David A. Rustebakke, DVM
Dr. Rustebakke is a long time large animal veterinarian, and owner of Rustebakke Veterinary Service
A seroma is a fluid pocket that accumulates under the skin. Seromas are generally caused by some sort of trauma that causes bleeding or damage to the blood vessels under the skin (a kick by another horse, or running into a solid object). Most common sites are on the front of the chest, the stifle, and the thigh. Think about where horses kick one another! The fluid is serum, which is the liquid portion of blood. We also often find blood clots and fibrin in the cavity. Fibrin is the jelly like framework that forms a clot.
This video shows a seroma that was treated in the summer of 2016 by surgical drainage. We do a surgical prep, sedate the horse and put in a local anesthetic; the fluid pocket is then opened and drained, and the fibrin clots removed. The end of the video shows what it looks like now; 6 months later it is completely healed.
David A. Rustebakke, DVM
Dr. Rustebakke is a long time large animal veterinarian, and owner of Rustebakke Veterinary Service
The call came in about 1:30 PM on a cold winter day; a cow was having problems giving birth. She was located in a corral in the Grand Ronde Canyon about 40 miles away; the road to the ranch was steep and snow packed; there was no way to haul her to the clinic. My assistant Sandra and I drove in to give her a hand. Chains on the 4 wheel drive truck were required!
What I enjoy most about Veterinary Medicine is the challenge; we are often asked to do things that seem difficult or impossible. However I have learned that difficult tasks are just a series of simple tasks put together in a logical sequence, one simple step at a time.
This video illustrates how we make do in the field. We have an uncooperative patient, and the operating room is primitive. Human surgeons seldom need to do it this way. We start out with a rope and halter with the cow tied to a fence as we don't want her going down in the squeeze chute. She fought too much to get much done, however we were able to tell the calf was still alive, but it was in a position that was going to be very difficult to correct. The chances for survival for the calf was better if we took her to surgery.
We put her in the squeeze chute to shave and inject the incision site with local anesthetic; then moved her to an open sided chute with a head catch to do the surgery. She had an epidural nerve block to control her straining and keep her from swishing her tail into the incision.
Although we do not have a sterile operating room available, we take great pains to be as sterile as possible; she was shaved and scrubbed with surgical soap and rinsed with alcohol; we use sterile instruments and sterile surgical gloves. We make every attempt to avoid contamination.
The video illustrates how we do surgery in the field. Cows are tough, and we seldom have complications. We always tell the cow to take it easy for 2-3 months and avoid any heavy lifting; I have yet to have one follow my advice. The rancher typically puts them in a smaller corral for a week or two, then they go back with the herd. Skin sutures are typically removed in 2-3 weeks, by the time the hair grows back there is no visible scar.
As soon as the calf is out, the rancher (Dennis) clears the airway and makes sure it is doing OK. After the surgery the cow is milked, and the calf is stomach tubed with fresh warm colostrum; they are typically up and ready to nurse within an hour after birth.
I have always admired these hard working men and women who ranch and raise cattle; it is not only a job, it is a way of life for them. With the cold weather we have been having, Dennis and other ranching families are on duty 24 hours a day 7 days a week till the calves are on the ground. Once the calves are dried off and get a belly full of warm milk, most do well in spite of the weather. Many of the calves get to live in the warm house or in the warm cab of a pickup for a few hours after birth till they get a warm meal and get dried off!
Thank you to my assistant Sandra Whittaker, who did double duty as surgical assistant and videographer; she tried to hand me stuff while remaining sterile with one hand and running the camera with the other; a master at multi tasking! She also edited the video. And thank you to Dennis Moss for allowing us to video his cow, and Bill Ruchert for his valuable assistance!
Have fun in the snow, but watch out for these winter hazards!
