Farm and Production Animals Tx + Procedures Flashcards
1
Q
Increasing duration of local anaesthetic
A
- Combine w/ vasoconstricting drug e.g. Epinephrine -> slower systemic uptake
2
Q
Neurological effects of inc local anaesthetic dose toxicity
A
- Nausea
- Muscle twitching
- Sedation
- Seizures
- Unconsciousness
- Resp arrest
3
Q
Cardiovascular effects of inc local anaesthetic dose toxicity
A
- Cardiac arrhythmia
- Cardiac arrest
4
Q
Use of morphine
A
- Epidural
- Intra-articular
- Horses only
5
Q
Alpha-2 agonists (sedation)
A
- Xylazine
- Detomidine
- Risk of abortion - cause smooth muscle relxation
6
Q
Topical
A
- Anaesthetise tissue directly
7
Q
Local
A
- Admin around nerve or as a ring block/perinural
8
Q
Regional
A
- Admin distant from surgical site creating a whole anaesthetised region
9
Q
Local anaesthetic injection sites in head - ruminants
A
- Local infiltration of eyelids
- Infraorbital
- Mental
- Cornural
- Auriculopalpebral
10
Q
Local anaesthetic injection sites in head - dehorning
A
- Infratrochlear
- Cornual
11
Q
Local anaesthetic injection site - castration
A
- Intra-testicular block
12
Q
Epidural - general
A
- Regional anaesthesia
- Pot complications - inadvertent intra-thecal injection, hypotension, motor block, urinary retention (morphine), neuro injury - from drugs - preservatives, adrenaline; infection, haematoma, trauma
13
Q
Epidural - cattle + small ruminants
A
- Co1 - Co2
- Procaine (lidocaine) 4 mL + Xylazine 1 mL
14
Q
Epidural - small ruminants
A
- Lubo-sacral
- Lidocaine 1 mL/5 kg
15
Q
Digital Sx - regional infiltrative nerve blocks
A
- Infiltrative nerve blocks - ulnar, median, radial n. (forelimb) + hindlimb
- 1 - 2 mL per site
16
Q
Digital Sx - regional intravenous regional nerve blocks
A
- Restraint, torniquet, inject 20 - 30 mL lidocaine (2%), give 10 - 15 min for full desensitisation, 20 min before moving tourniquet (leave on for up to 2 h in cattle + horses), provide good haemostasis
17
Q
Ocular Sx - regional retrobulbar nerve block
A
- 1 or 4 point technique - insert needle percutaneously through eyelid, through conjunctiva or 3rd eyelid
- 4 - 6” needle, 10 - 15 mL procaine (5) + epinephrine
- Pot complications - globe puncture, inc IOP, retrobulbar H+, subarachnoid injection, optica nerve trauma, oculocardiac reflex
18
Q
Ocular Sx - regional Peterson’s nerve block
A
- Depression where caudal rim of orbit meets zygomatic arch - rostral to the coronoid process of mandable
- 10 cm needle aimed rostroventrally towards point of ‘cone’ made by orbital contents
- Pot complications - anatomy knowledge needed, IV injection, blinking prevented to eye vulnerable to dust/trauma, keep out of bright light
19
Q
Flank laparotomy - regional line nerve block
A
- Injection of LA in line at site of injection (5 - 6 locations, make caudal incision)
- Adv - simple, little anatomical knowledge
- Disadv - large vol local (100 mL), no muscle relaxation - muscles in paralumbar fossa take longer to health, distortion of Sx site, H+ = messy Sx for closing up
20
Q
Flank laparotomy - regional inverted L block nerve block
A
- Adv - limited anatomical knowledge, local proximal to Sx site - further away, easy to extend if block fails, some muscle relaxation = less muscle damage
- Disadv - large vol local, time consuming
21
Q
Flank laparotomy - regional paravertebral nerve block
A
- Adv - local distal to Sx site, small vol local, good muscle relaxation, reliably anaethetises all layers of body wall
- Disadv - time consuming, requires sig anatomical knowledge, difficult in well-muscled + fat individuals, not easy to extend if fails
22
Q
Flank laparotomy - regional proximal paravertebral nerve block (Liverpool technique)
A
- L2 transverse process, walk off back, blocks L2 n.
