71. Caesarean section in small ruminants

Question 1

Incidence and cause of Cs?

Answer 1

Incidence:

• Seldom
• Routinely performed and with excellent success rates in general veterinary practice

Cause:

• Sire selection is still based upon phenotype → large foetus → dystocia
• Immature primiparous animal with a singleton foetus in posterior presentation
• Incomplete cervical dilation
• Vaginal prolapse

Question 2

Anaesthetia of Cs?

Answer 2

Left flank anaesthesia

• Local infiltration (2% lidocaine)?
• Distal paravertebral nerve block
• Sacrococcygeal: xylazine 0.07 mg/kg

o Analgesia of the flank approximately 30 minutes after injection

• Lumbosacral: 2% lidocaine inj. 3–4 mg/kg

o excellent analgesia

o Traumatized reproductive tract, a foetal monster

o hindlimb paresis after lidocaine inj. for up to 3 hours

o lambs unable to suck colostrum → gastric tube

Question 3

Caesarian section procedure?

Answer 3

Flank incision between the last rib and the wing of the ilium

• 10–15 cm below the level of the transverse processes of the lumbar vertebrae
• Incision with scalpel: skin, external abdominal oblique muscle, internal abdominal oblique muscle.
• Transversus muscle with peritoneum are grasped with forceps → avoid puncturing an underlying

viscus

• Small incision is made and subsequently extended
• Exteriorizing the gravid uterine horn
• Be careful→ thin wall!
• The incision is made using scissors
• From the tip of the uterine horn and extending towards the cervix

Question 4

Suturing the uterus?

Answer 4

Suturing the uterus:

• USP 1 synthetic absorbable suture material
• Inverting sero-muscular suture pattern(Cushing, Lembert or Utrecht)
• One efficient row of sutures is adequate if uterine involution is rapid
• A double row of sutures is preferred
• The objective is to seal the uterine incision completely

Question 5

Suturing the 3 layers?

Answer 5

Three-layers:

Layer 1:

• Peritoneum and transverse abdominal muscles
• Simple continuous pattern
• Monofilament absorbable No. 1

Layer 2:

• Internal and external oblique abdominal muscle and subcutaneous tissue
• Bite into the internal oblique muscle to close dead space
• Simple continuous pattern
• Monofilament absorbable No. 1

Layer 3:

• Skin
• Continuous interlocking or interrupted suture pattern
• Synthetic nonabsorbable suture material No. 1

Question 6

Postoperative Care of Caesarian section?

Answer 6

AB im for 3 consecutive days

• NSAID
• Toxaemic sheep → supportive therapy → 3 l of isotonic saline at a

dose rate of 50 ml/kg/h

o How to know?? Autolysed foetus