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la surgery final
final
| Question | Answer |
|---|---|
| Approximately what percentage of colic cases requires surgery | Most colics respond to medical mgt,about 5-10need to go to sx,some of these may not be suitable candidates though. |
| Pulse | > 80 bpm. |
| Capillary refill time | > 3 seconds. |
| Mucous membrane color | blue/congested. |
| GI motility | none. |
| Pain | uncontrollable. |
| Fluid in stomach | > 2 gallons. |
| Abdominocentesis | serosanguinous. |
| Rectal exam | distended small intestine. |
| What is the preferred approach for abdominal surgery in horses | The ventral midline provides the best exposure, easiest closure, and least hemorrhage. |
| What is the recommended suture type and pattern for closure of the abdominal tunic | Close the midline with a simple continuous pattern (for even tension throughout) using doubled #2 Dexon. |
| What are the advantages and disadvantages of using a mayo mattress closure | The mayo mattress (vest over pants) is very strong, but it does not provide anatomic apposition, so healing is delayed. |
| If there is contamination of the surgical site, what type of drain is preferred and how long is it maintained | Positive suction drains are preferred over penrose drains and they should be kept in for 1-2 days. |
| What is the best suture size and pattern for the subcutaneous tissue | Use #00 absorbable suture with a continuous pattern. |
| Why do some people prefer a paramedian approach over ventral midline | Some think that there is less chance of would breakdown using a paramedian approach, but this is controversial. |
| Disadvantage | There is less exposure and more hemorrhage with this approach. |
| T/F It is recommended to close only the superficial rectus sheath when using a paramedian approach | FALSE,Most recommend closing the deep and superficial rectus sheaths. |
| What are the advantages and disadvantages of a flank approach and which side is preferred | The flank approach can be done standing or in lateral recumbancy. |
| Flank approach | It is good for making a diagnosis, but does not provide adequate exposure to make any corrections. |
| Flank approach | The left flank has more room than the right. |
| Describe the steps of closure for a flank approach | Close peritoneum &transverse m as 1 layer using simcon,absor sut,next layer—close the intabdobl w/ absoruture simcont,insert drain btw int and external abdominal obliques, use a simple interrupted pattern with #2 absorbable suture in the external oblique. |
| Give two indicators that colic would be caused by a small intestine problem | Small intestine problems tend to cause reflux, smooth dilated loops could be felt on palpation. |
| the lateral band of the cecum becomes the | cecocolic ligament which attaches the cecum to the right ventral colon. |
| cecocolic ligament to | right ventral colon. |
| dudenocolic ligament to | descending colon. |
| ileocecal fold attaches the | dorsal band of the cecum to the ileum. |
| What is the most common reason for gastric dilatation | Gastric dilation is almost always secondary to ileus,caused by obstruction or dysfunction of the small intestine. |
| Primary dilatation is possible | though rare if the horse is on extremely poor feed or has a gastric mass. |
| T/F It is best to pass a stomach tube after anesthetic induction to minimize stress and reduce the risk of trauma to the horse | FALSE,It is very difficult to pass a stomach tube during anesthesia. |
| The stomach tube should always be | passed prior to induction. |
| What is the prognosis for gastric rupture prior to surgery& During surgery | If the stomach ruptures and is diagnosed in surgery, euthanasia is the only option,Gastric rupture during surgery may be treated, but the prognosis is not good. |
| T/F Gastric ulceration with pyloric stenosis is most common in older race horses | FALSE,Ulceration in the pylorus and cranial duodenum occurs in foals that are often stressed or on NSAIDs. |
| What is the treatment for gastric ulceration and pyloric stenosis | A gastrojejunostomy allows alternate flow of ingesta. |
| T/F Gastric neoplasia does not typically cause acute abdominal pain | TRUE,It may cause discomfort after eating. |
| What is the difference between a simple obstruction and a strangulating obstruction | Simple obstructions do not compromise blood flow,strangulating obviously does. |
| How much fluid is normally secreted in the small intestine of a horse in 1 day and why does this matter | A 450kg horse secretes about 100L of fluid into the small intestine each day,The number doesn’t matter, but the point is that blockage of the small intestine is VERY BAD,A stomach tube must be passed. |
| T/F Ascarid impaction occurs in all ages of horses | FALSE,Older animals develop some degree of immunity, so ascarid numbers are not great enough to cause an impaction. |
