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FA2 Anesthesiology > Lecture 12 10/14/24 > Flashcards

Lecture 12 10/14/24 Flashcards

1
Q

What are the main zoonotic concerns when working with ruminants?

A

-Cryptosporidium
-Rabies virus
-Listeria monocytogenes
-Toxoplasma spp.
-Mycobacterium spp.
-Tuberculosis

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2
Q

Which pathogens cause occult/old bronchopneumonia in ruminants?

A

-Mycoplasma spp.
-Pasteurella spp.
-Bordatella spp.
-Mannheimia spp.
-Parainfluenza

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3
Q

What is the importance of identifying occult/old bronchopneumonia in ruminants?

A

animal can have a smaller tidal volume, which can lead to hypoxemia

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4
Q

What are the general trends in vitals between adult and young animals?

A

young animals have higher HR and RR, while BP is lower

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5
Q

Why is it important to consider a ruminant’s complex stomach when placing them under anesthesia?

A

-fasting for 24 hrs decreases fermentation and increases functional residual capacity of the lungs
-want to avoid excessive fasting and its adverse effects

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6
Q

Why is it important to consider a ruminant’s eructation when placing them under anesthesia?

A

-ruminants cannot eructate under GA
-methane must be vented out

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7
Q

What are the possible complications when placing a ruminant under anesthesia?

A

-regurgitation
-bloating
-choking

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8
Q

What are the effects of ruminal tympany/overfilling of gas?

A

-reduced functional residual capacity
–hypoventilation and hypoxemia
-compression of great vessels
–hypotension

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9
Q

How is ruminal tympany accounted for?

A

-animal placed in sternal or right lateral recumbency
-stomach tube passed to evacuate gas

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10
Q

When does regurgitation occur in ruminants under anesthesia?

A

-during intubation/active
-during GA/passive
-in any recumbency (sternal and R lateral best for avoidance)

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11
Q

What should be avoided in order to prevent regurg?

A

-esophageal intubation
-intubation under a light plane of anesthesia

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12
Q

What steps can be taken to prevent regurg?

A

-make sure ET tube is cuffed properly
-tilt head down

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13
Q

What are the characteristics of salivation?

A

-production continues under sedation/anesthesia
-must replace the fluid lost
-can obstruct the airway; tilt head down

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14
Q

What are the characteristics of anesthesia in neonatal/juvenile ruminants?

A

-can be considered monogastric if still on milk
-limited fasting
-monitor for hypoglycemia; increased risk

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15
Q

What are other considerations that must be taken into account when placing a ruminant under anesthesia?

A

-drug residues entering food chain
-ability to move them
-health status
-temperament
-type of surgery/procedure

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16
Q

What are the general characteristics of dairy cow anesthesia?

A

-used to being handled
-mild physical restraint + local/regional sedation
-light sedation and lower doses of sedatives/anesthetics for standing procedures
-endotracheal intubation for GA
-smoother recovery

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17
Q

What are the general characteristics of beef cattle anesthesia?

A

-infrequently handled
-require more physical restraint
-heavy sedation and larger doses or sedatives/anesthetics
-endotracheal intubation for GA
-rougher recovery

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18
Q

What are the uses/purposes of sedation in ruminants?

A

-restraint
-minor diagnostic procedures
-medical procedures
-improving quality of GA induction, maintenance, and recovery

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19
Q

What are the general characteristics of sheep and goat anesthesia?

A

-easier to handle
-most procedures done with mild physical restraint, light-to-moderate sedation, and local anesthesia

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20
Q

Which drug classes are used in ruminants?

A

-opioids
-benzos
-alpha2-agonists
-acepromazine

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21
Q

Why are sedatives reversed in ruminants?

A

-speeding up recovery time
-emergency treatment for adverse effects

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22
Q

Which reversal agents are used to reverse alpha2-agonists in ruminants?

A

-yohimbine (least selective)
-tolazoline
-atipemazole (most selective)

23
Q

Which reversal agent is used to reverse opioids in ruminants?

A

naloxone

24
Q

Which reversal agent is used to reverse benzos in ruminants?

A

flumazenil

25
Q

Which veins are used for IV access in ruminants?

A

-jugular vein
-caudal auricular vein

26
Q

What are the characteristics of alpha2-agonist use in ruminants?

A

-VERY sensitive to xylazine
-increased CNS sensitivity compared to horses
-need very small amounts
-avoided in neonates/juveniles when possible due to profound sedation

27
Q

What are the side effects of alpha2-agonists in ruminants?

A

-increased uterine tone/abortion
-placental crossing
-GI stasis

28
Q

What are the adverse effects of alpha2-agonists specifically in sheep?

