Bovine GI Surgery 1 and 2

Question 1

What are the two broad methods of treatment of a left displaced abomasum?

Answer 1

Conservative management
Surgical management

Question 2

List 6 considerations of an LDA

Answer 2

Return and stabilise abomasum in normal anatomical position
Manage of concurrent abdominal pathology
Minimising additional risk
Practicality
Economic cost-benefit
Surgeon experience

Question 3

What is the success rate for the conservative treatment of an LDA?

Answer 3

40%

Question 4

List four open technqiues for the surgical correction of an LDA.

Answer 4

Right sided paralumbar fossa
Double sided paralumbar fossa
Left sided paralumbar fossa
Right paramedium

Question 5

List three closed techniques for the surgical correction of an LDA.

Answer 5

Toggle-pin
Blind fixation
Laparoscopy

Question 6

What are four disadvantages of a right paralumbar laparotomy?

Answer 6

Time
Cost
Requires a long arm reach
Difficult if abomasal adhesions to the left body wall.

Question 7

What is a left paralumbar laparotomy also called?

Answer 7

Utrecht method

Question 8

Where would you place stay sutures during a left paralumbar laparotomy for an LDA?

Answer 8

Dorso-cranial aspect of the abomasal fundus

Question 9

Where is the incision for a right paramedian laparotomy and abomasopexy?

Answer 9

Paramedian incision.
Hand’s breath to the right of the midline
Hand’s breadth caudal to the xyphisternum

Question 10

What position does the cow have to be in for a toggle pin surgical correction of an LDA?

Answer 10

Right lateral recumbency and rolled onto its back.

Question 11

When should the toggle pin be removed after LDA correction surgery?

Answer 11

7-10 days

Question 12

List four disadvantages of a toggle-pin suture.

Answer 12

Blind
Can’t visualise abdomen viscera
Potential risk of trauma to personal and cow
Requires rolling

Question 13

List 6 parts of the aftercare for all abomasal surgery.

Answer 13

NSAIDs
Antibiotics
Oral fluid therapy
Treatment of concurrent medical conditions
Calcium
Dietary management

Question 14

List 6 parts of the aftercare for all abomasal surgery.

Answer 14

NSAIDs
Antibiotics
Oral fluid therapy
Treatment of concurrent medical conditions
Calcium
Dietary management

Question 15

LIst 6 complications or abomasal surgery

Answer 15

Abomasitis and abomasal ulceration
Motility disorders
Infection
Pexy failure +/- re-displacement
Adhesions and intestinal incarceration

Question 16

What is the prognosis for open and closed abomasal surgery?

Answer 16

Open: 80-99%
Closed: 77-90%

Question 17

When is surgical treatment indicated for a right displaced abomasum?

Answer 17

Signs of hypovolaemic/endotoxic shock
Severe or increasing abdominal pain unresponsive to analgesics
No response to conservative management in 2-4 hours

Question 18

List five indications for rumenotomy

Answer 18

Traumatic reticulo pericarditis
Ruminal Foreign Body
Ruminal tympany
Grain overload and acidosis
Poisoning

Question 19

List four aspects of the conservative management of traumatic reticulo-pericarditis.

Answer 19

Broad-spectrum antibiotics
NSAIDs
Oral fluid therapy
Magnets

Question 20

How should you close the rumen after a rumenotomy?

Answer 20

Two layers
Continuous inverting suture pattern
~2 synthetic absorbable suture material

Question 21

List four differential diagnoses of umbilical masses in cattle.

Answer 21

Umbilical hernia
Omphalitis (navel ill)
Umbilical Abcess
Umbilical Remnant Infection

Question 22

What are the usual contents of an umbilical hernia in cattle? (list in order of occurence)

Answer 22

Greater omentum
Abomasal fundus
Intestinal loops

Question 23

What is the aetiology of an umbilical abscess?

Answer 23

Secondary to navel ill.
Walled-off infection persists within the umbilical stump.

Question 24

What are the clinical signs of umbilical abscesses?

Answer 24

Typically firm, hot and painful.
+/- draining sinus tracts and purulent umbilical discharge
+/- pyrexia or systemic signs

Question 25

What is the aetiology of umbilical remnant disorders?

Answer 25

Failure of elastic recoil/post-partum closure of elements of the umbilical cords
Concurrent umbilical hernia
Concurrent infection

Question 26

What are the three treatment options of umbilical masses?

Answer 26

Conservative
Drainage
Umbilical herniorrhaphy
En-block resection

Question 27

Describe the approach to establishing treatment for umbilical masses.

Answer 27

Restrain the calf standing or in lateral recumbency
Surgically prepare the incision site.
Make a bold incision at the most dependant point of the mass
Express all the purulent material and flush with dilute iodine solution.

Question 28

What are the indications of an umbilical herniorraphy?

Answer 28

Umbilical hernias greater than 3-5cm
Complicated umbilical hernias

Question 29

What is the best time for an umbilical herniorrhaphy repair?

Answer 29

Around 3-4 months of age

Question 30

What is the approach to an umbilical herniorrhaphy?

Answer 30

Dorsal recumbency
Elliptical incision
+/- preputial reflection

Question 31

Which tension relieving sutures can you use in an umbilical herniorrhaphy?

Answer 31

Mayo overlapping suture
Horizontal mattress suture

Question 32

Where are meshes contrainidcated in an umbilical herniorrhaphy?

Answer 32

On farm due to compormised asepsis
Complicated hernias with concurrent infection.

Question 33

How long should antibiotics be given after en bloc resection of umbilical masses?

Answer 33

5-7 days