Prolapse table

RE: Prolapse table

Anthony Todd — Thu, 10 May 2018 14:19:55 GMT

[quote user="vetbl.locum"]I thought calcium always gave arrhythmias so stopped listening to heart Too frightening[/quote]

Just clarifying, not turboing!!

The heart beats initially, on sternal palpation [left hand usually], were very faint and gradually got louder until an arrhythmia which didn't always occur. It was a good sign that there was enough Ca.

We took a series of bloods for Ca in "downer" cows unresponsive and got some really high Ca++, 27, I seem to recall [forgotten the normal limit].

Never had one die after or during Ca++ admin [nor Mg++ for hypoMg, damaged my car badly once when it charged it on recovery... odd insurance diagram of "vehicles on impact"!!]

RE: Prolapse table

vetbl.locum — Wed, 09 May 2018 09:05:08 GMT

[quote user="Anthony Todd"]Where was this? I can't remember one standing, let alone moving but, [/quote]

UK North West England

Lucky you ( on no deaths)

I thought calcium always gave arrhythmias so stopped listening to heart Too frightening

Rgds

RE: Prolapse table

Wren — Wed, 09 May 2018 08:40:54 GMT

[quote user="Busybee"]I've heard of two cases of cows dying - both colleague's cases, both on the same farm and within a week of each other. Both apparently collapsed and very pale even before any manipulation so suspected rupture of some major vessel. [/quote]

I had one die - prolapse replaced early evening, found dead the following morning. No PM done, but was very pale according to farmer. I'm guessing rupture of middle uterine artery or similar. These vessels can be as big as your thumb by the time pregnancy is at term, so perhaps more surprise they don't rupture more often, given the tension they must be under from the weight of a full and engorged prolapse hanging/swinging from a cow for several hours.

RE: Prolapse table

Busybee — Tue, 08 May 2018 21:24:46 GMT

I always use epidural whether standing or recumbent, will judge whether to give calcium based on the cow's symptoms and will give Oxytocin if I remember!

I've heard of two cases of cows dying - both colleague's cases, both on the same farm and within a week of each other. Both apparently collapsed and very pale even before any manipulation so suspected rupture of some major vessel.

RE: Prolapse table

Anthony Todd — Tue, 08 May 2018 17:15:21 GMT

Jo Berryman our medicine lecturer tells a true tale of a uterine prolapse in a sow so you can imagine the scene...

No problem thought Jo, as the sow was unmanageble in a large pen "We'll lasso her" so they did and the lasso slipped over the head, through the front legs around and down the abdomen, past the anus but tightened on the prolapsed uterus......

RE: Prolapse table

Vet2Vet — Tue, 08 May 2018 16:31:28 GMT

I had one race around the local holy mountain like a thing possessed gathering thorns from the bushes as she went . Eventually corralled her in a tiny shed . Request for water met with “ Will holy water do ? But it will be very cold ! “ Mad Ayrshire cross or similar . and I used a wine bottle - don’t do ginger beer or whiskey bottle if desperate

RE: Prolapse table

Anthony Todd — Tue, 08 May 2018 15:42:44 GMT

[quote user="vetbl.locum"]Even then ( back in the day or night )[/quote] etc.

Where was this? I can't remember one standing, let alone moving but, as this was in the "highest producing dairy area in the world", [arguably with the Waikato...]. low Ca++ may have been a precipitating factor, which was why they weren't walking and prolapsed in the first place.

PS I suppose a plastic bottle would be easier to manipulate than glass but they weren't around in NZ, way back then.

Don't think I ever had one die, and we stopped the CaboroG once, or if, we got a cardiac arrhythmia. Flicked their ears to judge reflexes whilst sitting on their scapula, left hand on the heartbeat.

Made the farmer hold the bottle high, or very high if he wouldn't stop talking.

Golden days when I once did ,more calls than the boss, but no chance ever again......

RE: Prolapse table

Catriona MacIntyre — Tue, 08 May 2018 11:58:53 GMT

Oh.... Most important bit of kit for replacing calf beds... An empty ginger bottle, in my case Barr's Irn Bru. Very useful as an arm extension for making sure the tip of the uterine horn is properly back as it should be.

The sugar and caffeine boost is a good pick me up on the way out to the farm in the middle of the night!

