NTCA - Reptiles Flashcards
1
Q
Considerations for Sx
A
- Skin structure
- Slower healing
- Lack of a diaphragm - easier for Sx
- Keep sutures in for min 8 w
- Ventilator/nurse needed to manually breathe for
2
Q
Suture material
A
- PDS/nylon sutures
3
Q
Analgesia
A
- Avoid if - GI disease/surgery, kidney disease dehydration/hypotension (hard to measure)/hypovolaemia corticosteroids administered
- Opioids - Buprenorphine, Pethidine or Methadone; Butorphanol (mainly sedation)
- Local - nerve block, epidural, local infiltration/topical
- Adjunct - Ketamine, Lidocaine, Fentanyl or Dexmedetomidine (bolus +/- CRI); Nitrous oxide
4
Q
Induction considerations
A
- Injectable preferred over inhalant - has 1 ventricle, shunts blood to periphery, may stop breathing, takes longer
- No diaphragm, most drugs cause resp depression, active process of inspiration/expiration, use same muscles for locomotion in turtles + tortoises
5
Q
Pre-O2 considerations
A
- Unlike mammals (ppCO2 stimulates resp centre only, inc rate if inc ppCO2), respond to mixture of ppCO2 + ppO2
- If pre-O2 w/ 100% O2, will stop breathing
6
Q
Injection considerations
A
- Renal portal system - veins of hind limb drain to kidneys before liver
- Inject at fore limbs, esp for toxic drugs
7
Q
ET tube considerations
A
- Glottis at tongue base, easy to find
- Don’t cuff species w/ complete tracheal rings e.g. turtles/tortoises
8
Q
Incision
A
- Controlled between scales - fine scalpel or hypodermic needle
- Skin moves towards inversion
9
Q
Closure of incision
A
- Utilise an everting pattern to enable apposition of ST for healing
- Horizontal mattress
- Skin staples
- Skin = 1y holding layer, muscle too thin, coelomic mem thin + friable
- Needs to be secure + durable, skin takes up to 12 w to heal
10
Q
Pharyngostomy tube placement - nutritional, med admin, physiological anorexia, hepatic lipidosis
A
- Pre-mark tube - length to enter stomach
- Curved haemostats inserted into mouth (anaesthetised)
- Tent skin on caudal neck
- Lateral pos of caudal neck - avoids major vv
- Incise skin with scalpel (no. 15) over point of haemostats
- Grasp feeding tube w/ haemostats + pull into mouth
- Turn tube 180 degrees using haemostats, advance down oesophagus
- Secure tube w/ nylon skin sutures + elastoplast + Chinese finger trap/purse to secure into skin - full thickness of skin
- Flush before + after giving food
11
Q
Skin biopsy - dertmatological conditions
A
- Biopsy site selected - where pathology + normal skin present; acceptable tension on skin at closure; no detrimental effects on structures e.g. eyelids/vent following harvest
- No. 11 scalpel - incise between scales
- Elliptical incision made - abnormal + normal scales
- Collect from multiple sites
- Close w/ everting sutures
12
Q
Scalpel for biopsy
A
No. 11
13
Q
Coeliotomy (access repro, GI, urinary tract + liver) (lizard)
A
- Single paramedian incision (beside midline ventral abdominal vein)
- Skin prepared to incised between scales
- Laterally compressed lizards - visualisation of coelomic viscera w/ incision caudal to last rib
- Transection of ribs to improve access
14
Q
Coeliotomy (access repro, GI, urinary tract + liver) (snake)
A
- Lateral incision (avoids ventral abdo v., avoids transecting large gastric scutes, speeds up healing)
- Can mark pos of lesion on target organ
15
Q
Tortoise plastronotomy
A
- Flap of shell created in abdo (+/- femoral) scutes - incised edges angled in to inc surface area + keep flap in position after Sx + avoid heart, paired paramedian vv + pelvic bones (size limited in species w/ hinged plastron)
- Closure = resin/fibreglass patching over defect
- Use Dremmel cutting disc, create angled incisions into plastron + produce mobile flap of bone to access coelom w/ sterile saline to prevent thermal injury to bone
- Leverage applied to displace plastron fragment
- Remove plastron flap + coelomic mem incised to access viscera
