L11: Peri-operative management of LA (Morton) Flashcards
which breed prone to hyperkalemic periodic paralysis (HYPP)
American Quarter Horse
broodmares susceptible to osteopenia
:)
how long should adult ruminants be fasted?
48hrs, NPO 24hrs.
- horses typically NOT NPO before sx!*
- do not fast neonate ruminants (rumen not functional)
pre-op patient assessment
- PE including re-breathing and thorough MS system exam
- hydration status
2-3 sec. skin tent –>
4-6% dehydration
3-5 sec. skin tent –>
7-9% dehydration
> 5 sec. skin tent –>
> 9% dehydration
death rate for healthy horses in anesthesia
1/1000
factors influencing anesthetic risk
age
type/duration of sx
time of day
weight
anesthesia risks
fractures
myopathy
neuropathy
anesthetic death
Fast horses?
- only for certain elective procedures (ie. laparoscopy)
- never in neonates unless dz indicates
- access to water unless refluxing (restriction can predispose impactions)
- minimal risk of aspiration
nasogastric tube
- indwelling during induction and sx of horses w/ gastric distention/reflux
- decreases risk of gastric rupture/aspiration
- removed for recovery
Pre-op fracture stabilization:
- rads
- Modified Robert Jones
- Kimsey splint for fractures/luxations of the fetlock and distad
- fractures of metacarpal/metatarsal bones and proximad require alternative splinting
induction of anesthesia
- flush mouth w/ water to remove food
- pre-sedate to achieve 5 legged stance
- position against wall
- calm/quiet area
myopathy results from:
ischemia
neuropathy results from:
excessive pressure or stretch applied to peripheral nerve
proper lateral recumbency**
dependent forelimb pulled forward**
support weight of upper limbs
protect down eye
proper dorsal recumbency
hind limbs flexed
should trough well padded
most dangerous time for patient
post-op recovery
post-op daily monitoring
- manure production (dec. production sign of impaction colic)
- NSAIDs and Abx to dec. risk for GI disease (ie. colitis, gastritis)
- intense monitoring of splints and casts
common sources of colitis
right dorsal colitis
salmonellosis
who is most likely to get gastritis?
foals
post-op exercise
- usually stall rest
- cross tie to prevent lying down
- daily grazing
- trotting good for post-op castration
Main considerations overall
- owner consent and prep
- jugular acces
- hydration and acid/base status
- gastric distention
- duration
- positioning
- potential sx procedures/complications
- recovery: head and tail ropes
- post-op therapies and complications
