Vaginal Prolapse & Cesarean Section Flashcards

1
Q

What is the proper incision length on the uterus for a cesarean section in a cow?

A

the length from the tip of the toe (of the fetus) to the hock

Avoid extreme tension to prevent tearing of the uterus

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2
Q

T/F: Dairy heifers and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse

A

False

Older beef cattle and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse

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3
Q

What is the surgical approach of choice for cesarean section in sows?

A

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
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4
Q

What suture pattern is shown here?

A

shoelace retention sutures

  • Simple; can use umbilical tape
  • Must take out at first sign of labor in pregnant cow!
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5
Q

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

A

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.*
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6
Q

On average, there is a ____% decrease in fertility following cesarean section in cattle

A

15%

Due to adhesion of serosa of uterus and damage to endometrium

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7
Q

Identify this piece of equipment:

A

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
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8
Q

What is the surgical approach of choice for cesarean section in a cow carrying a contaminated fetus or uterine infection?

A

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

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9
Q

What are some disadvantages of ventral midline and paramedian approach for cesarean section in large animals?

A
  • 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
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10
Q

Mares have a collective foaling rate of about ____% following C-section

A

Mares have a collective foaling rate of about 35% following C-section

(Foaling rate is normally 50-75%)

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11
Q

What is the most common reason for C-section in bovines?

A

oversized fetus

  • Usually the result of breeding the cow too young.*
  • Small cow + big calf = no bueno.*
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12
Q

What is being shown here?

A

manual reduction of a vaginal prolapse

Also, no gloving. Gross.

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13
Q

For a paramedian celiotomy, the incision is made between __________ and __________

A

For a paramedian celiotomy, the incision is made between the ventral midline** and the **milk vein. Can go as far caudal as the udder.

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14
Q

For closure of the uterus in the mare, it is important to place __________ suture pattern around the uterus because of their diffuse placentation

A

For closure of the uterus in the mare, it is important to place hemostatic suture pattern around the uterus because of their diffuse placentation

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15
Q

What is the proper way to close the uterus after cesarean section?

A

double layer inverting suture patterns using absorbable suture

Cushing, Lembert, Utrecht (most commonly used)

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16
Q

What are the ideal conditions for cesarean section?

A
  1. Live fetus
  2. Dam is a good surgical risk
  3. Favorable environment
17
Q

Through what layers will you incise during a paramedian celiotomy?

A
  • Skin
  • Subcutaneous tissue
  • External rectus sheath
  • Rectus abdominis muscle
  • Internal rectus sheath
  • Peritoneum
18
Q

What suture pattern is shown here?

A

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
19
Q

Where on the uterus is the incision usually made?

A

Greater curvature

Less bleeding!

20
Q

T/F: During a vaginopexy the surgeon tacks the anterior dorsal wall of the vagina to the inside of the sacrosciatic ligament

A

True

21
Q

What muscle layer is NOT incised in ventrolateral celiotomy that IS incised in a ventral midline approach?

A

transverse abdominal muscle layer​

22
Q

What is the main indication for performing a low flank celiotomy approach in a cow?

A

Recumbent cow

  • Almost same procedure as standing but the incision is started more ventrally
  • Incision goes to milk vein if necessary
23
Q

What surgical approaches are used for cesarean section in bovines?

A
  • Standing position:
    • ​Left and right flank celiotomy
  • Dorsal recumbency:
    • ​Ventral midline and paramedian celiotomy
24
Q

T/F: The animal can give birth with this in place

A

True

This is a prolapse retainer in a sheep

25
Q

What is the most common surgical approach for cesarean section in beef cattle?

A

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*
26
Q

After cesarean section, it is critical to make sure the calf gets how much colostrum within 12 hours?

A

10% body weight in colostrum within 12 hours

27
Q

For treatment of vaginal prolapse, which suture pattern simulates the action of the constrictor vestibuli muscle?

A

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
28
Q

T/F: Vaginal prolapse is typically non-recurring

A

False

Vaginal prolapse RECURS like a motherf***er

29
Q

What are some factors influencing choice of incision site for cesarean section in large animals?

List them all word for word, because why not.

A

Because there are a shit ton. That’s why not.

  1. Experience and preference of the surgeon
  2. Experience and preference of the client
  3. Environment for surgery and post-op
  4. Availability of restraint devices
  5. Availability of assistant – not a one-man show! (unless a flank- maybe can do by yourself)
  6. Physical condition of the dam, will she stand for surgery?
  7. Viability of the fetus - important because of contamination – how to check fetal viability
    1. US – left or right low flank transabdominal
    2. Rectal palpation: Pinch between toes, pull legs, anus, poke in the eye, put finger in the mouth (suckle)
  8. Condition of uterine fluids
  9. Accessibility to the uterus - for leakage, if you need to repair a tear - predisposes to infection with some approaches
  10. Type and use of animal: show animal - use ventral or paramedian
  11. Post-op marketability
  12. Individual variations
    1. Vascularity – milk cow
    2. Obesity
    3. Edema
    4. Udder development – first calf heifer with edema
30
Q

What is the surgical approach of choice for cesarean section in the equines and camelids?

A

Ventral Midline Celiotomy