Preventing Abscesses

If you were naïve to farming, would you still drink milk if you observed a large, festering abscess draining in the milking parlor?  “Get the coffee mug out and catch some creamer!”  Or better yet, “We have ricotta cheese for that lasagna your wife is making for tonight.”  Picture the dairy product images.  Now think of the expressions while conjuring up images of the worst abscesses you have ever seen.  After thinking back, the image is not so healthy and wholesome is it?  Sure veterinarians receive a high level of satisfaction deflating the abscess, yelling “Fire in the hole!” before we slice into a high pressure, high volume abscess impressing wide-eyed veterinary students who end up in the line of fire.  We try to estimate the sheer amount of that foul smelling ooze and attempt to create the perfect arch to astound the client as it drains.  In fact, the image is downright disgusting, not to mention the experience has an odor that simply will not go away.  In reality, this entire mess is completely preventable with proper needle and syringe usage, medicine and vaccine storage and handling, and clean injection sites.

Abscesses are caused by damage to soft tissue and an introduction of bacteria into the wound.  Soft tissue damage results from dull needles, improper animal handling causing muscle bruising, irritating drugs and vaccines.  A bacterial infection is introduced through dirty injection sites and contaminated needles, syringes, and bottles.  In cases of blackleg, infection ensues from consumption and injection of bacteria and distribution into muscle.  As you can see, there is one common contributor – NEEDLES! 

Hold a new gleaming, clean, sharp needle in your hand and take a good look at it.  Notice the sharpness of the point.  The new, sharp needle will pierce the skin and muscle with ease, causing minimal trauma.  A dull needle will have a “barb,” a curvature, on the point.  As the dull needle punctures the skin and muscle, the soft tissue is more severely traumatized especially during withdrawal as the barb snags tissue.  Tissue remnants and dirt can remain on the barb, contaminating the medicine or vaccine bottle and transferring material into additional injection sites increasing the odds of creating an abscess.  Trace blood and tissue remnants create an additional risk by transferring blood-borne infectious agents, such as viruses, especially Bovine Leukemia Virus.  Dairymen exporting cattle or embryos to Europe can certainly appreciate that risk. 

The Needle Gold Standard is a new needle for every cow.  Keep in mind that needles are cheap.  At the very least, use one needle for every 5 cows.  Always use a new needle when changing medicine or vaccine bottles.  Try to puncture the bottle top the least amount of times as possible by using a multiple-dose syringe or a single bottle-only needle.  Even the medicine bottle top has a dulling effect on the needle.   

To further reduce tissue trauma, use the smallest needle allowed by the thickness and flow-ability of the product being injected.  To some clients, that is a tough pill to swallow.  Larger diameter needles last longer.  Plus, larger needles handle a grinder better!  Please take that as a joke.  However, in addition to minimal tissue trauma, there are distinct advantages to using a smaller diameter needle.  Ever see that dribble of medicine, particularly prostaglandin or GnRH, flow out of the injection site after the needle is removed?  If using the minimum dosage, the dribble may now place the injected dose lower than needed for optimal response.  A smaller diameter needle tends to limit this outflow of medicine.  For the drugs mentioned, a 21g needle is sufficient.  Studies have also shown that for intramuscular injection of reproductive drugs, a 1.5 inch needle is needed for adult cattle for optimal absorption. 

Contaminated syringes are also sources for abscesses.  Watch for flashes of blood and “floaters” in the syringe.  Both can be sources of injection site infection and can be sources of infectious blood-borne disease.  If anything unusual is seen in the syringe, throw it in the trash.  Cleaning syringes with disinfectants can deactivate vaccines if residual disinfectant remains in the syringe. 

If you have trouble finding a clean injection site, you have serious management problems!  Beef quality assurance recommends injections in the neck region to save the quality cuts in the rear legs.  The neck region has an additional benefit to being typically cleaner than the rear legs reducing the likelihood of infections.  Fresh cows are at greater risk for abscesses of the rear legs as a result of uterine drainage and smearing.  Therefore, please use the neck!

Do not forget about drug and vaccine storage and handling.  Prevent dirt or other contaminants from entering the medicine bottle.  Obviously, dirty needles and syringes can be sources of contamination.  A bottle with a dirty, manure covered top with numerous puncture holes is guaranteed to be contaminated.  Manage drugs and vaccines according to labeled storage and handling instructions, being especially critical of temperature and expiration dates.  Any deviation, especially for vaccines, can result in a change in composition and an increased toxin load leading to greater tissue damage. 

Pay attention to the route of administration and dosage. Intramuscular injections create the most tissue damage.  Therefore, if the drug or vaccine is also labeled for subcutaneous injection, please select the subcutaneous route.  For a large volume of drug, only inject 10ml per site to avoid serious tissue irritation.  Focusing on disease prevention which decreases use of drugs is the best approach to preventing abscesses. 

