Fubini 16 - Cow Flashcards
what is it?
A Chain Craseur is an instrument designed for an ovariectomy.
what is this?
A Kimberling Rupp instrument is designed for an ovariectomy.
What is the are the ovary surgical approach in cow?
Flank celiotomy
Colpotomy
What is the risk of colpotomy?
Risk of hemorrhage and evisceration (especially if lies down after surgery)
What is colpotomy?
Colpotomy involves making an incision 2 cm at 10:30 or 13:30.
Describe flank ovariectomy of large and small ovaries
Large ovaries a sharp incision through all muscle layers is essential in the caudal paralumbar fossa. Small ovaries a grid incision in the internal abdominal oblique muscle is done by incising the muscle in the direction of the fiber.
Important preoperative considerations for colpotomy?
Withhold feed 24-30 hours to improve access. Good restriction. Urinary bladder catheterized.
What should be placed around the ovarian pedicle?
Place soaked lidocaine gauze around the ovarian pedicle.
How is the tension applied?
Tightened until 2 fingers can fit.
Why is unilateral ovariectomy performed in cattle?
For ovarian pathologies such as cystic ovaries, neoplasia, abscess formation, and adhesions.
What surgical approaches can be used for ovariectomy?
Celioctomy
Colpotomy
Abdominal laparoscopy
describe the flank celiotomy in cows for ovariectomy
Lidocain injected to the pedicle or lidocaine soaked gauze held around it
* Ligated with overlapping bites or surgical stapler or ligasure
* If both ovaries should be removed colpotomy or laparoscopic ventral midline
approaches should be considered
what is the best phase for ovary surgery?
by performing surgery only when the ovaries are in the follicular or early luteal phase, anestrus, luteal phase
describe colpotomy in cow for ovariectomy
Healthy young animal with small ovaries
* Starving 48h, evacuation of feces and urine.
* Vaginal wall incised at 10 or 12 o’clock, hand and arm entered and the ovaries are
removed with an ecaseur, Kimberling-rupp instrument, modified emasculator or Willis
rod (leaves the ovaries in the abdomen)
* If needed instruments can be guided with one hand in the rectum
what is the C-section indication in cowS?
Oversized fetus, inadequate cervical dilation, abnormal pelvic conformation, prepubic
tendon rupture, uterine rupture, uterine torsion, fetal malposition, fetal oversize,
emphysematous fetus
What is the left oblique celotomy?
Left oblique celotomy involves a sharp incision of external oblique.
what are the surgical techniques for C-section?
- Standing paralumbar fossa celiotomy – caudal 1/3 of the paralumbar fossa
- Ventral midline celiotomy – suffer cardiovascular and resp. distress
- Paramedial celiotomy – poor holding for closure
- Ventrolateral celiotomy (emphysematous calf, time consuming closure)
- Left oblique celiotomy
What is the standing paralumbar fossae celotomy? how many sutures for closure?
Suture 4 layers (transversus + perit; int, ext and skin).Standing paralumbar fossae celotomy involves a 40 cm incision.
Why is paramedian celotomy not much described?
Requires DR as well but the fact that the multiple layer incision is done in the caudal abdomen can result in hemorrhage and poor holding layer for closure.
What is the ventrolateral celotomy?
Skin incision parallel to mammary.Ventral lateral celotomy involves lateral recumbency and elevated HL.
what is the indication for ventrolateral incision?
emphysematous calfDisinfection and pneumovagin will help make incision.
What are the complications of cesarean section?
Peritonitis, metritis, abdominal adhesion, SSI (ventrolateral and emphysematous fetus)
What are the disadvantages of left oblique celitomy?
Disadvantages include surgical site infection and anesthesia of the ventral body wall.
What are the steps for lateral flank C-section? postop care
One limb locked in the incision, so the incision is made outside of the abdomen
* Large skin incision and large uterine incision so no tearing occurs, whatever
placenta that can be removed is removed
* Closure – SC followed by cushing, lambert or Utrecht
* Oxytocin given after suturing is finished and then the suture-line is reevaluated
* Abdominal wound lavaged and closed, attempt to remove air from the
abdominal cavity prior to closure
* Oxytocin post-op 24 or until the membranes have passed, abx 3-7 days
What clinical signs may indicate uterine rupture in cattle?
Depression, inappetence, fever, tachycardia, ileus, and abdominal pain leading to peritonitis
What is the recommended therapy for small dorsal tears in uterine rupture?
Small dorsal tears may heal with conservative therapy involving antimicrobials, intrauterine medication, and repeated administration of oxytocin.
when does it happen uterine torsion?
at the end of gestation after onset of labor
The broad ligament is stretched tightly across the uterus in the direction of the
torsion
what is the treatment for uterine torsion?
1) Correction can be attempted vaginally if the cervix is dilated and the calfs feet
can be grasped
2) Rolling
* Lateral recumbency on the side of the torsion, a large plank is positioned on the flank
and a heavy person balances on the plank while the cow is rolled to the back
3) If it doesn’t work – celiotomy, it is recommended to correct the torsion prior
to c-section
Diagnosis and surgical tx?
