Female Uro

Question 1

what are the maternal indications for C-section in cows?

Answer 1

• immaturity
• uterine tear
• uterine hydrops
• pelvic deformities
• uterine torsion
• lack of cervical dilation

Question 2

what are the fetal indications for C-section in cows?

Answer 2

• fetal oversize
• malposition
• elective (high value calf)
• pathology (conjoined twins, schistosomus reflexes, hydrocephalus, emphysematous)
• mummification
• prolonged gestation

Question 3

what are the 3 approaches for standing C-section in cattle?

Answer 3

• L paralumbar fossa (flank) = most common
• R paralumbar fossa
• L oblique (Marsenic approach)

Question 4

what are the 4 approaches for recumbent C-section in cattle?

Answer 4

• ventral midline
• R paramedian
• R paramamary (ventrolateral)
• L paralumbar

Question 5

where is the uterus located in a standing L paralumbar fossa C-section?

Answer 5

medial to rumen

Question 6

what prevents SI eviscerations in standing L paralumbar fossa C-sections?

Answer 6

rumen

Question 7

when should you do a recumbent ventral midline approach to a c-section?

Answer 7

down/reluctant to stand cow

Question 8

when should you do a recumbent R paramedian approach to a c-section?

Answer 8

down/reluctant to stand cow

Question 9

when should you do a recumbent R paramammary approach to a c-section?

Answer 9

emphysematous fetus

Question 10

tell me the broad steps to performing a C-section in a routine dystocia

Answer 10

L paralumbar fossa (standing)
1. exteriorize uterus
2. remove the calf
3. close the uterus
4. close the abdominal wall

Question 11

how do you exteriorize the uterus in a C-section in a cow?

Answer 11

• ID uterus
• ID hind legs/foot/hock (fetus)
• place 1 hand on fetlock and second under hock
• pull leg up to and over incision, locking leg in incision via fetlock and hock

Question 12

compare/contrast reducing uterine torsions prior to and after calf removal

Answer 12

prior:
- increases risk of uterine rupture
- easier to externalize uterus
- easier to suture uterus

after:
- decrease risk of uterine rupture
- hard to externalize uterus/increases contamination
- hard to suture uterus

Question 13

tell me in broad strokes how to remove a calf during a c-section

Answer 13

• full thickness uterine incision (avoid spillage of uterine contents internally)
• sterile calving chains + assistant
• put on calving chains, utilizing assistant (make sure to tell them not to touch you - they’re not sterile!)
• assistant pulls calf
• check for 2nd calf!

Question 14

tell me how to close the uterus after a c-section

Answer 14

• 2 layer inverting (Utrecht), catgut size 2 or 3
• don’t sew placenta into incision, don’t go full thickness
• lavage w sterile saline (no gauze)

Question 15

tell me how to close the abdominal wall after a c-setion

Answer 15

(same as other surgeries)
- transversus/peritoneum = close together, SC/absorbable’
- internal abd obl = single layer, SC/absorb
- external abd. obl = single layer, SC/absorb
- skin: non-abrosb, 3-polyamide, ford interlocking, finish with 1-2 simple inter. (remove if drainage needed)

Question 16

list 4 intra-op complications with c-sections with routine dystocias

Answer 16

• uterine exteriorizztion
• recumbent/down cattle
• rumen/SI evisceration
• uterine integrity/tears

Question 17

list 5 post-op complications with c-sections with routine dystocias

Answer 17

• peritonitis
• wound infection/dehiscence
• SQ emphysema
• retained placenta
• death

Question 18

true or false: the mortality rate for cows with emphysematous fetuses is low

Answer 18

false! its high (66%)

and those that survive, most are not fertile after (cull)

Question 19

tell me the type of fluids you want to use with c-sections for emphysematous fetus

Answer 19

hypertonic

Question 20

is euthanasia of the cow a good option when the cow has an emphysematous fetus?

Answer 20

yes

Question 21

what is the single most important factor for cow survival and future fertility when doing a c-section with an emphysematous fetus?

Answer 21

exteriorize the uterus as much as possible

Question 22

what are the 3 categories of c-section?

Answer 22

Emergency (non-emphysematous)
Elective
Emphysematous

Question 23

when done as a last resort, c-sections have a _____ px.

Answer 23

poor

Question 24

decision to perform c-section should be made in _______.

Answer 24

<20 mins

Question 25

emergency c-sections will have a _____ risk of intra/post op complications

Answer 25

increased

Question 26

before c-sections, tell me what you should do.

Answer 26

• examine cow (exhausted? toxemic? hypovolemic? hypocalcemic?)
• fetal exam (dead? alive? state of decomposition?)
• restraint (chute/head lock/maternity pen, chemical)
• Abx
• analgesia
• prep (clip, scrub, drape, gown, plastic sleeves, sterile gloves, capable assistant)

Question 27

true or false: you can use j-lube when dealing with c-sections

Answer 27

false! do NOT use j-lube

Question 28

why do you use Abx before c-se=ction? what bacteria are you worried about?

Answer 28

parietal fibrinous peritonitis in approx 2/3 cases

T. pyogenes, E. coli

Question 29

what analgesia do you use in c-sections?

Answer 29

NSAIDs… meloxicam

Question 30

what is important to know for after a c-section?

Answer 30

-owner/tech deals with calf
- allow umbilical vessel to stretch (don’t cut it!)
- stimulate breathing/clear membranes
- inspect/disinfect umbilicus
- colostrum!