I talked through with Tom exactly what I was planning. His cow was poorly and, although a displaced abomasum operation is not an emergency – it’s not like a twisted stomach in a dog – she was pretty sick and it would have been foolish to delay the inevitable surgery, which would (we hoped) be life-saving.
We got her into Tom’s excellent cattle crush, which had all manner of sophisticated mod-cons to allow perfect restraint of the cow and access to the surgical site. There are some farms that operate with antediluvian handling systems, rusting and fastened together with baler twine, which make handling cattle more challenging.
This evening’s operation would be under perfect conditions and both cow, vet and farmer would be safe from injury. Too many times, I’ve risked bruised arms, damaged kneecaps or worse, broken bones, because cattle have not been adequately restrained – but not this evening.
I have fixed many displaced abomasums, but today was an exciting day for me. Today was the day I tried a new surgical technique, which is always exciting.
What needs to happen, to correct the condition, is for the abomasum to be repositioned from the left (abnormal) side, to the right (normal) side of her abdominal cavity. There are lots of ways of achieving this repositioning.
One way, the one I’ve done most, is to use two vets, make two incisions in the cow – one on each side – and pass the abomasum from one vet to the other, literally with the arm of both vets inside the cow. It works well and is pretty fool-proof, but is time-consuming, two vets are needed (not great at 7.30pm) and the cow has two incisions – one on each side.
Another simple method, requiring just one vet but several helpers from the farm, is to roll the cow onto her back, hold her legs still and make an incision under her abdomen. The displaced stomach floats into approximately the correct position when the cow is on her back. The surgical time is kept to a minimum, but this version requires lots of assistants and, whilst it is quick, cows do not really like being held upside down.
There are several other options, one of which I was about to embark upon this evening. It involved making a single incision in the right side of the cow, with her standing upright. I would reach across her abdomen, identify the displaced fourth stomach, squeeze it to allow gas to escape into the first part of the intestines, and then attempt to return it to the rightful place, just below my incision.
In theory it was simpler, but required some skill and long arms, neither of which I had. Nonetheless, I knew it was the way forward as it is the method favoured by many cattle vets these days. Tom’s Friesian would, therefore, be a guinea pig.
I took a deep breath and made my first cut, then tentatively explored the abdomen. Sure enough, a hugely distended abomasum was trapped on the left side of her abdomen. I felt a bit like someone embarking on a rescue attempt for a cave-diving accident, as I felt blindly at full arm’s length. Tom was oblivious to the challenges I faced inside his cow’s abdomen.
Once I’d squeezed out some gas, the displaced organ was fairly easily manoeuvred into its correct position, and the fatty tissue adjacent to it was perfect to use to anchor it in place.
Everyone felt happy with the evening’s work, especially the cow, who walked off to join her herdmates, completely oblivious to what had been going on! It was early days, with much that could go wrong, but so far it was looking good.