| Foals and weanlings are most susceptible | ascarid impaction. |
| If an adhesion is found,what is the best way to treat it | Break down the adhesion and suture serosa over the defect to prevent reoccurrence. |
| Heparin and carboxymethylcellulose may prevent | adhesion if it is not possible to cover the area with serosa. |
| It may be necessary to divert the intestinal content around the | adhesion. |
| Where in the US is impaction of the distal ileum most likely to occur | Impaction of the distal ileum occurs in the southeast US It is rare elsewhere. |
| T/F Abdominal abscesses cause adhesions | TRUE,Ingesta should be diverted around the adhesion and long term antibiotics are recommended. |
| What findings help differentiate anterior enteritis from a mechanical obstruction | Anterior enteritis/proximal duodenojejunal enteritis causes a high protein with normal to slightly elevated nucleated cell count in peritoneal fluid,there is often fever and marked pain followed by depression after reflux is removed. |
| What should be done if an exploratory laparotomy is performed on horse with anterior enteritis | If a horse w/ ant enteritis is taken to surgery,even though surgery is not necessary,it may help to milk the fluid out of the small intestine and into the cecum. |
| Intussusception is most common in (foals, adults) and usually occurs at what location,What is the treatment | Intussusception usu occurs in foals at ileocecal jct,Resection & anastomosis is the most common treatment. |
| What is the difference between volvulus and torsion | Volvulus is twisting around the mesentery,torsion is twisting of bowel along the long axis on itself. |
| How long can the blood supply to the bowel be occluded before resection and anastomosis is required | If surgical correction is performed w/in 6hrs of occlusion,its possible to correct the twist w/out removing the bowel,Typically,resection & anastomosis is required. |
| What are the two most common locations for torsion to occur | Usually large intestine torsion occurs at the diaphragmatic and sternal flexures. |
| What signalment is most likely to have large intestine torsion | Broodmares within 6wks of foaling are most likely to have torsion. |
| Pedunculated lipomas are most common in what signalment,What is the treatment | Old horses are more likely to get pedunculated lipomas,If the lipoma entraps the bowel, it must be removed. |
| The most common type is when the intestine herniates through the | epiploic foramen. |
| A peritoneal tap is most likely normal if | the intestine is confined to the bursa. |
| The prognosis is generally | poor. |
| Usually the jejunum passes from | right to left into the omental bursa. |
| What is Meckels diverticulum and where is it found | Meckels diverticulum is a persistent omphalomesenteric duct, which forms a diverticulum btw the antimesenteric surface of the ileum & the body wall near the umbilicus. |
| T/F The lumen of Meckels diverticulum is continuous with the lumen of the ileum | TRUE. |
| What clinical problems are associated with Meckels diverticulum and how are they prevented | The diverticulum is a point for volvulus to occur,or it may become impacted and rupture,the diverticulum should be dissected out and removed. |
| What is the origin of a mesodiverticuluar band and where is it found | If the distal segment of a vitelline artery and its assoc mesentery fail to regress,it forms a mesodiverticular band,this creates a pouch from 1 side of the mesentery of the jejunum to the antimesenteric side. |
| What problems are associated with a mesodiverticular band and how is it repaired | The pouch may cause intestinal volvulus,The defect should be removed,along with any necrotic bowel. |
| T/F The Connell suture pattern is not recommended for closing intestine | TRUE,The Connell goes through all layers to the lumen and is not preferred,Cushing or Lembert are better. |
| If applying pressure or irritants to correct the hernia, this should be done | early on. |
| Surgical closure should be performed after weaning at about | 6 months. |
| A hernia clamp may be applied to | yearlings to correct a hernia. |
| Many umbilical hernias of equine regress over time,especially if | the ring is <3 cm. |
| Bowel is more likely to become incarcerated in a small hernia, causing | acute abdomen,Larger defects allow the bowel to move freely. |
| What is the best course of action if a hernia is noticed in a foal | The best thing to do is wait and see if the hernia will regress on its own. |
| If its not gone w/in 1,5yrs,a | hernia clamp can be applied to an anesthetized animal,The hernia will slough w/in 2wks,Sx closure is another option. |
| What is a common cause of ventral hernias | Ventral hernias may occur secondary to surgery. |
