Exam 3 Flashcards
Guttural Pouch Tympany; Signalment, Causes, Clinical Signs, Diagnosis
Signalment
Foals
Fillies>Colts
Causes
Idiopathic
Upper airway infection
Persistent coughing
Muscle dysfunction
Clinical Signs
Air swelling of parotid region
Unilateral > Bilateral
Respiratory noise
Nasal discharge
Dyspnea, pneumonia, dysphagia
Diagnosis
Endoscopy
Rads
Needle decompression
Guttural Pouch Tympany; Treatment
Surgical septum fenestration
* Makes 2 pouches into 1
AND
Surgical resection of inner mucosal flap of guttural pouch opening
* Gets rid of 1-way valve so that things can come in and out
Transendoscopic laser
* may cut more than you want
* less favored
What’s Included in Viborg’s Triangle
angle of mandible
linguofacial vein
tendon of the sternocephalicus
What do urachus, umbilical arteries, & umbilical vein develop into?
Urachus
Middle ligament of bladder
Umbillical Arteries
Round ligaments of bladder
Umbilical Vein
Falciform/round ligament of liver
Patent Urachus Vs infected Umbilical Remnants
Patent Urachus
Leaking urine at <2wks
Infected
Leaking urine at 2-4wks
Warm, painful swelling
Sepsis, pneumonia, septic joints, Ds
Heat & pitting edema = surgical emergency
Infected Umbilical Remnants; diagnosis, Surgical Options
Diagnosis
Ultrasound
Vein >1cm
Artery >1.3cm
All > 2.5cm
Surgical Options
Resection of umbilical portion
Marsupialization of hepatic portion
Inform owners of possible hernia
Uroperitoneum; Timing & Most Likely Cause
Ruptured bladder
* 3-4d
Urachal perforation
* 1-2wks
Ureteral defects
* 3-4d
Uroperitoneum; Signalment, Clinical Signs, Diagnosis, Presurgical Management
Signalment
Foals
Males>Females
Clinical Signs
Straining
Depression
Fluid in abdomen, scrotum, thorax
Diagnosis
Abdominocentesis
>2:1 peritoneal creatinine:serum ratio
Ultrasound
Contrast rads
Hyponatremia, hypochloremia, HYPERKALEMIA
Pre-surgical Management
Slow peritoneal drainage
IV NaCl
Dextrose or insulin to reduce K below 6meq/l
Surgery
Appositional
Followed by inverting
Umbilical Hernia; Treatment
Treatment
Herniorrhaphy
Hernia clamp
Elastrator bands
Irritant injection
Benign neglect
Strangulated Umbilical Hernias; Basics, Clinical Signs
Omentum, jejunum, ileum, cecum, or ventral colon in hernial sack
Clinical Signs
* Firm warm hernial sac
* Edema
* Colic
* Richter’s hernia (intestine opens)
* Enterocutaneous fistula
Inguinal/Scrotal Hernias; Signalment, Types, Treatment, Herniorrhaphy
Signalment
Males»_space; females
Standardbreds, draft horses, Tennesee Walkers, Saddlebreds
Types
Indirect – thru vaginal ring most common
Direct – thru rent near vaginal ring
Ruptured – most challenging
Treatment
Repeated manual reduction
Inguinal herniorrhaphy
Support bandage
If you don’t do sx you must be cautious at castration
Inguinal herniorrhaphy
Reduction and transfixation ligature
Closure of external inguinal ring
Tilt of operating table may ease repair
Foal Colic; Causes, Diagnosis
Causes
Meconium impaction
Small Intestine volvulus
Gastroduodenal obstruction
Ascarid impaction
Sand impaction
Congenital defects
Diagnosis
Rads – plain & contrast
abdominocentesis
Castration; When & What Position is Best
When
Before weaning, ~4mo
How
Dorsal recumbancy
Anatomy of the testicles & scrotum
o Go look at testical picture and review anatomy
Tools for Castration; What do these look like: Kocher Oschner, Serra Curved Handles, Reimer, Modified White Hausmann, Henderson Castrating Tool, Ferguson Angiotribe Forceps
