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VMS 4001 > Ruminant 1 & 2 > Flashcards

Ruminant 1 & 2 Flashcards

1
Q

What surgical location consideration?

A
  • Under cover (where possible)
  • Sheltered from the prevailing wind/rain
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2
Q

What flooring considerations?

A
  • Non-slip
  • Clean, deeply bedded straw pen
  • Ideally rubber metting
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3
Q

Restraint considerations?

A
  • Consider patient temperament / compliance
  • Halter, tied to a secure fitting with a quick release knot
  • Cattle crush, with good side access
  • Small ruminants tied down on a table / straw bale in lateral recumbency
  • Assistant(s)
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4
Q

Pre-Op Consideration - anaesthesia ?

A
  • Local/regional anaesthetic techniques
  • Speed of onset (5-15mins)
  • Licensed anaesthetic agents (procaine with adrenaline)
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5
Q

Describe local anaesthetic options?

A
  • Infiltration or Inverted L
  • Proximal / distal paravertebral (T13-L2+3)
  • Epidural (L6-S1 or C1-C2)
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6
Q

Pre-Op Considerations - analgesia?

A
  • Pre-emptive. NSAID use (fluxinin, meloxicam, ketoprofen, carprofen)
  • IV to maximise speed of onset
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7
Q

What AM Considerations?

A
  • Infection status
  • Risk of contamination (opening viscera, decompressing viscera, patient compliance
  • Likely bacteria present -> G+ ; G - , anaerobic organisms from GIT
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8
Q

What to remember about AMs?

A
  • ROA - Iv or IM to act quick
  • Licensed products
  • Milk & meat withold
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9
Q

What Am to use for non-contaminated abdominal surgery?

A
  • Aminopenicillins
  • Aminoglycoside
  • First gen cephalosphorins
  • Tetracyclines
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10
Q

What AMs to use for anaerobic contamination likely or infection establish?

A
  • Aminopenicillins
  • Cephalosporins
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11
Q

What AMs for suspected or known beta-lactamase resistance ?

A
  • Tetracyclines
  • Potentiated sulphonamides
  • Potentiated Aminopenicillin
  • 3rd gen cephaloS
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12
Q

HOw many days of AB for non-contaminated abdo surgery (theatre) ?

A

0 days

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13
Q

How many days of AMs for Non-contaminated abdo surgery (on farm) ?

A

3-5 days

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14
Q

how many days of AMs for contaminted or infected (on farm or theatre) ?

A

5-7 days

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15
Q

Fluid therapy?

A
  • Hydration status and degree of shock
  • Likelihood of electrolyte derangement
  • Acid/ Base balance
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16
Q

PreOp Surgical prep?

A
  • Wide clip
    • Make sure La complete first
  • Secure tail to cow
  • Surgical scrub (two buckets + brush ; chlorexidine or providone iodine / surgial spirit )
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17
Q

Describe steps to Abdominal incision?

A
  1. 15-40cm dorsoventral skin incision
  2. Identify and incise muscle layers individually
  3. The transverse abdominal muscle and attached peritoneum should be tented with a forceps and a cut made into the abdomen with scissors. A sharp hiss is usually heard at as air is sucked into the peritoneal cavity under negative pressure.
  4. Extend the incision dorsally & ventrally using fingers to elevate the body wall
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18
Q

When to use Absorbable suture to close ?

A

With simple conitnuous, or cruciate and a curved round bodied needle

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19
Q

When to use Non-abdorbable suture?

A

Ford interlocking
Simple interrupted (most ventral 2-3 sutures to allow removal and drainage if rq)
With half-curved cutting needle

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20
Q

What indications for Exploratory Laparotomy?

A
  • Severe or inc abdo pain unresponsive to analgesics
  • Unresponsive or deteriorating shock
  • Rectal exam findings
  • chronic rumenal indigestion/tympany
  • Complete absence of faecal production
  • Lab findings
  • To obtain a diagnosis
21
Q

How would u do a left sided ex-lap?

A
22
Q

How would u do a right sided approach?

A
23
Q

What categories of surgical conditions of the ruminant GIT ?

A

Ruminal disorders
Abomasal disorders
Intestinal disorders (uncommon)

24
Q

What ruminal disorders can be surgical?

A
  • Traumatic Reitulopericarditis
  • Rumental tympany
  • Impaction
25
Q

What abomasal disorders surgical ?

A
  • Left displaced abomasum
  • Right abosomal dilatation, displacement and volvulus
  • Impaction
  • Ulceration
26
Q

What intestinal disorders?

A
  • Intestinal intussusception
  • Caecal dilation and torsion
  • Rectal prolpase
27
Q

What indiciations for Rumenotomy?

A
  • Suspected TRP
    • Ruminal Impaction
  • Ruminal FB
  • Grain overload and acidosis
  • Ruminal tympany
  • Intoxication
28
Q

Describe the conservative management of Traumatic Reticulo-pericarditis ?

