Large Animal Surgery by HC12110619150

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									Large Animal Surgery


    Shoeing/ laminitis
  Castration/ Cryptorchid
How often does a horses hoof
    need to be trimmed
Every 4-6 weeks
How fast does a horses hoof
           grow
6 mm/ month
How long does it take for the
hoof to grow from the coronet
          to the toe
1 year
Where does the hoof grow
         from
Perioplic corium
The pastern angle in the front
  should be ____ degrees
50
The pastern angle in the back
  should be ____ degrees
55
   What instrument is this
Hoof nippers
   What instrument is this
Alligator clincher
   What instrument is this
Clinch cutter
  What instrument is this
Rasp
   What instrument is this
Hoof knife
 How do you remove horse
          shoes
Open nail clinches
Loosen the shoe at the bars
Pull the shoes off
  What are horses without
     shoes called
Barefoot
Why do horses wear shoes
To protect their hoof especially for
horses on pavement
Which is better: hot or cold
         shoeing
Its up to the preference of the farrier
 Where should the nails be
   placed in the shoe
Cranial to the widest part of the hoof
In the white line
What does it mean if the nail
      is “quickened”
The nail goes through the sensitive
lamina (bleeding around it)
What des it mean if the nail is
       “nail bound”
The end of the nail doesn’t come out of
the hoof
     What is the typical
presentation of a horse with a
    nail that is nail bound
Usually the horse jerks around when
being shod and is lame the next day
When should the tips of the
   nails be bent over
Immediately
     What is a clinch bed
Use clinch cutters or a rasp to create a
groove just below the nail tip for the end
of the nail to be bent into
    What are side bones
Calcified hoof cartilage
Common in older horses
How do you treat coffin bone
        fractures
Corrective shoeing to prevent the hoof
mechanism
  How is hoof mechanism
        prevented
Place some nails caudal to the widest
part of the hoof
Use full bar shoes
What type of shoeing will help
  treat navicular disease
Shoe with elevated heals
  What is a kimsey splint
Used for SDF, DDF and suspensory
ligament rupture
 What is the most common
 cause of lameness in the
           horse
Solar abscess
What are the CS of a solar
        abscess
Lameness
Thumping digital pulse
Draining tract at coronary band
Swelling
How do you diagnose solar
       abscesses
Hoof testers
Sterile probe in draining tract
Rads (fistulography)
   What is the tx for solar
        abscesses
Establish drainage
Tetanus toxoid/antitoxin
Antiseptic solution
Bandage
What is the prognosis for a
solar abscess in the sole
Good
What is the prognosis for a
solar abscess in the bulb
Good
 Solar abscesses in which
 areas require emergency
         surgery
Navicular bursa
Joint
  How do you treat a solar
         abscess
Debridement
Shoe packed with a lot of gauze
    What is this disease
Keratoma
     What is a keratoma
Abnormal keratinization in response to
chronic injury
What are the clinical signs of
         keratoma
Lameness
Fistulous tract at coronary band
Deviation at white line
What is the treatment for a
         keratoma
Resection
        What is “gravel”
Sole abscess with drainage at the
coronary band
What is the etiology of Gravel
Inflammation and infection follows the
line of least resistance and drains at the
coronary band
What are the clinical signs of
           Gravel
Lameness
Drainage at the coronary band
How do you diagnose Gravel
Hoof testers
     How do treat Gravel
Resection of undermined hoof wall
          What is this
Quittor
        What is Quittor
Chronic purulent inflammation of the
collateral cartilage
What is the etiology of Quittor
Subcoronary abscess
One leg bumping the other
What are the clinical signs of
          Quittor
Lameness
Localized pain over the cartilage
Chronic suppurative sinus tracts
How do you diagnose Quittor
Radiology
  How do you treat Quittor
Surgical excision of the necrotic
cartilage
         What is this
Canker
        What is canker
Chronic hypertrophy of the horn
producing tissues
What is the etiology of canker
Poor hygienic stabling
What are the clinical signs of
          canker
