The first-time calver had not been right since she had delivered her calf and a colleague had been to examine her. The tell-tale pinging, just like a small stone being thrown at a metal bucket, heard down the stethoscope when the upper left side of the abdomen was flicked confirmed the diagnosis of a left displaced abomasum.
This is a fairly common problem in cows soon after calving. When the large uterus, until recently full of calf, placenta and fluid, is suddenly empty there is a lot of spare space in the abdominal cavity. If the cow doesn’t start eating immediately, the fourth stomach can move and become trapped between the body wall and the huge rumen on the left. Further periods of poor appetite render it gassy, so it floats higher and becomes even more trapped.
Luckily, an observant farmer spots the problem, suspects the diagnosis and calls the vet. An eagle-eared vet hears the ping and swaps the stethoscope for the scalpel. Or sends for a colleague to come with his scalpel, which is what happened this time – I was summoned to do the good bit.
The surgery is very satisfying, often with instant results. The aim is to manipulate the abnormal abomasum back to its correct position and suture it in place so it doesn’t float away again, like tethering a boat.
There are a multitude of surgical options, but one of my favourites is to have two vets, one on each side of the patient, who stands patiently while first one vet, then the other feeds an arm inside the cow, passing the abomasum across the abdomen via a suture in its muscular wall.
This is pushed into the waiting fingers of the second vet after a brief, abdominal handshake. It’s simple and effective, but has the downside of needing two incisions and also two vets in the same place at the same time, which is often a challenge.
Another method involves just one vet. The cow is rolled onto her back, so the gas filled abomasum floats back to approximately the correct position, whereupon it is fixed in place. It has the advantage of simplicity, but cows so not usually like lying upside down, so there is a concomitant struggle, with stray bovine feet flying in unpredictable directions, a great risk to vets and helpers.
A third technique, that is currently in favour, is the one I employed on this afternoon’s cow. It has the advantage of needing only one vet and one incision. I made that incision on the right side of the abdomen, then reached in and across, past the rumen to find the gas-filled abomasum hiding behind it. With some difficulty, I squeezed the gas out so that I could pull the abomasum back to its correct place.
There is a piece of fat, attached to it that acts as a very useful landmark and a handy tab to grab and suture. It’s called the lesser omentum, or more affectionately the “sow’s ear”, because that is what it looks like. When this appears at the incision, I know I’ve got the right bit. I swiftly attached the sow’s ear to the inside of the cow and, 40 minutes after I’d started, I was washing blood from my arm and the cow was walking back to the field. I hung around to watch her progress.
“I know what you’re waiting for,” said the farmer, impressed in an understated way at the simplicity of the technique. “It’ll make your day if she puts her head down and takes a mouthful of grass.”
The Yorkshire Vet continues on Tuesday evening on Channel 5 at 8pm
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