Female Urogenital - Bauck

Question 1

Caslick’s indications

Answer 1

1. pneumovagina
2. age-related poor perineal conformation
3. urine pooling
4. perineal injuries
5. racehorses

Question 2

Perineal laceration classification

Answer 2

1st degree: vestibule and vulva (sx not ush required)
2nd degree: perineal body, vestibule, and anus
3rd degree: rectovaginal septum
Rectovaginal fistula

Question 3

Perineal lacerations are most common in

Answer 3

first foal mare with unassisted deliveries

Question 4

Perineal laceration surgeries

Answer 4

1. Wait 30 days for feces to soften, edema to resolve
2. two week diet of equine senior before and after
3. Mineral oil and magnesium sulfate per NGT
4. May have to stage repair, come back later to finish

Question 5

Aanes technique

Answer 5

Two stage repair for perineal lacerations

1. Sedated and restrained in stocks
2. First stage -> rectovestibular shelf reconstructed w/out repair of perineal body
3. Second stage 3-4 wks later to reconstruct perineal body

Question 6

To repair a rectovaginal fistula, turn it into

Answer 6

3rd degree perineal laceration

Question 7

Urethroplasty indication

Answer 7

Urine pooling (urovagina) from poor perineal conformation

Question 8

Urovagina can lead to

Answer 8

1. cervicitis

2. endometritis-decreased fertility

Question 9

Along with urethroplasty

Answer 9

weight gain also recommended

Question 10

Urethroplasty surgical techniques

Answer 10

1. Monin Urethroplasty
   - Caudal relocation of transverse fold
2. Brown, McKinnon, Shires technique
   - Caudal urethral extension

Question 11

Cervical lacerations

Answer 11

1. caused by trauma or dystocia
2. Palpation more helpful than speculum
3. Surgical repair indicated
4. High rate recurrence
5. Perform sx during diestrus; at least 3 weeks post-partum

Question 12

Cervical lacerations are repaired during

Answer 12

DIESTRUS; at least 3 weeks post-partum

Question 13

Cervical laceration sx

Answer 13

1. Standing with caudal epidural
2. Finochietto/Aanes retractors
3. Stay sutures on cervix, retract caudally
4. Long-handled instruments
5. 3 layer repair

Question 14

Cesarean section

Answer 14

1. Consider other approaches first (15-20 minutes)
   - assisted delivery
   - controlled vaginal delivery
2. Hemorrhage is very pronounced
3. Horses in extension puts pressure on Femoral n.

Question 15

Hemostasis

Answer 15

Whipstitch can help control bleeding

• simple continuous suture along entire edge of hysterotomy incision
• to close do simple continuous with an inverting oversew, do not include placenta

Question 16

Give oxytocin IV

Answer 16

Only after hysterotomy incision is closed

Question 17

Uterine torsion

Answer 17

1. Last two months gestation (NOT AT TERM)
2. Can be clockwise/counter-clockwise
3. Dx via rectal exam
4. 360 degrees
5. Failure to tx can kill baby, cause chronic torsion

Question 18

Uterine torsion tx

Answer 18

1. Rolling
2. Caudal ventral midline approach
3. Flank approach

Question 19

Uterine torsion-rolling

Answer 19

Roll in direction of torsion, wooden plank across mare’s flank

Question 20

Uterine torsion-Caudal ventral midline approach

Answer 20

Use if

1. large fetus
2. nonviable fetus/uterus
3. uterine rupture or concurrent GI lesion suspected

Question 21

Uterine torsion-flank approach

Answer 21

Incision made on side toward which uterus is twisted

Question 22

Uterine torsion prognosis: Mare survival

Answer 22

< 320 days = 97%
> 320 days = 65%
*Very good prognosis for rebreeding

Question 23

Uterine torsion prognosis: Foal survival

Answer 23

< 320 days = 72%

> 320 days = 32%

Question 24

Foal survival is significantly better if torsion corrected by

Answer 24

standing flank laparotomy than by midline celiotomy

Question 25

Uterine tear is a complication of

Answer 25

1. uterine torsion 2. normal foaling 3. dystocia

Question 26

Uterine tears most commonly present

Answer 26

1-3 days post-partum with signs of peritonitis

Question 27

Uterine tear tx

Answer 27

Direct repair via caudal ventral midline celiotomy

Question 28

Ovariectomy indications

Answer 28

1. tumor removal | 2. behavior modification

Question 29

Most common ovarian tumor

Answer 29

Granulosa theca cell tumor

Question 30

Granulosa theca cell tumor CS

Answer 30

1. Abnormal behavior (stallion-like, erratic, no estrus) 2. Large affected ovary, small contralateral ovary 3. Absence of ovulation fossa

Question 31

Granulosa Theca cell tumor DX

Answer 31

Ultrasound | Bloodwork

Question 32

Bloodwork of mares w/granulosa theca tumors

Answer 32

54% have elevated testosterone 87% had elevated inhibin levels Anti-mullerian hormone elevated in most cases

Question 33

Ovariectomy surgical approaches

Answer 33

1. Colpotomy 2. Flank laparotomy 3. Ventral midline 4. Diagonal paramedian 5. Laparoscopy

Question 34

Ovariectomy considerations

Answer 34

1. Hemorrhage | 2. preoperative starvation

Question 35

Ovaries > ?cm

Answer 35

25cm, ush have to be removed vial diagonal paramedian or ventral midline celiotomy

Question 36

Colpotomy

Answer 36

1. Incision through crania vaginal wall into abdomen 2. Ecraseur chain placed around ovary, tightened until ovary is transected 3. Anesthesia: caudal epidural + ovarian pedicle covered with lidocaine soaked lap sponge prior to placement ecraseur

Question 37

Colpotomy complications

Answer 37

Accidental transection/penetration of 1. bladder 2. rectum 3. uterine branch of urogenital artery

Question 38

Ovariohysterectomy indications

Answer 38

1. leiomyoma 2. chronic pyometra 3. chronic uterine torsion

Question 39

Ovariohysterectomy

Answer 39

1. Uncommon procedure 2. Caudal ventral midline celiotomy 3. Difficult but good prognosis for survival