Yay and neigh!

Not sure if that blog title makes sense… but its horse related!

I have always wanted to work with large animals after graduation, I have always had the hardest time finding equine experience. So one of my goals for final year was to gain more confidence working with horses so that after graduation I could be a mixed animal veterinarian who was willing to see horses and enjoyed the calls.  I had a 3 week placement at an equine clinic, there were boarded veterinarians on staff and they saw horses with many different kinds of problems.

For the first two weeks I was working with the surgery team. The mornings we spent in the surgical ward and then often the afternoons were filled with lameness exams.  My role often involved helping ‘drop’ (sedate) the horse in the padded recovery room and then move it onto the surgery table with the help of a winch. Here is a quick video showing how a horse is moved into surgery.  I could then help scrub the surgical site (for a really long time!!!) to make sure the area was clean before the surgeon made his incision. On the first day I scrubbed into a cryptorchid surgery and tried my hand at some suturing. I still haven’t been given the chance to do a gelding (castrating a male horse) myself and I cannot wait until I have the chance to do one. I watched a couple of arthroscopic surgeries; such as 3rd carpal bone fracture repairs on racehorses. One of the more interesting surgeries I got to watch (twice actually!) was a mandibular tooth retropulsion. The mandibular teeth are in the back of the jaw, on the bottom, so if they need to be extracted they are very hard to pull out the traditional way. It is much easier to drill a hole in the bottom of the jaw and then retropulse (basically hammer) the tooth out with a peg. This surgery required a lot of skull radiographs to ensure that the surgeon was drilling and hammering the peg in the right direction in order to remove the correct tooth. I was in charge of taking the radiographs and this is probably why these were my favourite surgeries to be involved with.

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Just in case you ever wondered how big a horse’s tooth is, here you go!

I also helped complete the treatments for all of the hospitalized horses. This meant giving injections, checking bandages, flushing intravenous catheters, taking horses for walks to graze, cold hosing wounds, etc.  In one part of the hospital there is a large model horse, we put it in front of the stall of any horses who are lonely or anxious without a friend –often it helps them calm down! One patient I helped with had gotten a large stick rammed up into his groin, another had extremely sore feet as he had a condition called laminitis.

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The lonely horse friend; conveniently on wheels!

During the first week there was an Ag Tour going on in the county; the tour group stopped by the practice on two different days. We had 3 stations in the hospital to explain to the people on the tour what actually goes on inside a big equine referral hospital. One of the tour groups actually got to watch through the windows of the surgical suite as we completed one of the mandibular tooth retropulsion surgeries.

On some afternoons we would load up the truck and go out to see horses at stables or farms. We often went to stables and looked at horses training for different competitions, we did lameness exams and joint injections. I often helped scrub the site prior to the injections. I did my first nerve block (abaxial) on this placement!  When owners are preparing to take their horses across the border into the United States they need to be checked by a veterinarian and have a recent blood test (Coggins) completed before they are allowed to enter the states. We did quite a few of these exams and blood tests. Often the paperwork for these horses can be monotonous but there is now a new app that allows vets to fill out information and take photo records on their phones! I also watched quite a few euthanasias and on a couple of horses we completed post mortems to find out why they had died. The intern and I got to practice finding our landmarks and performing joint injections.

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One of the lovely summer views we had while out on call. At this particular location we were dealing with a horse that refused to get onto the trailer!

I got to use some of the practice-owned horses to hone my lunging (an important skill for conducting lameness exams and just being a generally horse-competent person in general), reproductive rectal exam with the ultrasound, and placing a jugular IV catheter.  I also practiced putting in a nasogastric tube; it is an easy enough procedure to do when there is a calm situation.  NGT’ing is an important diagnostic for working up a colic case and I’m nervous for the first time I’ll have to get a NGT into a colicking horse (which can often be very stressful!).