A
  • Magnet bolus
  • Broad spec system Antibiotics
  • NSAIDs
  • Oral fluid therapy and probiotics
29
Q

Surgical Traumatic Reticulo-P?

A
  • Left paralumbar fossa lapatotomy and rumentomy
  • Careful manual exploration of the Cranioventral abdomen alongside the rumen and reticulum
  • Adhesions palpable between the reitucum and diaphragm
30
Q

Prognosis for Tramatic Reticulo-P?

A
  • Guarded to poor
  • Poor medical tx response
  • Surgery if often unrewarding
  • Timing of surgery is key
  • Guarded if the peritonitis is generalised
  • Very poor if muffled sounds
31
Q

Rumenotomy - Surgical approach?

A
  1. Explore the external surface fo the rumen and reticulum
  2. Secure the rumen to the skin (stay suture or frame)
  3. Rumenotomy incision
  4. Manual exploration of reticulum (identify hexagonal internal surface)
  5. Closure (two layers with a continuous inverting suture pattern in #2 absorbable)
32
Q

Indications for Ruminal Trochar placement?

A
  • Peracute ruminal tympany unresponsive to decompression
  • Management of chronic ruminal tympany
33
Q

Approach to ruminal trochar placement?

A
  1. Surgical prep & LA by infiltration
  2. Scalpel incision through skin
  3. Firmly insert trochar & cannula through body wall into rumen in a single motion
  4. Screw into place & remove cannula
  5. Secure with sutures
34
Q

Common & important abomasal disorders

A
  • Left displaced
  • Right displaced abomasum
  • Ulceration
  • Impaction
35
Q

Considerations of surgical approach - Abomasal disorders

A
  • Effective return & stabilisation of the abomasum in a normal anatomical position
  • Mangement of concurrent abdominal pathology
  • Minimise additional risk
  • Practicality in light of available handling facilities
  • Economic cost-benefit
  • Surgeon experience
36
Q

Left displaced abomasum - conservative management?

A
  • casting and rollig
  • +/_ analgesics & spasmolytics
  • +/- oral fluid thrapy
  • +/- ruminal probiotics
  • +/- tx of concurrent medical conditions
  • Dietary management
37
Q

Describe the Open approach to surgical correction of LDA

A
  • Secure the pylorus and/or lesser omentum -> right sided paraL fossa, both sided paraL fossa
  • Secure fundus -> right paramedian & left sided paralumbar fossa
38
Q

Closed approach to surgical correction of LDA?

A
  • Toggle-pin (common)
  • Blind fixation
  • Laparoscopy (+/- rolling)
39
Q

What intra-op complications of LDA ?

A
  • Failure of decompression
  • Failure of relocation
  • Other (peritonitis, friable intra-abdo/omental fat)
40
Q

Describe Failure of decompression?

A
  • Obstrution of tubing
  • Incorrect needle placement
  • Inadequate reach / large abdo sie
  • Incorrect diagnosis
41
Q

Failure of relocation - ?

A
  • Adhesions
  • incomplete decompression
  • Dorsal incision placement / deep abdomen
  • Incorrect diagnosis
42
Q

Advantages of open approach?

A
  • Good visualisation
    • Concurrent pathology addressed
  • Suitable for most DAs
  • Low risk of recurrence
  • Pg 80-100%
43
Q

Open Disadvantages?

A
  • More invasive
  • Time consuming
  • More expensive
  • Risk of generalised peritonitis
  • Reasonable surgeon arm length
44
Q

Closed - Advanatages?

A
  • Lless expensive
  • Rapid
  • Any surgeon arm length
  • Relatively low risk of recurrence
  • Pg 77-91%
45
Q

Disadvantages of Closed?

A
  • Blind procedure
  • Concurrent pathology not addressed
  • Risk of trauma to other viscera
  • Requires rolling
  • Careful case selection
  • Risk of local peritonitis and abomasal fistula
46
Q

Indications for surgical intervention (RDA)

A
  • PResent or deteriorating hypovol/ endotox shock
  • Severe or increasing abdo pain unresponsibe to analgesics
  • Regurg on passing a stomach tube
  • No response to conservative management in 2-4 hrs
47
Q

RDA - Surgical correciton ?

A
  • Right paralumbar fossa laparotomy pyloro-and/or omentopexy
  • Traction on the omentum does nto expose pylorus with RVA
  • An anticlockwise volvulus can be corrected by clockwise rotation of abomasum
  • Decompresison may be require before correction of the voluvlus

correct fluid/ electorlyte imbalances

48
Q

Conservative tx for RDA?

A

As for LDA
NB metroclopramide illegal in food producing animals in UK
Regular monitoring

VMS 4001 (17 decks)

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