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2025 - Intro to Surgery 737A > Exam 2: Lecture 17: Pre-operative Assessment and Preperation - LA > Flashcards

Exam 2: Lecture 17: Pre-operative Assessment and Preperation - LA Flashcards

1
Q

Before taking a LA into surgery, who should we communicate to

A

referring vet, owner/trainer/agent, and insurance company

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2
Q

before taking a LA into surgery, what should we do for animal prep

A

Get this history, confirm the need for sx, PE, any additional diagnostics, and prep for anesthesia

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3
Q

What is the role of referring DVM in communication

A

a liaison, complete referral history, post-op management, and case followup

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4
Q

what should we tell the owner/trainer/agent

A

risks of sx, risk of anesthesia, intra-operative communication, outcomes, progress of post-op, finances, and insurance

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5
Q

why should we talk to the insurance company before surgery

A

not all horses are insured so make sure to ask

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6
Q

why should we talk to insurance before euthansia

A

because sometimes euthanasia can forfeit the insurance policy and they want you to do everything you can to save the animal

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7
Q

what factors increase risk for LA anesthesia

A
  1. more time = more risk
  2. larger horses have more complications
  3. Age
  4. a high ASA score
  5. hypotension
  6. quality of induction
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8
Q

before we anesthetize any animal, what should we always have the owner do

A

sign a consent form!!

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9
Q

what are the surgical outcomes we should talk about to the owner

A
  1. communicate all possible negative outcomes to client before sx
  2. talk to the owner about the intended use for the horse and what the problem/sx is
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10
Q

what are some post-op expectations we should mention

A

is there a proper set up at home?

medications, bandage changes, stall rest, complications

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11
Q

when talking to owner about finances for LA sx, what is important to remember to do

A

give an accurate estimate and update regularly (esp if there are any changes in procedure/condition)

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12
Q

what are some things we talk about with intra-operative communication

A

if there is severe disease, if there are complications during sx, or if we need to euthanize during sx

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13
Q

What are inherent risk factors

A

signalment and medical history

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14
Q

what are some variable risk factors

A

primary disease (physical and cardiovascular status), elective vs emergent, and extent of procedure

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15
Q

what is important to get in the history for pre-op information

A

past medical treatments (including any surgeries and anesthesia), nutritional status, vaccination status, and owners perception of the problem

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16
Q

what specific inherent factors increase risk

A

foals (<1 yr), geriatric (>20 yr), cardiopulmonary status, increased size of patient

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17
Q

what are the specific variable factors that can increase risk

A

morbidity/mortality status, body system involved, severity of injury, and progression of disease

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18
Q

what surgeries have the greatest variable risk factor

A

colic and fractures!

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19
Q

T/F: Emergency surgery does not increase morbidity/mortality possibility

A

false, emergency surgery does increase both of these

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20
Q

what are the categories of ASA risk classification

A

I, II, III, IV, and V

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21
Q

what is the physical status and clinical example of a category I ASA

A

physical - normal healthy patient

clin - routine castration, routine arthroscopy

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22
Q

what is the physical status and clinical example of a category II ASA

A

physical - patient with mild system disease

clin - pregnant, obese, skin tumor removal

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23
Q

what is the physical status and clinical example of a category III ASA

A

physical - patient with severe systemic disease

clin - dehydration, anemia, fever, hypovolemia

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24
Q

what is the physical status and clinical example of a category IV ASA

A

physical - patient with severe systemic disease that is a constant treat to life

clin - sepsis, colitis, emaciation, severe dehydration

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25
Q

what is the physical status and clinical example of a category V ASA

A

physical - mortibund (point of death) patient not expected to survive sx

clin - colon torsion, severe trauma

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26
Q

what is included in the PE o pre-op

A

weight and drug calculations, careful auscultation of heart and lungs, demeanor of animal, lameness/neurological issues?, wounds near sx site

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27
Q

what should we always do for ortho sx

A

double check the leg !!! and confirm lesion previously described

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28
Q

what are the 4 classifications of surgical wounds/procedures

A
  1. clean
  2. clean-contaminated
  3. contaminated
  4. dirty
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29
Q

how should we treat dehydration pre-op

A

IV fluids

30
Q

how should we treat anemia pre-op

A

blood transfusion

31
Q

how should we treat hypoproteinemia pre-op

A

colloids

32
Q

how should we treat electrolyte imbalances pre-op

A

IV fluids +/- electrolytes

33
Q

under what conditions should we delay elective sx?