On the third week I worked in the reproduction barn. It was the end of the season and appointments were slowing down–but this was good because it left me lots of time to ask questions. I spent a lot of time running out to mares in pens and giving them injections of hormones to help manage their reproductive cycles so that we could get them bred (so they could have a foal next year).  When we weren’t giving injections to mares we often had them inside the barn for a reproductive tract ultrasound exam; we would look at the body of the uterus, the horns, the ovaries and any follicles or corpus lutea that were present. If a horse had already been bred then we would monitor her for fluid build up (that could ruin a pregnancy) and preg-check her at 14 days to see if she had twins or not, and then assess the fetus’s heartbeat at 25 days. Later in gestation, the owners could bring their horse back if they wanted to know the foal’s gender (filly vs colt). I also got to watch a couple of stallion collections using an artificial vagina— if you wanna talk about dangerous jobs; collecting stallions is definitely one!

There was a cute little loft apartment on site that ended up being really handy–I stayed there when I did on call with the vet. Some of our emergency calls included: a miniature horse foaling, colicking horses, a broken skull, a horse who wouldn’t get on a trailer, and wounds. Other notably cool appointments included a horse enucleation, a horse with a bullet in his leg, a suspected Strangles case, and a suspected Potomac Horse Fever case!

I had a great time on this placement, I really enjoyed the chats with vets in the vehicle, bonding with the intern, the variety of appointments to see, and the friendly nature of everyone at the clinic! Thanks a million Delaney Veterinary Services 🙂

P.S: This was the only placement that gave ME a thank you card at the end of my time there, I was so blown away by this!!

 

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‘Cows Around’

If anyone caught that Corb Lund reference, thank you.

This placement was a blessing.  Last year I was trying to find placements to go to in Australia (we have to do a certain number of weeks in Australia). I was really struggling because I do not have many friends and no family in Australia. At home, it is easy for me to stay with someone I know or visit people in different areas where I might do a placement. It looked like I was going to have to spend a lot of cash to pay for transportation and accommodation to do placements in Victoria. I was chatting to some of the girls from church about this, and next thing I knew, my friend’s mum called me! She explained that her and her husband had a dairy farm in Gippsland and their vet was amazing, very busy, and took students all the time. She had already called someone and vouched for me and they had agreed to take me on as an extra student at Tarwin Vet Group.

The first day of this placement was what I had imagined real Gippsland weather to be like. It was windy and POURING rain and I started to mentally prepare myself for 3 more weeks of downpour. Our first call was to see some sick cows at a dairy. We wore our normal clothes in the truck and when we arrived at the farm we changed into our boots and rubber pants. Classic student… I didn’t realize the side panels on the vet box on the truck flipped up…so while the vet was hiding from the rain and changing in the dry area I proceeded to dance around and struggle to get my rubber pants on over my coveralls as I got progressively more soaked in the rain.  I am not meant for rain. The first cow we saw had very bloody diarrhea and very pale mucus membranes. The vet wanted to recommend an exploratory laparotomy (abdominal surgery)—in this case we didn’t think the cow would survive a surgery because of the expected amount of blood loss. We thought she had a condition called jejunal hemorrhage syndrome.  We also saw a cow with extremely bad photosensitization—so much worse than any terrible sunburn I’ve ever had, I really felt for that girl.  During my placement we had quite a few ‘sick cow calls’ which allowed me to get lots of practice doing physical exams–a few times we were able to give farmers definitive diagnoses, other times the cattle required tests to figure out what was truly going on.  I saw a lot of different cases including ill-thrift, lumpy jaw, woody tongue, coccidia scours, pneumonia, bilateral pyelonephritis, and polioencephalomalacia.

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I spent all 3 weeks on twisty roads, going up and down hills. At the tops of hills (on clear days) there was some amazing views 

We often got calls to see cows and calves with lumps on them! Our first ‘calf with lump’ call actually ended up being the most interesting.  Lumps in cattle are commonly abscesses and I couldn’t wait to lance it!  But this calf had a large, soft lump down his neck. As I palpated the lump it started getting softer and the calf would walk away and regurgitate up hairball like materials. We spent a while massaging his neck until the lump got much smaller.  We suspected that the calf was sucking hair off his pen-mates ears and ended up with a choke-like condition (more common in horses).

