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540 (cow class) > GI sx > Flashcards

GI sx Flashcards

1
Q

LDA left sided approach - procedure?

A
  • thread suture onto large round needle and place continuous suture patten on more dorsal aspect of abomasum, lateral to greater omentum
  • pull through to mid-way of suture, exit incision, replace round needle w/ large PM needle
  • attach both ends of suture onto same needle for single exit point method
  • host PM needle in guarded manner, follow body wall ventrally, aim for exit point of needle to be 5cm R of midline and 5cm caudal to sternum
  • assist. pulls slowly and steadily on needle/string combo while surgeon pushes with flat hand and forearm –> abomasum deflates as pushed ventrally
  • abomasum should be flush to body wall, assist keeps suture snug while puncturing stopper with needle
  • tie in place w/ bottle stopper
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2
Q

in a LDA left sided approach, what can you see in the cranioventral aspect of incision? tell me where the greater omentum is in relation to this.

A

greater curvature of abomasum

greater omentum attaches along dorsal and caudal border of visible abomasum, then continues medially b/t abomasum and rumen

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3
Q

what are the pros and cons to using the left sided approach for LDAs?

A

pros:
- fast
- typically no deflation needed
- easier to perform on cows in last trimester of pregnancy
- abomasum mostly visible and entirely palpable
- abomasum is tacked to a relatively anatomically correct position

cons:
- can’t explore R abdomen easily
- if your
e wrong, you can’t do a prophylactic tack
- assistant safety

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4
Q

what is a possible complication with L sided LDA approach?

A

fistulation

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5
Q

you should operate on cows ____.

A

standing

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6
Q

you should operate on calves ___.

A

down

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7
Q

true or false: any cow/calf that is showing signs of colic, has abdominal distention, and positive succession on the R side should be considered surgical

A

true

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8
Q

true or false: cows/calves that have severe colic and systemic compromise are candidates for humane euthanasia

A

true

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9
Q

what can we exteriorize from the right paralumbar fossa ?

A

cecum, prox. colon
spiral loop of ascending colon
idk what else lmao

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10
Q

most SI lesions —-> ______ —> ____, sequestration of ____.

A

obstruction, ileus, fluids/gas

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11
Q

with GIT lesions, distension is ___ to the lesion

A

proximal

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12
Q

with SI lesions, there is ____ succession and changes in _____.

A

positive, body contour

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13
Q

strangulating lesions cause more/less/the same C/S than non-strangulating lesions

A

more

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14
Q

tell me C/S differences b/t strangulating and non-strangulating lesions (fecal output, abd. distension, systemic compromise, abd. pain)

A

fecal output:
- non-stran= decreased
- stran = little/no output, often only mucus present

abd. distension: both

systemic compromise
- non-stran= minor
- strang = mod. to major

abdominal pain
- non-strang = mod.
- strang = severe

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15
Q

tell me some signs of abdominal pain in cows

A

stretching out of hindlimb, treading of His, kicking at belly, severe pain = recumbency

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16
Q

tell me how to do field-level blood transfusions in bovines

A
  • donor can be any cow in herd
  • sedate donor and place IV
  • commercially prepared blood collection bags or prep your own anticoagulant
  • collect 4-6L of blood
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17
Q

what are the indications for a rumenotomy?

A

hardware dz, vagal indigestion, rumen acidosis

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18
Q

what are the VERY GENERAL steps to a rumenotomy?

A
  1. incision into L PLF + exploration of abd.
  2. tack rumen to skin creating a water tight seal and securing the rumen
  3. incise rumen, remove ingesta, and explore
  4. close rumen (double layer inverting pattern before undoing tack, rinse before you undo tack)
  5. remove tack and close abdomen
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19
Q

what are the indications for a rumenostomy?

A
  • chronic bloat in young, growing calves
  • chronic bloat in feedlot cattle
  • parenteral nutrition
  • rumen flora donors
  • unresolved vagal cows
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20
Q

what are the VERY GENERAL steps of a rumenostomy?

A
  1. remove circle of skin in PLF, remove another circle of skin the same size of EAO
  2. grid IAO and transversus
  3. incise peritoneum
  4. grasp rumen and pull it out, 4x stay sutures around the clock from rumen serosa to hypodermic
  5. remove circle of rumen, suture cut-edges of rumen to skin

we want a tight seal b/t rumen and skin

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21
Q

segmental intestinal volvulus usually happens where?

A

distal jejunum and ileum

22
Q

on a rectal of a segmental intestinal volvulus, what do you feel?

A

distended SI often wedged in pelvic inlet

23
Q

if you do U/S for a segmental intestinal volvulus, what do you see and where?

A

R PLF, distended loops of bowel

24
Q

what 2 systemic C/S do you get with segmental intestinal volvulus?

A

tachycardia, dehydration

25
Q

how do you treat segmental intestinal volvulus?