| ventral hernias are usually too big to cause | strangulation of the bowel. |
| mesh should be avoided if at all possible it is preferred to use | relaxing incisions and/or starve the animal. |
| bulk should be reduced | soft, pelleted feed should be used. |
| PDS or other long-lasting absorbable sutures are preferred because | the mesh cant be removed if it gets infected and non-absorbable sutures were used. |
| T/F Auscultation of bowel sounds in the thorax is good reason to suspect a hernia | FALSE,Intestinal sounds may be heard normally in the thorax b/c the diaphragm is so concave. |
| Diaphragmatic hernias are | rare. |
| What approach is used for repair of a diaphragmatic hernia | A long ventral midline incision is used to allow adequate exposure,The large colon may have to be placed outside the body cavity. |
| What is the most common cause of a mesenteric thrombus/ thromboembolic colic | Migration of strongylus vulgaris larvae is the primary cause for thromboembolic colic,De-worming prevents it. |
| If there is a mesenteric thrombus, how much of the small intestine can be removed at once | About 40pct of the small intestine can be removed with a more favorable outcome. |
| What is the best treatment for simple obstructions of the colon | Usually it is best to treat obstructions medically,give laxatives,analgesics and fluids and see if it resolves. |
| T/F Abdominal pain and obstruction for more than 24hrs normally requires sx intervention | TRUE. |
| What is the most common site for impaction of the large intestine | The most common location for impacted colon is at the pelvic flexure or the right dorsal colon. |
| How is an impacted colon treated surgically | horse place in dorsal recumbancy,ventral midline incision is made,colon should be bathed in heparin prior to the enterotomy to prevent fibrin formation on the serosa,then ingesta is flushed out of the colon. |
| In general, what causes impaction of the cecum | The cecum becomes impacted because of motility disorders. Erythromycin can be used to |
| Cecum may become impacted when | very coarse, poor quality hay is fed (like peanut hay). |
| Cecum impaction | First try laxatives and iv fluids and take off feed. |
| cecal impaction causes more of a | chronic pain than intense pain. |
| Cecum impaction | feces still passes. |
| Cecum impaction | A firm, hard, enlarged cecum may be palpated. |
| Cecum impaction | the jejunocolostomy works better than the cecocolic,horses tend to do better. |
| Most will have a | nidus of foreign material. |
| Miniature horses and Arabs are | more susceptible. |
| Alfalfa diets are often associated with | enteroliths. |
| Enteroliths | It is a bigger problem in the western US than other parts. |
| They are usually found in the right dorsal colon, transverse, or proximal small colon | enteroliths. |
| What is the other term for nephrosplenic ligament entrapment | Nephrosplenic entrapment is the same as a left dorsal displacement,The pelvic flexure moves cranially than comes back over the nephrosplenic ligament and gets caught. |
| T/F nephrosplenic entrapment causes severe, acute pain | FALSE,This is a nonstrangulating obstruction and is not acutely extremely painful. |
| What drug is of value in treating left dorsal displacement and why (besides analgesics) | Phenylephrine causes contraction of the spleen, which may allow the colon to free itself. |
| What are the treatment options for nephrosplenic entrapment | Medical therapy includes phenylephrine with forced exercise (at a jog), or rolling the horse under short acting gnl anesthesia, or keep off feed for several days, If sx is req a ventral midline incision is made and the problem is corrected. |
| T/F Colonopexy is recommended when a nephrosplenic entrapment is being corrected surgically | FALSE, Dr Humburg does not recommend colonopexy. |
| What is the most common location for colonic torsion | Torsion of the large colon usually occurs at the diaphragmatic or sternal flexure. |
| What direction do colonic torsions usually occur | Torsion is usually counterclockwise, so it is corrected by a clockwise twist. |
| What signalment is more likely to show up with colonic torsion | Broodmares 30-120days post-partum are more likely to have colonic torsion. |
| Where does colonic or cecal volvulus usually occur | Volvulus usu occurs crl to the mesenteric attachment to the right body wall. |
| T/F It is better to remove the bowel contents before manipulating it to correct a volvulus | TRUE,It is possible to reposition the bowel, but it is usually better to flush out the contents first. |
| Damage to the bowel is less likely following removal | of the contents. |
| Marked discoloration and lack of hemorrhage indicate | resection may be needed. |
| Euthanasia is the only option if the | entire cecum and large colon are involved. |
