Rumenotomy in cattle Flashcards
Special indications for rumenotomy
• Ruminal–reticular disease (e.g., rumenitis)
• Foreign body → traumatic reticulitis or traumatic reticuloperitonitis
• To remove ruminal contents:
o rumen impaction
o toxic indigestion
o omasalimpaction
o reducing a ruminal mass: before a pericardiotomy (not common but can be helpful)
General steps rumenotomy
- Surgical restraint
- Presurgical procedure
- Anaesthesia
- Incision site and technique
- Abdominal cavity manipulation
- Abdominal wall suturing
- Postoperative Care
Surgical restraint for cesarean section and rumenotomy
1-Standing restraint (preferred)
2-Dorsal and left lateral recumbency restraint
Surgical restraint for cesarean section and rumenotomy
Standing restraint (preferred)
• Cow SHOULD/MUST REMAIN STANDING for both CS and RUMENOTOMY!
• IF the dam CAN NOT STAND DO NOT FORCE this restraint!
o Heifers are more likely to lie down
→Higher probability of recumbency than cows
Surgical restraint for cesarean section and rumenotomy
Standing restraint (preferred)
Advantages
- Less assistance
- Minimal tension on the suture line -> Decrease risks of rupture
- Good for adult dairy cows → udder
Surgical restraint for cesarean section and rumenotomy
Standing restraint (preferred)
Disadvantages
- Contamination of the peritoneal cavity
* Physical strength
Surgical restraint for cesarean section and rumenotomy
Standing restraint (preferred)
Approach
Left paralumbar fossa approach (left flank): for both CS and RUMENOTOMY
● Right uterine horn pregnancy
● Rumen inhibits evisceration of intestine
● Access of caudo-dorsal sac of rumen
Right paralumbar fossa approach (right flank): only for CS
● Excellent for left uterine horn pregnancy:
Spine of the calf toward the left side of the cow and feet of the cow toward the right side of the cow
➔ Position identified by rectal palpation (before rumenoctomy ) to know the situation of the calf, not common
Surgical restraint for cesarean section and rumenotomy
Dorsal and left lateral recumbency restraint
If the dam CAN NOT STAND THEN USE these restraints for both CS and RUMENOTOMY !
Surgical restraint for cesarean section and rumenotomy
Dorsal and left lateral recumbency restraint
Advantages
- excellent exposure of uterus and fetus
* to minimize peritoneal contamination
Surgical restraint for cesarean section and rumenotomy
Dorsal and left lateral recumbency restraint
Disadvantages
• requires assistance • ruminal bloat and/or regurgitation • prolapse of the abdominal organs • postoperative complications Dorsal and left lateral recumbency restraint
Presurgical procedure
For both cesarean section and rumenotomy Check the instrument tray for:
• Sterile instruments and a scalpel blade
• Obstetric chains and handles (sterilized) (in a case of CS)
• Isolation large enough to cover the entire surgical area
• Sterile gloves
• professional Suture material
• Sterile saline
Preparation of the skin
- Clip and prepare, wash and disinfected the skin for aseptic surgery
- From the dorsal midline to the level of the flank and
- palpate from the 12th rib to the tuber coxae
Check the availability of pharmaceuticals before cutting
- LA antibiotics
- Respiratory preparation ( CS section ) and cardiac stimulants
- Uterine antibiotics (uterine tablets preferred)
- Iodine (Disinfectant ) for the calf’s navel
- Oxytocin -> Increase uterine contraction
Anaesthesia for any kind of laparotomy
Required (left paralumbar fossa):
- Proximal (preferred) or distal lumbar paravertebral
- Local (line infiltration) block
- Inverted L
Anaesthesia for any kind of laparotomy
Optional:
Caudal epidural (needed or not ?) to control tenesmus
• Not anesthesize uterus
IV sedation and analgesia if it is indicated:
• Drugs cross the placenta (CS)
• Cow may lie down
First look for behavior and general state of the animal
Recumbency !! preferred standing position
Incision site for rumenotomy or exploratory laparotomy
Incision site for rumenotomy or exploratory laparotomy Oblique : cranioventral
Want to get caudaventral sac
Incision technique for any kind of laparotomy
General incision technique: Know the muscle layers -> situate how far you are from abdominal cavity -> to minimize injury
skin and subskin → external oblique muscle → internal oblique muscle → transverse muscle → peritoneum → abdominal cavity
Skin + external oblique muscle - Skin + int + ext oblique muscle
Abdominal cavity manipulation
Before anything put sterile saline on gloves -> slippery -> Easier examination
- Isolation of ruminal caudo-dorsal (blind) sac (palpable )
- Suture the sac to the skin: a seal between the rumen serosa and the skin (Suture a ring )
- Monofilament noncapillary suture material
- Continuous or interrupted horizontal mattress sutures
- To avoid contamination of the muscle and the abdominal cavity to the rumen -> Peritonitis
Weingarth’s method
Frequently used in Europe
Metal ring fixed to the skin -> if open the sac of rumen these rings will Fix the ring to the opening
No suturing needed
- Isolation of ruminal caudo-dorsal (blind) sac
- Stabilize the rumen with more hooks to the metal ring
Suggested procedure after rumen is open
• Ruminal content: appearance, odor, consistency, and impaction
• Impaction: remove the ingesta (fibers, solid content ) until fluid is visible and palpate the
reticulum
• Acidosis: remove most of the content (keep the fluid )
• If not removal of solids -> No palpation of reticulum possible
• Evaluate the rumen and reticulum for foreign bodies and diseases
• Before removing foreign bodies: localize the area, degree and direction of penetration.
This information → prognosis:
◆ Simple ventral penetration in reticulum : favorable
◆ Deep anterior penetration: unfavorable (pericarditis)
◆ Cranio-medial penetration: questionable (N.vagus indigestion -> Offlung syndrome )
Suggested intraruminal medication as needed
- Alkalizers (e.g., magnesium hydroxide preparations)
- Rough, good quality hay
- Water with or without electrolytes
- Mineral oil
Suturing the rumen
- Flush the area -> Clean content
- No. 2 or 3 absorbable suture material
- Continuous inverting pattern
- CushingorLembert
- The ruminal incision with a second layer
Abdominal wall suturing for any kind of laparotomy
Layer 1:
• Peritoneum and transverse and internal oblique abdominal muscles together
• Simple continuous pattern
• Monofilament absorbable No. 2 or 3
Layer 2:
• External oblique abdominal muscle and subcutaneous tissue -> Suture the 2nd layer to the 1st
o If not : Maximize the risk of fluid accumulation of the abd. wall = Seroma (Infected, abcess formation
• Bite into the internal oblique muscle to close dead space
• Simple continuous pattern
• Monofilament absorbable No. 2 or 3
Layer 3:
• Skin
• Continuous interlocking or interrupted suture pattern
• Synthetic nonabsorbable suture material No. 3
Postoperative Care for any kind laparotomy
