Sunday, January 15, 2017

Bleeding Pigs and Other Horrors

They say that sometimes change is as good as a holiday.  Perhaps this is one of the reasons that I love working in cow/calf country.  The nature of my work is very seasonal.  Springtime is a mad rush of calvings, bull testing, disease outbreaks, branding, castrating, and all of the things that go along with a fresh batch of life coming into the world.  Summer time offers a reprieve from the fast-paced spring work, but affords an unending supply of outdoor activities to fill in the gaps.  Fall becomes a nose-to-the grindstone season of preg checks and regulatory work such as BANGS vaccination.  It is less hectic than spring, but certainly busy.  Then there's winter.  In winter, snow covering the ground and frigid weather combine to slow the pace of life down to a sluggish slog through a semi-suspended state of animation.  There's a small flurry of activity between Thanksgiving and Christmas to provide a little momentum, but the long, cold, dark nights of January and February seem to drag on with little hope of reprieve from the doldrums of winter.

That's not to say that there aren't things to like about winter.  I've spent many a blissful winter evening in the company of a good book and a warm fire, or seated in front of my fly tying vise creating the implements of my summer-time adventures.  I'm sure the folks at Netflix and Dishnetwork aren't too unhappy when the masses are forced indoors by the cold and snow, I know we sure give them a lot of business this time of year.  Despite the impetus winter provides to remain indoors, there are lots of outdoor activities that can only happen this time of year such as skiing, snowmobiling, and ice-skating.  Getting out for these activities also provides access to the peculiar atmospheric lighting and night skies of winter, which are often breathtaking and awe-inspiring.

Nonetheless, these wintry fringe benefits tend to grow stale quickly.  It's difficult for me to enthusiastically keep up these indoor activities for weeks on end while the natural world slumbers away.  It's also hard on cash flow.  I try to find things at work to keep me occupied during the weeks of deep winter, but the fact is most of my cow/calf clients don't have a lot for me to do this time of year.  It can be a little hard on the bottom line, and can add an extra measure of gloom to the long dark nights.  Perhaps it is for this reason that I agreed to go look at the pigs.

The call made me shudder.  A client that I had looked at a horse for a few weeks earlier (we'll call her Tammy) had been accumulating pigs over the past year.  She had about 15 of them and one of them was sick.

I hate pigs.  If it wasn't for the fact that every dollar I can muster this time of year is sorely needed, I probably would flat out refuse to have anything to do with pigs ever; short of eating them.  Pigs are smelly, odd-shaped, disgusting creatures, and they are also next to impossible to restrain.  Their anatomy doesn't lend itself well to examination, diagnosis, or treatment, but they do have the uncanny ability of being able to squeal at high volume, for indefinite periods of time, when they are unhappy with their situation.  They can also be quite vicious.  Many adult pigs weigh 2, 3, or even 4 times as much as I do, and they have sharp, nasty teeth that can make a mess of whatever appendage happens to find itself in close proximity to the snout.  Plus they are low to the ground which makes them difficult to wrangle.  I believe it was George Bernard Shaw who coined the phrase 'never wrestle with pigs. You both get dirty and the pig likes it'.  The pigs like it because they know they're going to win.

A few years ago I agreed to try sedating a pet pot-bellied pig in order to trim its feet.  The owners of said pig had never had one before, and they had no idea how to restrain it.  They had driven an hour to get to us because every vet between us and them had turned them down.  Before I dared give the pig any sedation, I wanted to get an accurate weight on it, but this pig had it's people figured out, and it proved to be impossible for them to get it on the scale.  Every attempt to restrain the pig failed, and when I finally attempted to use a slip leash to hold it still, the pig threw a violent, high-pitched tantrum that unsettled the owners so bad that they turned their frustrations on me.  My response was to refuse further treatment and they left in a huff, the pot-bellied pig grunting indignantly behind them.  I vowed a solemn vow, then and there that I was done with pigs, and never wanted to touch them again unless they were swimming in sage and nitrates.

I know I'm not the only veterinarian who feels this way.  When Tammy called me and asked if I would come look at her sick sow, I tried to make sure she knew that I wasn't a pig vet and that maybe I wasn't the best person to call.  Unfortunately she had already tried all of the other vets in the area, and they had all turned her down.  I knew it wasn't because Tammy wasn't good for her bill, she was.  It was because these other vets were either more financially secure than I was, or just a whole lot smarter.  Nevertheless, I reluctantly agreed to go look at Tammy's sow.