Colder temperatures are just as critical for our pets and livestock safety as it is for ours. If our animals are not prepared for cold, wet, or snowy weather, health conditions such as frost bite, hypothermia, and death can occur. If animals need to be outside, please make sure they have adequate shelter from rain, snow, and wind. Also, fresh water, warm if possible and proper nutrition. Blankets and sweaters can help keep dogs and cats warm as well, but do not leave them unattended if they can get tangled or caught. Hair coats can be left longer to provide more warmth if needed. Below is a chart to help you know when it is too cold for your pet. When it is too cold for us to be outside, then it is too cold for our pets.
Sidewalk Ice Melts:
Ice melts can be very irritating to skin and paws. They can also cause drooling and nausea. Most of these products are severe gastric irritants and will cause vomiting. First know the ingredients in your ice melt products so if your pet does ingest it, your veterinarian will be better able to help. If your dog or cat ingests a large amount, it can affect their electrolyte levels and will need treatment to correct it. Removing the contact with pet’s feet and hair by wiping them down after contact or having them wear outdoor paw booties will greatly reduce exposure. Please call your veterinarian if you have concerns about your pet consuming the de-icing salts.
Exercise is important in winter as well as the warmer months. Snow and our pets can be a lot of fun, however they face many of same risks as we do. Walking or running in snow can cause muscle and joint pain, especially in our older pets. Limit activity to your pets needs and don’t overdo it. Ice and frozen snow can contribute to slipping, falling, and injury, so use caution during outside time. Taking shorter walks, or playing in yard more instead of walks on slick sidewalks may be good alternatives. Also, look for indoor canine activities such as obedience classes or indoor agility events.
We wish you a safe and fun filled winter! Happy New Year!!
Dr. Jessica Bell
Some of the crew with Santa, December 2016
The following is a true story of a wonderful Christmas from years ago!
THE WEEK BEFORE CHRISTMAS
By David A. Rustebakke, DVM
Dec. 9, 1997
Twas the week before Christmas, when I got the farm call,
"I need you up North!" I tried hard to stall.
I said, "I can't go, I've got two little boys,
Can't leave before Christmas, I need to make them some toys!"
But the man was persistent, then I had to pause;
When I asked his name, he said, "Santa Clause!"
Said he needed a vet cause his deer were all sick;
Was in a heck of a bind, could I please help Saint Nick?!
This was the chance of a lifetime, I had to say yes!
I stocked up my truck, and filled it with gas!
It was a heck of a trip as I slogged through the snow,
With chains on all four, could still barely go!
It took near a week, as I drove day and night;
As I approached the North Pole, I saw his yard light.
He came out to greet me, he said, "We've a mess!
Just two days till Christmas; so please do your best!"
Well I checked out those deer, he dang sure was right!
They were sniffin' and coughin', was a horrible sight!
The worst were old Dancer, and Prancer and Vixen,
They looked so pathetic, were hardly worth fixin'!
And then, poor old Rudolph; his shiny red nose
Had lost its luster, it no longer glows!
And there in the shadows, dang near a goner,
Don't know if I can, but I'll try to save Donner!
For a reindeer rancher, the man knew squat.
What facilities he had had were totally shot!
For corrals he had zip, just a barb wire fence,
A heck of a philanthropist, but no common sense!
I wondered, "How will I get these deer restrained?"
I pondered it hard, I wracked my brain!
Like a thunderbolt, it hit me, "I'll bet there's an elf;
There could be hundreds, I'll just help myself!"
When I whistled and hollered, out of the woodwork they came!
They held down those deer, they made them seem tame!
I went right to work, I gave them injections
Of that new wonder drug, to cure their infections!
The pills that I poked down into their throats
I knew would put shine back into their coats!
I bandaged their owies, Kopertoxed their feet!
They were all droppin’ grain, so I floated their teeth!
I poured them for grubs, powdered their lice!
A couple had sprains; I packed them in ice!
I put pinkeye powder in Cupid's bad eye,
Pulled out that old cheat grass was makin’ him cry!
