L19: Basic Repro Tract Surgery - LA (Freeman) Flashcards
advantages/disadv. of standing castration
- inexpensive
- fast
- avoids anesthesia
- uncomfortable
- not recommended in mules, donkeys, ponies, AMH
- uses emasculator
- stifle can contaminate your instrument
adv/disadv. of recumbent castration
- IV anesthesia
- better access
- time consuming
- safer for surgeon
“open” castration refers to:**
the initial incision
-incises skin and vaginal tunic (closed incises skin only)
adv./disadv. of closed castration
- can remove a lot of tissue which is likely to swell
- may not get good hemostatic effect from emasculator
castration aftercare
- walking exercise at least 2x daily to reduce swelling
- hydrotherapy optional
- abx and NSAIDs rarely used
- digital opening of incision rarely needed
complications of castration
- swelling (edema)
- infection
- hemorrhage
- evisceration (bowel, omentum)
- severe pain
- unaltered behavior
- hydrocele
- urethral transection
- peritonitis
cryptorchidism
- abdominal or inguinal
- uni or bilateral
- can have stallion-like behavior due to undescended testicle still producing testosterone
dx of cryptorchidism
- Hx/PE/palpation
- rectal exam
- hormonal assay
- human chorionic gonadotropin (HCG) stimulation test
fx of gubernaculum
-precedes testicle and brings it down into the scrotum through the vaginal ring
penile reefing
-works well for smaller tumors on penis
episioplasty (“Caslick’s Operation”)
- surgically corrects pneumovagina “wind sucking,” an age-related condition due to poor perineal conformation (can carry into the uterus); feces can drop into vulva
- suture upper level of vulva
- combined w/ other treatments for: urine pooling, perineal injuries
3rd degree perineal laceration
- rectovaginal laceration: jx b/w rectum and vagina completely torn
- rectovaginal fistula: jx b/w rectum and vagina incompletely torn
risk factors for perineal lacerations
- first foal
- unassisted delivery
- often lose foal b/c foal gets stuck, or get infected uterus
repair of 3rd degree perineal laceration
- NOT an emergency repair!
- wait 30d for swelling to go down, THEN repair
- recreate tear then suture them from side to side using large bites in submucosa
- give epidural
Ovariectomy
- to remove a granulosa cell tumor or to castrate a “normal” mare (poor behavior, jump mare)
- granulosa-theca cell tumors can cause abnormal behavior: stallion-like, erratic or no estrus, infertility
dx of granulosa-theca cell tumors
Rectal exam: large ovary, small contralateral ovary, absence of ovulation fossa
-U/S, elevated(?) inhibin
approaches for ovariectomy
laparoscopy (most common) flank oblique paramedia ventral midline *hemorrhage a complication of all approaches*
approaches to consider BEFORE performing C-section
assisted vaginal delivery
controlled vaginal delivery
fetotomy
complications of C-section
- must be completed w/n 90 mins. to save foal
- hemorrhage from uterine incision
controlled vaginal delivery (wiki)
“If resolution of the dystocia seems challenging or not possible in the standing mare because of the mare’s straining or the orientation of the fetus, a controlled vaginal delivery should be considered. If general anesthesia and a controlled vaginal delivery are likely, epidural anesthesia should not be done. The mare’s hindquarters are hoisted to allow the GI tract to move cranially in the abdomen, providing space to more readily perform fetal manipulations.”