There were only two concrete things that I had retained regarding pig medicine while I was in vet school.  The first was that they could get a disease called erisypelas, or diamond skin disease, and the other was that you could treat it with penicillin.  Armed with this knowledge, I arrived at the little farm nestled deep in the Salmon River canyon where Tammy and her husband maintained a string of horses and mules for their outfitting business.  The farm also boasted a small flock of pea-fowl, several chickens, a few lion hounds, and an old gray tom turkey that followed us around and gobbled incessantly.  The sow in question had recently been purchased from another farm, and had gone off her feed about 1 week after her arrival.  She also had some nasal discharge and coughed occasionally.  Despite her anorexia, she had plenty of energy and was none-too-thrilled to discover that I was trying to keep her standing in place while I attempted to auscult her lung fields and take her temperature.  Tammy had a low piece of plywood with handles cut into it that seemed to keep the sow somewhat stationary.  However, when I tried to draw some blood from the sow's neck she was having none of it and barreled her way through the plywood to the opposite end of the enclosure.  I wasn't able to draw any conclusions from what little I was able to hear with my stethoscope, but I was finally able to register her temperature and she did have a fever.  I didn't think the sow had erisypelas as she lacked the characteristic 'diamond-skin' lesions along the top-line, but she did seem to have an upper respiratory infection of some sort.  As such, I drew up about 12 mL of penicillin and did my best to inject it into the thick muscles of the upper neck in front of the sow's shoulder, all while Tammy and the sow played red rover with the plywood.  I left the rest of the bottle with Tammy and instructed her to repeat the penicillin every day for a minimum of 3 days, but preferably 5.

Despite my lack of understanding regarding exactly why the sow was sick, she seemed to respond well to the penicillin and within a couple of days was back to her usual self.  I was relieved that the penicillin had worked, and hoped that this would be the last I would be hearing from Tammy and her pigs.  Alas, it was not meant to be.  Tammy phoned a week later to inform me that another one of her sows was sick, only this time she was passing bloody discharge from her reproductive tract and was quite depressed.  This sow had been bred by the boar a month or so ago, and it was likely that she was aborting her pregnancy.  The proximity of this event to the arrival of the sow with the nasal discharge and fever was alarming, and prompted further investigation.  In my career, I have investigated dozens, if not hundreds of disease outbreaks on farms and ranches.  I had been taught in vet school that the principles of epidemiology could be applied to any species, including pigs.  But I had no idea what I was going to do with this bunch of pigs that would help me better understand what was going on with these sows, or what I was going to do about it.

Tammy wanted me to pull blood from the sows to test for various diseases she had read about.  I had been doing some reading of my own and decided that this might not be a bad place to start.  I had heard that you could easily draw blood from a pig's external jugular vein.  But I had never done this before, or even seen it done.  I'd had a hard enough time injecting medicine into a full-grown sow; pulling blood from a writhing, squealing 300 lb mass of pork was a daunting prospect.  I had read, and been taught, that pigs could be restrained with a snare around their snout, but once again it was a technique that I had never performed or seen performed.  Even if I could get a snare around these pigs' snouts, my understanding was that they would squeal mercilessly the entire time.  I really couldn't think of anything I would rather do less than go back out to Tammy's place and try and draw blood from these pigs.  However, it was in the thick of winter, and business was slow.  Notwithstanding the lack of cash flow, by employers had continued to pay my salary, and at the very least I owed it to them to go back out there and give it a try.

