SPF 50 Please!!!!!

“Dr. Telgen, I have a heifer that is losing all her hair!!!! I’ve never seen anything like it! She’s looks disgusting!” This is the phone call I had from a client this week. It was an 18 month old heifer that had been out on pasture.  When the dairymen went to check on them, he found this girl with her hide sloughing off various parts of her body. They brought her back to the barn and called me. I was headed there, for a fresh cow with a DA and while I was there, I checked on the “freak” heifer that is losing all her hair. 

Below are several pictures of various parts of the heifer. The bright pink tint to certain parts of the animal is salve they applied to keep the areas moist and try to relieve some of the irritation.  If you look closely, you will notice that the areas where there is black hair, and subsequently black skin underneath, appear to be normal. The areas of white hair/skin are the portions of the animal that are affected.  

Notice how the affected skin follows the line of the black hair.

The is a case of photosensitization, which only affects the white portions of the animal. Only the white portions are affected, because there is a lack of melanin in the skin, like there is in the black portions, and those white portions are most sensitive to sunlight. If you look closely at the pictures, you can see the areas where the skin is sloughing and perfectly follows the lines of the black hair. Other common areas affected are the mucocutaneous junctions such as around the eyes, nose, vulva and teats.  This heifer had lesions around her nose, but the eyes, teats and vulva were unaffected. 

Her nose seemed to be the only mucocutaneous junction affected.

The hide feels very tough and dried leather like. Just peels off with very little effort.

The affected areas went all the way down to her feet!

Cows are not the most discriminant eaters. This heifer had been out on pasture and most likely consumed a plant or weed that causes photosensitization.  As the animal metabolizes the plant that it has eaten, metabolites within the plant enter the body’s circulation and make their way to the skin.  When these animals are outside on pasture and exposed to direct sunlight, these “photodynamic substances” now in the skin, cause inflammation, irritation and essentially peeling of the skin.  It’s like being a red-headed, blue-eyed person out in the sun all day with no sunscreen, getting fried and then having the top layer of skin peel off.  Not that I know what that is like or anything….

As badly as sunburns hurt on me, I felt sorry for this poor heifer! Surprisingly, this heifer does not seem to be too affected by the situation. She has been brought inside the barn to be kept out of direct sunlight and is being treated with supportive care. She has received some pain medicine, and as I mentioned, the salve is being applied to help keep the area moist. However, she was running around the pen and eats and drinks like nothing is wrong.  Unfortunately, the damage to the skin has already been done and there is nothing we can do to prevent the rest of the affected areas from sloughing.  As long as she does not suffer from bacterial infections of the exposed, raw skin, she has the potential to fully recover and go on to be a productive animal.

There are about 30+ plants, molds and chemicals that can cause photosensitivity like this. The most common plants are St. John’s wort and Buckwheat, both of which are pictured here.  Other common plants that cause this primary photosensitivity include, Bishop’s weed, Dutchman’s breeches, wild carrot, spring parsley, prairie lily, smartweeds, perennial ryegrass, Burr trefoil and even alfalfas and clovers. I would have to research what most of these plants/weeds look like, but if you have animals (cows, horses, sheep or goats) out on pasture and notice some of these plants, it may not be a bad idea to remove them. 

 

Buckwheat

St. John's Wort

Not all animals are affected. The other heifers in the pasture with this one all seem to be fine.  It is also pretty much impossible to know which animals are going to suffer from such a disorder, until you start to see signs of the skin sloughing.  If only they made sunscreen for cows, that would be easy to apply and actually work through the hair! 

OINK OINK SQUEEEEAAAALLLL!!!!

It’s May, which means farmers are all in the fields getting the corn planted and the forages mowed, chopped and packed away to start fermenting.  This is my favorite time of year as things start to green up, the weather gets warm, and I don’t have to wear 5 layers of clothing to work outside. Probably my favorite smell of spring is the smell of alfalfa after it has just been mowed in the field, and is getting ready to get chopped. The lilacs might be my second favorite….