- L1 transverse process, walk off back, blocks L1 n.
- L1 transverse process, walk off front, blocks T13 n.
23
Q
Flank laparotomy - regional proximal paravertebral nerve block (Cambridge technique)
A
- L3 transverse process, walk off front, blocks L2 n.
- L2 transverse process, walk off front, blocks L1 n.
- L1 transverse process, walk off front, blocks T13 n.
24
Q
Distal paravertebral block - the Cornell Technique
A
- Distal to transverse process, above + below
- L1, L2, T13
- Go above then withdraw
25
Multimodal analgesia - pig, ruminants, camelids
- NSAID - Flunixin, Ketoprofen, Meloxicam (licenced in pigs + ruminants)
- Opioid - butorphanol (not licensed)
- Local - procaine +/- xylazine
- Adjunct - alpha-2 agonists, ketamine (sub-anaesthetic dose = anaesthetic, not for licensed for pain)
- Not licensing in camelids
26
Injectable sedation + anaesthesia (pig)
- Sedation pre-med - *Azaparone* - 1 - 2 mg/kg deep IM, *Xylazine*, alpha-2 agonists (Xylazine - 1 - 3 mg/kg, Detomidine - 0.1 mg/kg)
- Analgesia - NSAIDs (metacam), butorphanol
- Local - procaine w/ adrenaline
- Induction - ketamine - 15 - 20 mg/kg (or 5 mg/kg IV) IM after Azaperone pre-med -> 40 min anaesthesia
- Maintenance - isoflurane (inhalant), 5 mg/kg IM/IV Ketamine q 30 min after induction
27
Injectable sedation + anaesthesia (ruminants)
- Sedation + pre-med - Detomidine (Atipamezole cannot be used in FPAs) - 0.1 mg /kg, Xylazine - 1 - 3 mg/kg IM, butorphanol - 0.01 mg/kg (+ Xylazine), Ketamine - 0.05 - 0.1 mg/kg
- Analgesia - NSAID (Metacam), butorphanol
- Local - Procaine (+ adrenaline)
- Induction - *Ketamine* - 2 - 2.5 mg/kg IV after sedation (xylazine + butorphanol), up to 5 mg/kg IV
- Maintenance - Isoflurane (inhalant), intermittent bolus of ketamine, 1/3 induction dose q 8 min, or CRI - 10 mL ketamine + 2.5 mL xylazine into 500 mL IV 2 - 3 drops/s (1 mL/kg/h)
(DON'T DO INHALATION - risk of bloat)
28
Injectable anaesthesia - standing stun (ruminants)
- Xylazine, 0.02 - 0.025 mg/kg
- Ketamine - 0.05 - 0.1 mg/kg
- Butorphanol - 0.02 - 0.1 mg/kg
- Sub-anaesthetic chemical restraint
- E.g. Ketamine triple stun - goat dehorning
- Lasts 15 - 20 min
29
Injectable anaesthesia - recumbent stun (ruminants)
- Xylazine, 0.02 - 0.05 mg/kg
- Ketamine - 0.3 - 0.5 mg/kg
- Butorphanol - 0.05 - 0.1 mg/kg
- Sub-anaesthetic chemical restraint
30
Injectable anaesthesia + anaesthesia (camelids)
- Sedation + premed - Detomidine, Xylazine, Ketamine (3 mg/kg) - atipamezole, not FPA?
