Ruminants 5 Flashcards
What umbilical disorders can we see?
Describe omphalitis ?
- Omphalitis is the infection of the umbilical stump
- Associated with poor hygiene and poor umbilical
- care of the neonate
- Prevent with iodine at birth
Secondary abscess?
- Umbilical abscess secondary to omphalitis
- Walled off infection persists in the umbilical stump
Signs of abscess?
- Firm, hot, painful NON-REDUCIBLE mass
- Pyrexia and systemic illness
- Draining sinus tract/purulent discharge
- Hyperechoic pus on u/s
Tx of umbilical abscess?
Minor surgical procedure - drain and flush through a ventral incision
What can we have concurrently with omphalitis +/- abscess?
May be concurrent with
umbilical hernia
Umbilical abscess drainage APPROACH
Umbilical abscess drainage ABS?
Pg umbilical abscess drainage?
good for non-complicated abscess
What can hernia be?
- Omentum
- Abomasal fundus
- Intestines? Short mesentery so less moveable
Why do we get umbilical hernias ?
- Failure of the normal development and closure of umbilicus
Hernia size gauge?
Hernias >2cm (2 fingers) are unlikely to repair naturally
Pre-op considerations ? umbilical hernia
- Small defects unlikely to become strangulating and can
- resolve themselves
- Large defects require surgical treatment
- Leaving/fattening the patient may result in entrapment and
strangulation - Anaesthesia
- High dose caudal epidural- preferred as immobilises back legs
- GA?
What important consideration for umbilical hernia
No rumen pressure on ventral abdomen
V’s
Old enough for good fibrous ring for suture holding
Umbilical hernia repair?
Umbilical hernia repair steps 6-9?
- Tie off each suture
- Oversew everted abdominal wall margin in a simple continuous pattern
- Routine closure of SC tissues and skin
- Secure a stent over the incision to provide protection for the first 24-72 hours
Complications and after care? hernia repair
In surgery complication
* Intestines adhered to body wall
Infection
* Wound dehiscence
Haemorrhage
Failure of sutures
* Re-herniation
Immediate post-operative complications
* Hypothermia
* Poor recovery
* Recovery injuries
Clean bedding
Close monitoring
Describe Umbilical remnant disorders?
- Urachal abscess
- Infection/abscessation of umbilical vein/arteries
- May require en-bloc resection
- I.e removal of the tissue and surrounding
capsule
Similar hernia surgery?
- Pre-operative considerations similar
- Antibiotic choice?
- Extreme care not to puncture the abscess
- Incise cranially in urachal or umbilical
abscesses - Incise caudally in umbilical vein
abscessation
Patent urachus?
ligate
Umbilical disorders?
- Is the umbilical mass non-painful, reducible, soft?
- Is the mass firm, hot, painful?
- Is there purulent discharge?
- Is the animal systemically unwell
- Any intra-abdominal extension of umbilical mass on
palpation
What is atresia ani/recti?
- Failure of the anal opening
- Congenital abnormality
- Surgical repair required
Signs of Atresia ani/recti?
Anorexia,
Dullness
Abdominal distension
Discomfort
Straining
No anus
No faeces
Atresia ani * Pre-operative considerations
- Case selection- cost implications?
- Anaesthesia- epidural
- Analgesia- Meloxicam?
- Antibiotics- dirty procedure
