A hole in the foot (Day -275)

Cow in crush after amputation

When you put your finger into a hole in the foot of a cow and can feel bone you know it is going be interesting for you and very painful for the cow.

Now to understand what happens here you need to understand that cows have two toes (or claws) that contact the floor on each foot. With such a severe problem involving the bones and tendons of a toe the normal treatment would be amputation of that toe. Cows can generally survive on a single toe pretty well just so long as regular foot trimming and management is carried out.

However in the case of this cow the second toe of the same foot was affected though it was only a mild case at this stage. So if we had done amputation here of the really bad toe, the second toe would deteriorate further to the point where it would not be able to support the cows weight, and so the amputation would be pointless.

Economics unfortunately come into play as each cow in the herd has a value, both as meat and as a milking cow. This can justify the cost of the amputation surgery or whether the cow goes to slaughter – however if she is a good milker it is often the farmers wish to avoid this. Now the economics of amputation followed by slaughter in a week or two do not balance and so a clinical gamble based on years of experience was taken by the doctor here.

Amputation is necessary however this amputation would only be done if the other toe recovered. However as with any infection the key is to remove the source and so it was decided that the necrotic bone, tissue and some of the toe would be removed from the toe that would potentially be later amputated.

This level of injury is painful, and so requires good anaesthesia. In cows anaesthesia is usually local – so it only affects the area of the body where the surgery takes place much like if you yourself go to the dentist.

For the legs we apply a tourniquet to separate the foot from the rest of the body, and then make an injection into the veins of a local anaesthetic drug. This time the anaesthetic drug we used was procain – it is another topic however just quickly when using drugs in cows we have to really careful to use drugs that will not get into meat or milk to protect humans.

I was offered the chance to try to make the anaesthesia, and after my dismal first attempt at blood collection on Monday made amends by putting the needle, and then the anaesthetic drug directly into the vein on my first attempt (yay!). Still really believe it was complete beginners luck as me and cows have not really ever got acquainted.

The doctor removed the sesamoid bone and the tendon around this before then debriding the open bone surfaces of the digit. In this process the bottom of the joint capsule was lost and so in an attempt to help preserve the toe for another two weeks for the second toe to heal we also placed antibiotic drugs into the joint space.

Just to show how well an amputation heals (and to avoid gross photos) I’ve chosen today’s photo to be a cow that had an amputation around 6 weeks before.

When pigeons need surgery too…

Pigeon intramedullary pin fracture fixation surgery

Being a vet student brings great diversity in my daily patients which is one of the reasons I love it so much, today I assisted in surgery on a pigeon. Now this is one of those things that is not always taught in vet school – there simply is not enough time with everything else that we must learn.

A lot of my knowledge on the less common animals come from a lot of self study (if you are interested in pigeons check out the BSAVA Pigeon Manual here) when really I should probably be learning about the common things on dogs and cats… However sometimes like today the extra study pays off.

Now birds are different to other animals because they need to extremely light to be able to fly. One of the main weight savings is made by the bones being pneumatised – this means that they are hollow and join the lungs in the respiratory system in helping the bird breathe. This also helps the birds respiratory system be more efficient than in other animals – it is one of the reasons they can fly at such heights where other animals would suffer from a lack of oxygen.

Another important difference for when we consider surgery is that bird bones are a lot more mineralised than in other animals. This means that they are more likely to splinter than to “break” – an important thing to remember.

Before we started the surgery we did radiography, one of the goals is to return function and this allows us to check that the important ligaments of the wing are intact. It also allows us to see the damage and plan the surgery – in this case because the fracture was near the end of the bone where there was muscle attachment we needed to fix this into the proper position before we could then insert a intramedullary pin into the bone to fix it.

I am extremely lucky here that I have some very talented vets to learn from, and I was allowed to assist in this procedure. For me it was the most delicate orthopaedic surgery that I have assisted on so far, and in this case I was amazed at just how we could work with bones barely wider than a matchstick. However the surgery went very well, we fixed the end of the bone into the correct position and then inserted a long pin through the middle cavity of the bone to fix the two pieces together. Now something important to remember is that this long pin would act like a hinge for the two pieces of bone to rotate around so we inserted a second pin into the bone and the other end so we could fix them together to prevent rotation.

Hopefully this pigeon will make a full recovery, and be the first of many different species that I will be able to help when I finally qualify!

Tests, Anatomy, and the Skull… (Day 38)

Anatomy practical learning the skull

Ok, so this morning I was a little bit nervous, I have two credit tests today which is a first for me and even worse it is my first ever test for physiology so I have no clue what the questions will be like. Anyways today starts with the anatomy lecture which today was on the different parts of the skull, by the end of this I was starting to get a headache.

We then had Physiology which was based on the heart and cardiovascular rhythm regulation. This originally used to be taught many years ago by a practical with a frog, however because of the welfare implications the EU regulated for it under animal welfare as illegal. I agree with this as there are alternatives available as demonstrated today we used videos to learn the theory behind this instead. To be honest its kinda interesting how different drugs have different effects on it, and even more so how much redundancy is built into the heart.

After a break it was time for the test, now this was interesting as we had been told that it was just stuff that had been in our practical sessions however I recognised several questions to be based on stuff from the lectures as well. I took my time to write my answers clearly though I was not sure whether it was short answers or long answers that they wanted. Anyways hopefully I should find out soon.

Moving onto Anatomy it was time for my test on the spine and thorax, I was going well until I got to the sternum, I got the species correct and then my mind went blank when I was asked why it was the horse and not the Ox. Now I can recognise it on sight however they both have the same number of sternae, the only difference is the shape and trying to think of the word I had a total mind freeze. However I still ended up with a B which isn’t too bad… Anyways onto the practical session, this week we started looking at the skull, for anyone thats ever imagined anatomy, this is what it really looks like…

Anatomy practical learning the skullTo be honest I am already nervous about next weeks test, the skull is actually composed of multiple different bones all fused together and there are both the outside and inside to learn in addition to all the different channels, cavitities and openings.