RE: Prolapse table

vetbl.locum — Tue, 08 May 2018 11:40:34 GMT

Even then ( back in the day or night ) , lots of cow/heifers would be standing with calf bed out. Some would even run away with it out.

Some would be lying down and most could be encouraged to stand. Some would even be standing as i put my fist through uterus , oops!

Some would be down unable to stand and some would die.

My preference get them up , epidural including wee bit rompon , calcium and oxytocin after replacement

Epidural was to even up the contest of you could push harder

Never sutured vulva lips as retention aid

Rgds

RE: Prolapse table

Anthony Todd — Tue, 08 May 2018 09:30:36 GMT

[quote user="Catriona MacIntyre"]I always use an epidural anaesthetic. Apparently my predecessor didn't. Seem a bit brutal for both patient and vet, to do it without![/quote]

Back in the day I never saw or heard of an epidural and the cow didn't seem in pain [but was probably paralysed by the hypoCa....

I must say it might have helped some of them that seemed to contest my attempts to replace the uterus. We didn't give the Ca, for that reason, until after replacement.

I can't remember seeing a cow standing up with a prolapse so Ca deficiency might have been the major factor.

We always did them totally alone with the farmer standing by, then holding the Ca aloft....

RE: Prolapse table

Wren — Tue, 08 May 2018 09:01:49 GMT

I always preferred them standing, as once you got it started moving back in then the weight of gravity pulled it over the pelvic brim. But cattle don't often give you a choice, you take what you get. No boards/bags /artificial aids, just scooped the whole thing up in my arms and held it against me with one arm while using the other to feed it back in. But I'm 6ft, with long arms.... Don't think I ever used oxytocin, but always an epidural, otherwise the cow would be trying to push it back out as quick as you were pushing it in. Used an epidural in sheep too.

RE: Prolapse table

Catriona MacIntyre — Tue, 08 May 2018 06:34:08 GMT

I haven't used oxytocin, but one of my shepherds swears by it for ewe prolapses. I was thinking of trying it next time, but rarely carry oxytocin because it's supposed to be a cold store drug these days.

Most of the calf beds I do are down, and if I'm honest I prefer that, as long as we have enough people/strength to get the cow positioned properly. But then, I'm only wee, so doing them with the cow standing can be challenging. In these cases I sometimes get the farmer to use the end of my parturition gown as a sling, but most of the time there's just me and one farmer, so not really able to do that.

I always use an epidural anaesthetic. Apparently my predecessor didn't. Seem a bit brutal for both patient and vet, to do it without!

RE: Prolapse table

Anthony Todd — Mon, 07 May 2018 15:14:02 GMT

All of these in NZ were "down" anyway and hypoCa was a precipitating cause, usually, or even if not, they got a bottle of Calcoborogluc.

Is that the same here?

Does everyone give oxytocin after the uterus is back?

RE: Prolapse table

Derek Lyon — Mon, 07 May 2018 12:43:49 GMT

Thanks Michael!! Prior to laying cows in sternal recumbency I did them standing and pushing back in with 2 fists! Always a feeling of great accomplishment now mater how one did it! Always associated with milk fever? Regards Derek

RE: Prolapse table

Michael Woodhouse — Sun, 06 May 2018 23:48:42 GMT

[quote user="Derek Lyon"]Always did mine over bale of straw with cow recumbent and legs facing back wards.[/quote]

Showing your age there, it's rare if a farm can provide a small bale these days. So useful for things like propping up cows, improvised surgery tables etc.

RE: Prolapse table

Derek Lyon — Sun, 06 May 2018 16:07:36 GMT

Always did mine over bale of straw with cow recumbent and legs facing back wards.

RE: Prolapse table

Evelyn Barbour-Hill — Mon, 09 Apr 2018 00:30:11 GMT

[quote user="Chris Milligan"]

looks like an old barbecue repainted :D

[/quote]

Complete with burger ready to char!!

J Wellington Wimpy, you're at it again.

RE: Prolapse table

Chris Milligan — Mon, 09 Apr 2018 00:05:56 GMT

looks like an old barbecue repainted :D

RE: Prolapse table

Evelyn Barbour-Hill — Sun, 08 Apr 2018 23:03:47 GMT

[quote user="Michael Woodhouse"]I see the tongue in cheek emoticon, but standing is so much easier on my back and knees. You also have gravity on your side once everything is back in.[/quote]

Hmm... you certainly have gravity against you until you've got most of it back in !

