We see intestinal disasters reasonably often – not one a week, but probably one a month. Twisted guts, displaced stomachs, intestine that telescopes in on itself like an inside-out sock… The most common presentation seen by the vet is a cow with her eyes sunken back in her head, low temperature, rapid heart rate and a big round stomach even though she hasn’t eaten anything for 24 hours. In those cases, the poor animal is dying of septic shock and the best and kindest thing to do is put her out of her misery.

But just occasionally, we see an abdominal disaster that we can fix.

Last week I was called to see a Jersey heifer who had come in for morning milking kicking at her stomach. She hadn’t been sick for long – her udder was full of milk and her colour was good. She had a rapid heart rate because she was in pain, and when I did a rectal exam I could feel loops of distended intestine. Diagnosis: either a very recent twisted intestine or a nasty painful gas bubble. I gave her a shot of Metacam and an injection to make the gut relax, and asked the farmer to ring me in an hour with a progress report.

The Allflex collar report for this heifer. The computer diagnosed her sudden drop in eating and rumination as a heat – actually, it was due to a knot in her intestines

One hour later, the report was that she looked more comfortable but not completely happy. We decided to give her another hour.

At the two hour mark, she was about the same. Not really any worse, but not great. I went back out to have another look.

Loops of intestine still palpable on rectal exam. Heart rate high – not as high as it was before she had metacam, but nowhere near normal. She wasn’t particularly bloated – just a little bit rounder in the stomach than you would expect for a cow who hasn’t been fed that morning.

The problem with gut surgery cases is that quite often, it’s not entirely clear that you need to open them up until it becomes clear that it’s too late. Early in the course of the disease, there’s always the risk that you’ll operate on a cow who just needs to fart.

Anyway, we decided that the risk of doing nothing and having her deteriorate was worse than the risk of opening the abdomen for no reason. And having opened the abdomen, we found a couple of metres of angry looking, swollen, purple intestine, the hallmark of an intestine that has got twisted around and had its blood supply cut off. We untwisted it, pushed it back in and stitched her up. She made a rapid recovery and is doing well. Hooray!