large animal surgery l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Large Animal Surgery PowerPoint Presentation
Download Presentation
Large Animal Surgery

Loading in 2 Seconds...

play fullscreen
1 / 118

Large Animal Surgery - PowerPoint PPT Presentation


  • 995 Views
  • Uploaded on

Large Animal Surgery. Equine Colic. December 2005 Amy Fayette. What is the definition of colic. An acute, painful condition in which the CS are referable to the abdominal cavity or its contents. What are some causes of non intestinal colic. Parturition-dystocia Uterine torsion

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Large Animal Surgery' - Ava


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
large animal surgery

Large Animal Surgery

Equine Colic

December 2005

Amy Fayette

what is the definition of colic
What is the definition of colic
  • An acute, painful condition in which the CS are referable to the abdominal cavity or its contents
what are some causes of non intestinal colic
What are some causes of non intestinal colic
  • Parturition-dystocia
  • Uterine torsion
  • Urolithiasis
  • Broad ligament hematoma
  • Granulosa cell tumor
what are the tx options for uterine torsion
What are the tx options for uterine torsion
  • Rolling (under GA)
  • Standing flank on the side of the torsion
what are the post op instructions if a standing flank laparotomy is required
What are the post op instructions if a standing flank laparotomy is required
  • 3 weeks stall rest
  • 3 weeks controlled exercise
what is the tx for prepubic tendon rupture
What is the tx for prepubic tendon rupture
  • Support until foaling
  • Induce parturition and assist delivery
why are horses prone to getting colic
Why are horses prone to getting colic
  • Very active peristalsos
  • Large intestine is so big that it must be folded
  • Fibrous nature of the contents
  • Different sized limens in large intestine
  • Singleness of blood supply- all from the cranial mesenteric artery
  • Management problems
what management factors predispose a horse to getting colic
What management factors predispose a horse to getting colic
  • Feed
  • Water
  • Environment
  • Drugs
  • Parasites
  • Teeth
  • Recent change
if an enterolith is not round what does this indicate
If an enterolith is not round what does this indicate
  • May be more…shape is due to them bumping into each other
where is sand colic usually found
Where is sand colic usually found
  • Ventral colons and right dorsal
how do you treat a severe case of sand colic
How do you treat a severe case of sand colic
  • Empty surgically– difficult due to the great mass
what two parasites most commonly cause colic signs
What two parasites most commonly cause colic signs
  • Larva of strongylus vulgaris
  • Ascarids
what is the tx for ascarid impaction
What is the tx for ascarid impaction
  • Multiple enterotomy incisions to remove the ascarids
what is the main cause of ascarid impaction
What is the main cause of ascarid impaction
  • Deworming a foal w ivermectin or panacur and killing off a large amount of worms at one time
what is your diagnosis
What is your diagnosis
  • Thromboembolism due to stongylus vulgaris
what is the tx for the previous case
What is the tx for the previous case
  • Resection and anastamosis
what is your diagnosis22
What is your diagnosis
  • Pedunculated lipoma
what is the signalment for lipomas
What is the signalment for lipomas
  • Older, overweight horses
  • Saddelbred, arabian, QH and ponies
is a pedunculated lipoma usually strangulated or nonstrangulated
Is a pedunculated lipoma usually strangulated or nonstrangulated
  • Strangulated but not always
what are the boundaries of the epiploic foramen
What are the boundaries of the epiploic foramen
  • Portal vein
  • Caudal vena cava
  • Caudate liver lobe
how do you treat epiploic foramen entrapment
How do you treat epiploic foramen entrapment
  • Correct by traction on the bowel
this mommy pony is in for treatment what should be done with her baby
This mommy pony is in for treatment what should be done with her baby
  • Put on preventative ulcer meds
what other things are good prognostic indicators
What other things are good prognostic indicators
  • PCV (especially over 60)
  • Pain (uncontrollable)
  • Rectal abnormalities
when is ng reflux normal
When is NG reflux normal
  • Never…occasionally a small amount may be seen if the tube is left in place for a long time
how can you get reflux form the large colon
How can you get reflux form the large colon
  • If its so distended that it presses against the duodenum as it passes over the base of the cecum
how long should tubes be left in place for
How long should tubes be left in place for
  • Only as long as needed..some animals develop irritation to the pharynx and larynx making swallowing difficult when feeding resumes
what will a horse with this disease look like what is the prognosis
What will a horse with this disease look like? What is the prognosis?
  • Will have preceding colic and then will suddenly look better
  • Terminal px
this large volume of orange brown alkaline ng reflux was collected what is your diagnosis
This large volume of orange brown alkaline NG reflux was collected. What is your diagnosis
  • Anterior enteritis
what are the other cs for anterior enteritis
What are the other CS for anterior enteritis
  • Fever, pain controlled w banamine, high protein abdominocentesis
a teat cannula is the preferred approach to abdominocentesis for which cases
A teat cannula is the preferred approach to abdominocentesis for which cases
  • Foals and distended colic cases
slide49
How do you know if you hit a vessel when performing abdominocentesis or if there is blood in the abdomen
  • If you hit a blood vessel the PCV will be the same as the horse
what is nephrosplenic entrapment
What is nephrosplenic entrapment
  • Colon lies between the left kidney and the spleen
  • 180 degree torsion
  • May involve only the pelvic flexure
what are the options for tx for nephrosplenic entrapment
What are the options for tx for nephrosplenic entrapment
  • Conservative: give time and remove feed
  • Phenylephrine
  • Rolling under anesthesia
  • Surgery
how does phenylephrine treat nephrosplenic entrapment
How does phenylephrine treat nephrosplenic entrapment
  • Contracts the spleen and creates more space
when rolling a horse w nephrosplenic entrapment which side should you start the horse on
When rolling a horse w nephrosplenic entrapment which side should you start the horse on
  • Start in right lateral…roll until the horse is on its back
what are the two approaches possible for surgical tx of nephrosplenic entrapment
What are the two approaches possible for surgical tx of nephrosplenic entrapment
  • Midline celiotomy
  • Rib resection
the decision for surgery should be based on
The decision for surgery should be based on
  • Unrelenting/unresponsive abdominal pain
  • Abnormal rectal exam
  • Abnormal paracentesis
  • Persistent NG reflux
  • CV deterioration
what are some contraindications for surgery
What are some contraindications for surgery
  • Ruptured bowel
  • Obvious peritonitis (WBC>50-75,000/mm3)
  • Lab indications of extremely guarded px
if you arent sure if a patient needs surgical or medical tx what should you do
If you arent sure if a patient needs surgical or medical tx what should you do
  • Error on the side of surgery
what should be done in preparation for transport
What should be done in preparation for transport
  • Contact referral center
  • Indwelling NG tube
  • Trocharize to decompress bloat (if necessary)
  • Analgesics
  • Record all tx and data base results
equine abdominal crisis usually includes
Equine abdominal crisis usually includes
  • Hypovolemia
  • Hemoconcentration
  • Impending shock
  • Pain
  • Motility changes
what are the ps of exploration
What are the Ps of exploration
  • Proper planning prevents piss poor performance
what should be done to the patient as preop preparation
What should be done to the patient as preop preparation
  • Hydration
  • Treat shock/ endotoxemia
  • Sepsis
  • Tetanus prophylaxis
  • Correct acid-base abnormalities
what is being done
What is being done
  • Decompression
    • 45 degree angle at the band
what are the long term post op requirements after large colon resection
What are the long term post op requirements after large colon resection
  • Tx for short bowel syndrome
  • Weight loss
  • Decreased protein
  • Diarrhea
will the horse ever be able to compensate for the loss of large colon
Will the horse ever be able to compensate for the loss of large colon
  • The cecum and SI will take over but it takes a very long time
what are some tests of viability
What are some tests of viability
  • Color, thickness, pulse, peristalsis
  • Enterotomy to examine mucosal surface
  • Fluorescein, doppler US, intraluminal pressure, pulse or surface oximetry, thermography
slide83
How long after ischemia begins do you have loss of mucosa over the whole villus resulting in dead bowel
  • 4 hours
enteroliths often become lodged within the
Enteroliths often become lodged within the ________
  • Right dorsal, transverse or small colon
how are freely movable enteroliths removed
How are freely movable enteroliths removed
  • Through a pelvic flexure enterotomy
what is the px for uncomplicated cases of enterolithiasis following removal
What is the px for uncomplicated cases of enterolithiasis following removal
  • Good-85% survival rate
what are some complications of colon resection
What are some complications of colon resection
  • Persistent endotoxemia
  • Diarrhea
  • Peritonitis
  • Displacement or volvulus of the remaining
what are some complications following colopexy
What are some complications following colopexy
  • Colon rupture, cecal tympany, intermittent post op pain
what is the prognosis for the following diseases
Displacements

