L12: LA Surgical Complications (Morton) Flashcards
monitor hemorrhage by:
counting sponges HR mm arterial pressure bucket
prolonged bleeding –>
tachycardia inc. hypovolemia/hypotension pale mm inc. RR metabolic acidosis
what percent of BW does blood compose in horses
8% (~40L)
transfusion should be performed when how much blood lost
> 10L
loss of what percent blood volume –> hypovolemic shock
20-25%
rapid loss of >50% –>
death
systems affected by hemorrhage
CV
renal
nervous
MS
hemorrhage tx
fluids (colloids) transfusion hypertonic saline pain relief monitor PCV throughout recovery
which horses have low blood antigenicity
geldings
quarter horses
-try to do cross-matching, esp. for 2nd transfusion
cause of acute airway obstruction
- recovery from anesthesia
- long sx duration, dorsal recumbency
- nasal/pharyngeal/laryngeal edema, nasal bleeding, arytenoid paralysis/spasm
CS of acute airway obstruction
- 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
Tx of acute airway obstruction
- remove obstruction
- phenylephrine in nostrils
- establish airway
- lasix
- O2 therapy
- Corticosteroids
Prevention of acute airway obstruction***
endotracheal/nasotracheal tube during recovery
tx of infection
- early recognition
- abx treatment (culture first)
- anti-inflammatories
- removal of infected/necrotic tissue, foreign material
- lavage, bandaging
reasons for dehiscence
infection
high motion
excessive tension (esp. a problem in horses)
poor blood supply
tx of dehiscence/herniation
- control infection (abx, anti-inflammatories)
- tension suture
- immobilization
- abd. support bandage to prevent hernia
- sx herniorrhaphy after 4-6mo.
- suture/mesh herniorrhaphy
CS of post-op colic
- abd. pain
- inappetence
- lack of fecal prod.
- tachycardia
- dehydration
- esp. cecal impactions*
tx of post-op colic
NPO monitoring fluids analgesics laxatives spasmolytics electrolytes anti-endotoxic tx colic sx
laminitis
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
CS of laminitis
- 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
tx of laminitis
- PREVENTION
- analgesics
- nsaids
- vasodilators
- icing feet
- deep bedding
- corrective shoeing
- dietary changes
- DDF tenotomy
predisposition for myopathy
- gen. anesthesia
- ischemia and reperfusion injury
- well-muscled horse
- intra-op hypotension
- sx position, length of sx, padding
most common form of myopathy**
triceps myopathy
-char. by dropped elbow stance
myopathy sequelae
- 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
tx of myopathy
- bandaging
- fluids
- anti-inflamm.
- m. relaxants
- analgesia
sign of radial n. neuropathy
dropped elbow
most common neuropathy
sign of femoral n. neuropathy
inability to extend stifle
sign of facial n. neuropathy
lip drooping
neuropathy inc. risk of fracture. May or may not resolve
:)
tx of neuropathy
supportive therapy bandaging/splints sling analgesics anti-inflammatories acupuncture