- Analgesia - NSAID (Metacam), Butorphanol (0.03 - 0.1 mg/kg, sed)
- Local - Procaine (+ Adrenaline)
- Induction - Ketamine
- Maintenance - Isoflurane (inhalant)
31
Ketamine stun (camelids)
- 100 mg Xylazine
- 1000 mg Ketamine
- 10 mg Butorphanol
- Into 100 mL in water solution bottle
- 1 mL + 1 mL/19 kg alpaca
- Sx castration
- 20 - 30 min
32
Xylazine - standing sedation 30 min (camelids)
- 0.1 - 0.2 mg/kg IV
33
Xylazine - recum 30 min (camelids)
- 0.3 - 0.4 mg/kg IV
34
Xylazine - 30 min sedation (camelids)
- 0.4 - 0.6 mg/kg IM
35
Xylazine - 30 - 60 min sedation (camelids)
- 0.25 - 0.35 mg/kg + Ketamine 3 - 8 mg/kg Ketamine
- IV = lower dose
- IM = higher dose
36
Castration (alpaca)
- Restraint/handling
- Aseptic technique
- Scrotal = standing under sedation/local, younger animal > 18 m, younger, vessels small, leave open to heal, slower 2nd intention healing
- Pre-scrotal - lateral recum, GA only (less pain + recovery time), quicker 1y healing of incision
- Open castration - close
- Similar to cattle - twist/torsion + traction/pull = open
- Clamp + ligate if bigger vessels = open/closed
- Leave skin un-sutured
37
Tooth root abscess (alpaca)
- Long-term AB - 6 - 8 w
- Analgesia = NSAIDs
- Tooth extraction
- Tooth splitting
- Tooth root resection - referral Sx, lateral alveolar plate resection (mandible, incise ventrolaterally/corner, bring down + out) at least under heavy sedation
- Size of swelling related to chronicity, bony changes -> poor Px
38
Uterine torsion (camelid)
- Rolling, direction of twist (usually clockwise) + hold foetus in position whilst rolling uterus
- Stabilise uterus through body wall
- Sx (caesarean) - when rolling not effects, foetal compromise, cannot determine direction of twist
39
Caesarean (alpaca)
- Patient choice - ischaemia/necrosis of uterus, foetal stress/hypoxia/deat, CVS stress - correct prior, during + post Sx
- Line block + lateral incision
- Anaesthesia - Local +/- sedation, Ketamine stun for fractious animals
- Analgesia - NSAIDs
- AB - broad spectrum coverage
40
Uterine prolapse (camelid)
- Emergency - patient choice
- Anaesthesia - epidural - procaine
- Analgesia - NSAIDs
- AB - broad spectrum
41
Angular limb deformities (camelid)
- Early recognition - Vit D + splinting long-term, both legs
- Sx for older cria = transphyseal bridging - growth phase, wedge osteotomy when growth plates have closed
- Referral Sx
42
Anaesthesia for minor Sx (pig)
- 2 mg/kg azaperone
- 15 - 20 mg/kg ketamine
- Duration = 30 min
- Onset sed = 30 min (long)
43
Anaesthesia for major Sx (pig)
- 5 mg/kg ketamine
- 1 - 3 mg/kg xylazine
- 0.1 - 0.2 mg/kg butorphanol
- Can top up w/ ketamine q 20 min
- Duration 40 - 60 min
44
Castration therapeutics (pig)
- Analgesia = meloxicam licensed IM + oral
Pet pigs:
- Anaesthesia = chemical restraint: Azaperone in small well-handled pigs; Ketamine + Xylazine +/- Butorphanol
- AB - more invasive Sx in older animals
(Same for hernia repair - but AB as abdo Sx in non-sterile environment)
45
Castration (pig)
- Aseptic skin prep
- Infusion of local anaesthetic in scrotal skin, testes +/- spermatic cord
- Incise though scrotum over testes individually - at level of inguinal ring
- Breakdown gubernaculum ligament
- Open castration = recommended in male adult large boar, for ligation of vv, H+ more risk of concern (torison + traction, ligating) - incise through tunica vaginalis + exteriorise testes
- Torsion + traction (care) in small piglets
- Clamp cord + double ligate transfixing ligatue to prevent slip
- Scrotal wound left open for drainage
- Tunica vaginalis/inguinal ring closed after castration to reduce risk of inguinal herniation
- (Closed castration (at risk breeds - herniation), tunic intact, or modified open to closed)
46
Correction of hernias alongside/before castration (pig)
- Easier closure of inguinal ring
- Approach as if closed castration
- Reduce hernia
- Twist spermatic cord
- Clamp + ligate twisted cord to contain hernia
- Close inguinal ring
47
Hernia correction (pig)
Umbilical