With all the hustle and bustle of spring time field work, the veterinary work seems to slow right down. I’ve been slacking on weekly blog posts, because I just don’t feel like I have done anything “exciting” to write about.  The sick cow calls are few and the majority of my time is spent doing my routine herd checks, paperwork and continuing education credits.  As today approached, I was again concerned that I didn’t have anything to write about, but yesterday I was called out for an emergency on an animal I hardly ever, never routinely see. 

"Mama"

Meet “Mama,” a 600 pound sow. I was called to the farm because “Mama” had a piglet over an hour ago, and still had not had any more.  Now, I know the title of my blog is “A day in the life of a COW vet,” but technically our clinic will take care of cows, sheep, goats and pigs. Most of our clients have dairy cows, and that truly is my passion, but pigs fall under our umbrella, so off I go.  Anyone who personally knows me, knows that I went to school in the Midwest, where pigs are abundant, so I shouldn’t have any problem with this right???? Wrong.

I often say, “There is only so much room upstairs, and eventually something has to fall out.” Well, the pig information I learned in school fell victim to the overflow.  Luckily we have another veterinarian on staff that also went to school in the Midwest, in a state where there are even MORE pigs then where I was. She is the resident pig expert so I called her for a little advice on what to do.  Her first warning was that a pregnant sow, in labor, can be very mean and to be very careful not to get killed by an angry 600lb sow. OK.  I’m looking forward to this…

First and biggest piglet born.

Next, reach in there and see if there is a stuck pig, if so, move it around and pull it out! Well, that sounds a whole lot like a cow with a stuck calf. I can handle that.  However, if there is no stuck pig, then a small dose of oxytocin given right in the vulva of the sow will help with uterine contractions and push the piglets towards the birth canal. 

Finding the milk!

When I arrived, there were no stuck pigs, so I gave the sow some oxytocin and waited a little bit before reaching in to see if I could feel another pig. Mama, had only had one piglet so far, and after discussion with Dr. E, pigs won’t maintain a pregnancy if there are any less than 4 piglets. Interesting! Based on this new fun fact, I knew I had to go find at least 3 more!  Back inside I go. I felt some very sharp teeth and finally a leg. I pulled out 2 more piglets and couldn’t reach any more. The client had smaller arms than myself, so I had her reach in to see if she could get in further and feel more. Three more piglets were in there, along with one small, under-developed, dead piglet.  We couldn’t feel anymore so we are hoping 6 is all she has.  She appeared to stop straining and was very hot and tired. The little piglets started squealing and were rutting around, looking for some milk. We helped get them all started on a teat, and off they go! 

It made for an interesting change of pace, but I like sticking with what I know. I’ll take care of the cows and let Dr. E have all the pigs she wants!!!!  ;-)

"It's Not a Toomah!!!"

A little Arnold Schwarzenegger humor to go along with my case of the week...

I was pregnancy checking heifers at one of my herd checks this week. As I've mentioned before, during herd checks, we always have to keep our eyes peeled for other things either happening with the animal we are currently working on, or other animals in the pen.  As I was checking this particular heifer, I noticed something hanging down from her udder. At first I thought it was just her tail that I caught out of the corner of my eye, but then I looked a little closer. Yup- it was attached to her udder and was hanging down between the front and back teats on the left hand side of her udder. It was a firm mass that almost appeared to be an extra teat, but was much more pendulous, hard and even had a portion of the mass that was black and rotting. It didn't seem to bother her as I was examining it, and it didn't feel attached to anything much deeper in the mammary tissue.