16
Q
Pre-ovulatory or follicular stasis
A
- Husbandry - early cases
- Sx - coeliotomy + bilateral ovariectomy
- Absence of oviductal pathology - no indications to remove the oviducts
17
Q
Ovariectomy / pre-ovulatory or follicular stasis Sx
A
- Single paramedian incision to access both ovaries
- Atraumatic forceps, grasp connective tissue between follicles + cotton buds to manipulate fragile follicles (don’t handle follicle itself, only surrounding connective tissue)
- Caudal VC in close association w/ right ovary
- L adrenal gland + L renal vein adjacent to L ovary
- Haemaclips placed on ligatures + for haemostasis
- Ovarian regn pos if incomplete resection
18
Q
Oophoritis
A
- Culture sample under sterile conditions
- Post-op AB
19
Q
Egg binding - oviductal inertia (chelonia + lizards)
A
- Oxytocin (unresponsive in snakes), more effective in tortoises
- Calcium therapy
- Collapsed/weak unresponsive to therapeutics - percutaneous aspiration of egg material to aid passage of retained eggs (risk of coelomitis), not pos in chelonia
20
Q
Obstructive + non-obstructive dystocia unresponsive to medical therapy
A
- Salpingectomy
- Caudal coeliotomy - access to both oviducts
- Bilateral ovariectomy recommended at same time
21
Q
Salpingectomy
A
- Long mesosalpinx - (fold of peritoneum over both uterine tubes) allows exteriorisation of vv + gentle retractiobn
- Ligatures/haemaclips applied to vv
- Transfixing ligature/haemaclip placed across caudal oviduct at junction w/ cloaca prior to removal
- Snakes - multiple incisions needed to access + remove both oviducts
- Closure via polydioxanone (PDS) suture with swaged on needle
22
Q
Caesarian
A
- Multiple salpingotomy incisions made -> ova/foetuses removed individually
- Lateral incision made w/ scalpel then extend w/ fine scissors, incise around scales
- Muscle layers sharply incised + ventral ribs transected to access coelomic cavity
- Coelomic mem incised + coelomic fat pad reflected
- Foetus within oviduct -> elevate oviduct wall
- Fine scissor sharply incise oviduct wall
- Gentle traction of each foetus for removal
- Closure of salpingotomy incision via polydioxanone (PDS) suture with swaged on needle
- Repeat over entire length of both oviducts - closed w/ apposition of edges of muscle layer + horizontal mattress sutures in skin
- Radiograph to confirm removal
23
Q
Hemipene/penile prolapse
A
- Replaced w/ suture over hemipene aperture if needed
- Infected/necrotic/chelonian penis - amputated
24
Q
Hemipene amputation
A
- Transfixing ligature placed at base
- Sharp dissection -> removal
- Affects fertility, no urinary tract effects
25
Q
Hemipene abscessation
A
- Remove purulent material
- AB + analgesic therapy
- Address underlying cause
26
Q
Oviductal prolapse
A
- Salpingectomy - unilateral + ovariectomy
(Retention of isilateral ovary w/ stimulation from the contralateral oviduct -> ovulation of yolks into coelom)
27
Q
Urinary bladder prolapse (chelonia)
A
- Cystotomy - via plastronotomy
- Closure of cystotomy - inversion of bladder lining
28
Q
Dec risk of coelomitis from urine leakage in Sx
A
- Elevate bladder up to incision
- Pack coelom w/ swabs + flush w/ sterile saline after Sx
29
Q
Small colonic prolapse
A
- Osmotic agents e.g. glucose, reduced oedema
30
Q
Repeat/large (> 1cm) colonic prolapse
A
- Surgical pexy (fixation) - supporting structures likely damaged
- Caudal coeliotomy + colon sutured to body wall (incisional colonopexy) -> greater stability long-term, but risk of dehiscence + coelomitis
31
Q
Aural abscessation (aquatic chelonia)
A
- Reptilian pus = solid, must be Sx removed
- Ventral half of tympanum removed (w/ 23G needle)
- Purulent material removed + swab taken of inner ear for C&S
- Cavity flushed 1:100 chlorhexidine
- Eustachian tube patency checked w/ microtip swab
- Incision left to heal via 2y intention
- Close skin in aquatics for return to water