| Up to 90pct | can be removed and the horse will still do fairly well. |
| T/F Cecocolic intussusception is very rare in horses | TRUE. |
| Rectal prolapse is most common in what species | Rectal prolapse occurs most often in pigs. |
| Which of the following predispose animals to rectal prolapse | estrogen in feed,antibiotic feeding,limited exercise,vaginal prolapsed,High protein diets. |
| What is the difference between a type 1 and type 2 rectal prolapse | Type 1 rectal prolapse involves edema and prolapse of the mucosa only,type 2 includes muscularis in addition to mucosa,Type 3 is even worse. |
| What type of anesthesia is used for repair of rectal prolapse in pigs,In other species | In pigs a lumbosacral epidural is used,In other species a caudal epidural is used. |
| What are the indications for direct replacement of a rectal prolapse and maintaining with a purse string suture | If the prolapse only involves mucosa and the tissue is fresh without lacerations, it can be put back in and tied with a purse string suture for several days. |
| T/F If the mucosa of a rectal prolapse lacks viability, it should be resected prior to replacing the rectum and tying a purse string suture | TRUE. |
| When is rectal amputation indicated | When the rectal prolapse is evaginated, amputation is the best treatment. |
| In what species are rectal rings most commonly used for amputation of the rectum | Rectal rings are commonly used in pigs with rectal prolapses,The entire ring and prolapse will slough off. |
| What suture pattern is used when the prolapsed rectum is to be transected | Numerous horizontal mattress sutures can be placed transverse to the rectum, then the prolapse is transected distal to the suture line. |
| What technique is recommended for repair of a rectal prolapse in horses | In horses,tube w/holes drilled in center placed in ectum,w/holes cranial tosite that willbe amputated,Suture through holes into the rectum,Incise the mucosa caudal to the suture line,The tube and prolapse will slough off,Keep the feces soft for 10 days. |
| How are most iatrogenic ruptures thought to occur,Where are they located | Iatrogenic ruptures are produced by exp vets as well as novices,maybe caused by peristaltic waves forcing intestine over the examiner knuckles,tear is usually located dorsally at elbow length. |
| Why shouldnt a rectal exam be performed prior to breeding a mare | The rectal exam may cause relaxation of the anal sphincter and allow misdirection of the penis, causing a rectal rupture. |
| What is the most important recommendation for preventing iatrogenic rectal tears,What other precautions should be taken | Always allow ur hand to be pushed caudally by peristaltic wave instead of fighting it,Use plenty of lube,clean feces from rectum,use proper restraint. |
| What steps should be taken when blood is found on a glove after rectal exam | If rectal tear is suspected, give epidural to prevent straining,perform bare-hand rectal exam to identify defect. |
| Describe the grading system for rectal tearsGrade 1 | mucosa and submucosa. |
| Grade 2 | muscularis only (these are rare). |
| Grade 3 | mucosa and muscularis. |
| Grade 4 | mucosa, muscularis and serosa (all the way to peritoneum these have poor prognosis. |
| What steps should be taken for a grade 1or2 rectal tear (after the owner has been notified | Notify owner of problem,give mineral oil/abs,limit hay,provide laxative diet for several weeks while making careful obs of the animal regularly. |
| What are the three tx options for a grade 3or4 rectal tear | Repair grade 3and4 rectal tears w/ diverting colostomy or divert feces through a plastic sleeve,or use a special basket speculum and repair the defect directly. |
| What is the most common complication of a diverting colostomy | Prolapse of the colon may occur with a diverting colostomy, but incidence is reduced with a diversion further cranialusu the colon is diverted to the left flank fold. |
| Which does apply to rectal tear correction by diversion of feces through a plastic sleeve | Use ventral midline approach under ga,Insert rectal prolapse ring ant to rupture,Pass 2 absorbable sut loosely around the rectum over indentation in the ring,Flush out the large and small colon through an incision in the pelvic flexure. |
| The suture pattern should be | INVERTING. |
| For a grade 4 rectal tear using the plastic sleeve diversion, after the horse is standing again an epidural should be given and | the rupture is closed with several approximating sutures. |
| How long does it take too pass the ring and sleeve and what should be fed until it is passed | Feed grain and bran with large volumes of mineral oil until the ring and sleeved are passed about a week later. |
| What is the prognosis for grade 3 and 4 rectal tears | Grade 3 and 4 rectal tears always have very guarded prognosis. |