The mass hanging between the two teats

Now, as a review for those who do know, and info for those that may not, cows have 4 teats. Sheep, goats and horses have 2 teats, pigs can have up to 14, dogs-10, cats-8.  As the fetus develops, the teats start as buds of epithelial cells that continue to develop into teats. Normally there are more buds during development than will actually be there when the animal is born. The other buds normally regress. It is quite common in cows, however, to find extra teats. These are buds that continued to develop and form teats. Even if there is an extra teat there, it may not have the mammary tissue, or milk producing glands to go along with it.  Because the extra teats can be problematic at milking time and can still end up diseased, they are often removed as young calves.

This mass had some resemblance of a teat, but did not look like your typical extra teat, which looks identical to a normal teat. Also, we remove all extra teats on this farm as calves, when we are vaccinating them 8 months prior to the current age of this animal. So I decided I should remove it. There was talk of putting a castrating band on it, but we always worry about tetanus, other infections and breakage of the band before the mass has been removed. Also, dealing with the udder of a cow can be quite bloody, as there are lots and lots of blood vessels going to the udder to allow milk production when the animal starts to lactate.

As a side note, a cow will pump  about 500 gallons of blood through her udder a day to make one gallon of milk. That's a lot of blood for cows making 11 gallons of milk a day!!!!!

Because she was just a heifer and not lactating yet, and because it was a beautiful day, I opted for surgery. We sedated the cow and I blocked the area around the mass with lidocaine.  Because it was between the two normal teats, I had to be careful not to cut too deeply or cut into the tissue of the normal teats. As I could tell from examining it, it was not deeply attached to the rest of the mammary tissue and was quite easily removed. I sutured her up with degradable sutures and she looks good as new!

Final suture layer

Back to a normal looking udder!

The inside of the mass

And of course, I HAD to cut into the mass to see what it was. It did have elements of being a teat. There was a little teat canal in the dark, black, rotting tissue, but the rest of the mass was firm with edema. I'm not sure if she was missed as a calf, or if this is something that developed after we had already checked them for extra teats, but it would not have been something to leave for when she was a mature lactating cow, and there were thousands of gallons of blood pumping through her udder. If it were to catch on something and rip off, she could very well have bled to death. I'm glad we did the surgery and with a little time and allowing the area to heal, we may never be able to tell she had a "toomah" in the first place!!!!

Droopy Ears and Drunken Behavior

Over the last couple weeks, I’ve been working with a farm having calves suffering from droopy ears and head tilts. This week I was called to a second farm, for a calf with the same symptoms, so I thought it was time to discuss.

Let’s start with a background. Farm A houses their calves in groups and feeds them milk replacer for the first month of life then switches them to waste milk that has been pasteurized. The calves that have been getting droopy ears are about 1 month old and are on the pasteurized waste milk.  Farm B had a calf that was about 3-4 months old, is weaned and is being fed hay, grain and water. 

One of the patients with droopy ears

Many times farmers will say to us “Doc- her ear is droopy and she’s walking like she is drunk!” Calves that have droopy ears and head tilts, suffer from what we call “otitis media,” a fancy way of saying and inner-ear infection.  The inner ear is responsible for hearing, obviously, but balance as well. There is an intricate system of bone and cartilage in the inner ear that works together with the brain, eyes and rest of the body to allow an animal, and a human, to know which end is up. When there is an infection in the inner part of this ear, the entire system is disrupted and the calves walk unbalanced, stumble and can fall down. 

The body is such an amazing unit that works so in synch, that we often take it for granted.  When these calves with inner ear infections are blind-folded, the head tilt is exacerbated and the balance is worsened.  We don’t realize how important eye sight is, and how much it helps compensate for deficiencies in other areas! So amazing! Anyway, I digress…

Most commonly we associate otitis media with the bacteria Mycoplasma.  Although this is a very common causative agent, it’s not the only bacteria involved in these situations. Farm A had been treating these calves with an antibiotic that Mycoplasma is susceptible to, but the calves were not getting any better, in fact they seemed to be getting worse.  Farm B had also treated the calf with the same antibiotic and this calf was not getting worse, but was slow to improve.  Because there are other bacteria that can be involved in otitis media situations, it was time to  take some real sample and submit them to the lab for analysis. 