Impactions

Strangulating lesions

Good

Good

Fair

What is the prognosis for the following diseases
what are some surgical diseases of the small colon
What are some surgical diseases of the small colon
  • Impaction, foreign material, enterolith, meconiu
  • Strangulating: volvulus, intussusception, lipoma, infarction, messenteric rupture, internal hernia
which animals are presented most for small colon dz
Which animals are presented most for small colon dz
  • Arabians, ponies, mini horses, female horses
what are the cs of mesocolon avulsion
What are the CS of mesocolon avulsion
  • No feces since parturition
  • Progressive depression
  • Progressive endotoxic shock
how do you dx mesocolon avulsion
How do you dx mesocolon avulsion
  • Abdominocentesis to document peritonitis
  • Laparoscopy
  • Exploratory sx
which patient is most likely to have ileus post op
Which patient is most likely to have ileus post op
  • One that was distended for a long time
how does bowel manipulation cause ileus
How does bowel manipulation cause ileus
  • Causes reflex antihistamine release and decreased motility
what is the tx for ileus
What is the tx for ileus
  • Hydrate
  • Fix electrolyte and pH
  • Decompress stomach
  • Exercise
  • Prokinetic agents
what increases the amount of adhesions
What increases the amount of adhesions
  • Time
  • Trauma
  • Contamination
  • Infection
how can you prevent adhesions
How can you prevent adhesions
  • Good sx technique
  • Broad spectrum ATBs
  • NSAIDS
  • Maybe DMSO, IP and systemic heparin and Na carboxymethylcellulose
what is your dx
What is your dx
  • Fibrous adhesions of the jejunum
why don t you want to debride adhesions
Why don’t you want to debride adhesions
  • Will create more inflammation
what is your dx113
What is your dx
  • Chronic laminitis
what causes myositis
What causes myositis
  • Acid base disturbances
  • Anoxia
  • Blood volume
  • Padding
  • Position
  • Renal failure
how do you prevent colic
How do you prevent colic
  • Deworm
  • Quality feed
  • Gradually change feed
  • Free choice water
  • Eliminate environmental hazards