Rumenotomy in cattle Flashcards

1
Q

Special indications for rumenotomy

A

• 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)

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2
Q

General steps rumenotomy

A
  • Surgical restraint
  • Presurgical procedure
  • Anaesthesia
  • Incision site and technique
  • Abdominal cavity manipulation
  • Abdominal wall suturing
  • Postoperative Care
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3
Q

Surgical restraint for cesarean section and rumenotomy

A

1-Standing restraint (preferred)

2-Dorsal and left lateral recumbency restraint

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4
Q

Surgical restraint for cesarean section and rumenotomy

Standing restraint (preferred)

A

• 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

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5
Q

Surgical restraint for cesarean section and rumenotomy

Standing restraint (preferred)

Advantages

A
  • Less assistance
  • Minimal tension on the suture line -> Decrease risks of rupture
  • Good for adult dairy cows → udder
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6
Q

Surgical restraint for cesarean section and rumenotomy

Standing restraint (preferred)

Disadvantages

A
  • Contamination of the peritoneal cavity

* Physical strength

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7
Q

Surgical restraint for cesarean section and rumenotomy

Standing restraint (preferred)

Approach

A

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

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8
Q

Surgical restraint for cesarean section and rumenotomy

Dorsal and left lateral recumbency restraint

A

If the dam CAN NOT STAND THEN USE these restraints for both CS and RUMENOTOMY !

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9
Q

Surgical restraint for cesarean section and rumenotomy

Dorsal and left lateral recumbency restraint

Advantages

A
  • excellent exposure of uterus and fetus

* to minimize peritoneal contamination

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10
Q

Surgical restraint for cesarean section and rumenotomy

Dorsal and left lateral recumbency restraint

Disadvantages

A
• requires assistance
• ruminal bloat and/or regurgitation
• prolapse of the abdominal organs
• postoperative complications
Dorsal and left lateral recumbency restraint
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11
Q

Presurgical procedure

A

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

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12
Q

Preparation of the skin

A
  • 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
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13
Q

Check the availability of pharmaceuticals before cutting

A
  • 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
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14
Q

Anaesthesia for any kind of laparotomy

Required (left paralumbar fossa):

A
  • Proximal (preferred) or distal lumbar paravertebral
  • Local (line infiltration) block
  • Inverted L
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15
Q

Anaesthesia for any kind of laparotomy

Optional:

A

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

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16
Q

Incision site for rumenotomy or exploratory laparotomy

A

Incision site for rumenotomy or exploratory laparotomy Oblique : cranioventral
Want to get caudaventral sac

17
Q

Incision technique for any kind of laparotomy

A

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

18
Q

Abdominal cavity manipulation

A

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
19
Q

Suggested procedure after rumen is open

A

• 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 )

20
Q

Suggested intraruminal medication as needed

A
  • Alkalizers (e.g., magnesium hydroxide preparations)
  • Rough, good quality hay
  • Water with or without electrolytes
  • Mineral oil
21
Q

Suturing the rumen

A
  • Flush the area -> Clean content
  • No. 2 or 3 absorbable suture material
  • Continuous inverting pattern
    • CushingorLembert
  • The ruminal incision with a second layer
22
Q

Abdominal wall suturing for any kind of laparotomy

A

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

23
Q

Postoperative Care for any kind laparotomy

A