I informed Tammy that I would be willing to try drawing blood from some of the pigs if she would invest in a hog snare.  I also made sure to remind her that I wasn't the world's greatest pig vet so she should keep her expectations tempered.  Her reply was humbling.  She informed me that I was the only vet that had agreed to even try and help her, and that she was just grateful that I was willing to do my best.  It reminded me that Tammy probably would rather have called another vet, and as such I should at least try to have a good attitude.  When I arrived on the appointed day, Tammy greeted me cheerfully and she seemed optimistic that we would soon know all we needed to know about what was occurring in her swine herd.  We cornered the sow that I had looked at originally; she remembered who I was and grunted suspiciously in the corner until Tammy mollified her with a bucket of grain.  The sow turned about, slowly oinked her way over, then greedily shoved her snout into the bucket which gave me an opportunity to pass the wire loop quickly around her snout.  I tightened the noose and the sow threw herself backward; fortunately the snare held even though the sow commenced to squeal as loudly as she could.  I had been prepared for this eventuality; both Tammy and I had ear plugs in place but it only helped a little.  The sow was positioned up against a fence in such a way that only her left side was exposed.  She must have weighed close to 300 lbs and I was reluctant to try moving her by her snout, so I attempted a blood draw from the left jugular groove . . . nothing.  I poked and prodded as the squeals varied in intensity and pitch, but I couldn't get a single drop of blood out of the sow's fat, non-descript neck.  I had read that pigs had an artery on top of the ear that was sometimes accessible so I doused it with alcohol and held off the base; no luck there either.  There was also a vein under the tail that purportedly could produce blood, but the sow really went to squealing and thrashing when I started poking her with the needle back there, and she finally managed to wriggle her way free from the snare.  She bolted for the other side of the enclosure and Tammy and I stood there in somber silence.

I considered calling it a day.  I had tried, and I had failed.  I had warned Tammy that I wasn't practiced at this, she would likely understand, even though it would mean she would be out almost $70 worth of mileage with nothing to show for it.  Tammy had given this sow shots of penicillin every day for almost an entire week; she knew how difficult this sow could get, in fact she had warned me that this sow could get downright nasty when she felt cornered.  The sow had ran into a little shed that was bedded with straw.  The shed roof was so low that I would have had to crawl on my hands and knees to go in after her.  That wasn't happening.  As I stood there contemplating my next move, the words of my mentor Dr. Ayers came floating up from the back of my memory, "Don't Weaken."  I knew that there was a way to draw blood from a pig, lot's of people did it every day.  I just had to keep at it.  Just then, somewhere in the back of my mind I remembered reading that it was easier to get blood from the right side of the neck, and that the jugular vein dove into the thorax very near the point of the shoulder.

I suggested to Tammy that she try to coax the sow out with some more grain.  I left the enclosure and Tammy somehow got the pig to come out of her shelter when she walked into the pen with more grain in her bucket.  While the sow dug in, I snuck around her and placed Tammy's plywood pusher over the entrance of the shed.  I then came up behind the sow and started blocking her retreat with my knee while I looped the snare once again over her snout.  This time I got it completely over the maxilla and pulled it tight.  The sow once again let out her loud, continuous squeal while I positioned her so that I could access her right side.  I found the point of the shoulder and inserted my 1 1/2" needle straight up into her jugular groove.  My syringe immediately filled with dark red blood.  It was some of the easiest blood I had ever drawn.  I pulled out about 10 mL and turned to show Tammy with a big poop-eating grin on my face.  We set the sow free and proceeded to draw blood from 5 more pigs, 2 others that had been sick and 3 that had not.   It took about an hour all told, probably 3 times as long as it would have taken someone with more experience, but we got it done.

Sometimes the prospect of facing our fears is worse than the thing we fear itself.  I confess freely that the reason I hate pigs is because I don't understand them and I therefore fear them.  While pigs can be nasty, cows and horses are much better equipped for hurting me than a pig is.  The difference is that I understand cows and horses and have a lot of experience handling them, so while I have a lot of respect for their ability to hurt me, I don't really fear them.  When I drove away from Tammy's place that day, I felt like I was ten feet tall.  Not because I had drawn blood from a handful of pigs, but because by facing my fear I had gained understanding.  I had been willing to step out of my comfort zone and persevere under pressure until I reached my objective.  I have no illusions about my abilities as a swine epidemiologist; no doubt I have bumbled my way through this investigation and will continue to do so.  Hopefully though, I will stick to it long enough to get it figured out.   Who knows, someday I might even get good enough at this whole pig thing that I might hang up my calf-jack and make a full-time profession out of it . . . or maybe not.  What I can say for sure is that regardless of the season, I will continue to accept the challenges that come my way and guard against the danger of becoming too comfortable, even if it means I gotta stick a pig or two in the process.