My first job out of vet school was with Dr Fred Erb of Landaff, New Hampshire. Fred had an old fashioned set of values and the respect of all his clients. He was proud of his German heritage. He was not a particularly tall man, but he had a barrel chest, a deep voice, and was very strong. He also had a loud “har de har har” laugh you could hear the next farm over. The episode that characterizes Fred for me happened during my first year of working for him. I had called for help. He gave me that, but also gave me a good standing with a client when he could have thrown me under the bus.
I was on a dystocia case in a cow named Blossom. The word dystocia means difficult birth, and that is what she was going through. Blossom was a black and white Holstein, which is one of the bigger breeds. Fortunately, the farm was just a 10 minute drive from the office. Harry, her owner, told me that Blossom had been straining for a few hours with no results. He stood next to her hind end and held her tail around to the side so it wouldn’t be in my way. I first put on a plastic glove and sleeve and lubricated it to do a rectal exam for a quick evaluation. In cows the rectal exam gives lots of information. As you feel through the rectal wall, you are able to explore the uterus, ovaries, and the fetus. I didn’t have to go in much past my forearm to feel the fetus’s head and forelegs. He or she was in the right position, head and forelegs heading toward the birth canal. I started bouncing the calf by pushing down over its shoulders. The calf reacted by pulling away. That was good news. We had a live calf!
I backed out of the rectum and pulled off the sleeve that was coated with Blossom’s manure. Then I washed her hind end with soap and water until everything was squeaky clean. After that I rolled up the sleeve of my shirt and scrubbed my right arm and hand. I pulled on a sterile glove and sleeve and applied lubricant liberally up and down my arm. Then I coned my hand and gently slid it into Blossom’s birth canal.
I was able to grab one of the calf’s feet, but that’s all. I kept wondering, she seems to want to calve, and all of her pelvic ligaments are relaxed, but why is there no room in here. Everything felt very cramped. What was I missing! After a couple of minutes I realized I was over my head. I pulled the sleeve off and said to Harry,
“I really don’t know what’s going on here. I’m going to see if Dr Erb is at home.”
I called Fred on the vehicle Motorola radio (this was long before cell phones) and was relieved to get him right away.
“Fred, I’m over my head on a calving case at Harry’s. Can you come bail me out?”
As we waited for Fred’s arrival I made small talk with Harry. As we talked I felt restless, wondering what I was missing with this birth. Fred arrived, joking with everyone as he always did. After scrubbing up, he lubed up his arms, and dove in. No sterile sleeves for Fred. He always said, “I can feel more this way.” He fussed around for about 5 minutes, did some grunting, used a lot of body mechanics, got up a mild sweat, and then said:
“There, I think I got things going. I’m pooped. You take back over. ” I did, and now everything inside that cow made sense. There was the calf’s head, cradled as it should be on its front legs. What did Fred do in there? I delivered a rambunctious bull calf. Back at the office he sat me down.
“That was a uterine torsion. It was about as complete a twist as I’ve ever seen. When the uterus is twisted like that, it rotates the whole birth canal. It’s no wonder you couldn’t make heads or tails of it.”
“We learned about it in school, but I’ve never seen one, and I’m not sure I have the strength to correct it like you did.”
“That didn’t take strength. All that grunting was a show put on for Bill so he wouldn’t think you were a dumb-dumb.”
“Well, it looked like you were working hard.”
“Nope. I had the correction done right away. What you do is slide your hand into the birth canal, and follow the folds to find out how complete the torsion is and in what direction it is going: clockwise or counterclockwise. Then you grab one of the calf’s legs and push straight ahead. For just a second the calf is floating in the uterine fluid. Use the leg you have as a lever to flip the calf’s body over. The uterus will unwind at the same time. It just takes some coordination. It was one more thing I wasn’t taught in vet school. I said that Dr Erb was very strong. I tried flipping these cases after that, but just didn’t have the upper body strength to flip things around.
Some vets will roll a cow with a uterine twist onto her back and lay a plank across her abdomen. Believe it or not, one or two men stand on the plank, and two more roll the cow in the correct direction. The pressure of the plank makes the uterus stay in one spot, and the cow untwists around it. If this sounds complicated, it is, and truth be told, I was never able to make it work myself.
In any event, Harry never knew how Fred saved face for me that day, and I was always grateful for that kindness.