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Module 18: Ruminant Production > Reproductive Surgery of Adult Ruminant > Flashcards

Reproductive Surgery of Adult Ruminant Flashcards

1
Q

what are the indications of a caesarean section (5)

A
  1. calf too big
  2. calf too small
  3. deformed calf
  4. twisted uterus
  5. dead/emphysematous calf
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2
Q

how do you prep for a c section

A

Find a suitable place and restrain cow

LIGHT

Assess temperament — sedation?

0.5ml xylazine IM, then walk away

Instruct farmer to get warm/clean water, electricity, string for tail, table for kit, extra help

Clip and prepare surgical site, LEFT side

Rumen is easy to push away

Right hand side has small, large intestine in the way

Admin local and other drugs

Open and organize kit

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3
Q

how do you restrain for a c section

A

crush - if she goes down its a disaster

Halter in corner? (Safety)

calving stall?

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4
Q

what drugs do you need for c section

A

epidural cow if straining

broad spectrum antibiotics

NSAID (meloxicam)

clenbuterol

local anesthetic for flank

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5
Q

what broad spectrum antibiotics might you use in a c section

A

penicillin and streptomycin (Pen and Strep)

Amoxicillin

Clavulanic acid (Synulox)

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6
Q

what are the landmarks for a laparotomy

A

Caudal edge of last rib

Transverse process of lumbar vertebrae

Line drawn down from hook bone (tuber coxae)

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7
Q

what is a line block

A

Line block: 100-150ml

Disadvantages:

  • Local anesthetic can delay wound healing
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8
Q

what is an inverted L block

A

upside down L

The local anesthetic is not on the surgical site

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9
Q

what are paravertebral blocks

A

2 options for nerves T13, L1 and L2

Distal L1, L2, L4

Proximal

90ml

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10
Q

before you enter the abdomen of the cow what should you do

A

Final scrub of cow and you

Scrub of farmer

Get suture material ready (in case of perforation of rumen)

Make sure everyone knows the plan if:

  • Cow goes down
  • Calf needs help
  • Someone faints
  • Etc
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11
Q

how do you perform a laparotomy on the left

A

muscle 3-10cm thick

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12
Q

what looks very similar to the rumen

A

peritoneum

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13
Q

how do you perform a c section

A

Locate uterus — hand in, to the right and down

Right horn = more difficult

Grasp metatarsal or hock and hoof and pull towards wound

Hook hock end of wound

Incise right over hoof (scissors) and up to hock

Incise placenta (grip)

Give farmer foot above metatarsal

Gently pull calf (+/- ropes/chains) caudal and dorsal

Watch umbilicus

Leave farmer to assist calf

Breathe

Trim placenta

Inverted closure of uterus (2 layers), clamps

Lembert, Cushing, Connell

Not into lumen and don’t trap placenta

Can result in retained fetal membrane

If friable — better to have one good layer

Scoop fluid from abdomen

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14
Q

how do you suture the uterus closed

A

Near far, far near then secure

Continue with approx. 1.5cm between each stitch and about 1.5cm from the wound edge

Tighten every 3-4 seiches

Vicryl (cat gut)

6-8 metric USP 2-4

Secure at bottom then head back up to top again

Can have bigger gap between stitches

Remember to tighten stitches

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15
Q

how do you close the peritoneal and transverse muscle layers

A

Peritoneum and transverse (3rd) simple continuous, absorbable

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16
Q

how do you close the external and internal abdominal oblique muscle

A

External and internal abdominal oblique (2nd and 1st) simple continuous, absorbable (vicryl – 6-8 metric or USP 2 to 4)

17
Q

how do you close the skin

A

Skin, surgeons preference (ford interlocking with 2x cruciate at bottom) non-absorbable (ex. supramid 6-8 metric or USP 2)

  • Variations — occasionally taking a bite of first layer when suturing the second muscle layer, subcutaneous for dead space, interrupted stitches at distal end skin wound (to allow drainage)
18
Q

what would you use to reverse the clenbuterol

A
19
Q

what are the care instructions to give the farmer

A

Administer meds as instructed/required

Watch for retained fetal membrane (RFM)

Watch for wound swelling (removal distal stitches)

Phone you if worried

SO 14-21 days

Normal post operative:

  • Would swelling
  • Emphysema
20
Q

what can go wrong in the short term c section

A

cow goes down (can do down)

enter rumen (have your suture ready)

friable uterus and stitches tear through

stressed/acidotic calf

21
Q

what can go wrong in the medium term c section (1-3 weeks)

A

retained fetal membrane (ideally repulsed within 24 hours)

wound infection

peritonitis (local or general)

poor fetal maternal bond

22
Q

what can go wrong in the long term c section (1-3 weeks)

A

subsequent milk production

subsequent fertility

23
Q

how is a c section in sheep done

A

restraint

lying down vs standing

less local 40-60ml inverted L block (don’t use too much)

24
Q

what are the key differences between a sheep and a cow c section (3)

A
  1. often multiple fetuses
  2. thinner muscle layers (can stitch all together if really thin)
  3. if one hole, need to go back to cervix to enter opposite horn
25
Q

how do you retrieve a lamb from the other horn

A
26
Q

what are the indications of an episiotomy

A

tight vulva

prevents tear

27
Q

how is an episiotomy performed

A

5-10cm skin incision (+/- mucosa)

10 and/or 2 o’clock

2 layer suture with vicryl or cat gut (6-8 metric USP 2 to 4)

  • Continuous mucosa
  • Simple interrupted skin

Tend to heal well

28
Q

when is a vasectomy done

A

teaser

synchro and advancement of breeding season

mainly tups

29
Q

what drugs would you need for a vasectomy

A

Pre op: 8-10 ml local around each chord (draw back!), epidural +/- sedation

Broad spectrum antibiotics

NSAIDs

30
Q

how is a vasectomy done

A

Vertical skin incision about 4cm

Digital dissection to isolate spermatic cord

Hook cord over finger or with pair of forceps (don’t confuse with the penis)

Locate deferent duct (should be medial, feels firm, artery/vein close by)

Secure between thumb and forefinger

Make a nick in vaginal tunic to expose deferent duct (2mm, has BV)

Exteriorize at least 3cm of duct, clamp at either end and ligate at either end

Cut between forceps —> keep the bit!

Skin sutures

Repeat on other side

31
Q

what can go wrong with a vasectomy

A

nfection, hemorrhage

Remove wrong tissue

Deferent duct re-anastomosis

Always offer histopathology (store if not running)

Always offer electroejaculation

32
Q

what is a penile hematoma

A

end to occur at base of scrotum

More proximal the better for prognosis

Can resolve so can try conservative treatment first —> must do surgery within 10 days

May abscess/adhesion/penile prolapse

? Nerve damage

33
Q

how is penile hematoma surgery done

A

GA

Incise over

Remove clot

Flush

Stitch

34
Q

how is an internal pudendal block done

A

Results in penile relaxation and analgesia distal to sigmoid flexure

Local infiltration of skin in ischiorectal fossa

Rectal to wrist, place hand lateral and ventral to ID foramen on sacrosciatic ligament

Find nerve cranial and dorsal to foramen

Inject 30ml (long needle) from outside

Repeat on other side

Module 18: Ruminant Production (25 decks)

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