Hydrops allantois Surgeons may pursue string a large bore stomach tube into the uterus to drain the fluid, and intravenous fluids are administered. Make slow drainage to avoid hypovolemic shock.
What risks are associated with cows that survive hydronephrosis allantois?
Increased risk of septic metritis and poor future fertility due to pathologic stretching of the myometrium and extensive adventitious placenta.
Under what circumstances can uterine rupture occur? how can you repair?
Traumatic birth – can take up to 5 days for clinical signs
* Prolapsing of intestine through the rent
* Can be surgically repaired through the cervix if still open(usually open for
48H)
* large - caudal flank celiotomy is required
What is the recommended approach for localized uterine abscess or tumor?
A partial hysterectomy is recommended. The uninvolved horn and ovary should be evaluated for prognosis.
what is the microorganism responsible for uterine abscess? what is the tx?
T. pyogenes
* Drainage with chest trocar or partial hysterectomy
* Intermittent injections with prostaglandin
What are the surgical options for partial hysterectomy in cattle?
Standing or lateral recumbency
Flank or ventrolateral incision
What are the surgical steps for partial hysterectomy?
Ovarian pedicle: double ligated and transected
Ligate and dissect broad ligament
Intestinal clamps Incision and remaining horn suture in 2 layers inverting or TA90
Complete ovariehysterectomy is performed how?
Standing
* Latex or umbilical tape around the cervix and resection.
What is the name of the pathology with abnormal function of the constrictor vestibuli muscle?
A Urovagina >100ml of urine in the vagina
What are the surgical tx for urovagina in cows?
1) Vaginoplasty
2) Transverse fold (not enough in cattle) but a modified purse string placed at the vestibulovaginal
junction is effective
3) Urethral tube extension technique U-shape and Mckinnon tx
What does McKinnon technique consist of?
Describes closing only the ventral shelf than risk leakage at the sites where the arms of the Y join the straight part.
What are the steps to prepare for all urethral surgeries?
Either procedure the cow has to be restrained in stocks, epidural anesthesia, rectum evacuated, vagina rinsed and tail tied. Vulvar lips retracted with stay sutures, towel clamps or Blafour self-retaining retractor. Incise dorsal vaginal commissure can help visualize. Secure 28 Foley catheter in the urethra.
Urethral tube extension techniques describe
- U-shaped incision in the vaginal mucosa and transverse fold
and dissection until one dorsal and one ventral flap is obtained - Ventral flap closed in a Y-shape continuous inverting suture
pattern and the dorsal in an everting pattern - Caslick
- Foley left in place for 72h
How is the vaginal flap incision closed?
The vaginal flap incision is closed in a Y configuration, using two layers beginning with the ventral flap. The dorsal flap is sutured next.
Vaginoplasty describe
Standing + epidural + stay sutures in the vaginal lips
* Incision of the vaginal dorsal commissure improves the view
* Foley in the urethra
Are transverse fold tx suffient?
Transverse fold techniques are not sufficient in cattle but a
modified purse string placed at the vestibulovaginal
junction is effective
What does consist the urethral tube extension?
Extending urethral tube by making U-shaped incision in the vaginal mucosaand transverse fold
and dissection until one dorsal and one ventral flap is obtained * Ventral flap closed in a Y-shape continuous inverting suture pattern and the dorsal in an everting pattern
dx and name the 2 surgeries to repair
Buhner suture
Cervicopexy or vaginopexy
What is the treatment for vaginal cervical prolapse?
Epidural anesthesia, emptying of bladder
1) Buhner suture
* Incisions of the skin dorsal and ventral to the vulva
* A Gorlach needle passed dorsally and ventrally
* Important to pass it in the vestibulevaginal region
* Tightened so 2 fingers can pass
2) Cervicopexy or vaginopexy
* Embryotransfer donors
* Suturing of the cranial vagina to the iliopsoas muscle
* On one side only to avoid pneumovagina
What are the predisposing factors of vaginal and cervical prolapses?
Intraabdominal pressure associated with: size of uterus, intraabdominal fat, rumen distension, relaxation of pelvic girdle
What is the treatment of uterine prolapse?
Sternal recumbency with its rear limbs extended caudally + elevated
Epidural anesthesia
Lubrication and reduction of edema with glycerol
Reduced prolapse and instillation of warm sterile saline solution
oxytocin and calcium
If the uterine prolapse is severe, what should you consider?
Uterine amputation: Closed: placing surgical callicrate band.
Name the grades of vaginal prolapse.
I: vaginal mucosa and intermittent
II: vaginal mucosa and continuous
III: vaginal mucosa and cervix + urinary bladder entrapped
IV a: cervicovaginal eversion
IV b: cervicovaginal eversion + necrosis
diagnosis
Uterine prolapse in cattle
diagnosis
uterine prolapse ewe
How to address hemorrhage of uterus or vagina?
