Vaginal Prolapse & Cesarean Section Flashcards
What is the proper incision length on the uterus for a cesarean section in a cow?
the length from the tip of the toe (of the fetus) to the hock
Avoid extreme tension to prevent tearing of the uterus
T/F: Dairy heifers and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse
False
Older beef cattle and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse
What is the surgical approach of choice for cesarean section in sows?
flank approach
- Can’t use ventral midline because of extensive mammary chains
- In sows, make two incision in uterus - one in each horn, along greater curvature
- Very rare to perform C-section on a pig - uterine malposition is usually the main indication
What suture pattern is shown here?
shoelace retention sutures
- Simple; can use umbilical tape
- Must take out at first sign of labor in pregnant cow!
T/F: Regarding cesarean sections in cattle, even if a live calf is delivered at surgery and the procedure goes well, the prognosis is still guarded
False
- If a live calf is delivered at surgery, and the procedure goes well, there is a good prognosis!*
- Survival rate for a FOAL is guarded.*
On average, there is a ____% decrease in fertility following cesarean section in cattle
15%
Due to adhesion of serosa of uterus and damage to endometrium
Identify this piece of equipment:
vaginal prolapse retainer
- Use a caudal epidural
- Non-invasive, simple; plastic retainer
- Sutured to the skin at the level of the tuber Ischia
- Can give birth with this in place
What is the surgical approach of choice for cesarean section in a cow carrying a contaminated fetus or uterine infection?
Ventrolateral celiotomy
The main advantage of this approach is minimal contamination of the abdomen! The incision site also stays clean post-op; cows don’t lie on it
What are some disadvantages of ventral midline and paramedian approach for cesarean section in large animals?
- Difficult to exteriorize the uterus
- Possibility of contamination
- Increased vascularity – do NOT use in high producing dairy cow with large milk vein
- Large abdomen – do NOT use in very heavy dairy cow
- Chance of herniation or evisceration
Mares have a collective foaling rate of about ____% following C-section
Mares have a collective foaling rate of about 35% following C-section
(Foaling rate is normally 50-75%)
What is the most common reason for C-section in bovines?
oversized fetus
- Usually the result of breeding the cow too young.*
- Small cow + big calf = no bueno.*
What is being shown here?
manual reduction of a vaginal prolapse
Also, no gloving. Gross.
For a paramedian celiotomy, the incision is made between __________ and __________
For a paramedian celiotomy, the incision is made between the ventral midline** and the **milk vein. Can go as far caudal as the udder.
For closure of the uterus in the mare, it is important to place __________ suture pattern around the uterus because of their diffuse placentation
For closure of the uterus in the mare, it is important to place hemostatic suture pattern around the uterus because of their diffuse placentation
What is the proper way to close the uterus after cesarean section?
double layer inverting suture patterns using absorbable suture
Cushing, Lembert, Utrecht (most commonly used)
What are the ideal conditions for cesarean section?
- Live fetus
- Dam is a good surgical risk
- Favorable environment
Through what layers will you incise during a paramedian celiotomy?
- Skin
- Subcutaneous tissue
- External rectus sheath
- Rectus abdominis muscle
- Internal rectus sheath
- Peritoneum
What suture pattern is shown here?
Modified Caslick Retention Suture
- Also used for windsuckers/pneumovagina
- Leave a bit at the bottom so they can urinate
- Looks like railroad tracks
- Best if used after parturition
Where on the uterus is the incision usually made?
Greater curvature
Less bleeding!
T/F: During a vaginopexy the surgeon tacks the anterior dorsal wall of the vagina to the inside of the sacrosciatic ligament
True
What muscle layer is NOT incised in ventrolateral celiotomy that IS incised in a ventral midline approach?
transverse abdominal muscle layer
What is the main indication for performing a low flank celiotomy approach in a cow?
Recumbent cow
- Almost same procedure as standing but the incision is started more ventrally
- Incision goes to milk vein if necessary
What surgical approaches are used for cesarean section in bovines?
-
Standing position:
- Left and right flank celiotomy
-
Dorsal recumbency:
- Ventral midline and paramedian celiotomy
T/F: The animal can give birth with this in place
True
This is a prolapse retainer in a sheep
What is the most common surgical approach for cesarean section in beef cattle?
Standing Left Flank Celiotomy
- 40 cm long iincision in middle of flank from 13th rib to tube coxae*
- DO NOT USE if the fetus is dead! It is hard to prevent leakage of uterine fluid into muscle layers*
After cesarean section, it is critical to make sure the calf gets how much colostrum within 12 hours?
10% body weight in colostrum within 12 hours
For treatment of vaginal prolapse, which suture pattern simulates the action of the constrictor vestibuli muscle?
Buhner Suture Pattern
- Preferred because most anatomically/physiologically correct
- Simulates the action of the constrictor vestibuli muscle
- Use 15” (long) Buhner needle and umbilical tape - sharp cutting needles
- Placing antibiotics (for mastitis) on the tape helps to slide easier and prevent infection
T/F: Vaginal prolapse is typically non-recurring
False
Vaginal prolapse RECURS like a motherf***er
What are some factors influencing choice of incision site for cesarean section in large animals?
List them all word for word, because why not.
Because there are a shit ton. That’s why not.
- Experience and preference of the surgeon
- Experience and preference of the client
- Environment for surgery and post-op
- Availability of restraint devices
- Availability of assistant – not a one-man show! (unless a flank- maybe can do by yourself)
- Physical condition of the dam, will she stand for surgery?
- Viability of the fetus - important because of contamination – how to check fetal viability
- US – left or right low flank transabdominal
- Rectal palpation: Pinch between toes, pull legs, anus, poke in the eye, put finger in the mouth (suckle)
- Condition of uterine fluids
- Accessibility to the uterus - for leakage, if you need to repair a tear - predisposes to infection with some approaches
- Type and use of animal: show animal - use ventral or paramedian
- Post-op marketability
- Individual variations
- Vascularity – milk cow
- Obesity
- Edema
- Udder development – first calf heifer with edema
What is the surgical approach of choice for cesarean section in the equines and camelids?
Ventral Midline Celiotomy