Lameness is another common reason a vet may be called to see a cow. We visited many lame dairy cows, and a few lame beef cattle during my placement. Depending on the vet I worked with I got to practice lifting up legs–either with pulleys (much easier) or just ropes (I need to get rid of my noodle arms). On one occasion we went to see a large Angus bull.  I learned that a lot of the vets will give a little bit of sedation to the lame beef cattle.  Sedation is given to the beef cattle because they are handled less than the dairy cattle and often more dangerous to work with, sedation can calm them down and allow us to safely complete a full lameness exam. I really liked this idea and think it is a smart option for me–especially as a new grad while I’m still developing clinical skills and figuring out my methods.  One of the best lameness cases I saw was a septic hock. I aspirated ~20ml of purulent exudate from the joint. It was very interesting to see the difference in treatment of septic hocks between the horses we saw at the referral hospital at the beginning of the year and this cow.

One of the vets that works at Tarwin is the ‘down cow guru’. One day we got an after hours call for a dairy cow with a dislocated hip. Two other students and I went with the vet to see the cow.  He showed us how to properly palpated the hip joint, the top of the femur (greater trochanter), and examine the abnormal appearance and movement of the of the leg in order to confirm that her hip had actually popped out of the  joint. He also showed me how to roll a cow over by myself (for when I’m working alone). We then put a metal bar under the cow’s leg and attached her up to a tractor to help put traction on the leg and pull it back into place —its hard to describe the procedure (but its so cool and I love it)! The sun went down as we worked and I drove back in the dark —they told me to watch out for wombats on the road…I imagine hitting a wombat is similar to hitting a boulder…

The next week we had another call for a cow with a luxated hip, I was excited because I felt like I had a better idea of what was going on and could be more involved in her treatment this time around. She ended up being a weird case–firstly, she was still walking around when we arrived on farm. We gave her enough sedation to drop a huge bull but she still wouldn’t lay down!  Then when we finally had her on the ground her knee felt swollen and we heard a loud pop when gently moving her leg. She may have had a partially luxated hip and also a knee problem.

During the last week we went to see a down cow and diagnosed her with compartment syndrome. We put hip clamps on her and used the tractor to pick her up and then completed a further exam. We tested reflexes, muscle tone, superficial, and deep pain. We diagnosed her with a radial nerve paralysis. The vet I was with then did some physiotherapy–>electrostimulation to assist her muscles in the healing process. While driving around with this vet I had some great discussions about acupuncture as a treatment for different conditions in animals.

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The machine we used for electrostimulation on the down cow

I enjoy reproductive work in cattle and horses. Unfortunately, we only had one calving call during my placement.  This was fun for me because the vet got me to stick my hand in first & diagnose the problem…. I felt 3 front legs…. and diagnosed her with twins! The vet untwisted and pulled the first one out and then left me to get the second twin out myself (which was pretty easy after she wasn’t entangled up with her sibling anymore)!  We treated quite a few cows with retained fetal membranes, did some metri-checks, and saw one cow with a mummified fetus.  Every day there was appointments booked for preg-checking. I actually quite enjoy this currently because preg-checking is something that is still quite difficult but I can see improvement in myself each time I practice. I received some great feedback from the vets on this placement about my preg-checking skills so that was encouraging!

Naturally, the call for a uterine prolapse came just after 5pm on a Friday evening. I’m sure I was much more excited about this than the vet (who probably just wanted to go home after a long week).  The cow was up and walking around when we arrived, she went down again about half way through replacing her uterus. The vet, me, and the other student had quite the time spinning her around out of the squeeze so the vet could continue…and then of course she wanted to stand up again after that!  We worked by the light of the quad and our phones until she was all put back together.  We went back to the same farm a week later to do some other work, I asked the herd manager how the cow was doing–fantastic!!

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The sun went down on us quite a few times. But I don’t mind–everyone needs more sunsets in their lives.

I also really like wounds and trauma cases. We were called to see a heifer with a torn vulva after dystocia (difficult calving) that the vet spent a while suturing back together so she could hopefully have another calf.

