L19: Basic Repro Tract Surgery - LA (Freeman)

Question 1

advantages/disadv. of standing castration

Answer 1

• inexpensive
• fast
• avoids anesthesia
• uncomfortable
• not recommended in mules, donkeys, ponies, AMH
• uses emasculator
• stifle can contaminate your instrument

Question 2

adv/disadv. of recumbent castration

Answer 2

• IV anesthesia
• better access
• time consuming
• safer for surgeon

Question 3

“open” castration refers to:**

Answer 3

the initial incision

-incises skin and vaginal tunic (closed incises skin only)

Question 4

adv./disadv. of closed castration

Answer 4

• can remove a lot of tissue which is likely to swell

- may not get good hemostatic effect from emasculator

Question 5

castration aftercare

Answer 5

• walking exercise at least 2x daily to reduce swelling
• hydrotherapy optional
• abx and NSAIDs rarely used
• digital opening of incision rarely needed

Question 6

complications of castration

Answer 6

• swelling (edema)
• infection
• hemorrhage
• evisceration (bowel, omentum)
• severe pain
• unaltered behavior
• hydrocele
• urethral transection
• peritonitis

Question 7

cryptorchidism

Answer 7

• abdominal or inguinal
• uni or bilateral
• can have stallion-like behavior due to undescended testicle still producing testosterone

Question 8

dx of cryptorchidism

Answer 8

• Hx/PE/palpation
• rectal exam
• hormonal assay
• human chorionic gonadotropin (HCG) stimulation test

Question 9

fx of gubernaculum

Answer 9

-precedes testicle and brings it down into the scrotum through the vaginal ring

Question 10

penile reefing

Answer 10

-works well for smaller tumors on penis

Question 11

episioplasty (“Caslick’s Operation”)

Answer 11

• 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

Question 12

3rd degree perineal laceration

Answer 12

• rectovaginal laceration: jx b/w rectum and vagina completely torn
• rectovaginal fistula: jx b/w rectum and vagina incompletely torn

Question 13

risk factors for perineal lacerations

Answer 13

• first foal
• unassisted delivery
• often lose foal b/c foal gets stuck, or get infected uterus

Question 14

repair of 3rd degree perineal laceration

Answer 14

• 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

Question 15

Ovariectomy

Answer 15

• 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

Question 16

dx of granulosa-theca cell tumors

Answer 16

Rectal exam: large ovary, small contralateral ovary, absence of ovulation fossa
-U/S, elevated(?) inhibin

Question 17

approaches for ovariectomy

Answer 17

laparoscopy (most common)
flank
oblique paramedia
ventral midline
*hemorrhage a complication of all approaches*

Question 18

approaches to consider BEFORE performing C-section

Answer 18

assisted vaginal delivery
controlled vaginal delivery
fetotomy

Question 19

complications of C-section

Answer 19

• must be completed w/n 90 mins. to save foal

- hemorrhage from uterine incision

Question 20

controlled vaginal delivery (wiki)

Answer 20

“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.”