I combed out their mudballs, disinfected their germs,
I picked off their ticks, and killed all their worms!
I worked all night long, half through the next day.
They were all feeling better, when Santa hitched up his sleigh.
They were dancin’ and prancin’ and rarin’ to go!
I saw Rudolph's nose had back its red glow!
We loaded that sleigh plumb full up with toys,
He's near back on schedule, for those good girls and boys!
It made me feel good, it warmed up my heart,
Knowin' saving this Christmas, I'd played a small part!
He asked, "What do I owe you?" I thought a short while,
"An extra toy for my boys, little Robbie and Kyle!"
I'd already been paid more than money could buy.
His mouth was a quiverin’ as he looked me in the eye.
He shook my hand with a grin ear to ear.
And said, "Merry Christmas, Doc, and Happy New Year!"
By Dr. David A. Rustebakke
Although nature has equipped horses to deal with extremes in temperature, there are a number of things you can do to make winter easier on your horse. While you are winterizing your home and vehicles, also think of winterizing your horses.
Horses do not perceive cold to the same degree that we do. Nature has equipped the horse with the ability to acclimate itself to the average winter temperature. A healthy horse in a good state of nutrition with a normal, healthy hair coat is perfectly comfortable at temperatures in the 20's and 30's in the Lewiston Clarkston Valley. I was raised in Eastern Montana where winter temperatures were commonly 10 to 40 degrees below zero; the horses there grew much heavier hair coats, and appeared to be comfortable at those temperatures.
In a nutshell, the key to winterizing a horse is to allow him to acclimate to the prevailing temperatures, provide shelter to protect him from the wind and moisture, and minimize other stressors (the cold weather is enough stress, he doesn't need other health problems to add more stress).
Some sort of shelter is necessary. Wind chill and loss of insulating ability due to a wet hair coat make the temperature appear much colder than it is. Horses turned out on the range can find a canyon, bluff, or trees to escape from the wind; a horse confined to a small pasture has only what you provide for him. Shelter does not need to be elaborate; a 3 sided shed with a roof is adequate.
Blanketing is no substitute for shelter. If done improperly, it can actually be detrimental in that it keeps the horse from becoming properly acclimated to the prevailing conditions. The purpose of blanketing is to prevent long hair growth in horses that are being shown, to provide some warmth while trailering or during colder than usual weather, or to cool out a hot horse in cold weather. A good waterproof well insulated blanket is useful during an unusually cold period; horses that are well acclimated to the 20’s and 30’s of a typical Lewiston Clarkston Valley winter will appreciate a warm blanket on those rare nights when it dips down near zero, or below. However, long term blanketing of an un-sheltered horse may actually prevent growth of a proper hair coat, and can actually increase the chances of the horse becoming chilled.
By Dr. Rustebakke
Veterinary Medicine and Animal Nutrition are separate specialties in the animal care industry; however in my career I have found that in order to give good health care advice I need to know something about nutrition. As primary care health providers to these animals, the veterinarian is the one who actually has eyes on the animals or on the herd, and we are in the best position to diagnose a nutritional problem and recommend specific products to help solve a problem. Many of us in practice are not familiar with all of the products available, and few of us actually have extensive training in nutrition. Because of this, our best option is often to refer the owner to a nutritionist to help you formulate a proper ration.
Nutritional based diseases seen in a typical veterinary practice
Malnutrition or under nutrition is by far the most common problem I see. This is often a result of ignorance (as opposed to willful neglect) on the part of the owner. These horses are often presented to look for a reason for weight loss. Most of these horses have dental problems, which we correct as well as possible. However the dental problems are often not severe enough to be the entire reason for the weight loss. To fully work up these horses we do a thorough physical examination including taking the vital signs (temperature, pulse, and respiration, listening to the heart and lungs, assessing body condition, hydration, capillary refill time, look for chronic pain issues, see if the stated age corresponds with the age estimated by the teeth, etc..). If no obvious problems are noted, we recommend a blood test (serum chemistry and CBC) to look for any chronic infections or organ system failure. If we identify a specific disease condition, the recommendations are based on whatever disease we see. Otherwise, the next step is to assess the diet and recommend changes.