| T/F The rumen and reticulum can be palpated and visualized from the left flank | TRUE. |
| What approach should be used to palpate and visualize the duodenum | The duodenum is accessible for visualization and palpation from the right flank. |
| T/F The jejunum can only be visualized from the right flank | FALSE,The left flank allows palpation and visualization as well, and possibly exteriorization. |
| It is possible to exteriorize the ileum from | the right flank. |
| What four parts of the GI tract can be assessed from the left flank | The rumen, reticulum, jejunum, and cecum can all be palpated from the left flank. |
| T/F Only the 1 st part of the proximal loop of ascending colon can possibly be exteriorized | True. |
| How many turns are there in the spiral loop of the ascending colon in bovine, ovine,caprine | Cows have 1,5to2turns,sheep 3 turns,goats have 4 turns. |
| T/F In sheep and goats,the last centrifugal turn of the spiral colon becomes associated with the anti-mesenteric border of the jejunum | FALSE,The last centrifugal loop of the spiral colon associates with the mesenteric border of the jejunum. |
| A grid approach involves incisions parallel to the muscle fibers each muscle layer | causing less trauma and making closure easier, but allows the least exposure. |
| A modified grid starts with an incision through the belly of the external abdominal oblique | then makes incisions parallel to the internal and transverse abdominal muscles. |
| A nongrid approach allows the best visualization,but cuts through the belly off both | external and internal abdominal oblique, causing more trauma and making closure more difficult. |
| Which of the following is NOT routinely used as an approach for an exploratory surgery | ventral midline. |
| Under what circumstances is a right paramedian approach used | There are no advantages to the paramedian approach over the flank, and it causes more hemorrhage. |
| It is sometimes used specifically for abomasal displacement repair | right paramedian. |
| What are the two patterns used for local anesthesia of the flank | Local anesthetic can be injected where the incision will be made using a line block or inverted L. |
| What are the two types of regional anesthesia used to desensitize ventral and lateral body wall | Regional anesthesia can be achieved using paravertebral nerve blocks or a seg lumbar epidural dorsal lumbar epi are difficult and not commonly used. |
| What three nerves provide sensation to the lateral and ventral body wall and are blocked in paravertebral anesthesia | T13, L1 (iliohypogastric) and L2 (ilioinguinal) are sensory to the body wall. |
| Which vertebrae correspond to spinal cord segments T13, L1, L2 | To block T13, L1, and L2, anesthetic must be injected at L1, L2, and L4. |
| Describe the Farquaharson method of paravertebral anesthesia Farquaharson technique | insert the needle just caudal and perpendicular to the transverse spinous processes, about 2in from the dorsal process. |
| In the Cakala-Delahanty method, the needle is | directed parallel to the transverse processes, with anesthetic injected above and below them. |
| T/F The Cakal-Delahanty method may be preferred over the Farquaharson technique because some find it easier | TRUE,The dorsal spinous processes may be difficult to palpate for the Farquaharson technique. |
| When is general anesthesia indicated for GI surgery in bovine | GA is not commonly used,It may be used for neonates and small and large bowel/mesenteric volvulus. |
| T/F Left displaced abomasum is more common in beef than dairy cattle | FALSE,LDA is more common in dairy cattle. |
| Why is a left displaced abomasum more likely to occur immediately prepartum or early postpartum | There are often dietary changes immediately prepartum or postpartum that may be low in Ca or low in fiber. |
| The rumen doesnt adequately fill the abdomen immediately postpartum because of the | empty uterus and it is not full prepartum because the fetus takes up too much room,this allow LDA. |
| What does a left displaced abomasum sound like | There is a distinctive ping sound when the displaced abomasum is percussed. |
| Describe the Liptak test for diagnosing abomasal displacement | Fluid is withdrawn just ventral to the lowest ping and a pH <3 indicate abomasal fluid,pH of ruminal fluid should be >5,5. |
| Give four differential diagnoses for a ping on the left side | could be LDA,ruminal gas cap with poor rumen motility,abdominal void b/c of poor rumen filling or pneumoperitoneum. |
| Describe the conservative method of correcting a LDA,List adv/disadvantages | In some cases the cow can be cast on rt side,roll to lft,allowed to stand,This often corrects problem w/out invasive methods or anesthesia, but likely to recur. |
