Reno needs advice ...again on c-sec. heifer

[reno1014]

Okay, here goes...I need yalls opinion and help.  I had a heifer that my vet did a c-sect. on last Wednesday.  The vet told me to come and get her on Thursday...which I asked if she could stay one more day
because its 50 miles to my house from there and I thought the extra day would do her better.  So I went to get her on Friday he told me that she didnt need anymore antibiotics or anything because they
had given her some that morning.  I brought her home.  She made the haul really well and I put her in her spot by herself.  She did okay Friday and Saturday...but not eating very much.  On Sunday
I noticed that she ate very little and she was very slow and the side where the stitches was a little distended.  I thought maybe a little swelling and she was laying on the opposite side.  On Monday I checked
her at lunch and noticed that one of the outer stitches was out, and the distention was worse.  I felt of her and decided she had a fever, as well as a little bit of awkward movements...I inverstiged her
waste and noticed that there was blood in it (feces).  I called the Vet and he had me bring her back in.  When I walked her through his exam chute and he closed it her side popped open and smelly watery
bloody stuff came pouring out in bucket fulls.  He first told me that she had an infection between the outer muscle and hide.  Then 30 minutes later he said it was further in than what he thought. 
When I went to the back of the office to check on her myself he had a garden hose with an end sprayer and was hosing her out.  It smelled really bad.
Well, I left her there and this morning (Tuesday) he called and said that all her stitches had come apart and that is why she got infected.  I am not a vet but how in the heck did this happen?  She is not
wild by any means and there is around her to hurt her.  Am I wrong but it this normal stuff for a c-sect?  I just dont feel right about this whole experience from the get go.
She now has a drain tube in her and they are giving her more antibiotics.  He wants to keep her for awhile, which is fine IF they take good care of her...but so far I am really dissapointed in my Vet.
I wanted to take her to another vet but he is 2 hours away and I didnt know if he even wanted someone elses mess. Should I have to pay more for this?  The first episode cost more than she did.
Will my heifer be okay...or am I putting her through alot of misery for nothing?

 

[dori36]

I"m so sorry for you and the heifer.  I hope DL will weigh in here as she would have the professional viewpoint.  From an owner's viewpoint, and considering that the whole delivery/c-section with this heifer has been a disappointment, to say the least, I'd surely be disappointed with the Vet, too.  I'd want the same answers you do and would, in a measured and "professional" way, ask those very questions of the vet himself.  DL....?

 

[Cattledog]

Yikes!  Man have you had a bad run of luck or what!?!  I don't have much experience with C-sets but this whole deal just strikes me as wrong.  We have had two C-sections and we never had anything like that happen.  Hopefully we can get some more input on this.

 

[amss101]

I thought most c-sections were done on the farm...but this definitely doesn't sound right.  I'm w/ everyone else, I'd be asking some questions.  Can you call the other vet anonymously and give him a run down to get his opinion?

 

[DL]

reno - sorry you are having such a time - have to say though you are the kind of client I like to work with - observant, intuitive, good husbandry

ok - these are my thoughts

just because you (generic you) get good results it doesn't mean you have a good vet, and just because you get unfortunate results it doesn't mean you have a bad vet - sometimes things happen that none of us have any control over

a CS is conceptually a very simple procedure - but in practice it can be very challenging and difficult (some vets won't even do them). What could be simpler? Make an incision in the uterus and remove the calf - sew her back up and off she goes. Well the idea is to exteriorize the uterus (bring it to the outside thru the skin incision) so that when you make the incision in the uterus the fluid goes on the ground and not into the abdominal cavity.

So for example you have an 80 pound calf floating in about 120 pounds of thick stick gooey slimy fluid - if the calf is alive the fluid shouldn't be nasty and infected - if the calf is dead there will be bacteria and other ickys in the fluid. While you have the uterus (which is slippery itself) exteriorized you make an incision in the uterus and then pull the calf out - all the while keeping the uterus and the fluid outside and pulling the slippery calf thru the 6 or 8 or 10 inch incision in the uterus. The uterus is fragile having been stretched with calf so you don't want to tear it, but you also don't want to make too big an incision because the longer it is the harder it is to get it closed tight when you suture it back together.

