Exam 2: Right Flank Celiotomy Flashcards
Trace a bolus of food from mouth to small intestine
in the cow.
Oral-Rumen-Reticulum-Omasum-Abomasum-Small Intestine
ORROA
What are the causes of left displaced abomasum (LDA)?
Abomasal atony
Decreased rumen volume
Calving
What 4 conditions can be precursors to
abomasal atony,
which can eventually result in left displaced abomasum
Increased abomasal VFA (volatile fatty acids)
HYPOcalcemia
Metritis
Mastitis
When are you most likely to see left displaced abomasum (LDA)
in a cow?
First 3 months of lactation
Describe how the abomasum moves in
Left Displaced Abomasum (LDA)
Transverse and to the left
What is the mean incidence of
left displaced abomasum (LDA)?
1 - 5%
If “pings” are auscultated at the black dots pictured,
what is your primary differential?
LDA (left displaced abomasum)
T/F:
Fever commonly accompanies LDA
FALSE
Cows with left displaced abomasum have normal temps
What 4 options are considered
in treatment of LDA (left displaced abomasum)?
Right Flank Omentopexy
Left Flank Abomasopexy
Right Paramedian Abomasopexy
Toggle Pin Technique
What are your nerve block options for
Right Flank Omentopexy?
Proximal paravertebral block
Distal paravertebral block
Inverted L block
Line block
T/F:
Right Flank Omentopexy is a standing procedure
TRUE
Where is the incision made for a
Right Flank Omentopexy?
In the paralumbar fossa halfway between
the last rib and the tuber coxae.
Start VENTRALLY
____________ is a surgical procedure
whereby the greater omentum is sutured to a nearby organ.
Omentopexy
What structures are palpable via
right flank celiotomy?
Liver
Kidneys
Urinary bladder
Which condition is being treated in this image
via right flank celiotomy?
Left displaced abomasum (LDA)
Describe closure of a right flank omentopexy/
right flank celiotomy
Continuous suture pattern for
transverse abdominal mm and peritoneum.
DO NOT BURY THE KNOT in the
transverse abdominal mm (risk of hitting rumen/GIT)
Fixation of the replaced abomasum, after correction of a displacement, by suturing the abomasal wall or its attached omentum to the abdominal wall
Abomasopexy
Where is the incision made for a
Left Flank Abomasopexy
(a treatment for LDA)?
Incision made over the distended and displaced abomasum
2 straight intestinal needles with
______ feet of suture in between them is required
for a Left Flank Abomasopexy
3 feet
Describe closure of the abomasum in
a Left Flank Abomasopexy
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
How do you position a cow for
Right Paramedian Abomasopexy
in which the abomasum is tacked to the body wall?
Dorsal recumbency and heavily sedated
In regards to a Right Paramedian Abomasopexy:
20 cm long incision between
midline and the ________
right SQ abdominal vein
In regards to a Right Paramedian Abomasopexy:
The incision is started 8cm behind the _______
xiphoid
In regards to a Right Paramedian Abomasopexy:
The lateral aspect of the greater curvature of the abomasum
is sutured to the _________
periotoneum
In one method of treating an LDA,
the ___________ technique is used
to blindly suture the abomasum to the body wall
Toggle Pin technique
Blindly suturing the abomasum to the body wall
is known as
Blind Tack
Closed suture or bar techniques
are also known as
Toggle Pin technique
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
RIGHT
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
right paramedian
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
Shaking
In regards to the Blind Tack/Toggle Pin Technique used to
correct a left displaced abomasum:
Where is the toggle pin placed?
Where the ping is heard the loudest
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
_____________
abomasum lumen
For a _____displaced abomasum,
you will hear a right sided ping on the
caudal area of the rib cage
right (RDA)
Name the differentials for a right-sided ping
RDA
Abomasal volvulus
Cecal dilatation/volvulus
Intussusception
Pneumoperitoneum
Gas in uterus or spiral colon
PIGCAR
A ping is auscultated on the right side
and goes from the
right paralumbar fossa out to rib 8.
What is your primary ddx?
RDA or Dilatation
A ping is auscultated on the right side,
but is only heard in the paralumbar fossa.
What is your primary ddx?
Cecal Dilatation/Volvulus
How can you tell the difference between RDA and
Cecum Dilatation/Volvulus via auscultation?
RDA= ping goes from the right paralumbar fossa to 8th rib
Cecum D/V= ping only in paralumbar fossa
How can a simple RDA displacement
be treated medically?
Calcium, Dextrose, + Exercise!
