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AAA VMS4001 > NTCA - Rabbits > Flashcards

NTCA - Rabbits Flashcards

1
Q

Upper respiratory tract obstruction

A
  • Long narrow mouth, large tongue base, small diameter airway
  • Use ET intubation
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2
Q

Ileus (intolerance of oral intake due to inhibition of GI propulsion)

A
  • Predisposed by pain, stress, starvation, change in diet
  • Feed ASAP after recovery
  • Admin prokinetics - metoclopramide, ranitidine
  • Continue analgesia, discharge quickly
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3
Q

Premed anaesthesia

A
  • Opiates + midazolam combo -> sedation, muscle relaxation, dec stress
  • Buprenorphine, 30 µg/kg
  • Fentanyl/Fluanisone, 0.1 mg/kg
  • Pethidine, 10 mg/kg
  • Sedate before vascular access
  • SC preferred, same dose + less painful than IM
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4
Q

Pre-induction, vascular access

A
  • Give EMLA cream (mix of local anaesthetics), cover w/ bandage/plastic, leave for 20 - 30 min on both ears (then sedate during this time)
  • @ Marginal ear v (cephalic if large rabbit)
  • 22 - 24G (blue/yellow)
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5
Q

Pre-O2

A
  • Face mask preferred if sedated enough
  • O2 tent if stressed, aware of providing face mask quickly for induction
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6
Q

Induction - inhaled

A
  • Inhalent to effect = isoflurane
  • Or Sevoflurane - un-licensed, but more solvent
  • Face mask needed for humans, more dangerous for gas contamination
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7
Q

Induction, Ketamine combos - IM

A

(Use ketamine for shorter procedures, gives 15 - 20 min procedures, be aware of cranial reflexes)
- Ketamine, 15 mg/kg
- Midazolam, 3 mg/kg

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8
Q

Induction, Ketamine combo - IM/SC

A
  • Ketamine, 15 mg/kg
  • Medetomidine, 250 µg/kg
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9
Q

Induction, Ketamine combo - SC

A
  • Ketamine, 15 mg/kg
  • Medetomidine, 500 µg/kg - inc dose in rabbits
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10
Q

Induction, Ketamine combo - IV

A
  • Ketamine, 2 mg/kg
  • Medetomidine, 100 µg/kg
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11
Q

Induction - ‘hyponorm’ - IV/IM

A
  • Fentanyl/flaunisone, 0.1 mg/kg
  • Midazolam, 0.7 mg/kg to effect
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12
Q

Induction - IV to effect

A
  • Propofol, 2.2 mg/kg
  • Alfaxalone, 4 mg/kg
  • Only use if planning to place ET tube, cause apnoea
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13
Q

ET tube techniques

A
  • Visual - dilate larynx w/ equipment e.g. laryngoscope + spray larynx
  • Sound-guided - bung + whistle noise heard in trachea (no sound in oesophagus)
  • Blind
  • V-gel sits on top of larynx, prevents obstruction but not secretions/aspiration - don’t use in dentals, imaging procedures
  • Laryngeal mask airway
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14
Q

Anaesthesia maintenance

A
  • Induction combo - ketamine may be sufficient
  • Inhalant - isoflurane (sevoflurane un-licensed)
  • Use non-rebreathing system, T-piece, smaller tidal vol + inc resp rate -> inc minute vol ventilation
  • Reduce dead space w/ equipment, connector on ET tube, use high fresh gas flow to get rid of CO2
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15
Q

Fluid therapy

A
  • IV preferred (SC/IP used)
  • Hartmann’s
  • Higher maintenance - 10 mL/kg/hr
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16
Q

Anaesthetic recovery

A
  • Warm, calm environment
  • Rapid return to consciousness via reversal drugs: medetomidine = atipamezole; fentanyl/fluanisone = buprenorphine (sequential analgesia, partial agonist, will displace some of fentanyl bound to receptors)
  • Prevent ileus - offer food ASAP, give prokinetics, syringe feeding
  • Minimise stress - rapid discharge, analgesia
17
Q

Analgesia

A
  • NSAID - Meloxicam (continue via mouth), dog formulation more palatable
  • Maropitant - visceral pain (not licensed)
  • Opioid - Buprenorphine - long duration of action
  • Local - nerve blocks (dentals - mandibular, maxillary - ensure dose below toxic); local infiltration; topical
  • Adjunct - Ketamine; alpha 2-agonists
18
Q

Blood vol

A
  • 55 - 65 mL/kg
  • 10% loss safe
  • > 15 - 20% = hypovolaemia
  • Small patients, don’t want to lose much blood
19
Q

Fluid therapy

A
  • Marginal ear vein IV (cephalic, saphenous)
  • Intraosseous, subcut
20
Q

Surgical kit

A
  • Iris scissors
  • Metzenbaum scissors
  • DeBakey atraumatic forceps
  • Cautery - strict haemostasis
  • Sterile cotton buds
  • Crile + halsted forceps
  • Non-powdered gloves - reduce adhesions (can form in bowels -> obstruction)
  • Flush + swabs
21
Q

Suture material

A
  • 4-0, 3-0 (larger rabbits)
  • Absorbable synthetic = PDS, Vicryl, Monocryl
  • Tissue glue - skin
22
Q

Patient prep

A
  • Thin skin - easily injured + dense fur, avoid damaging during clipping + Sx (prefer intradermals)
  • Gentle scrub = chlorhexidine/spirit
23
Q

Adhesion

A
  • Pain and inappetance - obstruction, common after abdo Sx
  • Minimise tissue handling - use appropriate instruments
  • Keep tissue moist
  • Meticulous haemostasis
  • Minimal Sx time
  • Appropriate suture material + size
  • Mild cases analgesia - metacam
  • Severe may require revision surgery
24
Q

