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VMS 4001 > Rabbit Surgery > Flashcards

Rabbit Surgery Flashcards

1
Q

Halstead’s Principles?

A
  • Gentle tissue handling
  • Meticulous haemostasis
  • Preservation of blood supply
  • Strict aseptic technique
  • Tension free closure
  • Accurate apposition of tissues
  • Eliminate dead space
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2
Q

Pre-Op Considerations?

A

blood and urine sampling
thoracic radiographs (abdo calculi & pulm uterine adenoC ?)
- Stabilisation (no fasting)
- Hypothermia (min fur removal, limit use fo alcohol-based products)

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3
Q

What is the blood volume of a rabbits?

A

55-65ml/kg
10% loss safe
Above 15-20% = hypovol

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4
Q

Fluid therapy?

A
  • Marginal ear vein IV
  • IO, s/C
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5
Q

Surgical kit for rabbits?

A
  • Iris scissors
  • Metzenbaum scissors
  • Debakey atraumatic forceps - cautery
  • sterile cotton buds
  • Crile and halstead forceps
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6
Q

What to use or not use in rabbit surgery?

A

Don’t use powdered gloves reduces adhesions
DO use flush & swabs

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7
Q

What suture materials to use?

A
  • 4-0, 3-0 (larger rabbit)
  • Absorbable synthetic (PDS, vicryl, monocryl)
  • Avoid catgut
  • Tissue glue may be enough for skin
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8
Q

Clipping fur ?

A
  • Thin skin, easily injured
  • Dense fur
  • Well maintained clipper blades
  • Clip slowly
  • Spread skin
  • Flat surface of blade parallel
  • Avoid damaging skin
  • Only what is needed

CARE as skin tears easily

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9
Q

Detail skin prep?

A
  • Gentle scrub
  • Chlorehex / spirit
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10
Q

what species differences of skin?

A
  • Easy to create unwanted dead space
  • Prone to granulation tissue formation
  • Rapid healing
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11
Q

TOP TIPS ?

A
  • Well maintained clippers with sharp blades & small teeth & care to minimise trauma
  • Wavoid excess scrubbing
  • keep alcohol to minimum
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12
Q

Describe Adhesions in Rabbits

A

pain & inappetance
- Minimise tissue handling
- Meticulous haemostasis
- Keep tissue moist
- Minimise surgical time
- Appropriate suture material

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13
Q

Tx for adhesions?

A

Mild cases analgesia
Severe may require revision surgery

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14
Q

Describe abscessation as post-op complication?

A

PUS is thick, infections difficult to manage
CLs: redness, heat pus, swelling
TX: debride , swab? delayed closure or secondary intention healing

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15
Q

Post-op complications- wound breakdown?

A
  • Meticulous surgical technique
  • Minimally reactive sutures
  • Appropriate closure
  • Analgesia
  • Avoid buster collar -> t shirt better
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16
Q

Post-op complications : gut stasis.

A
  • Inappetance/ gut stasis
    potentially fatal
    CLS: anorexian reduced fecal output, depressio,
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17
Q

TX for Gut stasis?

A
  • IVFT
  • analgesia
  • Prokinetics - metoclopramide
  • Anti-ulcer therapy - ranitidine
  • Avoid buster collar (caecotrophy)
  • Nursing & monitor
  • Minimal stress
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18
Q

INdications for OVH?

A
  • Prevent unwanted pregnancies
  • Avoid hormonal territorial bhvr
  • AdenoCs
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19
Q

when should we do OVH?

A

5-9 months

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20
Q

describe anatomical consideration of OVH?

A
  • Bixornuate duplex uterus.- 2 uterine horns into 2 distinct cervices
  • Lots of fat encasing ovary (mesovarium) in the mesometrium
  • Long fallopian tubes, convoluted and friable
  • Ovaries small, elongated pale
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21
Q

Step 1 OVH?

A
  • Ventral midline incision (halfway between umbilicus and pubic symphysis or between caudal nipples)
  • Tent linea alba away 2-3cm long
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22
Q

Step 2 OVH?

A
  • Exteriorise cervix
  • Follow the horn - follow along to exteriorise ovary (encased in fat) & identify blood supply
  • Make your window (tear)
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23
Q

Step 3 OVH?

