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New Grad Top Tips: Difficult C-Section
By John Fitzpatrick MVB MRCVS | 11th June 2020
A section crush is obviously ideal. In a lot of situations this is not available.
Section one:
Animal restraint
The classic scene/nightmare for a new grad is to land out to a farm and there is a mad heifer calving, massive feet out the back, in an open pen with no crush facilities.
What do you do?
Tip 1: Some farmers have a section gate/crush that they completely forget about, sounds mad but this happens more often than you think. Be sure when arrive to a new farm to ask if they have a section gate or ask colleagues before you go out. Farmers often don’t do this intentionally, just genuinely don’t think or in some cases don’t want to stress the animal by moving it to that area.
Tip 2: If a section gate is not available, does a neighbor have one that could be transported over to the farm? Sounds like a lot of messing about but could save cow farmer and vet a lot of stress.
Tip 3: Ok no section crush available, time to think outside the box.
Safety of everyone present is paramount. A halter and sedation are the first step. Run the cow up the normal crush or behind a well tied gate, anyway you can to get the sedation in and the halter on.
Tip 4: If you can, shave and local anesthetic when either in the normal crush or behind the gate before you let out.
Tip 5: Halter the cow to something solid!! Also tie the cow with something solid to its right side, whether that be a tractor, gate or wall. To prevents the cow swinging side to side.
Tip 6: Tie a rope or ratchet strap from the front of the cow on its left side to behind the cow to stop them swinging towards you. (see photo)
Someone on the tail at all times where possible too.
Tip 7: Without out a section gate, 2 people to be there to help without exception.
Tip 8: If all else fails, the heifer is completely wild and someone is going to get hurt, knock the heifer with sedation and do the section down.
Tip 9: Don’t be afraid to call for help. No matter how many sections I have done, the odd time I still phone for a second set of hands. Sometimes a fresh set of eyes on a stressful situation can be helpful.
Tip 10: Farmer peer pressure is a thing we all have to put up with on a daily basis. Things like ‘the boss wouldn’t need a section gate”, “The boss usually just does them in the middle of the field”. If you don’t think it is safe, don’t continue. But work with the farmer in a positive and calm way with options.
Tip 11: Don’t forget about the grinder. Rails can be cut out of crushes/gates. Use this as a last resort but always have it in the back of your head.
Section 2:
The actual section process:
Tip 1: Learn how to shave with a free blade or a bic razor, I have tried them all, the clippers are great but 3am some morning, no battery, you need a plan b. There is nothing that will wreck the farmers confidence in you more than if you cent get the animal shaved.
Tip 2: Use a needle long enough to freeze the inner layers of muscle.
Tip 3: Hygiene- Sometimes aseptic techniques aren’t 100% possible but strive for the best.
Tip 4: When making your incision, watch for nerves, the most likely time to get a kick is when you cut one. The next time, is opening into the peritoneum. Because of this use scissors to open the inner layers or you will find your-self in the rumen very quickly.
Tip 5: If sectioned before, go with the assumption that adhesions will be there. On the other side of the coin, don’t assume they aren’t there because it is a heifer, I have seen them in heifers too. Best to open every cow with the assumption that adhesions are present. Count your layers, when in far enough try to break down to the right just with your hand.
If you cut into the rumen, which will happen at some stage, don’t panic. Stitch it up like a calf bed and continue.
Tip 6: The use of a guarded blade. University describes getting the leg out of the incision site before cutting over it. Real life this happens about 60% of the time, the rest is cut inside in my experience for various reasons.
Tip 7: The calf bed that star fishes (i.e. a multiple direction tear like a spaghetti junction)
Keep calm and just keep stitching. Stitch straight sections one at a time, then try to bind all closed. This is very hard to explain but best advice is just keep stitching.
Tip 8: The twisted calf bed section:
This is dealers’ choice but I untwist them before I open the calf bed, which is carried out generally by lifting and pushing. These are always challenging so definitely one to get help with for your first few.
Tip 9: The calf in the far horn.
I take the leg over the top towards the incision; I find it easier than below. Again internal use of the guarded blade is also an option.
Tip 10: Open your cow lower than you would think. This makes life a lot easier for your self. It’s hard to get used to but definitely handier.
