Underwater Therapy for Evie
Wednesday, June 24, 2015
There is a First for Everything: Calf Undergoes Groundbreaking Treatment
It’s New Year’s Eve. Many people plan special celebrations and often party into the wee hours of the morning. At OSU’s Veterinary Medical Hospital, the order of the night is treating emergency patients like a newborn Brahman heifer calf.
Patient History
She was born out in a cold, snowy pasture on Dec. 27, 2014. Her owner, Bill Martell of Jacktown, Okla., got her into the barn as soon as he could but was unable to reunite the baby with its mother. This means the calf didn’t ingest colostrum missing antibodies to protect it against disease and give it energy for keeping warm.
“I have a cow-calf operation with about 350 mamas—Angus, Brangus and a few purebred Brahmans because they are different and I like them,” says Martell. “Brahman cows don’t do well in the cold. I tried everything I could think of to get her to drink from a bottle but she wouldn’t. I knew I needed to get her some help.”
Martell brought the calf to OSU’s Veterinary Medical Hospital on Dec. 31. Diana Pirolo, a Ross student finishing her clinical training at OSU, and Dr. Melanie Boileau were assigned the case. The calf’s body temperature was only 93 degrees (101.5-103 degrees is normal for a calf) and she still refused to take a bottle.
“Diana asked me what her name was,” Martell recalls. “I told her she didn’t have one and that if she saved her, she could name her. They named her Evelyn, Evie for short because it was New Year’s Eve.”
“When a calf’s temperature drops below 101 degrees, it can’t thermo-regulate and keep warm,” says Boileau, food animal medicine and surgery section chief. “We warmed Evie up and treated her for dehydration, abomasitis (inflammation of the inner lining of the stomach), diarrhea with secondary metabolic acidosis, or increased acidity in her blood, and pneumonia. We eventually gave Evie a feeding tube to get some nutrients into her system until we could teach her to drink from a bottle.”
While Evie was hospitalized, veterinarians noticed there was something wrong with her two front legs.
“Evie has laxity in her flexor tendons,” Boileau continues. “Her tendons are too loose and in a constant state of extension. We put splints (initially) then casts on her legs to give her support hoping that as she grows, the problem will self-correct.”
Evie was discharged on Jan. 16, 2015, still wearing casts on her front legs. At the designated interval, Martell brought Evie back to OSU’s Veterinary Medical Hospital to have the casts removed and her legs checked. Dr. Robert Streeter, associate professor of food animal medicine and surgery, attended to her.
“Evie’s legs still needed support so we put new casts on and sent her home,” says Streeter. “We told Mr. Martell to take the casts off in 10 days.”
Martell did as instructed but it wasn’t long before Evie was back at OSU.
“When Evie returned on Feb. 15, 2015, I felt her legs had worsened and decided to consult with Dr. Michael Schoonover, one of our equine veterinary surgeons and sports medicine rehabilitation specialists,” says Streeter. “Dr. Schoonover has a lot of experience with tendon issues.”
In addition, Streeter brought in one more clinician, Dr. Lara Sypniewski. Sypniewski works primarily with small animals and is also a certified veterinary medical acupuncturist. She uses a variety of modalities in her non-traditional approach to treating patients.
“This is what is so exciting about bringing your animals to OSU for treatment,” says Sypniewski. “We have all these experts here who can collaborate about each client’s animal. The three of us went over Evie’s case and discussed the best options.”
Martell was given three choices: 1) euthanize Evie; 2) treat her with underwater treadmill exercise, electric stimulation and anabolic steroids; or 3) fuse her knee joints making her stiff-legged.
“I told them if we do option 1, we won’t know if 2 or 3 work,” says Martel. “If we do option 3, we won’t know if 2 will work so let’s start with option 2 and see where it goes. If it doesn’t work, we will still have two choices left.”
Making Veterinary Medical History
Dr. Sypniewski’s rehabilitation center on the small animal side of OSU’s Veterinary Medical Hospital has an underwater treadmill that will hold up to a 250 pound animal. Normally dogs use it for conditioning or strength training and once in a while a cat needs water therapy. But it has never held a calf—that is until Evie arrived.
“I don’t think any other veterinary college has treated a calf with underwater therapy—it’s a first and we’re glad her owner was willing to try this different approach,” says Sypniewski. “Evie weighs 125 pounds so the treadmill can easily accommodate her.”
Housed in a pen in the food animal barn, the first issue was getting Evie from one side of the hospital to the other. Since the floors in the small animal section are slippery to a calf, Evie was helped into a moving crate and wheeled through the hospital. Once at the rehab room, she was helped into the 400 gallon tank.
“It was a learning process for sure,” says Dr. Megan Downing, food animal medicine and surgery intern on Evie’s case. “We put foam noodles (like people use in the water) on each side of Evie so she would stay on the moving track and away from the sides of the treadmill. A student would put on waders and get in the tank to keep Evie from sliding into the back of the tank.”
Since the calf was not used to being in chest high water, a special life jacket was secured around her.
“Brahman cattle tend to lie down when they are stressed,” says Downing. “Once she started to lie down, Evie discovered she could float with the life jacket on, which defeated the purpose so we had to take it off her.”
“We also tried encouraging her to walk by giving her part of a milk bottle,” says Cynthia Smith, one of the fourth year veterinary students who rotated onto Evie’s case. “But she decided she wanted all of the bottle so that didn’t work as an enticement either. Instead she would get her bottle as a reward at the end of her treatment while the treadmill water drained. Then we would towel her off and put her back into the moveable crate to wheel her back to her pen.”
“Evie started walking for three 3-minute sessions with a rest in between each session,” Schoonover adds. “At first she would do three minutes, rest, maybe do two and one-half minutes, rest. And if we were lucky, we could get her to walk one more minute for the third set.”
In addition to the treadmill, Evie’s rehabilitation included electrical stimulation.
“We gave Evie electrical stimulation on both forearms to stimulate her flexing muscles,” explains Sypniewski. “And by putting her in the underwater treadmill, the water takes the weight off and allows her to flex easier.”
“When she first started walking in the water, she walked stiff legged,” adds Downing. “Now she is able to flex her legs. Evie exercises twice a day with Wednesday off.”
Gradually, Evie built up her stamina and by the time she was discharged on March 23, 2015, the calf could walk three 5-minute sessions at a rate of .9 miles/hour with no problem.
As he picked up Evie, Martell had this to say:
“I’ve been here (OSU Veterinary Medical Hospital) on Saturdays and Sundays and even on holidays. I’ve been on the small animal side, too. Not too long ago, I brought my 9 year old boxer in and they found and removed a small tumor, which means the quality of her remaining years will be better. There is always someone here to help and I’m grateful for that.”
Evie’s prognosis is fair and Martell will bring her in for checkups to monitor her progress. Evie’s unique case will probably be the subject of a future journal publication so that other veterinarians may learn from OSU’s experience treating tendon laxity in a calf using an underwater treadmill, electrical stimulation and anabolic steroids.
The Team
Throughout Evie’s stay at OSU’s Veterinary Medical Hospital the following people played an important role in the calf’s rehabilitation: Drs. Melanie Boileau, Robert Streeter, Michael Schoonover, Lara Sypniewski, Megan Downing and Chase Whitfield and fourth year veterinary students Diana Pirolo, Sarah Fry, Cynthia Smith and Celena Quist.