A
  • Place one/two clamps beneath ovary & fat pad
  • Small window in mesovarium
  • Ligate artery in the body of fat
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24
Q

STEP 4?

A

Incise between clamps to release ovary

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25
Q

Surgical technique difference?

A
  • Vessel in broad ligament which needs ligating
  • Uterine artery passes along horn and meets with ovarian artery
  • Make small hole in mesometrium in avascular area and ligate ovarian and uterine artery together in one
26
Q

STEP 5?

A
  • Ligate just caudal to the cervices (far cranial vagina): transfixing or encircling -> ligate more distally risks damage to ureters, bladder vasc & urine leakage
  • Transect and remove uterus & ovaries
27
Q

STEP 6?

A

Check stump for bleeding

28
Q

Closure?

A
  • Routine abdo closure (scs linea alba, intradermal if poss or skin suture)
  • AVOID TENSION
  • 3-0 or 4-0 synthetic absorbable
29
Q

Post op care?

A
  • ABs not necessary if no complications
  • Analgesia (NSAID & Opioid)
  • +/- prokinetics
  • Nutritional support (syringe feeding asap, monitor eating & faecal output)
30
Q

OVH: Complications?

A

Hemorrhage
- Leakage of urine into the abdomen
- Granuloma/adhesion
- Fat necrosis
- WOund interference
- Gut stasis

31
Q

top tips for OVH?

A
  • Ligate at level of cervix
  • Intradermal skin closure with tissue glue
  • Small suture material
  • Small suture material
  • Careful tissue handling
  • EXcellent post op care
32
Q

Why do orchiectomy?

A
  • Hormone-related aggression
  • Unwanted litters
  • Reduce unwanted sexual bhvr or sexual frustration
  • Testicular neoplasia
  • Testicular torsion
33
Q

When to do Orchiectomy?

A
  • Once testes decend from around 10 weeks (usually from 5 months)
  • It is not always necessary to neuter male rabbits (less health benefits as neoplasia and torsion rare)
34
Q

Castration anatomy?

A
  • Cremaster muscle well developed and readily retract testicles (pressure on inguinal region to get out)
  • Inguinal ring is open and prone to herniation (always closed castration or close tunic)
  • Tunica vaginalis firmly attacked to scrotal skin (section attachment with scissors if needed)
35
Q

Describe the modified open tachnique? (part 1)

A

Gently incise scrotal sac and vaginal tunic
* Gentle pressure to extrude testicle
* Incise the tunic
* Release the attachment between the scrotal skin and tunica vaginalis to
improve exteriorisation
* Break down ligament of the head of
* epididymis

36
Q

Describe modified open tech (part 2)

A
  • Place two clamps over cord
  • Place two encircling ligatures
  • Cut between clamps to remove testicles
37
Q

Modified open to closed (Part 3)

A
  • Release cord into tunic
  • Excise some proximal
  • Liagte tunica vaginalis
  • Repeat for other testicle
38
Q

Closed Castrate technique? (pt 1)

A
  • Incise over scrotal sac
  • Strip away vaginal tunic from scrotal skin
  • Break down ligament at caudal tip of testicles
39
Q

Pt 2 closed castrate?

A
  • Place 2 clamps on spermatic cord
  • One encircling and one transfixing
    cranial to clamp
  • Incise between clamps
  • Check stump for bleeding
  • Repeat for other testicle
40
Q

CLOSURE of closed castrate?

A
  • SKin edges can be opposed (SI suture) or glued
  • Continue to separate from female for minimum of 6 weeks
  • Sperm can be stored and survive
41
Q

post op care castrate ?

A
  • As for OVH
  • Continue to separate from female for minimum of 6 weeks
  • Sperm can be stored and survive
42
Q

Closed?

A
  • Closed is simple
  • Tends to be more painful
  • Higher risk of bleeding from slipped ligatures
  • Less chance of herniation
43
Q

open to closed?

A
  • Tend to be same time in length
  • Less chance of bleeding
  • Inguinal herniation is rare in rabbits
  • Easy to accidentally open tunic upon opening
44
Q

Cryptorchid what to do ?