Hind feet
Fetid odor
Loose horn
Draft horses
  What is the treatment of
           canker
Removal of all loose horn
Caustic agents (Cu sulfate)
Dry area and remove from unsanitary
conditions
What is the major differential
         for canker
Thrush
  What is the difference
between thrush and canker
Thrush affects the frog
Canker affects the sole
       What is this
Corn
         What is a corn
Bruising at the angle of the wall and the
bar
What is the etiology of corns
Improper shoeing
What are the clinical signs of
           corns
Lameness
Red stains in sole
  How do you treat corns
Padded shoe
How do you treat toe cracks
Cut grooves in the hoof capsule to
break the line of tension
  How do you treat quarter
          cracks
Suture with nylon or leather or glue
How long will it take for this
    crack to go away
Never because it affects the coronary
band
  How would you treat this
You wouldn’t because they are very
superficial cracks
    How do you treat this
Cast for 10-14 days or fill with
methylmethacralate
What about NSAIDS for the
      previous case
Probably not in pain due to cutting the
nerves
   What is the definition of
          laminitis
Inflammation of the laminae of the foot
  What is chronic laminitis
Laminitis after 48 hours of continual
pain or when rotation of the distal
phalanx occurs
What are the clinical signs of
          laminitis
Shifting weight to hind feet
Unwilling to walk
Sinking at the coronary band
Non parallel growth rings
Sole abscess
What are the risk factors for
         laminitis
Pony
Fat horse
Late summer
High carb diet (grain)
Non weight bearing lameness
  What are the treatment
options for chronic laminitis
Therapeutic shoeing
Dorsal hoof wall resection
DDF tenotom
Euthanasia
What are the benefits of the
      heart bar shoe
Allows for better distribution of weight
along the whole foot
Supports the frog
   At what age are horses
      usually castrated
1-1.5 years
  Why are horses usually
        castrated
To affect a behavior change
At what age are farm animals
     usually castrated
10-14 days
Why are farm animals usually
 castrated at a young age
Less complications
Less pain
Better flavored meat
  What are the 2 types of
        castration
Surgical
Blunt (burdizzo emasculatome)
   What is this instrument
Burdizzo
 What are the uses for the
        burdizzo
Teat amputation
Tail docking
Bloodless castration
   What are some of the
  complications of using a
   burdizzo for castration
Scrotal sloughing
Slips
Clamping of the penis
   What is this instrument
Plain emasculator
  How many crushing/cutting
   surfaces does the plain
     emasculator have
1 crushing/ 1 cutting
   What is this instrument
Reimer emasculator
How many crushing/ cutting
 surfaces does the reimer
     emasculator have
2 crushing/ 1 cutting
   What is this instrument
Serra emasculator
   What is this instrument
Serra modified
   What is this instrument
White emasculator
   What is this instrument
White modified
  What is this instrument
Hausmann emasculator
What is the difference between
the closed and open technique
Closed: vaginal tunic stays intact-
doesn’t open the abdominal cavity
Open: opens the vaginal tunic- opens
the abdominal cavity
    How do you place the
       emasculator
“nut to nut”
What is the rule for how long
to keep the emasculator on
1 minute per year of age
 How many times should you
ligate the pampiniform plexus
Once
  Why should you not double
ligate the pampiniform plexus
Increases the risk of infection
After releasing the pedicle
back into the scrotum what
   should be done next
Stretch the incision manually
Why do you want to stretch
       the incision
Allows for good drainage
 What is the function of the
           testis
Produce spermatozoa
 What is the function of the
        sertoli cells
Nourish spermatozoa
 What is the function of the
        leydig cells
Production of androgens
Where is the proper ligament
        of the testis
From the caudal testis to the epididymal
tail
Where is the ligament of the
  tail of the epididymis
From the middle of the tail to the
parietal tunic
Where is the scrotal ligament
From the parietal tunic to the scrotum
   What is responsible for
    descent of the testis
