Calves can experience an inflammation of the mouth, throat and larynx called diphtheria. In the past, a similar inflammation occurred in children. But diphtheria in children scarcely occurs anymore due to a national vaccination programme. The diphtheria bacillus of the calf is not the same as that of the child: thus calves cannot contaminate children.

Shortness of breath
A calf of a few weeks or a few months old that is secreting saliva with its tongue hanging out of its mouth and that does not want to drink, is suspected of having diphtheria. The animal has a fever and it has patches in its mouth and throat with greyish, mortifying mucous membrane. If the inflammation is in the larynx, then the animal may experience a severe shortness of breath within a short time and the calf may suffocate. The diphtheria-bacillus is sensitive to penicillin. Yet the antibiotic does not kill all of the bacilli because the blood supply stagnates in mortifying tissue. The infection can be obstinate, particularly in the larynx. Essential when treating a calf is to ensure that the calf does not suffocate before the penicillin can take effect.

Tracheal tube
If there is a risk of suffocation, then a small tube must be inserted in the trachea just below the larynx. This will allow the calf to breathe while the penicillin has time to work. A tracheal tube of this kind has the width and length of a little finger, with a curve of almost 90 degrees and with two eyes to use to tie it around the neck with a small strap. It contains a second inner tube that can be removed and cleaned.

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tracheal tube with exchangeable inner tube

Emergency
A double-muscled calf is severely short of breath. It had begun snoring while drinking from the milk bucket the previous evening. But now it is close to suffocating. I am on the road when the call comes. I turn the car around and step on the gas. The young bull is stretching its neck in an attempt to breathe. The shrieking sound is a sign that its throat is almost shut. Its eyeball is blue. I quickly inject an anaesthetic under the skin of its neck, brush away some hairs and spray betadine on the skin. The calf is then laid down on its side. This increases the tightness of its chest; he struggles wildly, fighting for its life. “Hold on to that head!”

Operation
I make an incision in the skin below the throat and I cut the trachea open using a scalpel. I then stick the handle of the knife between the cartilage discs. This creates an opening and the animal breathes in gasps. A small amount of blood trickles into the trachea, causing the young bull to cough. My face is covered in a red mist. I keep the scalpel in place with one hand and use the other to grab the tracheal tube. It must be inserted and slid inside through the opening between the cartilage discs. But there is little room next to the handle of the knife. And if I remove the scalpel, the crack in the trachea will immediately shut. The calf coughs again and blood sprays from the wound. But a third attempt hits the mark: the small tube is in position. I place a bandage around the neck and tie both sides to the tracheal tube. Done! My face is red with blood. That was just in time!

After-care
The calf is set upright and is still panting violently. The small tube in its neck provides ample air. I explain to the farmer how to remove the inner tube and clean it. That must be done every day in order to prevent the tube from becoming obstructed by mucous. The calf is given an injection with penicillin. I give the farmer a full bottle for the after-care treatment in the week to come. The calf is separated from the others and is given its own milk bucket. The calf’s saliva contains diphtheria bacilli that can spread to other animals by means of the drinking bucket. Four weeks later, on a routine visit to the farm, I shall remove the small tube. After that the opening will soon close by itself.

Outcome
The calf has grown considerably in four weeks. It is playing around the pen and is breathing calmly. The bandage around its neck is the only reminder of its scary adventure. I cut the bandage free and pull the small tube from the trachea. After a week, however, the snoring starts again. The opening in the neck has meanwhile closed, but the larynx had not healed. The tracheal tube has to be inserted again. When I hand the farmer a bottle of penicillin for the after-care, I notice that the first bottle is still half full. The calf had seemed fine after the first three injections, so why keep going? Sometimes farmers can be penny-wise and pound-foolish.