 Farm A had a calf that was severely neurologic, was falling down consistently and had already had the appropriate treatment. Her prognosis was grave, so we chose to euthanize her and perform a necropsy. When I removed the ear, there was brown, thick discharge in the ear canal. Using a sterile swab and special culture media, I sampled the discharge, from both ears and sent it into the lab. I also sent in the other standard necropsy samples such as lung, liver, spleen, kidney, intestines, thymus, lymph node and heart muscle.  Usually in neurologic cases, we also submit the brain, however, I was confident that the neurologic signs were coming from the inner ear infection, so did not add the brain to my samples.

The results came back with several different bugs. There was indeed Mycoplasma cultured from one of the ear swabs that I sent in. The lab also cultured Trueperella pyogenes, Proteus Mirabilis, and Pseudomonas Aeruginosa.  So, where do all these bugs come from????

Let’s start with Mycoplasma. This is a bacterium that is commonly associated with pneumonia in calves and mastitis in cows.  It is found in the respiratory secretions of calves and is considered part of the “Bovine Respiratory Disease Complex” that I’ve discussed before. It is a contagious bacterium that can be transmitted from animal to animal in the milking machines, nose to nose contact, or from the environment. It has been shown to live for months in sand, ponds and in other cool, humid conditions.  As I mentioned earlier, it is susceptible to a few different antibiotics and when it’s the only bacteria involved in the situation, it can be cured.  Because cows shed the bacteria at different times, many farms routinely sample their milk to check for Mycoplasma. Due to its contagious nature and the trouble it causes for cows and calves, most farms will sell any infected cattle. Proper pasteurization does kill the bacteria so animals fed waste milk, or milk sold for human consumption is clean.

Abscessed udder from Trueperella pyogenes

Trueperella pyogenes is a common mastitis bacterium.  The bacteria are found on the skin of the cow and can be spread by flies and fly bites. It can also infect the udder if the teat end is damaged, the cow was not treated with clean hands or the cow is in a dirty environment. The bacteria form little abscesses in the udder of a cow. Because of the abscesses formed in the udder, these animals are very difficult to treat as very few antibiotics are able to penetrate the wall of the abscess to get to the bacteria. 

The other two bacteria that were isolated from the culture are very difficult bacteria to kill. They are resistant to many drugs and the bacteria have little flagella that allow them to move or “swim” around.  Again, they are found in a dirty environment and commonly associated with fecal material.  They may not have been the true causative agent, but rather took advantage of the opportunity of an infected ear and are wreaking havoc along the way.

So now that I know what bugs I’m dealing with, what’s next? Well, we have been sampling Farm A milk for a couple weeks now, trying to see if the pasteurization of the waste milk is adequate and see if we can culture Mycoplasma from the waste milk. If we find a positive, she will automatically be culled. We know there are Trueperella mastitis cows, and they may be more of an issue than the Mycoplasma alone.  As I mentioned earlier, many of these bugs are found in a dirty environment.  Cleaning up the environment for these calves and the cows will go a LONG way in preventing these diseases from occurring.  We need to minimize, if not eliminate, the source of the bacteria for these calves. If you start with dirty milk, there is only so much you can do, to make it clean. Pasteurization helps reduce bacteria load, but it does not sterilize the milk.

Finding what is causing the issue is easy. It’s getting people to change their practices that cause more stress than anything in a veterinarian’s life!

Farm B’s calf seems to be more of a respiratory issue than dirty milk. She has had a fever that has coincided with the droopy ear. We have decided to try to flush her ear out with hydrogen peroxide and if there is no improvement, we can pop her ear drum to allow the “gunk” to drain. Overall I feel like she on the mend and has a decent prognosis. There does not seem to be any other calves affected so it’s not a “herd issue,” rather an isolated case.  She may always have the droopy ear, but as long as she continues to eat and grow, she can go on to be a productive animal.