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large animal surgeries
Terms in this set (57)
Routine/ minor surgeries
Mass/ tumor removal
Attitude (distance exam)
Mucous Membranes, CRT
Manure output and consistency
Proper restraint is important.
Observe from a distance and estimate weight
Head to Tail - don't forget hooves
Nasogastric Tube placement
Causes include rectal exams, breeding injury, foaling trauma or spontaneous
Prevalence: young, nervous horses
Most common malpractice claim!
grade 1 rectal lac.
mucosa or sub-mucosa
grade 2 rectal lac.
muscular layer ruptured, others intact
grade 3 rectal lac.
mucosa/ sub-mucosa and muscular layer
grade 4 rectal lac.
rectal lac. dx
Fresh blood on sleeve
Sudden loss of rectal tone
Sweating, pain, discomfort post rectal exam
Abdominocentesis (belly tap)
rectal lac. prevention
Do not palpate against taught rectal wall
Treatment for rectal tears
All get abx
Grade 3 & 4 require suturing - usually referral
Prognosis is best for Grade 1, grave for Grade 4
IV Catheter Placement
Repeated IV injections
Clip and Scrub
Preparation of sheath
Place stethoscope in the paralumbar fossa to listen.
Listen dorsal and ventrally for borborygmi on both sides.
Cecum is on the right side. Can "ping" this area to check for tympany.
Catheter placement procedure
Clip 4x4in area over jugular groove in the middle proximal 1/3 of the neck.
Perform aseptic scrub
May or may not perform "cut down"
Hold catheter at about 45 degree angle, firmly and rapidly puncture skin/SQ.
Should see blood in hub. "Seat the catheter"
Advance the catheter, remove stylet, attach cap.
Make a "tape butterfly". Suture butterfly to skin.
Over the needle in adults
Through the needle or Over the wire in neonates
Often sutured to the skin
using heavy sedation
Alpha-2 Adrenergic Agonists
tech role in anesthesia
Correct patient, clients paper work (consent), PE, history.
Rinse mouth with water and oral syringe
Have any surgical items ready (Catheter, sx pack, blood tubes etc)
Inhaled: Isoflurane/ Halothane
IV: Triple Drip :Guaifenasin, Xylazine, Ketamine
IV: Repeat doses of Ketamine
tech role in general anesthesia
Everything as for standing sedation but also need;Padding for when horse is down, towel to cover eyes, anesthetic machine or fluid bags if using TIVA
Monitoring under anesthesia
HR: 35-50 bpm
Pulse : submandibular, facial, digital + other locations
RR: 6-12 brpm
MM: pink, CRT < 2 sec
Depth: palpebral reflex, nystagmus
Temp: 98-101 F
one part of the intestine telescopes into another
Pedunculated lipomas wrap around intestine.
**STRANGULATION COLICS ARE ALWAYS SURGICAL!
Most common elective surgery in horses
Best done early in the spring, or late fall
Age of horse: Usually < 1yr
Prevent undesirable traits
Removal of disease
equine castration Equipment
Clean bucket with water
Hemostats (may have sterile sx pack or cold sterile pack +/ - drapes)
induction for equine castration
Horses can be castrated with local anesthesia or following induction of a short acting general anesthesia
Choice of which can depend on surgeon's preference, horse temperament, testicular pathology, and owner preference
equine castration procedure
Typically left lateral recumbency
Tie the "up" hind leg with quick release knot so that it is extended cranially.
Incise scrotal skin
Free testicle and cord
Emasculators on tunic and cord together as close to the inguinal ring as possible
Leave emasculators on for 2-5 minutes
Open vs. Closed
After Sx, return patient to clean stall.
Monitor for hemorrhage.
Client Instructions for equine castration
Hand walk 15 min. 4 x day for several days
Work up to light trot x 5 days
Observe for swelling, anorexia, hind leg edema, difficulty urinating.
Separate from mare for 60 days.
As a generalization, if he tolerates scrotal and testicular palpation with no restraint and no resentment, he is likely a good candidate for a standing castration using a
- local anesthetic
Pros & cons of standing castration
Faster; requires less help; less risk to patient
Dangerous to surgeon
More difficult to visualize
Sterile Surgical Castration
Must be used for cryptorchids ("rigs")- if abdomen needs to be opened- needs to go to hospital.
