Rumenotomy, displaced abomasum, cesarean Flashcards
Its hard to diagnose foreign bodies.
What are some tests to use? (4)
- Pain tests. Withers pinch, Stick test
- Fibrinogen (espesh when fever fluctuates)
- Ultrasound of the reticulum
- Laparotomy
Clinical findings depend on
* Foreign body type
* Duration of symptoms
* Possible perforations
Clinical signs of reticuloperitonitis. (8)
- Sudden loss of milk yield
- Loss of appetite
- HR/RR elevated
- Stands hunched over
- Bruxism
- Elbows point out
- Rumen hypomotility, tympany
- Dry feces
Treatment of Reticuloperitonitis.
Conservative method
* MAGNET!
* Procaine penicillin 20-22mg/kg i.m. SID 3-5d
*NSAIDs
Surgical method
* If the cow doesn’t feel better in three days -> discuss with owner
* Laparotomy -> rumenotomy
Surgical approach to traumatic reticuloperitonitis.
If possible
* Procainepenicillin (6h) before operation 20-22 mg/kg i.m.
* Ketoprofen 3 mg/kg i.v./i.m.
- Distal paravertebral anesthesia (L1, L2, L4) + local infiltration anesthesia of the skin
If you detect tympany, put a stomach tube in before operation. It helps you get the gas / foam away 🡪 easier to operate.
If there is tympany, it can be hard to decide where to do the incision, use the Highest point.
WHat is Accessory rib resection?
may be in the way when performing laparotomy, cut with fetotomy wire
First an exploratory laparotomy. Check everything! Like what? (3)
Check for:
* Adhesions
* Abscesses
* Signs of peritonitis (odor, sight, free fluid)
Rumenotomy: before closing rumen do what
before closing rumen get excess feed + fluid out so you can close more easily and if the rumen begins to contract during closure, its less likely to spill ruminal contents on your closure site.
Rumenotomy: after closing the rumen, do what?
rinse rumen sutures with NaCl! room temp or 39’C fluid, NOT cold water
Close Rumen in 1 or 2 layers with what type of pattern?
do not go through mucosal layer, only muscular and serosal layers of the rumen.
2 layers using Schmieden and then Plahhotin (or Utrecht, or Cushing)
Rumenotomy – closing the abdominal wall
When Norway method, 1 layer
- (nonabsorbable) Vertical mattress
When 2-3 layers
* Peritoneum + muscles (absorbable)
* Muscles - absorbable. Simple continuous.
Skin – nonabsorbable
* X - sutures
* Horizontal mattress
* Ford interlocking (favorable)
Vertical mattress suture with tubing for dsitributing pressure, is not mandatory.
Horizontal mattress suture
Ford Interlocking
Peritonitis and rumenotomy.
* How to detect?
- Rumenotomy has the highest risk of peritonitis.
- Risk is present for two weeks after operation.
- How to detect?
- Tell the farmer to take the temperature 2 times per day after surgery + after the ab stops-> if over 39,5 2 times in a row -> suspect peritonitis and perform abdominocentesis to confirm.
When is displaced abomasum most likely to occur?
90% of cases in the first 6 weeks after calving
* Or in the last trimester of pregnancy
Which one is more common LDA or RDA?
Which one is more likely to torse?
90% LDA (left displaced abomasum)
RDA always has a risk of torsion
Name some causes of displaced abomasum. (8)
- Abomasal atony
- Hypocalcemia
- Cow with no appetite
- Change in diet after calving -> less fiber, more concentrates
- More room in abdomen cavity after calving
- Diseases that cause endotoxemia
- Metritis, Colimastitis
(40% of cows with displaced abomasums also have placental retention, mastitis or metritis) - Stress – animal are tied stall during calving or heatstress
- Foreign bodies in reticulum, omasum, abomasum
- Ketosis – chicken and egg situation
- Fatty liver
- Abomasal ulcers
RDA displacement location. (2)
Right - between rumen and the omentum
* ATTENTION! Always a risk of torsion!
Cranially – between liver and diaphragm
identify
Normal abdominal cavity from the right
identify
RDA + torsion counterclockwise
Clinical findings in LDA.
- Doesn’t eat concentrates
- Similar to subacute ketosis
- Anorexia, apathetic, rumination ↓
- Temperature normal
- HR normal 40-80 x min
- Feces can be watery, variable
- Less feces ↓
- Loss of BCS
- Slow drop in milk yield
- Slight metabolic alkalosis
- Rarely fluid in abomasum
- ! You don’t hear the ping in 15% of the cases !
- Can manage with life for 2-4 weeks
Explain Rolling
Conservative attempt at replacing displaced abomasum back into position.
- Cure rate 25%
- Pull the cow down on the right side -> get it on its back -> massage/(kick) the abomasum on the right place.
- Danger of intestinal/mesentery torsion
Explain Rolling + toggle pin.
pros and cons
Conservative attempt at replacing displaced abomasum back into position + pexying it.
- Cure rate 75%
+ quick, easy, cheap
+ if surgery not an option - If you cannot hear the ping, you can’t do it
- Risk of damaging other organs
- Risk of intestines/mesentery torsion
- Only if LDA!
local peritonitis risk is present but not too bad
Before choosing cesarean…
First calving aid!
- Consider Alternatives:
- Uterine torsion and flipping/rolling the cow?
- Use of hormones
- Fetotomy if the calf is emphysemic and/or dead
- Stretching of the cervix
Swollen birth canal
May be an indication for c-section.
Rupture of abdominal muscles
indication for c-section
Cesarean section – surgical approach (3)
- Left paralumbar fossa most common
- Right paralumbar fossa is possible too (but risk of small intestines falling out) – in case of tympany at least
- Linea alba can be used with gen. anesthesia (risk of hernia)
Getting the uterus out/ to the surgical wound:
Multiple ppl needed for c-section.
- If the calf is in frontward position, get hold of one hind leg and pull carefully.
- Cut the uterus with scissors/uterine safety cutter (on curvatura major).
- Start from the middle, cut towards the hock, then towards the claws.
- Be careful not to cut the carunculas cause they bleedy.
- The cut must be as long as necessary but as short as possible!
- Possible to open the uterus inside abdominal cavity but visibility is poor then and you risk uterine contents spilling into the abdo cavity. Is better to take the uterus out of the wound a bit.
Remove fetal membranes before closing, if they are easily removed.
Uterine sutures
Can be done in 2 layers.
- Schmieden (from inside out) Plahhotin / Utrecht (up-down)
identify
Uterine sutures – Utrecht method
identify
Uterine sutures - Utrecht method
identify
Vertical mattress
identify
Horizontal mattress
identify
Ford interlocking
identify
X suture
