Exam 2: Right Flank Celiotomy

Question 1

Trace a bolus of food from mouth to small intestine

in the cow.

Answer 1

Oral-Rumen-Reticulum-Omasum-Abomasum-Small Intestine

ORROA

Question 2

What are the causes of left displaced abomasum (LDA)?

Answer 2

Abomasal atony

Decreased rumen volume

Calving

Question 3

What 4 conditions can be precursors to

abomasal atony,

which can eventually result in left displaced abomasum

Answer 3

Increased abomasal VFA (volatile fatty acids)

HYPOcalcemia

Metritis

Mastitis

Question 4

When are you most likely to see left displaced abomasum (LDA)

in a cow?

Answer 4

First 3 months of lactation

Question 5

Describe how the abomasum moves in

Left Displaced Abomasum (LDA)

Answer 5

Transverse and to the left

Question 6

What is the mean incidence of

left displaced abomasum (LDA)?

Answer 6

1 - 5%

Question 7

If “pings” are auscultated at the black dots pictured,

what is your primary differential?

Answer 7

LDA (left displaced abomasum)

Question 8

T/F:

Fever commonly accompanies LDA

Answer 8

FALSE

Cows with left displaced abomasum have normal temps

Question 9

What 4 options are considered

in treatment of LDA (left displaced abomasum)?

Answer 9

Right Flank Omentopexy

Left Flank Abomasopexy

Right Paramedian Abomasopexy

Toggle Pin Technique

Question 10

What are your nerve block options for

Right Flank Omentopexy?

Answer 10

Proximal paravertebral block

Distal paravertebral block

Inverted L block

Line block

Question 11

T/F:

Right Flank Omentopexy is a standing procedure

Answer 11

TRUE

Question 12

Where is the incision made for a

Right Flank Omentopexy?

Answer 12

In the paralumbar fossa halfway between

the last rib and the tuber coxae.

Start VENTRALLY

Question 13

____________ is a surgical procedure

whereby the greater omentum is sutured to a nearby organ.

Answer 13

Omentopexy

Question 14

What structures are palpable via

right flank celiotomy?

Answer 14

Liver

Kidneys

Urinary bladder

Question 15

Which condition is being treated in this image

via right flank celiotomy?

Answer 15

Left displaced abomasum (LDA)

Question 16

Describe closure of a right flank omentopexy/

right flank celiotomy

Answer 16

Continuous suture pattern for

transverse abdominal mm and peritoneum.

DO NOT BURY THE KNOT in the

transverse abdominal mm (risk of hitting rumen/GIT)

Question 17

Fixation of the replaced abomasum, after correction of a displacement, by suturing the abomasal wall or its attached omentum to the abdominal wall

Answer 17

Abomasopexy

Question 18

Where is the incision made for a

Left Flank Abomasopexy

(a treatment for LDA)?

Answer 18

Incision made over the distended and displaced abomasum

Question 19

2 straight intestinal needles with

______ feet of suture in between them is required

for a Left Flank Abomasopexy

Answer 19

3 feet

Question 20

Describe closure of the abomasum in

a Left Flank Abomasopexy

Answer 20

Simple continuous on greater curvature of abomasum.

Take needle to the right paramedian area an push

through abdominal wall.

DO NOT HIT THE MILK VEIN!

Make sure no viscera is caught between abomasum and

body wall

Question 21

How do you position a cow for

Right Paramedian Abomasopexy

in which the abomasum is tacked to the body wall?

Answer 21

Dorsal recumbency and heavily sedated

Question 22

In regards to a Right Paramedian Abomasopexy:

20 cm long incision between

midline and the ________

Answer 22

right SQ abdominal vein

Question 23

In regards to a Right Paramedian Abomasopexy:

The incision is started 8cm behind the _______

Answer 23

xiphoid

Question 24

In regards to a Right Paramedian Abomasopexy:

The lateral aspect of the greater curvature of the abomasum

is sutured to the _________

Answer 24

periotoneum

Question 25

In one method of treating an LDA,

the ___________ technique is used

to blindly suture the abomasum to the body wall

Answer 25

Toggle Pin technique

Question 26

Blindly suturing the abomasum to the body wall

is known as

Answer 26

Blind Tack

Question 27

Closed suture or bar techniques

are also known as

Answer 27

Toggle Pin technique

Question 28

In regards to the Blind Tack/Toggle Pin Technique used to

correct a left displaced abomasum:

The cow is casted on its _____ side and

rotated into dorsal recumbency.

This allows the abomasum to correct itself

Answer 28

RIGHT

Question 29

In regards to the Blind Tack/Toggle Pin Technique used to

correct a left displaced abomasum:

A ping should be heard at this location if

the abomasum was properly replaced

Answer 29

right paramedian

Question 30

In regards to the Blind Tack/Toggle Pin Technique used to

correct a left displaced abomasum:

Casting a cow on its right side and rotating it into dorsal

recumbency is known as

Answer 30

Shaking

Question 31

In regards to the Blind Tack/Toggle Pin Technique used to

correct a left displaced abomasum:

Where is the toggle pin placed?

Answer 31

Where the ping is heard the loudest

Question 32

In regards to the Blind Tack/Toggle Pin Technique used to

correct a left displaced abomasum:

The toggle pin is pushed through the cannula and trocar

which goes through skin, muscles, and into the

_____________

Answer 32

abomasum lumen

Question 33

For a _____displaced abomasum,

you will hear a right sided ping on the

caudal area of the rib cage

Answer 33

right (RDA)

Question 34

Name the differentials for a right-sided ping

Answer 34

RDA

Abomasal volvulus

Cecal dilatation/volvulus

Intussusception

Pneumoperitoneum

Gas in uterus or spiral colon

PIGCAR

Question 35

A ping is auscultated on the right side

and goes from the

right paralumbar fossa out to rib 8.

What is your primary ddx?

Answer 35

RDA or Dilatation

Question 36

A ping is auscultated on the right side,

but is only heard in the paralumbar fossa.

What is your primary ddx?

Answer 36

Cecal Dilatation/Volvulus

Question 37

How can you tell the difference between RDA and

Cecum Dilatation/Volvulus via auscultation?

Answer 37

RDA= ping goes from the right paralumbar fossa to 8th rib

Cecum D/V= ping only in paralumbar fossa

Question 38

How can a simple RDA displacement

be treated medically?

Answer 38

Calcium, Dextrose, + Exercise!