We did a couple of abdominal surgeries in dairy cattle during my placement. Left displaced abomasums are a relatively common problem in dairy cattle. This is a condition that is usually seen not too long after a cow has a calf, starts producing milk, and eating a really high energy diet—> part of her stomach (the abomasum) is displaced to the incorrect location in her abdomen and fills up with gas. This makes the cow feel sick and she begins to produce a lot less milk. To fix this condition you have to cut into the abdomen of the cow and deflate the abomasum before pulling it back into the correct position. It was very interesting to put my arm inside of the cow and feel the abnormal abomasum while it was full of air, and then to feel it again after we had removed the air and pulled it into a normal location. I’m concerned that I’ll get called to see a really large dairy cow with this problem and I wont be able to reach her abomasum because my arms are too short!!! One of the other surgeries we completed was an exploratory laparotomy— one of the vets had felt a large mass inside the cow’s abdomen during a rectal exam. Once we cut into her abdomen we discovered that she likely had a large abscess on her kidney!

I got to participate in an awesome new herd health management technique that Tarwin is performing—teat sealing heifers. A teat sealant is a substance put into the teats of dairy cows after they are finished milking to prevent them from getting mastitis.  The procedure is now being offered for heifers (cows who haven’t had a lactation yet) in herds who have a high percentage of mastitis in that group. I had no idea what I was in for when the vets and nurses were explaining the process to me but we donned our aprons and boots and hats and even duct taped our gloves on. They unloaded a specially made trailer and set up a whole table with ‘dirty hand wash’, ‘clean hand wash’, paper towel, and teat sealant. The farmer ran the heifers on to the trailer and then we loaded 6 or 7 of them on, cleaned the teats, put in the sealant, marked them with paint and then released them into the field. I loved how seamless the process was and would be interested in seeing results in regards to how much the mastitis rate decreased on farm.

Another day we went out and did some sedated calf de-hornings. I feel as though more and more people are moving towards this more welfare friendly option. We injected sedative into all the calves and waited until they fell asleep and then did cornual nerve blocks.  After they took effect we burnt off the horn buds,  gave each calf an anti-inflammatory/pain medication drug, and checked for supernumerary teats and removed those. This was really fun because I got to do some of the nerve blocks and removed the supernumerary teats! Also, seeing 40 sleeping calves all snoring at the same time is adorable.

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For the first week of the placement I would come back and study for my board exam (NAVLE) every night. I took one day off to write the exam in the city.  

I also really enjoy post mortem examinations–especially after my feedlot placement at the beginning of the year.  As the vet and I drove to the call we discussed reasons for sudden death of a calf a few months old. Our top differential was black leg (failure or absence of Clostridial vaccination). The calf actually died due to a failed/bad castration. We found a huge amount of hemorrhage in the lower abdomen and legs and an infection tracking up from the prepuce.

Pink eye is a common condition in cattle, especially in areas with a lot of flies because they can transmit the disease. In severe cases a 3rd eyelid flap can be performed to protect the eye and help it heal. After watching the vet do a couple of them I started helping out as well. We also injected antibiotics into the eyelids.

There was also a horse vet working at Tarwin. I spent some time shadowing him as well.  The first call we went out to was a very loved horse that had been fed bread and had choke (an obstructed esophagus). This seems like it would be a really emergent situation but its actually not that bad and horses can remain like this for a couple days while we treat them. You just have to nasogastric tube them and flush the obstruction a lot of times until it starts to break down and either goes forward into the stomach or backwards through the tube. We also went and did a gelding (male horse castration surgery) in the hot sun! No more of that pouring rain—I actually really lucked out with the weather for the rest of the week. The farmers probably wouldn’t agree, but I liked the sun.  We drove out to to a pre-purchase exam on an older horse. This was something we practiced on my equine external rotation.  We also had to put a foot cast on a couple different horses because of wounds they had.

I had an amazing time on this placement! With all the hands on practice, tutorials on abscesses, down cows, nursing strategies, calving management, and chats in the car–I learned so much! Staying at my friend’s parents’ house was also lovely; they had warm home cooked food for me each night and made me feel so at home.

Thank you to the Payettes and Tarwin Vet Group!

 

The Mane Event

The MANE event! Get it? ha! (It’s probably too late at night to be writing for the public eye…)

After a week “off” for research my group headed back to the equine hospital for our External Equine Rotation. This rotation was meant to be like a ‘general practice horse vet’ but we actually only spent one day driving around to farms to look at horses.