A

fever or systemic illness, abnormal bloodwork, wound near sx site, any cardio abnormalities

34
Q

if we notice something pre-op that we think should delay sx, what should we ALWAYS do

A

communicate that with the owner!

35
Q

when should you delay an emergency sx

A

if the patient is unstable but can be stabilized before surgery or if the patient is stable enough to delay for normal business hours

36
Q

how do we prep equines for general anesthesia

A

fast overnight, free choice of water, groom/pick feet, place jug cath

37
Q

how do we prep ruminants for general anesthesia

A

fast for 24-48 hours (decreased rumen volume to decrease regurg), withhold water for 24 hours, +/- catheter placement

38
Q

how do we prep camelids for general anesthesia

A

fast overnight, free choice water, place jug cath

39
Q

what is the most important question for surgery in the field

A

is performing the surgery in the field what is best for the patient? Does it compromise the care?

40
Q

what 5 things should we consider when doing surgery in the field

A
  1. proper facilities
  2. equipment needed
  3. personnel needed
  4. patient care
  5. weather
41
Q

what animal(s) is/are standing surgery common

A

cattle and TBD for equine depending on procedure

42
Q

why is standing cattle the best for sx

A

because it has the best abdominal approach

43
Q

what procedures can we do for equine standing

A

laparoscopy, enucleations, and mass removals

44
Q

what type of anesthesia do we use for standing sx

A

none vs bolus vs CRI

also can use local or regional nerve blocks

45
Q

what is a tilt table for cattle

A

it is a table that puts cattle on their side

46
Q

what are the advantages and disadvantages of a tilt table

A

advantages - good restraint for foot/distal limb procedures, sedation/anesthesia

disadvantages - expensive, need sedation or anesthesia, must be fast bc of bloat or neuropraxia

47
Q

explain the history we should get for equine colic surgery

A

detailed history from client and rDVM

48
Q

explain the history we should get for elective arthroscopy surgery

A

specific to ortho problem, previous rads

49
Q

explain the history we should get for bovine LDA

A

drop in milk production/feed intake, typically within weeks of parturition

50
Q

explain the PE we should do for equine colic sx

A

complete PE, GI focus

51
Q

explain the PE we should do for elective arthroscopy

A

complete, focus on specific problem, may do a lamness evaluation first

52
Q

explain the PE we should do for bovine LDA

A

complete, GI focus, PING

53
Q

explain any other diagnostics we should do for equine colic sx

A

complete colic work up: rectal, NG tube, ultrasound, bloodwork +/- abdominocentesis

54
Q

explain any other diagnostics we should do for bovine LDA

A

chemistry or blood gas with electrolytes and UA

55
Q

explain any other diagnostics we should do for elective arthroscopy

A

PCV/TP, review radiographs +/- new rads if needed

56
Q

explain any antibiotics (If any) we should use for equine colic sx

A

broad spectrum, injectable, penicillin/gentamicin most common

57
Q

explain any antibiotics (If any) we should use for elective arthroscopy

A

none, some people give one dose pre-op

58
Q

explain any antibiotics (If any) we should use for bovine LDA

A

generally none (milk withdrawl on abx)

59
Q

explain any pain management we should use for equine colic sx

A

flunixin meglumine - pre-op and several days post op

60
Q

explain any pain management we should use for elective arthroscopy

A

phenylbutazone or flunixin meglumine for several days

61
Q

explain any pain management we should use for bovine LDA

A

flunixin meglumine - day of sx and day after

62
Q

explain pre-op prep we should do for equine colic sx

A

emergency sx - performed immediately

63
Q

explain pre-op prep we should do for elective arthroscopy

A

admit the day before sx, withhold feed overnight, free choice of water

64
Q

explain pre-op prep we should do for bovine LDA

A

semi-emergency, no withholding feed

65
Q

what position should we put patient in for equine colic sx

A

dorsal recumbency, general anesthesia

66
Q

what position should we put patient in for elective arthroscopy

A

dorsal or lateral recumbency, general anesthesia

67
Q

what position should we put patient in for bovine LDA

A

standing procedure, right paralumbar fossa block

68
Q

what is the prognosis for equine colic sx

A

good to grave, lesion dependent (may not know until we are in sx)

69
Q

what is the prognosis for elective arthroscopy

A

excellent to guarded, lesion dependent (may change during sx)

70
Q

what is the prognosis for bovine LDA sx

A

good, fairly routine sx

2025 - Intro to Surgery 737A (19 decks)

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