Surgery/Procedures Flashcards
Risk factors for GDV
Relatives who had GDV Higher thoracic depth to width ratio Lean body condition Advancing age Eating quickly (large but not giant breeds) Stressful events Fearful/nervous/aggressive temperament Raised food bowl Fed only dry food Fed a single meal a day
Post prandial exercise association with GDV?
Several studies showed not a risk factor; one internet survey suggested beneficial.
% of dogs with GDV with pre-op aspiration pneumonia
14%
What % of GDV have arrhythmias
40%
Significance of elevated troponin with GDV?
Elevated in many dogs and associated with severity of ECG changes and with outcome
In what direction does the stomach typically rotate in GDV
pylorus rotates clockwise towards the left side of the body (i.e., ventrally and fundus goes dorsally).
Survival of dogs with GDV that require gastric resection
70-74%. Two studies do not agree as to whether need for gastric resection is prognostic indicator
What suture types are recommended for pexy
Polypropylene (prolene) or polydioxanone (PDS)
what are preoperative risk factors for mortality with GDV
Hypotension at any time during hospitalization
Combined splenectomy and partial gastrectomy
Peritonitis
Sepsis
DIC
Findings on study evaluating keppra in PSS Dogs
Use of keppra was protective against development of PO seizures - rec starting at least 24 hours prior to surgery (Fryer)
What is goal portal pressure when occluding a PSS
Increase in portal pressure of no greater than 10 cm H2O
How do you convert mmHg to cmH2O
Multiply mmHg by 1.36
What is the normal portal venous pressure
approx 10-12 cmH2O (8-10 mmHg).
What are the 3 major complications of post-op PSS
Portal hypertension, coagulopathy, neurologic complications
Possible causes of post-op neurologic signs with PSS
Increased blood ammonia
Increased GI hemorrhage leading to increased NH3
Portal hypertension -> GI bleed -> increased NH3
Production of GABA, aromatic amino acids, and endogenous benzodiazepine receptor ligands by GI tract that are normally removed by the liver.
What factors predicted surgical mortality in patients with single EHPSS treated by aneroid ring constrictor?
occurrence of post-op complications
pre-operative white blood cell count
Perioperative mortality rate for EHPSS with slow attenuation, cellophane banding, or aneroid ring?
5.5-7%
Mortality rate for IHPSS?
12.5%
Predictors for short term outcome in dogs with intrahepatic PSS?
Body weight
TP
Albumin
BUN
What recumbency is recommended for abdominocentesis
left lateral - allows spleen to fall away
At what point should a closed suction drain be removed
When drainage declines to 5-10mL/kg/24hours
Describe technique for intercostal nerve block
at least adjacent intercostal spaces should be blocked on both sides. Place needle at caudal border of rib near intervertebral foramen. Use approx 0.25 to 1 mL (based on size of dog) of 0.5% bupivacaine per site. Will maintain pain control 3-6 hours.
Which factors that regulate allograft rejection are inhibited by cyclosporine
IL2 IL4 IFN-gamma TNF-alpha Granulocyte-macrophage colony stimulating factor (GM-CSF).
prognosis for cats after kidney transplant
70-93% have been discharged from hospital with MST of 360-616 days.