So our patient is in the head gate in record time. I have all the gear I need to go to work and I shaved down an area to work on and I”m injecting Lidocain. The cow looks fine and this should only take a few minutes and we’ll be done. He breathing is a bit labored (that’s why bloat kills them, they can’t breathe) but give me 10 minutes and this will all be over.
Then our patient decides he doesn’t like being in the headgate and start bucking and thrashing. I’m holding a needle in my hand so I immediately pull back so nobody gets jabbed. Thrashing about isn’t abnormal and usually it’s just a test to see if this thing really holds. Once they figure out it does, they usually settle right down and stand still. 99% of the time things are very calm. This is just that few seconds of the 1%. No big deal. A few thrashes and the cow slumps. I hear a huuugh of a big exhale and look at his head. His mouth is open, tongue hanging out, and there is no intake of breath. I’m not sure what foul language I used, but as my nephew said later, “I stuck to the classics.”
This cow had just stopped breathing and was laying, effectively dead, in the head gate. His heart didn’t know it yet, and his brain didn’t know it yet, but in the next 45 seconds he’d be dead and there was nothing I could do at that point.
I grew up watching M.A.S.H. I always remember Hawkeye Pearce as being funny, drunk, and basically against doing anything until the patient needed attention NOW. Then he jumped in and did what no one else could with blinding speed and intense focus. I was always in awe of his (and any surgeons) knowledge and ability. I knew I’d never be a surgeon, and never in his situations as depicted on the small screen.
Except here I was standing there with a cow that had seconds to live suddenly. I called Vicente back over and had him start handing me things that I needed (kind of like Margaret Houlihan). I assembled a scalpel quickly, then made my incision in a quick second. By that point Vicente was handing me a trocar. I inserted it, made sure it was in correctly, and pulled the plug to release the air and take the pressure off of the cows diaphragm. Once that was clearing correctly, I released the head gate to get the pressure off of the cow’s head, relaxing the airway. Then I waited. It felt like an hour but it could only have been a few seconds.
ONE. BIG. BREATH…..
Then one big breath again, and another. And another.
A quick thank you to the man upstairs and then it was back to attending to our cow. His eyes were unfocused and he was drooling at this point. The gas from the bloat was long gone and he was breathing if not normal, at least normal enough. I stayed with him for a good 5 minutes just making sure he came back around. At this point he was laying in the head gate, on the ground, and had no interest in getting up. He was reactive to stimulus but not your normal cow, confused and groggy but alert. Eventually I went and got him a bucket of water which he looked at but didn’t want.
Vicente suggested we open the escape chute which basically swings open the entire side of the head gate. Even with that open he still laid there about 20 minutes just collecting his thoughts. It was obvious he had had a warm reboot and all the operating systems were still coming online. He looked around at everything as if for the first time. Eventually he stood up and walked out of the head gate. He still looked around as if everything was new but he walked back to the rest of the herd and resumed the rest of his day. He’s now fine and back to normal.
So what happened? Bloat puts pressure on the diaphragm of the cow, making it harder and harder for the lungs to inflate until eventually the cow can no longer breathe and passes out. Death quickly follows. When the cow thrashed in the head gate, one of his legs kicked open a bar and was hung outside of the gate (see picture above). It was on the opposite side of where I was so I didn’t see it. This elevated his rear end, putting additional pressure on his diaphragm. As that pressure took effect (loss of consciousness), his front end dropped while his head was still elevated, making things worse.
It only takes a few seconds for all this lack of breathing to cause loss of consciousness. In a person if this happened, I’d pick him/her up and relieve the pressure, or push the leg back in. When it’s a 1000 pound cow, you can’t just move them around like you want. Afterwards it took us a good 5 minutes to get his leg back in, with Vicente and I both working at it. All we could do in our situation was relieve the bloat and drop his head to clear the airway, which is what we did. We couldn’t have stopped the thrashing and it was just bad luck that his leg popped out.
I did feel a bit like Hawkeye Pearce after it was all over though, minus the drinking of course. It was too hot for that.