Preemie Problems

"Friskie"

Meet “Friskie” (so named by our receptionist). She was born 3 weeks early with some noticeable deficits. The biggest concern we have when calves are born early is lung development. One of the last things to develop in a fetus is the “surfactant.” Surfactant is a substance made up of fats and proteins that allow the lungs to inflate and deflate without collapsing.  Because this is one of the last things to develop, we often use a steroid when we induce animals to help with production of this surfactant, so the calf is able to breathe upon rupture of the umbilicus. The steroid is also used to start the labor process.

“Friskie” seemed to have had adequate surfactant production when she was born and was able to breathe normally. However, she was born with a noticeable abnormality- a cloudy eye. She was quite small, and had weak tendons. The weak tendons were not severe enough that she couldn’t stand, but when she did stand, her pasterns (ankles) were touching the ground. After a few weeks, her tendons strengthened and she began walking more normally. Her eye on the other hand, began to get worse.

When we see calves that are born with cloudy eyes, we often want to test them for Bovine Viral Diarrhea (BVD).  This is a disease that affects almost every body system of an animal, causing oral lesions, pneumonia, diarrhea, poor growth and weight gain, reproductive failure, and abortion to name a few. If the mom has been infected with the disease while the fetus is 40-125 days in gestation, they may become persistently infected with the disease and shed exponential amounts of the virus to other cows on the farm. The cloudy eyes are one of the congenital lesions associated with in-utero infection.  “Friskie” was tested and was found to be BVD negative.

  

Knowing that she is BVD negative, we proceeded with the diagnosis of a congenital cataract. There are many things that can cause a congenital cataract. Unfortunately, without any other clinical signs in the cow or the calf, it is difficult to pinpoint the cause. “Friskie” was completely blind in the eye. She was eating and growing well, but the eye continued to get cloudier and even started to bulge. After watching her for a couple weeks, we decided it was best to completely remove the eye to prevent further pain, damage or rupture of the eye.

Because she was small, I opted to use gas anesthesia on her and completely sedate her. Once she was under anesthesia, I gave her some pain medicine in the vein, clipped and scrubbed the area around the eye and blocked around the eye with lidocaine. I then sutured her eyelids closed, and proceeded to cut all the surrounding muscles, ligaments and attachments of the eye. It comes out in one piece. Pressure is applied to stop the bleeding in the eye socket and then the remaining tissue surrounding the eye socket is sutured closed.  Caution, of course, must be taken when working with cows with only one eye as they have drastically limited vision, but they adapt very well to their surroundings and use their other senses (hearing and smell) to make up for their loss of vision.

Blocking around the eye with lidocaine

Cutting around the eyelids that are sutured closed

Removing the eye in one piece

The empty eye socket

Suturing the eye socket closed

The eye socket sutured closed

The removed eye

Angular deformity in Carpal Joint

Not only did “Friskie” have trouble with her eye, but when the owner dropped her off at the clinic, he mentioned that her right front leg still had an angular deformity to it. It was not broken, but the joint still had some laxity to it, that would cause the carpal joint to angle outward when she was bearing weight. After discussion with the owner, we decided to put a light cast on the leg to see if, as she grows, it would gain strength and correct with the support. I’ll remove the cast in two weeks to see if any progress has been made. If not, we may need to apply another splint for another 2 weeks or so, and see if it will correct.

Applying the Cast

Cast applied

I had a 4^th year veterinary student riding with me today, so of course he dissected the removed eye to see how thick the lens of the affected eye was. It was about 4x thicker than it should be and affected the entire lens of the eye. I think “Friskie” will feel much better in a few days with the eye removed.

Dissecting the eye

She was woken up from anesthesia and within 30 minutes was standing in her stall looking for a bottle of milk.  She went home on pain medication and antibiotics and will be rechecked within a week.