VIEWS: 6 PAGES: 3 POSTED ON: 11/10/2012
Large Animal Surgery Review General principles: Suture; absorbable vs. non, multifilament vs. mono, natural vs. synthetic Patterns; interrupted vs. continuous, inverting vs. everting, full vs. partial thickness Surgical technique; minimize tissue trauma, aseptic technique, controlled hemostasis, minimize dead space, keep surgical time to a minimum. Remember time, tissue trauma Soft tissue: Colic= abdominal pain…Remember that diarrhea, renal disease, urolithiasis, liver disease, choke, pleuropneumonia, testicular torsions, foaling, laminitis, neuro disease, ovarian tumors etc. can cause signs that look like colic. Common colics: Enterolithes- horses in California or sandy climates Old horses- more likely to get strangulating lipomas (s. intest most common site) and impactions (bad teeth) Broodmares- Large colon torsions, uterine artery bleeds, uterine torsions (don’t be fooled by foaling) Standardbreds- more likely to get inguinal hernias Foals: meconium impactions, ruptured bladders, leathal whites Weanlings- ascarids, r. equi abscesses Warmbloods and horses with big nephrosplenic spaces- Left D. Displacements (phenylephrine) Normal values on belly tap: t. protein < 2, WBC <5000 If heart rate is >60 bpm, horse is severely painful or s. intestine is felt on rectal PASS A STOMACH TUBE!!!! Most common colic is gas (spasmodic) colic which responds to banamine and hand walking. To treat endotoxemia, banamine (low dose), plasma, polymyxin, acepromazine, nitroglycerin (laminitis), pelvic flexure enterotomy Upper Airway Roarers (left laryngeal hemiplegia) inspiratory noise; tie back; partial arytenoidectomy DDSP; expiratory noise, poor performance; tie forward Epiglottic entrapment; laser resection of subepiglottic+/- aryepiglottic folds Epistaxis (decide uni or bilateral)- guttural pouch mycosis, ethmoid hematoma, lung abscess, Cushing’s disease Strangles (strep equi) vs strep zoo. Sinusitis: usually bad tooth, cysts Hernias: Usually congenital in horses, infection related in cattle Evaluate for reducibility, heat, pain, hernial ring Castration: post op infection (champignion vs schirrous cord) complications include swelling, eviceration and excess bleeding Sedation Xylazine, detomidine, butorphanol, acepromazine (except stallions) commonly used Remember ruminants are EXTREMELY sensitive to xylazine (30-50 mg will cause recumbency in a healthy cow) Non Steroidals Banamine, Bute (not in cattle), aspirin (more in cattle) Ulcer meds Omeprazole (proton pump blocker), ranitidine/famotidine/cimetidine (H2), sucralfate (bandaide) Antibiotics TMS/SMZ/trimethoprim sulfa: most common first line antibiotic in horses (not for food animals) Ampicillin/PPG (cattle)/ K pen commonly used for gram + coverage Gentocin/amikacin: good gram – coverage (NOT FOR FOOD ANIMALS) Metronidazole: anaerobes Cattle specific Right sided ping: abomasum, cecum, s. intestine, spiral colon Left ping: rumen, LDA Either: uterus, pneumoperitoneum, pnuemorectum Jejunohemorrhagic syndrome, clostridial abomasitis Ways to pexy: omento, abomaso, pyloro, long tack, roll and tack C- sections in cattle- standing L flank Rumenotomy: hardware, grain overload, frothy bloat, vagal Foot abscesses: medial claw in front, lateral in hind Lameness: Down on sound, hip hikes/drops QH commonly get Navicular disease Jumpers: hocks TB: fetlocks OCD: DIRT, prox P1, lat trochlear, SBC Remember joint communications, function of peroneus tersius, laminitis ALD-varus vs valgus Common terms: Poll evil, knees, hocks, stifle, coffin, pastern, ringbone, splint, hopples, cribbing, stall weaving, heaves, spavin, chondroids, curb, thoroughpin, jacks,
"Large Animal Surgery Review"