A
  • Even if testicle is abdominal, you can often find caudal end of tunica vaginalis in
    inguinal canal and gently pull it into inguinal region
45
Q

Describe facial (SC) abscesses in rabbits?

A

Underlying dental disease
* Must radiograph
* Extract affected teeth if possible
* Curette infected bone
* Abnormal suppurative reaction ➔thick caseous pus
* Fibrous capsule
* Culture capsule/not pus
* Location can affect prognosis
* Care with antibiotic-associated diarrhoea

46
Q

aim of rabbit abscess?

A

remove in entirety without breaching capsule

47
Q

Surgical technique for rabbit abscess?

A
  • Surgical excision in total id poss
  • Exploration and removal of infected tissue (flush and pack)
  • Marsupialisation - location or size means surgical removal not poss
    ABS
48
Q

Abscess removal steps?

A
  • Make skin incision.
  • Blunt dissect skin away from abscess capsule taking care not to penetrate.
  • Vessels ligated/ cauterised.
  • Skin closed
  • Rarely achievable near oral cavity
49
Q

Describe Marsupialisation?

A
  • Open abscess capsule and suture to surrounding skin
  • Topical antibacterial preparation is applied which is non toxic if ingested
    e.g. Manuka honey
  • Clean with chlorhexidine regularly before applying preparation
  • Can suture hydrocolloid dressing which can draw pus away whilst
    protecting wound (Remove in 3-5 days)
50
Q

Complications of SC Abscess ?

A
  • Jaw fracture
  • Acquired malocclusion
  • Recurrence or failure to resolve
51
Q

TOP TIPS for abscesses?

A
  • Always palpate mandible and maxilla to check for abscesses
  • Always radiograph – include oblique views
  • Remove surgically in total where possible
  • Remove affected teeth/alveolar bone
  • Always culture (capsule not pus)
52
Q

Why do we get uroliths & sludge?

A
  • Unique calcium metabolism and high levels of calcium excretion compared to
    other species
  • Overweight animals with reduced exercise levels and low water intake are predisposed
53
Q

How do we remove uroliths and sludge?

A
  • If urethral obstruction attempt to catheterise and flush into bladder and remove via cystotomy
  • If in bladder remove by cystotomy
  • If in kidney - don’t remove poor rates
54
Q

Cystotomy technique? (Pt 1?)

A

Midline incision from umbilicus to pelvis.
* Care not to incise bladder when cutting linea alba
* Exteriorise Bladder.
* Moistened laparotomy swabs are packed around the bladder.
* Stay sutures cranial and caudal to planned incision avoiding blood vessels.
* Incision in an avascular area on ventral surface.

55
Q

Cystotomy pt 2?

A
  • Stones may be embedded in bladder wall or may accumulate at bladder neck where
    they can be easily missed.
  • Catheter placed through the bladder into urethra to help flush
  • further calculi out and ensure free flow
56
Q

Csytotomy pt 3?

A
  • Flush bladder
  • Closed using one or 2 layer closure, inverting suture pattern
  • TOP TIPS
  • Try to avoid suture penetrating full thickness as it can act as a nidus for stone
    formation.
  • Can inject saline into bladder to leak test it
  • Biopsy of the bladder wall can be taken for culture
  • Routine closure of laparotomy wound.
57
Q

How to diagnose gastric distention?

A

Abdo palp , CLS, onset of lethargy/weakness/bloating
Radiography of gas distended stomach

58
Q

Management of gastric distention?

A
  • Provide analgesia
  • After radiography need to decide
59
Q

FB?

A
  • Intestinal surgery difficult in rabbit as intestines so thin
  • Gastrotomy is possible
  • At ex lap can try and move foreign body to stomach or ileo-colic valve
60
Q

Causes of Obstruction?

A
  • Trichobezoars-pellets of impacted hair
  • Adhesions secondary to previous surgery
  • Ingestion of other foreign material e.g. carpet
61
Q

Post op Care?

A
  • Fluids
  • ANalgesia
  • Prokinetics
  • Syringe feeding
  • Pg guarded

VMS 4001 (17 decks)

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