Also for older horses, horses with health issues
Sterile environment, longer procedure
Sterile Surgical Castration can be done
Equine Castration complications
-Painful to patient
-Injury to handler or surgeon
Swelling and edema
Unaltered behavior "Proud Cut"
Best performed at young age
Usually without analgesia in young calves
open LS castration
scrotum incised (open), testicles pulled until cords break in young calves
Open in older calves-scrotum incised, use of emasculator that cuts and crushes
Emasculatome crushes cord without cutting skin
Elastrator band can also be used (2-3 weeks for scrotum and testicles to slough , watch for infections, esp Clostridia)
closed LS castration
Use of Reimers emasculator
Calf Castration - what to prepare
Scalpel blade and handle
Water bucket with disinfectant
Large Animal C-Sections indicaitons
Failure of cervical dilation
Prepubic tendon rupture
Large Animal C-Sections considerations
Condition of the dam
Condition of the fetus
Condition of the uterus
Position of the fetus
Value of the dam
Value of the fetus
Experience of the DVM
Evaluate the reproductive tract
External evaluation: ballotment
Large Animal C-Section ventral midline
Use if animal cannot stand for procedure
Pull against gravity
Avoid mammary veins
Large Animal C-Section Ventrolateral
Uncomfortable for surgeon
Animal in lateral
Large Animal C-Section flank
Paralumbar fossa approach
Can be done standing or in lateral recumbency
Eversion of the entire uterine body and horns through the vulva.
Usually occurs at parturition
Usually 1st calf heifers
Not likely to recur
Predisposing factors- hypocalcemia, recumbency, dystocia
Considered an emergency -exposure of mucosa leads to shock, hemorrhage, or bladder and intestinal compromise.
Uterine ProlapseWhat to prepare
Water bucket with dilute chlorhexidine.
Supplies for caudal epidural
-18g x 1.5in needle
-12 mL syringe
Lots of LUBE
Any medications the DVM wants
Uterine Prolapse - reduction procedure
Restraint will vary
IV catheter (+/-)
-Sometimes sugar water in ruminants
Ligate any bleeders
Lift uterus and gently begin working back into vaginal vault.
Once reduced, place a vulvar purse string suture
Remove purse string in 5-10 days
Uterine Prolapse- mare
Decreases chance of mare carrying another foal to term
Next pregnancy is high risk
Used to diagnose or treat abdominal disease
Left flank commonly used for rumenotomy, correction of left displaced abomasum, C-section
Right flank used for abdominal exploration, left or right displaced abomasum, volvulus, or intestinal obstruction
Paramedian or ventral midline for C-section, abomasal ulcers, abomasal displacements
Laparatomy what to prepare
Clippers with #40 blade
Surgical scrub and solution
Bucket of water
Lidocaine 2% (2 bottels)
Syringes (12-60 mL) and needles
Surgical drape and towels
Suture (sizes 0-3 or whatever DVM wants)
Sterile gloves , gown etc
Technician's role for lapatomy
Clip and prep surgical site
May be asked to perform nerve block
Lay out surgical pack, gloves, gown, other materials
Verify flank anesthesia by poking with needle
May be asked to help with "restraint" (tail jack)
Be prepared with your own sterile gloves
The abomasum is the true stomach of the ruminant, normally found in the right ventral abdomen.
Left displacement (LDA)
- Right displacement (RDA)
- Abomasal torsion
*80% occur within 1 month of calving (1 month "fresh") (high producing dairy cows).
more common than RDA (8:1)
LDA more common than torsion (25:1)
Physical dilatation→ atony → displacement
Clinical signs of Displaced Abomasum
Anorexia (may refuse grain but continue to eat hay).
Decreased milk production
Ping on auscultation/percussion
TPR usually normal
Etiology of Displaced Abomasum
1. Abomasal atony
2. High gas production from high concentrate diet
3. Electrolyte imbalance
5. Often occurs as sequel to another problem (mastitis, metritis, lack of exercise)
Clinical signs of abomasal torsion
Indistinguishable early from RDA
Signs of DA worsening
On rectal exam a torsion can be felt, but a DA can't.
Usually have an increased HR.
Can lead to shock and toxemia
Treatment of DA or torsion
Surgery: preferred method is Right sided abomasal or omentopexy (means it is sutured in place) for all three problems.
Usually very successful for RDA or LDA, but torsion depends on vascular and neurological compromise.
THIS SET IS OFTEN IN FOLDERS WITH...
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VET 268 asepsis
VET 268 surgical forms
VET 268 The preoperative patient
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