Kocher Oschner
* Look like hemostats w/ rat teeth & alligator teeth
Serra Curved Handles
* Emasculator
* Curved handles
* 2 rounded grabbers
Reimer
* Emasculator
* 3 handles
* Several curved grabbers
Modified White Hausmann
* One strait grabber and one curved
Henderson castrating tool
* Attaches to power drill
* Twists testicle off
Ferguson Angiotribe Forceps
* Curved tip
* Looks like thinning shears
Ragle’s 13 Steps to Castration
Wipe scrotal injection site w/ alcohol prior to surgical prep
Inject each testicle until full w/ lidocaine
Aseptic prep of sx site & surgeon
2 parallel scrotal incisions 2cm from median raphe
Incise into cranial portion of vaginal tunic of one testicle, place index finger into tunic & place kocher forceps firmly over tunic & tail of epididymis
Apply firm tension to tunic/testicle & w/ the other hand strip away connective tissue & fat covering tunic & cremaster
Divide cremaster from vaginal tunic & clamp w/ angiotribe & section w/ electrocautery
Expose pedicle from inside tunic blunt puncture mesochorium to separate into vascular & non-vascular segments of pedicle
Clamp & ligate vascular portion & section w/ electrocautery
Replace ligated vascular portion inside tunic
Clamp & ligate tunic & section w/ electrocautery
Repeat steps 5-11 on remaining testicle
SQ closure of scrotal incision and/or invert scrotum & glue
Castration AfterCare
2hrs quiet
Exercise 20 mins 2x per day for 2wks
If doing Ragle method, no aftercare
Risks of Castrating NOT the Ragle Way
Hemorrhage
Scirrhous cord
Eventration or evisceration
No such thing as premature closure only excessive drainage
Preventing Hemorrhage After Castration, what to do if hemorrhage starts
Make sure not stressed or high BP
Ligate cord on mules, donkeys, mature stallions
Crush cord for 6 mins prior to removal of emasculator on draft horses
If Hemorrhage begins
Cross clamp cord for 24hr w/ R angle clamp
Limit dissection w/in inguinal canal
Visceral Prolapse; Signalment, Prevention, Treatment
Signalment
* Draft horses
* Some Standardbred lines
* Gaited Horse-TW
Prevention
* Ligate cord excluding the cremaster muscle
* Ligate cord in all horses with predisposition to inguinal hernias and/or large vaginal rings and horses with history of inguinal swelling
* Close inguinal rings
Treatment
* Anesthetize horse, replace bowel and suture superficial ring and skin
OR
* Anesthetize horse, suture skin incision
OR
* Pack canal and close skin
OR
* Pack canal and wrap groin -> REFER
Cryptorchid; Types, Stats, Surgical Options
Inguinal
OR
Abdominal
* Testicle in abdomen & epidydimus outside
* Both testicle & epidydimus in abdomen
Stats
* Unilateral > bilateral
* L – usually abdominal
* R – usually inguinal
* Bilateral abdominal > bilateral inguinal
Options for Cryptorchidectomy
* Inguinal
* Parainguinal
* Flank
* Ventral midline
* Laparascopic standing flank or ventral umbilical
Why do Laparascopic Cryptorchidectomy
- Allows thorough examination
- Eliminates chance of evisceration
- Earlier return to normal function
- “Close all the holes”
Partial Phallectomy; Indications, William’s Technique
Indications
Intractable paraphimosis
Traumatic penile injury
Squamous cell carcinoma
William’s Technique
Need supreme hemostasis
ID urethra w/ catheter ->
Cut patch out of skin ->
Dissect down into urethra ->
Suture urethra to skin ->
Remove end of penis
What is Preputial Resection for
o avoid penis amputation
o Remove lesion on penis