20-50 IU oxytocin to promote myometrial contractions. Ligate if possible. If not, packing vagina.
What pathologies are found in the vagina?
Urovagina, imperforate hymen, cystic major vestibular glands, dystocia due to stenosis of constriction of vulva and vestibule
Imperfect hymen is different from horses, describe.
Always associated with segmental aplasia of other parts of reproductive tract: vagina, cervix or uterine body. NO SURGICAL (because multiple defects and genetic condition).
What is the source of perivaginal bleeding and hematoma?
Internal pudendal artery (hematoma can become abscess you have to drain).
First degree perineal lacerations how to adress?
Casclick +/- removal of protruding perivaginal fat
*
Second degree perineal lacerations
Triangular shape mucosa removed from each side and
sutured. Sutures are first placed deeply, and mucosa and submucosa
are apposed in an attempt to create a wide surface like the
original perineal body with 2-0 or 3-0 absorbable sutures.
Third degree perineal lacerations
One stage repair: modified Goetz (6-bite).
6-8wks after calving
* One stage 6-bite w/o rectal mucosa
what is the blood supply of mammary gland?
LArterial supply – external pudendal artery and mammary branch of the ventral perineal
artery
what is the blood supply of mammary Innervatuion?
Innervation – L1, L2, genitofemoral nerve, sacral spinal nerves
What are the options for mastectomY?
Chemical destruction
Radical mastectomy (neoplasia)
Ligation of external pudendal artery in small ruminants
describe radical mastectomy
Neoplasia, chronic mastitis, granulomatous udder
* Sx should be performed in a non-lactating animal
* Elliptical incision saving as much skin as possible
➢ External pudendal artery and veins
➢Mammary branch of the ventral perineal artery
➢ Caudal superficial epigastric vein
* Tension relieving sutures and incisions, drain, open wound if needed
describe ligation of external pudendal artery in small ruminants
Gangrenous mastitis
* After trippel ligation and resection of the external pudendal artery the teats should be amputated
Teat surgery requires anesthesia, how is performed?
Circumferential injection of 20ml of 2%
lidocaine at the base of the teat
* +/- teat clamp or tourniquet
what are the 2 main problems in teats?
Supranumerary teats
Cojoined teats
why do supranumerary teats have to be removed?
MIncreased risk of mastitis and interference with milking
* Removal at 3-6 months with scissors
diagnosis? how do you diferentiate from fistula?
cojoined teat in lactating dairy cow
Differentiated from fistulas by injecting methylene
blue or ultrasound
What is the artery in the vaginal region?
Vaginal artery, a branch of internal pudendal artery
What is the success rate of rectovaginal fistula repair?
75% after rectovaginal fistula repair
What is the treatment of vaginal torsion?
- Vaginal correction (calf feet are grasped and rotated)
- Rolling lateral recumbency to side of torsion (R torsion the cow is cast in the R and rolled on the R side) + plank is placed on cow flank
- Celioctomy (after removal of the calf is easier to manually correct)
Reason for reduced milkflow
Agenesis of the streak canal - imperforate skin membrane – opened with
scalpel
* Tight streak canal – Hug’s teat knife at every 90 degrees
* Obstruction in the area of the rosette of Furstenberg – tissue flap
removed by Thelotomy/Theloscopy common with tight strak canal as well
* Milk stones
name the types of teat cistern and annular ring
Obstruction of the teat cistern and annular ring
* Type 1 <30%
* Type 2 >30%
* Type 3 – Between teat and mammary gland
* Type 4 – From the teat sinus to the gland sinus
what is the treatment for obstruction of teat cistern?
Thelotomy removal and suturing of the mucosa with 4-0
* Prone to granulation tissue formation
* If the defect is too big an autogenous vestibular mucosal
Graft with Silastic tube can be introduced
which type of teat laceration heal better?
Longitudinal lacerations
How is performed the surgical repair of teat laceration?
Three-layer closure with 4-0 absorbable sutures (submucosa, intermediate layer, skin)
* If the streak canal is affected a permanent teat catheter is introduced for 10 days
* Worse prognosis if the streak canal is affected compared to the teat sinus
* Fistula formation diagnosed by injection of methylene blue
* Repaired as full thickness lacerations after resection of the fistula
diagnosis
teat laceration
describe teat amputation
Teat clamp, elliptical incision around the teat at the junction of
the proximal and middle thirds
* Submucosa and intermediate layers are tightly apposed with
non-penetrating horizontal mattress sutures, skin closed with
interrupted sutures
describe thelotomy
3-4 cm longitudinal incision through the skin and intermediate
layers
* Blunt metal probe is inserted through the streak canal when
the mucosa is being incised to protect the contralateral
mucosal wall
* Inspection and routine 3-layer closure
describe theloscopy
Removal of obstructive tissue in the area of the rosette of
Furstenberg
* One portal in the canal and one lateral incision 10mm distal to
the teat clamp