As an aside…we received a phone call from a client a month ago.  He just injected a cow with J-5.  After withdrawing the needle, the cow backed into him plunging the 18 gauge, 1.5 inch long needle deep into his thigh.  Fortunately, his thigh was free of manure and the needle was sharp; he makes a point of using single-use needles.  The client was certainly in pain, but fortunately, he did not annoy his wife with a festering thigh abscess.

Abscesses affect beef quality and are a legitimate animal welfare issue.  With more intensive management and greater dependency on injections, cattle are at greater risk for developing abscesses which can negatively impact milk production and cow health.  Fortunately, through proper needle and syringe management and strict injection site selection, abscesses are easily preventable.

More Stories of the Disgusting, Mutated, and Absurd

Nothing makes the veterinary career more interesting than observing cases of the disgusting, mutated, and absurd. Case in point...We had a calf at my family's dairy that was not passing manure and spiked a fever at 3 days of age. By 5 days of age, the calf died after an aggressive treatment regimen. I had to cut her open because I was suspicious of an atresia coli (the lower plumbing was not connected) which would explain the lack of feces. However, I needed an explanation for the fever. The calf was definitely an astresia case, and unfortunately the poor heifer had a perforation at the ileal-cecal junction, which explains the fever from peritonitis. The distension from the atresia, poor perfusion and stress which lead to ulcers, likely caused the perforation.




I was in the middle of a C-section, helping a colleague deliver a calf that was a legitimate 3 weeks overdue, a truly gargantuan calf weighing-in at almost 180 pounds; A fetal-maternal mismatch of epic proportions. I happened to be on call. Just when we finally had the calf in position to cut out of the uterus, another call came in, another mad calving. Great. Plus, it was hot and humid and I was hungry, thirsty, and I had a 45 minute drive ahead. Time to put the windows down, and listen to some music.

When I reached the farm and reached to the cow, I quickly came to the conclusion, that another c-section was in order. She was only dilated 6 inches and the calf was coming rear-end first. However, the presentation was more unusual. The calf was a true breech position with rear end coming first and rear legs forward. But, the tail was nowhere to be found and the rear legs were skinny, curved and intertwined with each other. This calf was going to be visually interesting. Time for another C-section. Being hot and humid, I was greatly concerned that the cow's chances of surviving the surgery were low, but we had to try something. When we finally delivered the calf from the cow's lower caudal left side, the calf lived up to expectations.

The calf was stillborn and clearly missing the tail, a congenital anomaly known as coccygeal agenesis. The rear legs were significantly skinny and curved, like they originally palpated. Interestingly, the lumbar vertebrae were also missing. We had to take some photos. And after a hot, tiring evening, my client's wife sent me home with an extremely tasty, rich chocolate milkshake. The treat definitely hit the spot. And to truly cap off the case, the cow survived and is currently completing her lactation.

I love congenital anomalies, especially when the calf is alive. Meet the bovine version of "Shrek." This calf presented with "Shrek" ears, having a congenital anomaly called microtia, in which a small portion of the auricle is still present. Except for the deformity, the calf was healthy and happy.

In the next case, the cow was not very happy or healthy. She had a displaced abomasum, commonly known as a "twisted stomach," for the second time. Judging by the incision, your's truly performed the previous surgery. I take a lot of pride in my work, so my ego took a significant hit, when I had to re-cut this cow a year later. After entering the abdomen and re-positioning the abomasum, I quickly realized a problem. She had a grapefruit sized mass at the end of the abomasum, about 4 inches caudal to the pylorus. Clearly, this mass was not benefiting the cow, so I ripped it out.

The mass looks like a heart. But I could not leave without cutting the mass open.


Oh dear. My ego took another hit. You are not looking at cream cheese, or blue cheese dressing. The mass happened to be an abscess, and the white, creamy ooze happens to be pus. I guess I should have been a little cleaner. Unfortunately, the environments we work in are not sterile. Even though we strive for complete sterility, we can none the less expect an imperfect environment. The cow recovered quickly post-surgery and I recently rechecked her pregnancy.

I have to conclude with an ode to my truck. In November 2004, my 2004 Chevy Silverado 2500HD entered my life after a tortuous relationship with a Toyota Tundra. This truck has taken me everywhere, through torrential downpours to the "Call the National Guard out!" epic blizzards. The Large Animal Veterinarians truck is truly the office, lunchroom, and conference room. Two weeks ago, she finally made it over 200,000 miles in the rural Pennsylvania town, Roxbury.

The truck and I have more miles to tread, memories to make, cows to save, and stories to tell. I looking forward to another 200,000 miles!