| What procedure should accompany all abdominal surgery | An exploratory should be done any time the abdomen is entered. |
| It is most difficult to do a good exploratory using which approach | The right paramedian approach does not provide enough exposure for a good exploratory. |
| An omentopexy is the least secure method, so adhesions should form before a | high grain diet is fed, to prevent future displacement. |
| having a full rumen prevents | LDA. |
| contamination and concurrent disease may necessitate antibiotics | LDA. |
| List four possible complications of abomasal displacement correction surgery | Abomasal dysfunction, peritonitis, abomasal rupture,abomasal fistula formation. |
| What is the difference between right abomasal displacement and abomasal torsion | With displacement, the abomasum rotates clockwise 90 so that the pylorus is displaced cranio-dorsally,torsion is a 180-270 degree counterclockwise rotation. |
| A lot of organs on the right side can result in a ping when filled with air,Which ones dont routinely cause a ping | bladder,omasum,reticulum will NOT cause a ping. |
| What does the abomasal volvulus/torsion feel like on rectal exam | On rectal palpation of an abomasal torsion/volvulus, there will be a tightly distended smooth surface structure in right cranial abdomen. |
| What happens to the position of the liver in an abomasal torsion/volvulus | The liver becomes displaced medially, away from body wall by the greater curvature of the abomasum. |
| What results are found clinical pathology during abomasal torsion | Abomasal volvulus/torsion causes sequestration of HCl, which leads to a metabolic alkalosis, hypochloremia and hypokalemia. |
| What approaches can be used to repair abomasal torsion | The right flank pyloro/omentoopexy or the right paramedian abomasopexy will work for abomasal torsion, but the left flank approach will not. |
| Which way is the abomasum rotated to return the pylorus and liver to the proper position after a torsion | Rotate the abomasum clockwise to reposition the abomasums,this will automatically correct the displaced liver as well. |
| What are the possible complications following abomasal volvulus | death from metabolic derangement,vagal indigestion several days after surgery,ischemic necrosis (uncommon)peritonitis if contamination/rupture of the abomasum. |
| T/F Cecal torsion causes a right-sided ping | TRUE. |
| T/F The cecocolic valve and ileocecal valve are just a slight narrowing in cattle,not really valves | TRUE. |
| After the apex and as much of the cecum as possible have been exteriorized, what is the next step in treating cecal dilatation/torsion | a cecotomy is performed to empty the cecum and part of the ascending colon. |
| What type of suture pattern can be used to close the cecotomy | Use a two-layer inverted closure on the cecum. |
| What are the possible complications following cecal torsion | Peritonitis, adhesion formation with delayed incarceration of the bowel, and recurrence assoc with adhesion formation. |
| T/F the cecum must be replaced in precise anatomic position to prevent further dilatation and torsion | FALSE, As long as the cecum is completely empty it will sort itself out. |
| What post-operative care should be provided following cecal torsion | Fluid replacement may be necessary, as well as broad spectrum antibiotics. |
| What is the prognosis for cecal dilatation and torsion | prognosis depends on the chronicity,if the tone returns to the cecum following decompression,greater potential for recurrence. |
| T/F Intussusception causes unrelenting colic in cattle | FALSE,Colic lasts for about the first 6 hours then seems to subside. |
| Cattle are often presented 5-7 days after the intussusceptions,Why isnt it noticed sooner | There is great ability for rumen expand and hold more ingesta and intestinal reflux,after initial pain, theyre ok until rumen is too full. |
| What does the feces look like in a cow with an intussusception | Intussusception causes dark,tarry,foul smelling feces, starts out sticky mucus on rectal palpation. |
| What is the average length of an intussusception in cattle and why | Most intussusceptions in cattle are only about 8-10in long b/c of short mesentery and great deal of mesenteric fat. |
| T/F Intussusceptions are more common in adult cattle than calves | TRUE. |
| What is the most common location for an intussusception in cattle | Intussusceptions are almost always at the jejuno-ileum aka flange area. |
| How is an intussusception repaired | area of intussusception is exteriorized, resected,anastomosis made using an appositional or everting pattern,DO NOT USE INVERTING PATTERNS. |
| T/F Postoperative care after intussusception includes postoperative antibiotics, high fiber diet, and close monitoring of hydration status | FALSE,Fiber should be restricted for 5-7 days postop. |