On the first day of the week we used a teaching horse from the university herd and did a practice ‘Pre-Purchase Exam’ on her. This is a special type of physical exam that veterinarians can do on an animal (typically horses or breeding animals) if someone is interested in buying it. There can be a lot of legal implications surrounding these exams– disclosure of medical information, high value of animals, suspected performance status. As a veterinarian you need to know the full extent of your role in this situation. During our exam of the teaching horse we detected some lameness so we took some radiographs of her leg. I have taken many x-rays on cats and dogs but never on horses. It is very difficult to know exactly how to position the horse for x-rays and where to position the machine in order to get the best pictures. This is something I will likely need a lot more practice with if I end up seeing some horses in practice.

Horses have this weird anatomical structure called ‘guttural pouches’ inside their heads. They are a common site of infection in horses so it is important to examine them.   I got a chance to practice driving the scope again. I really like this—its the only “video game” I enjoy.

On Wednesday, my wish came true! The main event! I finally got to see a colic surgery, and not just one, but two!! The horses went into surgery right after each other. I was able to stay on the “dirty side” of the surgery (I didn’t scrub in and work on the “sterile side”) and help out with an impaction colic.  This involves getting rid of all the excessive food material in the horse’s gut that is unable to move through. This was so cool! The second colic surgery was a different kind of colic—this horse had a twist in his intestines.  Can you imagine how painful it would be if your intestines twisted up on themselves? I am so glad that I finally got to see colic surgeries before I finished my equine rotations and be involved in helping these animals recover!

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This is just before the surgeons will open the gut to remove the impacted feed material

We worked with another teaching horse from the university herd and practiced placing bandages on his limbs. I much prefer practicing on live animals instead of models or cadaver legs–it is a much more real experience and there is a lot of factors that you learn to deal with i.e: windy day, muddy feet, how to pick up a foot on a horse that doesn’t like his feet being picked up, etc.

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I know this isn’t a limb, but can we all just take a moment to appreciate how great this vet wrap is?!

We also practiced nasogastric tubing (NGT)  horses. This is a really common procedure veterinarians can do to provide a horse with fluids, medications, or decompress a stomach during colic!  It is important to make sure that you put the tube in the stomach of the horse and not the lungs! Quite often we pour fluids down the NGT and we really don’t want to be pouring fluid into the horses lungs.  The way a horse’s larynx & pharynx is placed inside it’s head means that by flexing a horse’s neck downwards while we insert the tube (through the nose) the horse will swallow the tube into the esophagus (where we want it to go!).  You can smell stomach smells from the tube (surprisingly not as bad as you would think…) and hear the stomach bubbling away (a fancy medical version of the game ‘telephone’).

Everyone looks forward to the ambulatory day of this rotation. We drove out to meet one of our wackiest professors for a day of horse vetting in the field! It was a very relaxed day, seeing and chatting about a variety of patients. None of the patients were very sick and it was a pleasant day. We preformed a Caslick procedure, a mini-neurological exam on a mini horse, did some more guttural pouch scoping, and had a lot more fun! Our lunch on this day was legendary! An extremely lovely family made us a feast and I experienced the best date scones I’ve ever eaten…

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Me and two of my group mates with our horse vet professor! There was a huge sunflower field just outside one of our appointments.

On the last day of the week we gave a presentation that we had prepared and spoke about our ambulatory cases. Our last practical class this week was on a life-size model horse. We practiced rectal palpation–it is SO important to know the anatomy of a horse (or cow) so that you know what you are feeling (because you can’t see what you are feeling). You can make a lot of diagnoses this way, so the practice was appreciated!

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My group isn’t going to leave any rotation without some great baking!

 

Thanks again to the equine team for a wonderful week! We had a blast 🙂

Dookie Trip

A little while ago my whole DVM1 class packed up and went out to the University of Melbourne’s Dookie campus as part of our Animal Health and Production Systems class. I was excited, because who doesn’t like a couple days without lectures?

In the morning we caught the bus from our regular campus bright and early and began a drive out into the Australian country side. As we move from spring into summer, the rainfall has decreased and the pastures are not growing as fast and are beginning to dry up and turn yellow. Our first stop was at Chatswood, a thoroughbred horse stud.  A stud farm is a farm that focuses on breeding of animals.