- Same as cattle approach
- Can contain omentum + intestines
- Penis + prepuce reflected to access hernia
- Open/closed hernia repair - either cut through or leave peritoneum intact
- Often adhesions - so hernia sac may need to be opened + explored
Inguinal
- LHS more common
- Can contain omentum + intestines
- Alongside castration
- Hold piglet upside down/at angle
- Gravity to advantage
- Milk contents of hernia through inguinal canal
- Leave closed for castration
- Twist entire cord - vasculature + tunica
- Clamp + ligate
- Closing everything in sac, tight as pos
- AB - penicillin, cephalosporin (travel to skin)
48
Tail docking (pig)
- No anaesthetic
- Emasculators to crush
- Scalpel to remove tail/sharp pilers
- Not too small = inc risk of rectal prolapse
49
Tooth clipping (pig)
- Canine teeth - cut back to gum line
- > 18 h old - avoids colostrum intake disruption
50
Tusk trimming (pig)
- Restrain by snare/deep sedation/GA
- Length of embryotomy (obstetrical wire) w/ handles on each end
- Cut just above gum margin (above pulp cavity)
- Edges of tooth rasped to remove sharp edges
- May have to be repeated q 6 - 12 m depending on growth rate
51
Caesarean (pig)
- Supportive therapy for exhaustion - analgesia, AB
- GA - X, K, B combo
- Lateral recum
- Easy to exteriorise uterus
- Incise as close to bifurcation as possible
- Milk piglets down horn to incision + remove
- Close in more layers than cattle/sheep
- SC/fat layer closure
52
Uterine prolapse (pig)
- GA/heavy sed + epidural
- Uterine amputation if not possible to replace
- Check for lacerations + repair, if full depth/sow in severe shock then euth recommended
- Wash
- Apply sugar/electrolyte powder to reduce oedema
- Lube not recommended
- Replace horns progressively, starting from vulval lips
- Instil 3 L sterile saline solution into horns after replacement
- Admin oxytocin to encourage uterine involution
- Or lateral laparotomy to pull uterus horns into abdo possible
53
Uterine amputation (pig)
- Haemostasis - base of uterus surrounded by overlapping mattress suture, full thickness of uterine wall tied tightly (monofilament nylon material)
- Amputation - two anchor pins, distal uterus amputated distal to mattress suture line
- Ligation of bleeding vessels
- Removal of anchor pins
- Uterine stump replaced into pelvis
- SC purse string suture arounf vulva
54
Rectal prolapse (pig)
- Replacement (lube) + application of sphincter purse string suture, then remove later
- NSAID med
- Soft feed - inc water intake
- Under epidural
- Prolapse amputation
55
Rectal prolapse amputation (pig)
- Anaesthesia - sed + epidural/GA - xylazine in epidural = reduced tenesmus q 24 h, local perianal infiltration
- Analgesia = NSAIDs
- Complications = anal stricture
- Insert tube into prolapse + rectum to ensure patency
- Rubber ring or tightly tied suture material around tube - purse string suture rectum
- Cut off blood supply + necrotic tissue falls off within 3 - 7 d
56
Entropion (pig)
- GA - approach as dog/lamb Sx
- If 2y ulceration of eyeball -> enucleation
- Length + width of skin resected - place pair of forceps 3 - 5 mm below/parallel to lower lid margin
- Test length + width of skin held between jaws of forceps
- Position forceps adjusted so entropion is resolved w/o entropion
- Removal of skin - ridge of skin marked by jaws of forceps removed using scalpel
- Skin incision - closed using interrupted PDS sutures
- Complications - under-correction
- Can repeat if problems of upper eyelid
57
OVH (pig)
- GA anaesthesia
- Analgesia - NSAIDs
- More vascular braod ligament than dogs
58
Cutting of alpaca fighting teeth to reduce risk of injury
- w/o anaesthesia using embryotomy/cutting wire
- Not invase/painful, patient can be restrained
59
A farmer has requested placement of a nose ring in a 18 month old pedigree Belgian Blue bull. Which of the following loco-regional anaesthetic techniques is the most appropriate?
-Infraorbital nerve block - will block the upper lip, nostril, and floor of the nasal cavity rostral to the block