Now this all assumes that the cow is standing nicely - sometimes they don't - so you will be doing all of this with a kicking bounding bovine

Once the calf is out you check for tears in the uterus - calf can easily stick a foot thru - often you will flush the abdominal cavity to dilute any fluid that ended up in the abdominal cavity (dilution is the solution to pollution) - some vets will add dilute antibacterial or antibiotics

Then the peritoneum and abdominal muscles are sutured, then finally the hide. We suture the hide in a continuous pattern with 2 single sutures at the end. With this pattern if there is an infection the bottom sutures can be opened and the fluid can drain. With any kind of surgery there is leaking of fluid and blood from the cut tissue - this stuff really is a great medium for bacteria to grow.

Now remember that the cow is not a sterile critter and unless the hide is scrubbed to white glove clean (not likely) there are bacteria - cow, even show cows, live in a barn!

Infection at the incision site, either superficial or in the muscle, abdominal infection (peritonitis), or uterine infection (metritis or endometritis) are not uncommon complications of CS. You don't want them to happen but sometimes they do

Popping the sutures and getting all the smelly gunk out of the heifer will probably make her feel tons better. Antibiotics are certainly a good idea - are they giving her something for pain and discomfort?? ie flunixamin (aka Banamine) - likely it will make her feel better and she will likely be more apt to eat

If they are able to give her TLC, hand feed if necessary, hydrotherapy to the incision site etc then probably leaving her there is a good idea - if they can't do that then you might want to bring her home

I can't tell from your post exactly how deep or the extent of the infection is - but it sounds like they are doing the right thing in an unfortunate situation - I hope she does alright - let me know if you have any other questions - DL

amss101 - I wouldn't take an anonymous call about care of an animal I hadn't seen - have the guts to identify yourself

 

[braunvieh]

My dad had a heifer with a c-section this spring and the situation sounds very similar to yours. I gave her antibiotics for 5 days as instructed and she was fine until about a week after the CS. The started oozing and getting distended. Vet said to open bottom suture to let it drain and to give more antibiotics. We did this and she seemed to improve but kept draining, smelly and infected. She seemed to do OK when on antibiotics but as soon as stopped she got worse. Another vet looked at her and said it was just an infection in the layer between muscle and skin and suggested more antibiotics and some hydro therapy and thought she would be fine. We did this for a while, meanwhile she was losing weight like crazy, the calf had to become a bottle calf. Finally stopped giving her antibiotics, she just slowly wasted away and had to be put down. I REALLY hope your situation works out better. I do agree you can't blame the vet. He did a c-section for us a couple weeks earlier and it went beautifully. Most do, but sometimes it just happens.

 

[amss101]

DL:  You seemed to have a problem w/ my comment but isn't that same basic thing as getting on here and asking...fine, identify yourself or don't...my rationale was that if it was anonymous you didn't make the other vet or yourself look bad just seeking information.  It's always good (in MY opinion-for whats worth-maybe nothing) to get as much knowledge as possible.  If he called the other vet and he said as you did that a lot of that was normal then the vet who did it, the vet who was called, and yourself are only out a phone call.  If the vet was horribly concerned then it might be time to do something different--maybe call a third vet as tie break.  I don't think I said anything too traumatic.

 

[amss101]

Reno-sounds like DL def. has the c-section thing down...good luck to you and your heifer.  We've never had a c-section around here but some rough births from time to time.  Keep us updated.

 

[DL]

DL:  You seemed to have a problem w/ my comment but isn't that same basic thing as getting on here and asking...fine, identify yourself or don't...my rationale was that if it was anonymous you didn't make the other vet or yourself look bad just seeking information.  It's always good (in MY opinion-for whats worth-maybe nothing) to get as much knowledge as possible.  If he called the other vet and he said as you did that a lot of that was normal then the vet who did it, the vet who was called, and yourself are only out a phone call.  If the vet was horribly concerned then it might be time to do something different--maybe call a third vet as tie break.  I don't think I said anything too traumatic.

I don't think you said anything traumatic but if I got a call from someone who would not give their name who wanted information I suspect I wouldn't take the call...that is what I was referring to

 

[kanshow]

DL - Do you find a big difference in doing a CS with the cow stand vs her laying down?    Up til last spring, any sections our vet did with the cow up & standing.  There were no problems with those sections.  However, last spring we had a cow go down & he had to do the section with her on her side.    He really fought trying to get the uterus back in.    We were able to get the cow back on her feet by the next day but a couple days days later, she developed an area on the lower side of her incision that needed to be drained. 

