Caesarean section in cows: indications, contraindications, surgical restraint, preparation of abdominal wall

Question 1

Special indications for CS

Answer 1

• Dystocia (main reasons):
    o Immature heifers and cows with large (relatively oversized) fetuses 
    o Uterine torsion
    o Pelvic injuries
    o Fetal monsters and fetal anomalies hydrallantois or hydramnios)
    o Malpresentations
    o Severely prolapsed vaginas
    o Breed (belgian blue)
• To perform research (elective cs)

Breed (belgian blue) -> Beef cattle

Pbm : big big muscles around the pelvic cavity -> Not possible

Collab farmers and vet -> 10 sections per day

Question 2

Special contraindications for CS

Answer 2

Bacterial infection:
• Emphysematous fetuses -> when opening abd. cavity -> Toxicosis -> Death
• Uterus rupture (too late)?
Swollen -> Bad position on uterus wall

Question 3

Decision on CS can be (very) difficult!

Answer 3

Factors must be considered:
• Viability and probability of a viable uninjured calf
• Degree of contamination
• Time required
• Value of the calf and value of the dam (slaughtering value)
• Facilities and assistance
• Experience of the surgeon
• Overall prognosis
• Surgical risks, aftercare, fees
• Uterine rupture? (too late)

Question 4

General steps of CS and rumenotomy

Answer 4

• Surgical restraint
• Presurgical procedure
• Anaesthesia
• Incision site and technique
• Abdominal cavity manipulation
• Abdominal wall suturing
• Postoperative Care

Question 5

Surgical restraint for cesarean section and rumenotomy

Answer 5

1-Standing restraint (preferred)
• Cow SHOULD/MUST REMAIN STANDING for both CS and RUMENOTOMY!
• IF the dam CAN NOT STAND DO NOT FORCE this restraint!
o Heifers are more likely to lie down
→Higher probability of recumbency than cows

2-Dorsal and left lateral recumbency restraint
If the dam CAN NOT STAND THEN USE these restraints for both CS and RUMENOTOMY !

Question 6

Surgical restraint for cesarean section and rumenotomy

1-Standing restraint (preferred)

Advantages

Answer 6

• Less assistance
• Minimal tension on the suture line -> Decrease risks of rupture
• Good for adult dairy cows → udder

Question 7

Surgical restraint for cesarean section and rumenotomy

1-Standing restraint (preferred)

Disadvantages

Answer 7

• Contamination of the peritoneal cavity

* Physical strength

Question 8

Surgical restraint for cesarean section and rumenotomy

1-Standing restraint (preferred)

Approach

Answer 8

Left paralumbar fossa approach (left flank): for both CS and RUMENOTOMY
● Right uterine horn pregnancy
● Rumen inhibits evisceration of intestine
● Access of caudo-dorsal sac of rumen
Right paralumbar fossa approach (right flank): only for CS
● Excellent for left uterine horn pregnancy:
Spine of the calf toward the left side of the cow and feet of the cow toward the right side of the cow
➔ Position identified by rectal palpation (before rumenoctomy ) to know the situation of the calf, not common

Question 9

Surgical restraint for cesarean section and rumenotomy

2-Dorsal and left lateral recumbency restraint

Advantages

Answer 9

• excellent exposure of uterus and fetus

* to minimize peritoneal contamination

Question 10

Surgical restraint for cesarean section and rumenotomy

2-Dorsal and left lateral recumbency restraint

Disadvantages

Answer 10

• requires assistance
• ruminal bloat and/or regurgitation
• prolapse of the abdominal organs
• postoperative complications
    Dorsal and left lateral recumbency restraint

Question 11

Presurgical procedure

Answer 11

For both cesarean section and rumenotomy Check the instrument tray for :
• Sterile instruments and a scalpel blade
• Obstetric chains and handles (sterilized) (in a case of CS)
• Isolation large enough to cover the entire surgical area
• Sterile gloves
• professional Suture material
• Sterile saline

Question 12

Preparation of the skin

Answer 12

• Clip and prepare, wash and disinfected the skin for aseptic surgery
• From the dorsal midline to the level of the flank and
• palpate from the 12th rib to the tuber coxae