The horse racing industry is huge in AUS, especially in Melbourne. High class and very famous races like the Melbourne Cup take place only a few minutes from my house! Unfortunately the Melbourne Cup is on one of the same days as my final exams this year so it doesn’t look like I’ll be going.

The farm was built on 1000 acres and is very impressive looking. We talked a bit about the process behind bringing mares to be served by 1 of the 3 stallions on the property and everything that process included. Thoroughbreds are only allowed to have natural breedings  (instead of artificial insemination) and this brings along a new set of challenges and things to look out for. My group was lucky because we got to watch some vet checks on the horses, each horse would come in for an ultrasound to look for follicles on her ovaries. If the follicles are a certain size the vet will say she is ready for breeding soon. The ultrasound is also used to detect if the horses are pregnant and if they have twins. It is very hard for twins to be carried to term in horses and so if 2 embryos are detected one of them will need to be terminated. We also got to watch a Caslick procedure being preformed and undone (this is a very common and minor surgical procedure that equine vets will do).

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Reward for Effort; Taken from: http://chatswoodstud.com.au/stallions/reward/

Our group then went to the breeding area; it is very nice, clean, quiet, and covered. Here we watched a teaser stallion come in and prep a mare for her breeding. I then quietly peaked through a hole in the gate to watch Reward for Effort (one of Chatswood’s best stallions) breed the mare. Thoroughbred breeding on a stud is very expensive ($11 000 for a service) and an important procedure that can be very dangerous for the handlers.

The foaling area has a 24 hour watch over all of the paddocks as each foaling is assisted. After each foal is born a blood sample is taken and assessed.

Next we went to Kennedy Creek, which was our professor’s own polled Dorset farm. I found it actually really cool to create a connection between someone we are learning A LOT from in lecture and his actual life experience in agriculture. Dorset sheep are used for meat but not wool. This does not mean that they do not need to be sheared! The wool from these sheep would only generate an income of 5% or less for the farm.

Polled Dorset Sheep: Picture provided with permission

Polled Dorset Sheep:
Picture provided with permission

While on farm our prof (who is also a vet) identified a sick sheep. The animal was moved out of the hot sun to recover. The sheep was likely sick with either thiamine deficiency or pulpy kidney (no way to know unless diagnostic tests were done). While we were on farm the sheep began to improve and look better. Talking about this individual sick sheep was a great learning opportunity on the differences between single animals and herd health.

The second day started at the sheep farm on Dookie Campus where we were able to assist with the marking of lambs. Marking included putting elastic on the tails of all sheep (tail docking) and testicles of male sheep (castration), vaccination (for Clostridial diseases), applying fly strike spray, and applying an ear tag for identification.

This is a 'cradle' it is a piece of equipment that helps the farming with marking

This is a ‘cradle’ it is a piece of equipment that helps the farming with marking

After we were finished marking the lambs we went inside the shed to look at the rams. We discussed important things to assess at a ram sale (teeth, toes, temperament, testicles, and skin). We also spoke about crutching and muesling and the advantages and disadvantages of each husbandry practice. I thought it was interesting that Dookie is one of the only farms in VIC that does not muels their sheep; the practice was supposed to be banned in AUS around 2 years ago but fell through because of the fly strike problems. We practiced catching sheep and how to safely tip them over so we can look at them (always fun!).

Our last stop was to the dairy calves and then the Dookie Campus robotic dairy! Here is some coverage from when the dairy opened:

This is the same dairy we visited during my first week of vet school. Cows can be milked whenever they please, the robot will take a sample from each cow to test for infection and milk quality. The robot is able to keep track of all cows treated with medications and what the withdrawal periods. Detecting when cows are ready to breed is very complicated in the dairy industry—the robots can help with this too!! The robots will keep track of all the steps each cow takes (each cow wears a pedometer) and the amount of rumination/chewing to create a graph that will give a good indication of when the cow is in heat (ready to breed)!! How cool is it to see science and farming come together like this?!

I really enjoyed getting out of the city for a couple of days and seeing these high quality and top class farms was very interesting! 🙂