a buying co-op. Think out of the box.
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