From here, this is not rocket science. We know that a horse requires a certain number of calories per day for maintenance, and a few more calories for work or production. This can vary from 15 Mcal per day for an average sized horse at maintenance to over 30 Mcal per day for a horse working hard, or in maximum lactation. The problem with most of these horses is not a lack of vitamins or minerals or other micronutrients or probiotics; the problem is a shortage of calories. They may be lacking vitamins, minerals, etc. but that is not why they are thin; they are thin because they are not getting enough to eat. They may or may not be getting enough pounds of feed (2% of body weight per day is the common recommendation). But many of the forages do not have the energy density to provide the required caloric intake at the 2% level. So the solution is to increase the energy density. That is when I refer them to the feed store to provide them with products that will increase the energy density without causing secondary problems. There are a myriad products out there designed to do just that. It is important to use a product that is safe, which means combining soluble carbohydrates such as found in grain products, with digestible fiber and fat. Most of the commercial products out there, if fed as per the manufacturers label instructions, also include the required vitamins and minerals and often other products to make the entire diet more digestible as well.
Over nutrition and obesity is the next most common problem that I see in practice. This is also often due to a misguided sense of what is good for the horse. A few of these in my practice area are due to the unreasonable breed standards required by halter classes in horse shows. There is nothing I can do to solve the obesity required by the AQHA halter horses...
By Dr. Rustebakke
This is a "Summer Sore" in the corner of the eye causing the eye to be very sore and inflamed. It is caused by a tiny worm called "Habronema muscae" which is carried by flies, and burrows into the tissue; they can occur anywhere on the body, but we commonly see them in the eye. If you have a horse with a sore, swollen and runny eye, or a sore that will not heal we always need to rule out summer sores this time of year.
Prevention is the best medicine; fly control including fly mask, repellent, anything you can do to keep flies off the horse. Once they are established we use oral Ivermectin or Quest dewormer to kill the parasites, try to remove the necrotic debris from the sores, and use corticosteroids to reduce the inflammation.
By Dr. Bell
Spring is Here and with it new puppies and kittens. There are many things to consider when bringing a new puppy or kitten into your home. One of the most important, is vaccinations for your new arrival.
Puppies and kittens as well with all mammals, are born with a limited immunity against diseases from their mothers. They also receive protection via passive transfer from their mother’s colostrum (first milk). However, if the mother was not properly vaccinated prior to pregnancy or the kitten/puppy did not consume enough colostrum, they are at risk for diseases such as parvo virus and panleukopenia.
A mother’s antibodies in a new puppy or kitten are only effective until approximately 6 to 9 weeks of age. Every animal loses their protection at different rates. This why it is so important to start vaccinating a puppy or kitten at 6 to 8 weeks of age, with booster vaccines every 3 weeks until they are approximately 16 weeks old. It is crucial to have two vaccinations over 12 weeks of age in order to get full protection.
Puppies are not considered protected against parvo until after their third vaccine and in some high risk environments, not until the fourth booster. Parvo virus is transmitted by infected dogs via vomit and diarrhea. An unprotected puppy will be infected by touching a contaminated surface and then start showing signs 3-7 days after. Clinical signs usually start with depression, lethargy, then vomiting and diarrhea. There is not a cure for Parvo, only supportive care until the puppy’s immune system can recuperate. The intestinal lining is a very important part of the immune defense system. When the virus destroys the intestinal lining, secondary infections are very likely. Death may occur 50% of cases or more. The younger and smaller the puppy, the higher risk of death.