| Give four indications for a rumenotomy | Traumatic reticuloperitonitis,grain overload,recent toxin ingestion,frothy bloat are all reasons to enter the rumen. |
| Why isnt a trocar effective in relieving bloat caused by legumes | Some legumes cause frothy bloat, which requires a rumenotomy to relieve the pressure. |
| What is the ONLY acceptable position for a rumenotomy | The only approach for a rumenotomy is in the left flank with the patient standing. |
| When performing a rumenotomy, how is contamination of the abdomen prevented | not a concern with the rumen as with other organs,rumen sutured to skin,held with rumenotomy shroud,Weingart’s rumenotomy apparatus, or with towel clamps so that ingesta doesnt spill into abd while performing exploration,also makes it easier to work with. |
| What type of suture pattern is used to close the rumen | The rumen should be closed with a two-layer inverting pattern. |
| What dietary restrictions are necessary following a rumenotomy | There are no dietary restrictions after a rumenotomy. |
| Why is a small intestinal volvulus so uncommon in cattle | The short mesentery in cattle prevents volvulus, so this seldom occurs. |
| Describe the appearance of a cow with small intestinal volvulus | mesenteric or small intestinal volvulus causes all 4 quandrants to become severely distended,si, cecum,spiral colon are distended. |
| T/F Cattle often become alkalotic because of mesenteric volvulus | FALSE,Mesenteric volvulus may cause acidosis because of shock and perfusion problems. |
| Which has the worst prognosis abomasal torsion, intussusception, cecal torsion, or mesenteric torsion at the root of the messentary | Torsion of the mesenteric root has a poor to guarded prognosis. |
| It is generally not economically sound to repair | atresia ani. |
| Under what circumstances would this condition have a good prognosis | prognosis for atresia ani is poor unless the segment only involves the last 1-2 cm of the rectum. |
| What is the most likely location for atresia coli | Atresia coli is usually found in the spiral colon. |
| In repairing atresia coli, the atretic segment is removed,Where is the anastomosis made | An anastomosis is created between the distal end of the patent intestine, and the descending colon. |
| T/F Atresia coli and atresia ani are heritable | FALSE,Only atresia ani is considered heritable. |
| How does intussusception of neonates differ from adults | In neonates, intussusceptions are not only found in the jejuno-ileum,they are more acute because of a lack of mesenteric fat, and less common. |
| What is the most common presenting sign of a displaced abomasum in calves 2-12 months old | Calves under a year old that have a displaced abomasum present with chronic bloat |
| What approach is usually preferred for left abomasal displacement in calves | The right flank approach is usually suggested for calves with left abomasal displacement. |
| What is the signalment for abomasal volvulus/torsion of neonates | Abomasal volvulus in calves usually occurs in those bottle fed 1-8 weeks old,seen after a large milk feeding. |
| What approach provides the best exposure for repair of abomasal volvulus in neonates | The right paracostal or right paramedian approach provides the best exposure. |
| List three structures likely to be involved in a strangulating hernia and which one is most likely | Strangulation of si, omentum, or abomasum may occur in through an umbilical hernia,abomasum is the most common. |
| T/F Foals are more likely than calves to have abscesses in umbilical hernias | fALSE,Calves are more likely to have abscessed umbilical hernias. |
| T/F A foal with an abscess is more likely to show systemic signs than a calf | tRUE,Calves tend to wall off the abscess and will not show clinical signs. |
| T/F Typically,a hernia with a fibrous core or abscess will be reducible dorsally and have a firm, non-reducible ventral part attached to the skin | TRUE,Most umbilical hernias in calves are completely reducible and have a palpable ring, If an abscess or fibrous core forms,ventral part becomes nonreducible. |
| It is possible to have umbilical hernias with infection | The most common type of infection is a urachal abscess, then omphalophlebitis, then omphaloarteritis. |
| What organism is most commonly implicated in infection of umbilical cord remnants | Corynebacterium pyogenes most common pathogen found in umbilical cord infections,others inc E coli,Proteus, Enterococcus, Staphylococcus,strep. |
| T/F Illthrift is a common sign of umbilical abscess or umbilical cord infection | TRUE. |
| You palpate a warm, painful, nonreducible, firm mass in a neonate,What is the most likely diagnosis | Umbilical abscesses are warm, painful, nonreducible (unlike hernias), and usually firm, but may be fluctuant. |