 

[renegade]

How common are c sections?

 

[CAB]

In the club calf world, c-sec. are always in the back of your mind. I've had 5 to 10 done in my lifetime. I'm 50, have calved the 1st 3000 hd approx., so I'd say not a big deal. I have never lost one yet but am selling an 11 yr old cow today that had a c-sec last spring B/C she wouldn't dilate. I have never had a previous cow that wouldn't rebreed in a timely schedule. All of my c-sec. but 1 have been done standing up. The one that is going to town today was the one that was done laying down.

 

[braunvieh]

We have an older vet that prefers to do them laying down, actually, they are on their backs with legs  up and tied. The incision runs along the belly kind of between udder and navel, but not that long. We have never lost a cow using his method but all the other vets in the area do them standing.

 

[dori36]

Reno-sounds like DL def. has the c-section thing down...good luck to you and your heifer.  We've never had a c-section around here but some rough births from time to time.  Keep us updated.

Great post from DL:  factual, gentle, not criticizing, good information and advice.  Yes, she's got the c-section thing down as she's a Veterinarian!  yay!

 

[shortyjock89]

Yeah, DL's a good vet and has it down, but just sayin..sounds like reno would have been better off living in Michigan and having access to DL's services rather than her "local" vet...now I have had some awful things happen with cattle, some might have been the fault of the vet, but I don't blame them...but we have a Universiy Animal Hospital less than an hour away, and that's where we take our more serious cases.

 

[kanshow]

We've had C-sections done by several of the area vets and never had a problem. The incident where the cow was done on her side was not the vet's fault.  It was just bad circumstances.    So to us, a section is really not a big deal.  I'd even go on to say that most of the heifers will rebreed although we usually choose to ship them.       

We do have one vet we do NOT call when we need a section done.  He would rather hack away at the rear end of the cow doing his version of an episiotomy than do a section.    We have had horrific results - and lost more cows  when he does that.  We simply do not call him or call him as a very last resort.

 

[amss101]

Great post from DL:  factual, gentle, not criticizing, good information and advice.  Yes, she's got the c-section thing down as she's a Veterinarian!  yay!

Just make sure if you with a question, you identify yourself-otherwise your up a creek!  (lol)

 

[CAB]

author=CAB link=topic=6421.msg72830#msg72830 date=1223560456]
  I don't like to induce cows/heifers, & I'm sure that most of us that frequent this board would have similar opinions about inducing. I have  induced a few during my lifetime because of necessity. I don't have a problem with them inducing the heifer, but what I would have issue with is that if they induced her and then didn't have an experienced person cking her at least once every 4 hours around the clock. According to Reno's description of the calf's swollen head and tongue, I would more than likely be upset myself. That would be my main concern, not wether or not  that they should have induced her or not. That decision, after it was made was water under the bridge and we could have dealt with the aftermath of that decision, but once induced, something's gonna give, usually 24 to 72 hours later.
  Reno, if you don't mind asking, what part of the country do you live? This is just out of curiosity. I was wondering the other day when you first posted this thread up B/C of your comments about how and what the vets asked you to do, I was wondering how much experience the vets in your area have with calving cows. Like I say, just curious. Sorry for your loss. I guess we all have these kinds of things happen and it's part of what makes birthing a miracle in away. Best wishes for your heifer. Sincerely, Brent
[/quote]


  Reno, this is from your original post prior and after the induction and post c-section, I was concerned about the amount of experience that your vet had @ that time and am curious how many c-sections they do a year, if you don't mind my straight out asking.
  What kind of prognosis are the vets giving you now? Is the heifer septic and has peritonitis began to set in? I think that they are doing what they need to and the drains are a must along with very heavy use of antibiotics. Honestly IMO according to what you are asking, I regret to say that it doesn't sound real promising although I would not give up hope and I will be hoping for the best for you in regards to your heifer. Sincerely, Brent

 

[reno1014]

He told me that she wasnt "down" and she still held her head up when I asked him about her chances for living.  That was the prognosis I got.
He never mentioned that she was septic or that she had perotinitis.  But I didnt specifically ask those questions either.  She sure is ill though.
I am going to call again this afternoon and speak with him again.

 

[reno1014]

DL my Vet said she was definitely septic....what exactly is that?