Post-op complications - abscessation

A
  • Thick pus - difficult to manage, redness, swelling, heat, pus
  • Debride - remove all infected tissue
  • Swab for C & S
  • Delayed closure/2y intention healing
  • Tx as abscess - leave partially open to drain + flush then remove
25
Q

Post-op complications - wound breakdown/self-trauma

A
  • Gentle prep of Sx site
  • Meticulous Sx technique
  • Appropriate suture material
  • Appropriate closure - no tension, apposing wound correctly
  • Analgesia following Sx - systemic + local - metacam if hydrated enough, buprenorphine
  • Avoid buster collar (coprophages) - t-shirt
  • Tx - revison Sx
26
Q

Post-op complications - gut stasis

A
  • Inappetance/gut stasis - anorexia, dec faecal output, depression
  • Tempt to eat - palatable foods straight after Sx, syringe feed
  • Continuous fluid therapy
  • Analgesia
  • Prokinetics - metoclopramide
  • Anti-ulcer therapy - ranitidine
  • Avoid buster collars (caecotrophy)
  • Minimise stress
27
Q

Ovariohysterectomy

A
  • Dorsal recum -> ventral midline incision 1/2 way between umbilicus + pubic symphysis + between caudal nipples (2/3 cranial, 1/3 caudal) + remove any fat for linea alba visualisation
  • Tent linea alba away from abdominal organs (no. 15 scalpel upside down) - 2 - 3 cm long, then extend w/ scissors
  • Exteriorise cervix (double) -> follow to horn -> follow along cranially to exteriorise the ovary (encased in fat)
  • Place 1 - 2 clamps beneath ovary pedicle + fat pad
  • Make small window in mesovarium + ligate (PDS) artery (ovarian + uterine artery) in body of fat of broad ligament
  • Ligate pedicle using PDS (surgeon’s/modified miller’s knot) + inspect for bleeding return to abdo + repeat on other side
  • Incise between clamps to release ovary
  • Ligate caudal to cervices (far cranial vagina) - transfixing/encircling (vicryl)
  • Transect + remove uterus + ovaries
  • Check stump for bleeding before release
  • Routine abdo closure + avoid tension
28
Q

Routine abdo closure

A
  • Simple continuous - linea alba
  • Simple continuous - subcut
  • Intradermal if possible or skin suture = tissue glue
  • 3-0/4-0 synthetic absorbable vicryl/monocryl
29
Q

Post op care

A
  • AB not necessary if no complications
  • Analgesia (NSAIDs + opioids) - metacam, buprenorphine, maropitant (visceral pain)
  • +/- Prokinetics - emeprid (metoclopromide)
  • Nutritional support - syringe feeding ASAP, monitor eating + faecal output
30
Q

Castration - modified open to closed

A
  • Gently incise scrotal sac + vaginal tunic
  • Gentle pressure to extrude testicle
  • Incise tunic
  • Release attachment between scrotal skin + tunica vaginalis to improve exteriorisation
  • Break down ligament of head of epididymis
  • Place two clamps over cord + place two encircling ligatures (within crush), cut between clamps to remove testicle
  • Release cord into tunic
  • Excise some proximal tunic
  • Ligate tunica vaginalis = less chance of bleeding
  • Repeat for other testicle
31
Q

Castration - closed

A
  • Incise just over scrotal sac
  • Strip away vaginal tunic from scrotal sac
  • Break down ligament at caudal tip of testicle
  • Place two clamps on spermatic cord - one encircling + one transfixing ligature cranial to clamp -> incise between clamps
  • Check stump for bleeding + release into abdo
  • Repeat for other testicle
32
Q

Castration - closure + post-op

A
  • Skin edges opposed (simple interuprted sutures) or glued
  • Separate from female for min 6 w, sperm still viable
33
Q

Cryptorchid

A
  • Inguinal or abdominal
  • Abdo - find caudal end of tunica vaginalis in inguinal canal -> pull into inguinal region
34
Q

Facial (subcutaneous) abscesses - remove in total

A
  • Must radio before
  • Make skin incision
  • Blunt dissect skin away from abscess capsule taking care not to penetrate
  • Vessels ligated/cauterised
  • Skin closed
    (Rarely achievable)
35
Q

Facial (subcutaneous) abscesses - marsupialisation

A
  • Open abscess capsule + suture to surrounding skin
  • Topical antibacterial preparation applied (non-toxic if ingested) e.g. Manuka honey
  • Clean w/ chlorhexidine regularly before applying preparation + flush out
  • Can suture hydrocolloid dressing - draw pus away whilst protecting wound (remove in 3 - 5 d)
36
Q

Uroliths + sludge

A
  • Urethral obstruction - attempt to catheterise + flush into bladder + remove via cystotomy
  • In bladder - remove by cystotomy
  • In kidney - Sx removal not recommended
  • Give fluids orally - may dilute stones
37
Q

Cystotomy

A
  • Dorsal recum - midline incision from umbilicus to pelvis (care not to incise bladder when cutting linea alba + avoid damage to caecum (v thin)
  • Exteriorise bladder
  • Moistened laparotomy swabs packed around the bladder
  • Stay sutures cranial + caudal to planned incision avoiding blood vv.
  • Incision in avascular area on ventral surface
  • Surgical spoon used to scoop out any bladder stones (calculi)
  • Catheter placed through bladder into urethra to flush further calculi out + ensure free flow of urine
  • Flush bladder
  • Closure - one or two layer closure, inverting suture pattern (partial thickness), leak test - inject saline
  • Routine closure of laparotomy wound

AAA VMS4001 (15 decks)

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