| What is the treatment for umbilical abscesses | Lance, drain and flush the umbilical abscess. |
| Give three possible causes for enlargement of the umbilical stump | The umbilical stump may appear enlarged due to omphalitis, patent urachus, or treatment with chemical irritants. |
| T/F If a hernia is present, open herniorraphy should be performed | TRUE. |
| What is the ideal treatment for a combined hernia and abscess or draining tract | 2 separate procedures should be done, first drain the abscess,flush draining tract several days before surgery,then do herniorraphy. |
| In reality, usually the draining tract is closed to | prevent contamination and the hernia is repaired. |
| Describe the skin incision for hernia repair of a heifer compared to a male calf | In females, an elliptical incision should be made around the base of the mass,males it is a semi-lunar incision. |
| An elliptical incision is made around the mass in the | body wall of males and females. |
| T/F umbilical arteries are seldom the primary problem and can usually be ligated and transected | TRUE. |
| What should be done if the umbilical vein is infected all the way to the liver | If infection of the umbilical vein extends to the liver,vein should be marsupialized,second incision made in body wall and vein is attached to the skin,Then lavaged to clear the infection. |
| How is an abscessed urachus treated | If the urachus has an abscess, cut out the apex of the bladder with it and close it back up. |
| If there is intestinal strangulation within a hernia, how is it treated | Resection and anastomosis is required for strangulated bowel. |
| What suture is used most commonly in repair of hernias | 3 vetaphil is often used in hernia repair,Chromic gut is not recommended. |
| What suture patterns are used if there is excess tension on the incision line | A near-far-far-near, simple interrupted, or mayo-mattress (vest over pants) can be used if there is too much tension or the ring is not strong enough. |
| What is the most common complication of removing umbilical masses | Infection is common because there is often contamination at the surgical site, Abs often given 3-5 days postoperatively. |
| What is the best age to dehorn a goat and why | Dehorning should be done before 10 days of age, After this time surgery is more difficult,more complications,regrowth common. |
| How long is the electric cautery held on the horn bud | Dont burn for more than 10 seconds. |
| T/F Tetanus antitoxin is often recommended following dehorning | TRUE. |
| How does dehorning differ in older animals from younger | Dehorning in older animals requires anesthesia and sedatives,gigli wire or hard backed saw is often used instead of electro-cautery,bandage is placed following surgery, Powder not recommended for wound care. |
| What is the maximum dose of lidocaine that can be used in goats | Do not exceed 05mg/kg of 2pct lidocaine,goats are very susceptible to toxicity. |
| What nerves can be blocked to provide analgesia during dehorning | Block the cornual branch of the lachrymal and infratrochlear nerve,which are branches of the trigeminal. |
| Give three complications of dehorning | hemorrhage, brain damage, and sinusitis. |
| Where do uroliths tend to lodge in small ruminants | urethral process most common place,also occur frequently in the distal sigmoid flexure and bladder. |
| What are the signs of bladder rupture | Abdominal distention, recumbancy, and electrolyte abnormalities,hyperkalemia,hyponatremia,hyperphosphatemia,elv BUN. |
| What are the treatment options for urolithiasis at the distal sigmoid flexure | Urethrostomy, penile amputation, and tube cystostomy may be used to eliminate an obstruction. |
| What are the predisposing factors for rectal prolapse in swine | Young pigs are more likely to get rectal prolapsed,maybe ass with respiratory infection and dietary problems. |
| Give two techniques for correction of a prolapsed rectum | A prolapse ring can be applied to the mass and it is allowed to slough off, or resection/anastomosis performed. |
| What does balling refer to in swine | Balling is ejaculation into the preputial diverticulum. |
| If you don’t want to cull your balling boar, how is it treated | It is best to anesthetize boar, put in dorsal recumbancy, pack the diverticulum with gauze, make paramedian inc lateral to gauze,dissect out the diverticulum. |
| What technique is used to castrate pet pot-belly pigs | prescrotal incision as in dogs,Use caution when restraining them prone to orthopedic problems. |
| What type of limb deformity is common in llamas | Carpal valgus is a recognized problem in llamas. |
| What technique may help correct carpal valgus in young llamas | Periosteal stripping along with ulnar osteotomy,Strip periosteum from the concave side,bridge the convex side. |
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