L12: LA Surgical Complications (Morton)

Question 1

monitor hemorrhage by:

Answer 1

counting sponges
HR
mm
arterial pressure
bucket

Question 2

prolonged bleeding –>

Answer 2

tachycardia
inc. hypovolemia/hypotension
pale mm
inc. RR
metabolic acidosis

Question 3

what percent of BW does blood compose in horses

Answer 3

8% (~40L)

Question 4

transfusion should be performed when how much blood lost

Answer 4

> 10L

Question 5

loss of what percent blood volume –> hypovolemic shock

Answer 5

20-25%

Question 6

rapid loss of >50% –>

Answer 6

death

Question 7

systems affected by hemorrhage

Answer 7

CV
renal
nervous
MS

Question 8

hemorrhage tx

Answer 8

fluids (colloids)
transfusion
hypertonic saline
pain relief
monitor PCV throughout recovery

Question 9

which horses have low blood antigenicity

Answer 9

geldings
quarter horses
-try to do cross-matching, esp. for 2nd transfusion

Question 10

cause of acute airway obstruction

Answer 10

• recovery from anesthesia
• long sx duration, dorsal recumbency
• nasal/pharyngeal/laryngeal edema, nasal bleeding, arytenoid paralysis/spasm

Question 11

CS of acute airway obstruction

Answer 11

• anxiety, strong inhalation against obstruction (stridor/sturdor)
• high negative intrathoracic pressure –> alveolar fluid accumulation and pulmonary edema and hemorrhage
• no evidence of air passage through nostrils
• inc. abdominal effort
• abnormal abdominal movements
• nostril flaring
• panic and strugging

Question 12

Tx of acute airway obstruction

Answer 12

• remove obstruction
• phenylephrine in nostrils
• establish airway
• lasix
• O2 therapy
• Corticosteroids

Question 13

Prevention of acute airway obstruction***

Answer 13

endotracheal/nasotracheal tube during recovery

Question 14

tx of infection

Answer 14

• early recognition
• abx treatment (culture first)
• anti-inflammatories
• removal of infected/necrotic tissue, foreign material
• lavage, bandaging

Question 15

reasons for dehiscence

Answer 15

infection
high motion
excessive tension (esp. a problem in horses)
poor blood supply

Question 16

tx of dehiscence/herniation

Answer 16

• control infection (abx, anti-inflammatories)
• tension suture
• immobilization
• abd. support bandage to prevent hernia
• sx herniorrhaphy after 4-6mo.
• suture/mesh herniorrhaphy

Question 17

CS of post-op colic

Answer 17

• abd. pain
• inappetence
• lack of fecal prod.
• tachycardia
• dehydration
• esp. cecal impactions*

Question 18

tx of post-op colic

Answer 18

NPO
monitoring
fluids
analgesics
laxatives
spasmolytics
electrolytes
anti-endotoxic tx
colic sx

Question 19

laminitis

Answer 19

disruption of blood flow to lamina

• failure of attachments b/w P3 and hoof wall
• can be caused post-op by endotoxemia, or support limb laminitis

Question 20

CS of laminitis

Answer 20

• inc. lameness
• shifting weight b/w front and back feet
• inc. digital pulses
• inc. heat in affected feet
• sensitive to hoof testers
• rotational and/or sinking

Question 21

tx of laminitis

Answer 21

• PREVENTION
• analgesics
• nsaids
• vasodilators
• icing feet
• deep bedding
• corrective shoeing
• dietary changes
• DDF tenotomy

Question 22

predisposition for myopathy

Answer 22

• gen. anesthesia
• ischemia and reperfusion injury
• well-muscled horse
• intra-op hypotension
• sx position, length of sx, padding

Question 23

most common form of myopathy**

Answer 23

triceps myopathy

-char. by dropped elbow stance

Question 24

myopathy sequelae

Answer 24

• local or general swelling and pain
• m. fasiculations
• horse becomes anxious, profusely sweats
• can cause huge delay in recovery and increases risk of fracture
• renal damage
• m. damage

Question 25

tx of myopathy

Answer 25

• bandaging
• fluids
• anti-inflamm.
• m. relaxants
• analgesia

Question 26

sign of radial n. neuropathy

Answer 26

dropped elbow

most common neuropathy

Question 27

sign of femoral n. neuropathy

Answer 27

inability to extend stifle

Question 28

sign of facial n. neuropathy

Answer 28

lip drooping

Question 29

neuropathy inc. risk of fracture. May or may not resolve

Answer 29

:)

Question 30

tx of neuropathy

Answer 30

supportive therapy
bandaging/splints
sling
analgesics
anti-inflammatories
acupuncture