And, you know, the point about the legs-retracted position is that mechanically it's much sounder. It's that the pelvis is tilted in a way that helps you rather than hindering. When the cow is standing, the "canal" is tilted down towards you and you have to push the stuff all the way up it, until it drops over the cranial lip of the pubis; I admit, that means that once you've got more than half the thing over the lip it will be dragging the rest in, but you've got to get that first difficult half in.

Whereas in the legs-back position the canal is tilted gently down towards the abdomen and all you need to do is ease that organ up and into the chute. And you don't have to lift it up far to do so.

Being, personally, rather nearer Bruce Banner than Incredible Hulk, Peter Parker rather than Spidey, tending more to the 5-stone weakling than to Arnie Schwarzenegger, I knew the first time I tried legs-back that this was the way to do it. I've no objection to kneeling, in fact I've been known to lie down when the situation called for it. But with the cow in the picture, without the table thingy, I'd probably "kneel" with my knees on the cow's thighs and the pink bag-pudding in my lap.

Anecdote: My First Prolapse. I was sent out to this as a milk fever. The boss later confessed that he knew it was a prolapse, but if he told me that I'd be worrying all the way, whereas if I arrived and found it I would just take a deep breath and get on with the job.

RE: Prolapse table

Sammy82 — Sun, 08 Apr 2018 22:24:22 GMT

I agree that doing them standing is usually much easier, but from memory (haven't worked in farm practice for 4 years now) , more often then not the patient was unable/unwilling to get up. I was taught to sit on a bucket and put the uterus on my knees to let gravity help. I have a heavy long rubber gown which was very helpful in this case. I remember trying a board once when doing it standing up but it just got in the way.

RE: Prolapse table

Michael Woodhouse — Sun, 08 Apr 2018 22:03:15 GMT

[quote user="Evelyn Barbour-Hill"]The great British sporting instinct..... everything should be as difficult as possible?[/quote]

I see the tongue in cheek emoticon, but standing is so much easier on my back and knees. You also have gravity on your side once everything is back in.

I'm told the ladies with ample chests can use them like a table when the cow is standing, but I will leave that comment there...........

RE: Prolapse table

Evelyn Barbour-Hill — Sun, 08 Apr 2018 21:37:48 GMT

[quote user="Busybee"] I too prefer replacing them standing,[/quote]

The great British sporting instinct..... everything should be as difficult as possible?

RE: Prolapse table

Busybee — Sun, 08 Apr 2018 20:29:09 GMT

I took it to be you'd have to straddle the table as you replaced the uterus so could be fiddly but could help to take the weight if there's noonen else around.

I actually really enjoy uterine prolapses ! Michael, I too prefer replacing them standing, ideally with another person or two supporting the weight with a large body bag. But have done them recumbent also, which is a bit more work and generally messier!

The last bit - the ''schluuurp" - as it disappears is just so satisfying!

RE: Prolapse table

Neil Wheadon — Sun, 08 Apr 2018 17:53:45 GMT

I can see it now, as you finally get to use that table that has been cluttering up your car for months. Far better a bag of sugar to shrink the uterus down and a wine bottle to evert it better. (Calving and these were my specialities in days gone by

Neil

RE: Prolapse table

Evelyn Barbour-Hill — Sun, 08 Apr 2018 17:30:42 GMT

[quote user="Michael Woodhouse"]I don't think I could push that back, with the thing in the way. The cow is sitting right but I need to be as close as possible because you push with more force close to your body than away from it. A long gown and kneel behind the cow, support the uterus on your thighs.[/quote]

Agreed.

If using the table thing, I'd have to sit astride it. Could work.

[quote user="Michael Woodhouse"]Standing up is always my preference. In those cases a simple plastic dinner tray can allow the farmer to take some weight, but I find it gets in the way and much prefer to take the weight myself.[/quote]

Wow. OK for Popeye with spinach freshly consumed.

Since I qualified I can remember any number of devices to assist with bovine prolapses being invented. They come.... and they go again. The only real advance has been the discovery (and it's so obvious, now) of the recumbent-with-legs-back position.