A

-pulmonary edema
-increased airway pressure
-parenchymal damage
-bronchospasm
-venospasm
-hypoxemia
-cardiorespiratory collapse
-death

29
Q

How do alpha2-agonists impact the alveoli of sheep?

A

-macrophage response
-release of cytokines
-damage to alveolar type 1 cells, endothelium, and lung parenchyma

30
Q

What are the characteristics of butorphanol use in ruminants?

A

-synergistic effects with other sedatives
-no MAC reduction
-mild analgesia

31
Q

What are the characteristics of morphine use in ruminants?

A

-usually sedative
-reduces MAC
-moderate/profound analgesia

32
Q

What are the characteristics of benzo use in ruminants?

A

-short term sedation
-no analgesia
-mainstem of pediatric sedation
-mainstem of induction when combined with ketamine

33
Q

What is a ketamine stun used for?

A

dose dependent sedation/immobilization, usually with recumbency

34
Q

What are the original ketamine stuns?

A

IM or IV xylazine + ketamine

35
Q

What are the modified ketamine stuns?

A

-IV butorphanol, ketamine, and xylazine
-IM butorphanol, ketamine, and xylazine for aggressive cattle

36
Q

Which supplies are necessary for large ruminant intubation?

A

-your arms
-mouth gag/speculum
-appropriate size ET tube

37
Q

What are the characteristics of large ruminant intubation technique?

A

-always performed if under GA
-done in sternal recumbency
-palpate/use hand as guide for ETT

38
Q

Which supplies are necessary for small ruminant intubation?

A

-appropriate size ETT
-laryngoscope
-stylet

39
Q

What are the characteristics of small ruminant intubation technique?

A

-always performed if under GA
-done in sternal recumbency
-neck hyperextended to 180 deg. angle
-visualization of arytenoid cartilages and tracheal opening
-lidocaine used to prevent laryngospasm

40
Q

What should be expected when intubating a ruminant?

A

-regurg. and upper airway obstruction
-thick epiglottis and base of tongue
-small, far target with small opening between maxilla and jaw

41
Q

What are the complications that arise from placing the ET tube too far?

A

-blockage of the tracheal bronchus
-V/Q mismatch and hypoxemia

42
Q

What steps should be taken when positioning a ruminant for a procedure?

A

-use mats for padding
-avoid stretching limbs
-pull dependent limbs forward
-tilt head down to drain oral contents

43
Q

What are the characteristics of neuropathy/myopathy complications?

A

-depend on patient’s weight and time in recumbency
-superficial nerves compressed on hard surfaces (radial, femoral, peroneal)
-heavy muscular masses on hard surfaces
-poor tissue perfusion due to hypotension leads to ischemia

44
Q

What are the characteristics of bovine anesthesia maintenance?

A

-injectable or inhalant-based
-similar side effects to other species
-machine and ventilation similar to horses
-mechanical ventilation recommended
-on FiO2 of 1

45
Q

What are the characteristics of small ruminant anesthesia maintenance?

A

-injectable or inhalant-based
-similar side effects to other species
-machine and ventilation similar to large dogs
-mechanical ventilation recommended
-on FiO2 of 1

46
Q

Which drugs are used for injectable maintenance of anesthesia?

A

-guaifenesin
-ketamine
-xylazine

47
Q

How are the eyes positioned in the anesthetized bovine?

A

-ventral when in Plane III Stage 1 or 2
-central when in Plane III Stage 3 or Plane IV

48
Q

What are the characteristics of eye position in anesthetized small ruminants?

A

-inconsistent and unreliable
-generally central
-jaw tone used to assess depth

49
Q

What is the cut-off for hypotension in ruminants?

A

80 mmHg

50
Q

How is temperature monitored in ruminants?

A

-nasopharynx
esophagus

51
Q

What are the key points regarding ruminant recovery?

A

-always in sternal recumbency to favor eructation
-always elevated with a supported head
-extubate when ruminating motions are consistent
-always keep IV catheter in as long as possible

52
Q

What are potential post-anesthetic complications in ruminants?

A

-regurg.
-airway obstruction
-choking
-ruminal tympany
-prolonged recovery
-neuropathy
-myopathy
-hypothermia

53
Q

What are the characteristics of drug residues?

A

-use of off-label drugs is protected by AMDUCA
-very few drugs labeled for use in small ruminants
-consult FARAD for withdrawal recs
-provide withdrawal recs for each drug to every client, even if a pet
-phenylbutazone prohibited in female dairy cattle older than 20 months

FA2 Anesthesiology (23 decks)

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