Rectal Palpation: Fear of Failure, Chapter 12
Rectal palpation is one of the veterinarian’s most significant procedure in both horse and cow medicine. Proper training allows the mind to visualize the structures the fingers are feeling. Deciding I needed more veterinary experience, and I called Dr. Walton in Corona to see if I could observe and assist.
The first day I shadowed him, Doc took me to a farm store and bought me a pair of rubber boots. One cannot do dairy work without these boots. There is manure everywhere, sometimes an inch thick, pooling on the concrete runway of the barn. We wore the boots with just socks, no shoes, and Doc always wore a pair of coveralls. Working with dairy cattle meant getting lots of manure on every part of you.
They milk cows every 12 hours, usually between four and five in the morning and four and five in the afternoon. A dairyman’s life rotates around this schedule seven days a week.
Doc’s routine starts after the morning milking when the cows are locked in row stanchions inside the barn. Because they are fed high-quality feed while milked, the girls are compliant, eagerly pushing their heads through angled vertical bars to get to the feed. Once the girls are munching contentedly, a lever locks them into place, catching each cow at her neck. The space between the two vertical bars becomes too narrow for any cow to pull her head out, preventing them from backing up and leaving.
Doc was doing routine reproductive stuff. Milk only comes when a baby is born, so these girls are re-bred as speedily as possible. With the milking finished, it was time for Doc to push his arm inside each cow’s rectum.
Doc pulled a long plastic sleeve onto his left arm to check each cow in the lineup. Walking behind the first cow, he grabbed the tail a foot or so from the body with his ungloved hand and pushed upward, making the tail flag high in the sky, leaving the rectal area wide open.
Closing his fingers together in the gloved hand to form a triangular point at the end of his glove, Doc carefully pushed his hand through the winking butt hole. Pushing past the first rectal constriction, he opened his hands, scooping handfuls of feces out, allowing the green shit to fall to the floor.
“Why do you do that?” I asked.
“It gives me room to maneuver my hand. I need to twist it here and there, and I don’t want to be working through this muck every time I rearrange,” Doc replied. He needed room inside, so he could safely advance his entire arm up into the cow’s rectum.
“Push hard at first, because the cow strains against the intrusion. An automatic reflex keeps the anal sphincter closed against any outside, untoward visitations,” he said.
I looked at him to see if he was joking, but Doc remained serious, focusing on the cow.
Keeping the wrist rigid and in-line with the rest of the lower arm, the palpator’s rectal push then comes from the bent elbow as the wiggling fingers make their way deeper into the mama bovine’s rectum. Doc carefully wiggled his hand and then his arm into the rectum, past the elbow, up to Doc’s mid-humerus. He was so deep inside the cow he was able to palpate the cow’s kidney through the thin lining of the cow’s rectum. The wall of the rectum is tough yet thin, narrow enough to feel the outlines of other organs.
Satisfied his patent had been evacuated, Doc pulled backward to restart his diagnostic exploration, explaining the details as he groped. “Once I have room to work, I find the cervix, feeling for it at the front rim of the pelvic bone; it has a solid cylindrical shape,” he said, with his forearm in halfway, his elbow still bent. “I’m turning my hand back and forth on the rim of the pelvis here, feeling for a giant kielbasa. If you’re up to your shoulder in the cow and still can’t find the cervix, you’re in too far. Move back until you can feel the cylindrical object below your fingers. It’s important to find the cervix,” he said.
I nodded, trying to visualize what he was explaining.
“Finding the cervix is crucial,” he repeated. “If you can’t find it, then back off and check the sex. Sometimes the dairymen play games and set up a steer in the stanchion; males do not have cervixes. You will forever be the brunt of bad jokes if you call a steer not pregnant,” he finished.
I was hesitant to ask him if someone told him this or if it was firsthand knowledge.
Doc continued. “My fingers follow the uterus just in front of the cervix. The uterus is where I palpate for evidence of a baby. If the cow is open, not pregnant, I can walk my fingers along the uterine horns to locate the ovaries,” he explained. His arm was straight out; he was in past his elbow. “Once I grab an ovary, I palm it and run my fingers on it feeling for hardness. I try to find a water-filled bubble growing on the ovary, that’s a follicle, and it means the cow is ready to ovulate an egg, she is coming into heat. She is marked for breeding or artificial insemination.”
“If she is pregnant, can you tell how far along the baby is?” I asked.
Doc nodded. “If you feel the uterus is distended, with a small oval ball of liquid floating inside it, that's a fetus, the cow is pregnant. If I feel the uterus a small oval ball of liquid floating inside, it’s a fetus; the cow is in early pregnancy. As the baby grows, the palpation findings change. The baby is the size of a mouse at two months, a large cat at five months, and the size of a beagle at seven months.”
Two months - size of a mouse Three months - size of a rat Four months - size of a small cat Five months - size of a large cat Six months - size of a small dog Seven months - size of a Beagle
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