Urogenital Surg (EQ) Flashcards
When does normal testicular descent occur?
270-300d
What are the 3 indication for equine castration?
Modify Behaviour
Prevent Breeding
Neoplasia
What are your 2 anaesthetic options for the equine castrate?
Standing sedation or GA (field/theatre)
What should you use to sedate a horse for a standing sedation?
alpha 2 and an opiate
+NSAID, AB
Which testicle should be removed first if the horse is in GA lateral recumbency?
Lower testicle
What is the rule with burdizzo placement?
Nut to Nut
How should castration be performed with a history of inguinal/scrotal hernia?
Closed
How long should a gelding be box rested for following castration?
24h
What are worrying signs post-castration?
Dripping >4h (or steady stream of blood)
Tissue hanging from incision
Marked swelling >3d
Depression, inappetence or colic
How is cryptorchidism diagnosed in horses <2yo?
hCG stimulation test
How is cryptorchidism diagnosed in donkeys?
hCG stimulation test
How is cryptorchidism diagnosed in horses >3yo?
oestrone sulphate assay
What is a new test for diagnosing cryptorchidism?
AMH
What imaging technique can be used to diagnose cryptorchidism?
US
When should surgery be performed on a foal with an inguinal hernia?
IF increasing in size or strangulating viscera
How are inguinal hernias diagnosed?
Palpation and US
What is he most common neoplasia of the penis?
SCC - proliferative, ulcerative
Which tumour may occur on the sheath?
Melanoma or sarcoid
Apart from visual signs, how are penile tumour diagnosed?
Biopsy
How are penile SCCs treated?
Excision/cryo
Surgery (amputation)
PTS if mets suspected
How can penile SCCs be prevented?
Regular penile washing - smegma carcinogenic
Which sedative may cause priapism?
ACP
Why can prolonged paraphimosis become permanent in the horse?
Pudendal nerve injury
Which procedure should be used to cure a pneumovagina?
Caslicks or Gadds
Which procedure should be used to cure a urovagina?
Urethral Extension
Which procedure should be used to cure cervical incompetency?
Cervical repair
Which procedure should be used to cure delayed uterine clearance?
Uterine suspension - improve clearance and conformation
What should be given to aid oviduct blockage?
Oviduct lavage
PG
What is caslicks procedure?
Surgical closure of the upper vulva
What is Gadds procedure?
Removal of a triangular portion of dorsal vestibule
When should gadds be used?
Second degree perineal lacerations or older mares
How is urovagina diagnosed?
Cytology (rule out ectopic ureter)
What should be done for a 3rd degree perineal laceration?
Wait 4-6w
Caslicks and Gadds
What is the most common neoplastic Dz of the ovary in the mare?
Granulosa Cell tumour (GCT)
What are the signs of a GCT?
Anoestrus/Permanent Oestrus
Stallion-like
Aggressive
What is the Px for a GCT?
Good - rarely metastasise
How is a GCT diagnosed?
Rectal exam
US (honeycomb)
Endocrine (best to worst): inc AMH, inc inhibin, inc testosterone
How is a GCT treated?
Unilateral ovariectomy - laproscopic or laparatomy if v large
How is uterine prolapse treated?
Replace under standing sedation or GA
Which horses are predisposed to uterine artery haemorhage?
Older Mares - present w/colic and signs of shock
How is uterine neoplasia treated?
OVH
How is pyometra tx?
Drain pre-surgery
OVH
Which cancer affects the vulva and clitoris and what is the Px/Tx?
SCC
Poor even if radical resection
What causes intermittent vulvar bleeding which worsens at oestrus?
Varicose veins
How are vaginal varicose veins Tx?
Ignore
Topical astringents
Ligate
Cauterise
how often should urine flow out of the ureter in a horse?
q20-45s under xylazine
How can you image the bladder in adult horses?
Transrectal US
What can you see on transcutaneous urological US of the horse?
Kidney
Umbilicus
(bladder in foals)
What imaging method can be used to assess equine renal fct?
Scintigraphy
At what age does a ruptured bladder most commonly present?
foals 1-4d ESP colts
What are the clincial signs of a ruptured bladder?
Depression
Abdo distension
Colic
Inc urinary freq, dec vol
What changes are seen on HBC with a ruptured bladder?
Hyper K
Hypo Na/Cl
Dehydration
Metabolic Acidosis
What is seen on peritoneal fluid analysis of a foal with a ruptured bladder?
Serum:Fluid creatinine: 1:2
How must a foal with a ruptured bladder be stabilised before Surgery?
Resolve HyperK (<5.5)
IV Hartmans + Bicarb + Caborogluconate
Insulin/glucose
+ abdominal drainge
How is a ruptured bladder treated?
Surgical repair via midline laparotomy +/- concurrent resection of umbilicus/urachus
Which horses are most predisposed to uroliths?
ADULT males
What are the majority of horse uroliths made from?
Ca Carbonate
Type 1: spiculated yellow-green
Type 2: smooth and white
What are the presenting signs for urolithiasis?
Haematuria
Stranguria
+/- pollakuria, pyuria, incontinence
Apart from clinical signs, how else are equine uroliths diagnosed?
Rectal
US
Endoscopy
How is equine urolithiasis treated?
Laparotomy/Laparocsopy removal
What is sabulous cystitis secondary to?
Issues with bladder emptying i.e. paralysis
What are the 2 indications for nephrectmy in the horse?
Renal Neoplasia
Pyelonephritis non-resp to medical Tx
How long does it take for the normal umbilicus to disappear?
4-6w
When should an umbilicus be investigated?
Moist >24h
Swollen
Painful
Febrile Foal
What are the signs of a patent urachus?
Moist umbilicus
Dripping urine
cHECK FOR SEPSIS
How is a patent urachus treated?
ABs, topical cautery
Should self-resolve, of not can surgically resect urachus
In the 1st 1-2w of life a foal appears depressed and off suck with a painful swollen umbilicus, what is your Dx?
Umbilical sepsis
How is umbilical sepsis diagnosed?
US
How is umbilical sepsis tx?
IgG assessment
Systemic ABs
Surgical resection if worsens/no response
When do umbilical hernias need repairing surgically?
Large defect that persists > 6 mths of age
Defect enlarges
Associated with colic
