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Clearing The Airways

There’s not much time to make a difference to a calf that’s not breathing.

Hopefully the calf has a heartbeat; the objective then becomes getting it to breathe on its own. At that moment you’re on the spot and you’ve got to use what you’ve got handy. You need to clear the mucous from the upper airways and stimulate the calf to breathe to get life-giving oxygen into the lungs.

What have you got to work with?

Some of the traditional methods of clearing the fluids, such as suspending the calf upside-down can sometimes do more harm than good. Dr. Jocelyn Dubuc is a Ruminant Field Service veterinarian with the Ontario Veterinary College in Guelph. He explained that in theory this procedure would put the weight of the guts on the diaphragm and the animal will then have trouble breathing.

The same goes for swinging the calf around in an attempt to use centrifugal force to clear fluids: it’s not recommended. Not only does it take a good deal of strength but there also a risk of injuring the calf.

What else can you do? “Once the animal is born, it needs a shock event to realize he is in the real world and he needs to breathe,” says Dubuc. “In humans, they give a little slap on the butt and the baby starts crying and breathing.” In calves, the same theory holds true, only the stimulation typically comes through the sneeze reflex where gently tickling the nasal passage with a piece of straw will make the calf sneeze.

You can also remove mucous from the calf’s mouth and nostrils with clean fingers and place the calf on its sternum to make breathing easier, as well as elevating the calf’s neck to allow the nose and mouth to point down.

As Dubuc explained, what makes a calf want to breathe is the fact that he is lacking oxygen (apnea). This sends a message to the brain that he’d better breathe or he’s going to die. “If the animal is weak, this is when it gets in trouble and the animal might not be able to do it by himself,” he says.

In most cases, the breathing will start and the small amount of fluid naturally present in the lungs will be absorbed. In rare cases, the calf might have breathed some fluids inside the uterus. In such a case there will be fluids in his trachea and it will be very difficult for him to breathe. This is when a tracheal tube should be used to clear the fluids and provide air to the lungs. Dubuc says that this technique can be difficult to perform but a properly trained layperson can do it safely.

What about using a commercial calf resuscitator to inflate the lungs?

Dubuc questions the effectiveness of a calf resuscitator to do the same job given that, if you can’t block off the esophagus, you can easily inflate the rumen instead of the lungs: using a calf resuscitator would put positive pressure in the mouth and the air would end up going in the esophagus and the stomach.

Boyd Dingus has heard this concern many times in the past 10 years — that’s how long their aspirator/ resuscitator tool has been on the market. He’s the sales manager for McCulloch Medical, distributors of several livestock resuscitator models including one for calves.

What you’re ultimately trying to do with their aspirator/resuscitator, says Dingus, is to stimulate the calf to breathe on its own. At this stage you’re in a “go for broke” situation and he’s not so concerned about air getting into the esophagus and rumen since the number of pumps generally required to “jump start” the breathing is minimal.

Here’s how it works: Using an aspirator/resuscitator will first help to clear the upper airways. A vacuum is created when the aspirator mask is placed over the nose, pumping four or five times until you feel the suction that will effectively draw the mucous from the nasal passages. After that the resuscitator mask is attached and pumped every five to 10 seconds for four to five pumps.

Dingus says that what can stimulate the animal to take its first breath is the air travelling over the nerves in the nose, more so than the air being introduced to the lungs.

Dr. David Anderson is a Professor at the Kansas State University College of Veterinary Medicine. He has done clinical research with the McCulloch resuscitator and uses it routinely in their teaching hospital to assist distressed neonates.

As Anderson explained, the resuscitator causes a forceful blast of air into the nose of the calf. That has the effect of stimulating all of the nerve endings in the nasopharynx, which stimulates sudden deep breaths. In his opinion, this is the key to resuscitation. His research has shown that blood oxygen levels are increased and carbon dioxide levels are decreased through the use of the resuscitator.

Anderson acknowledges that the design of the face mask-style ventilators causes some of the air to go into the rumen, but much of it does goes into the lungs as ventilation therapy — increasing the depth and/or frequency of breathing. He suggests that the calf’s head be positioned in a hyper extended posture, similar to a human CPR posture, to maximize the size of the opening to the trachea, in turn maximizing the amount of air going into the lungs.

In his clinical research Anderson has observed deep breaths, head shaking, coughing and head raising much more commonly in calves when the respirator is used as opposed to traditional methods of stimulating breathing such as putting straw up the calf’s nose, or swinging or suspending the calf.

The device is not intended for persistent breathing issues, says Anderson, who recommends intubation in that case.

Is it worth having a resuscitator in your calving kit? It can be handy, but at $100 or more, it will need to be pencilled out for your own herd.

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