Parvo is a very sturdy virus and can live in a moderate environment indefinitely. It can be killed by very cold winters and hot dry summers, or by thoroughly disinfecting an environment. Most disinfectants including bleach are inactivated by organic materials, such as grass, dirt, feces, etc., making elimination in yards and carpets almost impossible. It also effects coyote packs and possibly carried by raccoons. Isolated dogs and puppies can have exposure.
Kittens are susceptible to a similar disease as Parvo, called Panleukopenia. Panleukopenia is an older virus and may have mutated into the Parvo virus. Kittens exhibit a similar disease process and elimination problems as puppies with parvo. Kittens often die before the vomiting and diarrhea are noticed.
Parvo and panleukopenia are very difficult to treat due to severity and speed it affects young animals and also because of how contagious it is. It can wipe out whole litters in a matter of days. In the clinic, treatment includes strict isolation for these patients. Veterinary doctors and staff must use very strict protocols to prevent spread to other animals in the clinic and boarding areas. This greatly increases the cost of in hospital treatment. Without vaccines, the only way to prevent infection is to eliminate exposure. That can be impossible due to environmental restrictions. Vaccination is our best defense. Even if your puppy or kitten is on a proper vaccination schedule and is exposed to one of these disease, his or her chance of survival is much greater than with no vaccines.
The next most common time to see parvo and panleukopenia is when the first yearly vaccine is due. Adult animals are also at risk if they don’t have proper vaccinations prior to exposure. Please keep your adult pet’s vaccinations current to help keep them healthy and reduce transmission to other pets.
It is always less expensive to prevent the disease with vaccinations than it is to treat!
I, as most other veterinarians, would love to never see parvo or panleukopenia in our hospitals and communities.
If you have any questions regarding vaccination protocols and what is best for your new pet and your adult pets, please contact us or your regular veterinarian.
I wish everyone a fun and safe spring and summer for you and your four-legged friends.
By Dr. Rustebakke
There are few things more beautiful than watching horses enjoying lush green pasture. Unfortunately the lush green pasture may have a dark side. Every Spring we see a few horses that develop a crippling disease called "Founder" or "Laminitis". There are multiple causes of laminitis; however one of the more common causes is excessive exposure to green pasture by horses that have not been properly acclimated to it. The sugars in the green grass pass into the large intestine where they are fermented by bacteria causing an overgrowth of bacteria; the bacteria produce a chemical called "endotoxin" which is toxic to the small capillaries in the feet resulting in swelling of the sensitive laminae inside the hooves. This causes necrosis and weakening of the attachment of the hoof wall to the coffin bone. The hoof can in extreme cases separate from the coffin bone, and actually come off. The x-ray is of a horse we saw last week whose coffin bone actually came through the bottom of his foot and had to be destroyed. Please be careful when turning your horses out on green pasture!
There are a lot of variables on the ideal way to acclimate a horse to green pasture. Like anything in life, there is always going to be some risk, regardless of how careful you are. In the natural state horses come out of winter eating whatever is available, and their diet gradually changes to green grass; this gives the bacteria in the gut plenty of time to adapt. Also there are variables between individual horses's tolerance to sugar in the hay. Most horses can tolerate green pasture very well, however some researchers claim that about 10% of horses are likely to have problems. Horses with a history of previous episodes of laminitis should not be on green pasture at all. The sugar content rises during the day, and decreases during the night; it is generally at its lowest right before sunrise. Putting your horses out early in the morning and locking them away from the green grass by mid morning works for many people.
The following link is a good read for those interested in more information: http://www.thehorse.com/articles/26766/pasture-sugars
By Dr. Rustebakke
Sometimes the profession of veterinary medicine intersects with other professions; this is an example of the intersection of veterinary medicine and horseshoeing. This horse kicked a horse trailer (bad mistake) and fractured his hoof capsule allowing dirt and debris access to the inside of his sensitive laminae. We removed the overlying sole and hoof wall, cleaned out the debris, stabilized the hoof with a shoe, and applied a bandage to keep everything clean while it is healing. The prognosis is good!
Dr. David A. Rustebakke
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