A

sx

go in and untwist bowel (often exteriorized), then put back in and assess bowel viability

26
Q

tell me generally how to assess bowel viability? namely in the treatment of segmental intestinal volvulus

A
  • colour (pink>red)
  • motility (moving>not moving)
  • submucosal edema (some but not lots)
  • hemorrhage
27
Q

tell me the prog. of treatment of segmental intestinal volvulus

A

good if bowel colour and contractility improve w/I 5mins of correcting twist

28
Q

true or false: the amount of bowel involved with SI volvulus doesn’t often allow for resection

A

true

29
Q

with torsion of the mesenteric root, only part of the ___ and ____ are spared.

A

duodenum and dorsal colon

30
Q

true or false: torsion of the mesenteric root is not that painful

A

false. it is profoundly painful

31
Q

what is the tx for torsion of the mesenteric root?

A

humane euthanasia

32
Q

who is more prone to intussusception? and where?

A

calves > cows
distal to ileum

33
Q

what are the C/S of intussusception?

A
  • low grade abd pain
  • fecal material contains mucus or melena
  • pronounced fluid wave upon succession of R side of abd
  • low bilateral abd. distention
34
Q

what is the tx for intussusception?

A

surgery

exteriorize obstruction, resection and anastomosis

exteriorize obstruction by rotating cecum 90 degrees outside of abd to bring ileum into view, follow ileum pros to distal flange, bowel prox to obstruction is distended

35
Q

tell me the difference b/t good and bad prognosis for intussuception

A

good: passing of manure w/I 24 hours of sx
bad: peritonitis already present, post-op ileum, too much devitalized bowel

36
Q

what 2 organisms play a role in jejunal hemorrhagic bowel syndrome?

A

Clostridium perfringes type A
&
Aspergillus fumigatus

37
Q

jejunal hemorrhagic bowel syndrome is seen in what signalment of bovines?

A

high producing, multiparous dairy cows at peak lactation (60-120 DIM) who are consuming a high E TMR

38
Q

what are the C/S of jejunal hemorrhagic bowel syndrome?

A
  • depression
  • decreased/absent rumen motility
  • dramatic drop in milk prod
  • colic
  • bruxism
  • R side abdominal ping and succession
  • distention of ventral abdomen bilateraly
  • dehydration
  • tachycardia
  • pale mm
  • melena and/or clotted blood in feces
39
Q

what happens to cattle who get jejunal hemorrhagic bowel syndrome?

A

intraluminal and/or intramural hemorrhage and necrosis with subsequent blood clot formation and intestinal obstruction of jejunum

40
Q

what is the ddx for the C/S of jejunal hemorrhagic bowel syndrome?

how do you differentiate?

A

abomasal ulcers

ulcers are not obstructive

41
Q

how do you dx jejunal hemorrhagic bowel syndrome?

A

rectal palp of distended loops + scant/no feces

profound abd. distention

percutaneous U/S

Sx ID

42
Q

what are the options for treating jejunal hemorrhagic bowel syndrome and when do you use them?

A

medical: early and aggressive tx
surgical: once clots adhere to intestinal lumen, a complete intestinal obstruction is formed and surgery is needed

43
Q

how do you do medical treatment of jejunal hemorrhagic bowel syndrome? before clots form

A
  • IV fluids (LRS or 0.9% saline), add calcium gluconate
  • 2% lidocaine at 3mg/kg/hr for 18 hours
  • blood transfusion
44
Q

how do you medically treat jejunal hemorrhagic bowel syndrome in commercial/low value cows? assuming clots have formed

A

-2L hypertonic saline IV followed by 5-10 gallons of water orally (can add mineral oil to lubricate clots to pass)
- 250-500mL calcium gluconate SQ
- oral KCl 75-150g BID

45
Q

tell me the prognoses for medical and surgical treatment of jejunal hemorrhagic bowel syndrome

A

medical: grave if clots have adhered, fair if clots don’t adhere and animal is sufficiently supported, fair to good if you train farmers to recognize early signs and implement aggressive medical therapy asap

surgical: poor even if sx occurs <48 h after onset; grave if sx occurs >48h after onset = humane euthanasia

46
Q

list 3 things that can cause cecal dilation, dislocation, or torsion

A

hypocalcemia
confinement
diets excessively rich in starch

all cause atony and distention

47
Q

tell me the relative locations of the cecum and abomasum in the cow

A

right side

cecum: dorsal PLF
abomasum cranial to that, and a little lower (bigger area)

48
Q

what are the C/S of cecal dilation/dislocation?

A

decreased feed intake, decreased milk prod, decreased feces, normal HR

49
Q

what are the C/S of cecal torsion?

A

off feed & dramatic decrease in milk prod, abd. pain, abd. distention (papple shape), dehydration, tachycardia

50
Q

how do you treat cecal dilation? (no torsion or dislocation)

A

IV fluids, NSAIDs, increase roughage in feed

51
Q

how do you treat cecal torsion, dislocation, or what do you do if medical mgmt of cecal dilation isn’t working?

A

surgery –> typhlotomy

540 (cow class) (32 decks)

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