The gubernaculum shortens during
gestation and pulls the retro parietal
testes into the scrotum
At birth where are the testis of
           the foal
 In the inguinal canal
When do the testes of the foal
     lie in the scrotum
 1-2 weeks
After the testes arrive in the
  scrotum what happens
External ring diameter
What are some other names
   for cryptorchid foals
Rig, ridgling, original, high flanker
   What is the definition of
      cryptorchidism
Anomaly of testicular position
   What are the problems
associated with cryptorchidism
 Reduced sperm production
 Aggressive behavior
    What are the types of
      cryptorchidism
Abdominal, incomplete abdominal,
inguinal
What type is most common
Left sided abdominal retention
   What is the etiology of
     cryptorchidism
Improper functioning gubernaculum
Inguinal ring too small in diameter
Hormone imbalance (E shortage)
Hereditary
    Is it more common to have
unilateral or bilateral cryptorchids
  Unilateral is more common
Is it more common to have left
       or right cryptorchids
 Equal incidence
In abdominal cryptorchids is
  left or right more common
Left
In inguinal cryptorchids is left
     or right more common
 Right
    How do you diagnose
      cryptorchidism
Stallion like behavior
Palpation
US
Laparoscopy
Hormonal assay
On rectal palpation what will the
 cryptorchid testicles feel like
 Smaller and very soft
How can you determine between a
 gelding and a cryptorchid after
   giving an injection of hCG
   Geldings <40 pg/ml testosterone
   Cryptorchids >100 pg/ml testosterone
     How can you treat a
        cryptorchid
Benign neglect
Give hCG
Surgery (orchiopexy)
 Why is benign neglect an
   option for treatment
May take up to one year for testis to
descend naturally
Why is surgery considered
        unethical
It may be perpetuating a genetic
anomaly
 What are the two types of
   cryptorchidectomy
Standing (laparoscopy)
GA dorsal recumbency
 What are the advantages/
 disadvantages of standing
     cryptorchidectomy
Advantage: fast recovery
Disadvantage: expensive equipment
     Which method of
 cryptorchidectomy is most
          common
GA dorsal recumbency
What is the key to finding the
            testis
Find the gubernaculum
 If one side is normal but the
other side is cryptorchid what
is the worst thing you can do
Castrate the normal side and refer for
the cryptorchid
What are the important after care
      instructions after a
      cryptorchidectomy
  Tetanus vax, stall rest for one day,
  forced exercise twice daily
 Do you need antibiotics or
         NSAIDS
Not antibiotics
NSAIDS if you spend a lot of time
digging
Why should you isolate them
  from mares for 2 days
May be some live sperm
What are some complications
 associated with castration
Swelling
Hemorrhage
Scirrhous cord formation
Hydrocoele
Evisceration
Peritonitis
Continued masculine behavior
What are some less common
 complications of castration
Iatrogenic penile trauma
Penile paralysis
Anesthetic accidents
    What causes swelling
Inadequate wound drainage
Inadequate post op exercise
Poor lymphatic drainage
Excessive surgical trauma
If you have a pulsing stream
 of hemorrhage what is your
          problem
Testicular artery
If you have an intraabdominal
  bleed what will indicate this
           problem
Pale mm, high pulse rate
If you have a fast drip how do
     you treat the animal
Pack with gauze for 24 hours
If you have a slow drip how do
      you treat the animal
 Observe
   What is scirrhous cord
         formation
Infection often caused by strep
 What can cause scirrhous
      cord formation
Foreign body (non absorbable suture)
Poor technique
Inadequate exercise and drainage
How do you treat scirrhous
         cord
Surgery
      What is hydrocoele
Fluid filled painless swelling from the
vaginal tunic
How do you treat hydrocele
Drain
Remove vaginal tunic surgically
Cauterize vaginal tunic chemically
How do you treat evisceration
Pack and go to surgery
What are the two reasons for
continued masculine behavior
Retention of some epididymal tissue
“proud cut”
Psychic causes “false rigs”
  How long can castrated
   horses remain fertile
Up to 3 weeks

								
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