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Vet 115 > Small Animal Medical Nursing > Flashcards

Small Animal Medical Nursing Flashcards

1
Q

Abdominocentesis

A

Sampling of free fluid within the peritoneal space.

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2
Q

Anastomosis

A

Reconnecting/suturing of bowel after resection of a portion of bowel.

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3
Q

Arthrodesis

A

Surgical fusing of a joint together such that motion at the joint is lost.

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4
Q

Capillary refill time

A

Time required for blood to refill the small capillary beds of the mucous membranes after digital blanching.

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5
Q

Celiotomy

A

Surgical opening of a coelomic cavity e.g. the abdominal cavity.

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6
Q

Cellulitis

A

Sterile or non-sterile inflammation of the intestinal tissue

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7
Q

Cystotomy

A

Incision into the urinary bladder

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8
Q

Dehiscence

A

Loss of integrity of the sutured layers of an incision.

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9
Q

Enterotomy

A

Incision into the a small intestinal lumen

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10
Q

Evisceration

A

Uncontrolled exposure of organs through an incision as a result of dehiscence or trauma.

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11
Q

Gastrotomy

A

Incision into the stomach

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12
Q

Hydrometra

A

A condition in which the uterus fills with sterile fluid that causes mild to moderate distention

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13
Q

Ileus

A

Functional loss of intestinal motility

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14
Q

Intussusception

A

Telescoping of a portion of the bowel into another

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15
Q

Mucometra

A

Sterile mucus within the uterus causing mild to moderate to distention

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16
Q

Onychectomy

A

Removal of a claw

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17
Q

Orchidectomy

A

Removal of the testicles

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18
Q

Ostectomy

A

Removal of a portion of bone

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19
Q

Osteochondrosis

A

Defect in cartilage matureration that causes lack of ossification of maturing cartilage

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20
Q

Ovariohysterectomy

A

Spay; removal of the uterus

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21
Q

Pseudocyesis

A

False pregnancy

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22
Q

Pyometra

A

Bacterial infection of the uterus with purulent fluid accumulation

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23
Q

Seroma

A

Sterile fluid accumulation beneath an incision after surgery

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24
Q

Strangulation

A

Encircling of a tissue with the suture or internal sutures such that blood supply to the tissue is lost and death of the tissue ensues, unless the tissue is released and blood flow can resume.

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25
Q

Urethrostomy

A

A surgical procedure that creates a permanent opening in the urethra. This procedure is most commonly performed in male cats that have a history of multiple urethral blockages. In this species, a urethrostomy is made in the perinuem

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26
Q

Prophylactic antibiotics

A

Decrease the risk of infection and clean or clean-contaminated surgeries. Will not entirely eliminate surgical site infections.

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27
Q

Indications for prophylactic anabiotics

A

Operative time longer than 90 minutes.
Patient is immunosuppressed.
A hollow viscus is to be entered e.g. G.I. tract, urinary bladder etc.
Sx site is difficult to aseptically prepare.
Orthopedic implants are placed or a joint is entered.

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28
Q

For anabiotics to be effective what needs to be present?

A

Therapeutic drug levels in the wound fluid at the time of the surgical incision.

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29
Q

Prophylactic anabiotic’s must be given at least –

A

20 minutes before the surgical incision is made.

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30
Q

Anabiotic’s given three or more hours before the procedure –

A

Select for resistant bacteria.

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31
Q

Anabiotic’s given 3 to 5 hours after the incision has been made will likely –

A

Not be effective in preventing infection.

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32
Q

There is no advantage in continuing anabiotic’s beyond 6 to 24 hours after surgery unless:

A

Necessary to treat an active infection or a break in sterile technique occurred during surgery.

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33
Q

Signs of blood loss in the post operative patient:

A

Possible continued hypothermia or drop in body temp.
Rapid HR with weak peripheral pulses.
Rapid RR.
Pale/white MM
Incisional swelling or oozing of blood.
Abdominal distention if intra-abdominal hemorrhage occurs.
Decreased lung sounds if intrathoracic hemorrhage occurs.

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34
Q

A surgical incision is ideally covered with an adhesive or a wrap bandage for the first few days to:

A

Keep it clean, prevent contact with the hospital environment and absorb seepage.

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35
Q

Pointman’s and creams should not be placed on the incision because

A

This can cause irritation, and components of the pointman and can delay wound healing.

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36
Q

Abnormalities in the early postoperative period (1-3 days) include:

A

Redness, swelling, drainage, dehiscence

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37
Q

Swelling secondary to surgical trauma will usually resolve within

A

3 to 7 days after surgery

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38
Q

Animals usually lake or chew at the incision only if

A

Character of the incision site is irritating.

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39
Q

Contributors to incision irritation include:

A

Sutures placed too tight, Traumatic tissue handling, suture reaction, tension on the suture line, clipper burn, prepping irritation, incision infection and seroma formation.

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40
Q

Seromas can form if:

A

Extensive surgical dissection occurred beneath the incision. Tissue planes could not be or were not adequately closed or excessive motion occurs at the incision site.

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41
Q

So aromas are recognized as

A

Localized areas of fluctuant swellings, not usually painful or warm to the touch.

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42
Q

What made in resolution of seromas?

A

Warm compresses, Hydrotherapy and bandaging

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43
Q

Drainage of a seroma is warranted if

A

It is very large and/or causing impairment

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44
Q

Possibility of infection or cellulitis must be considered if:

A

Incision swelling occurs 4 to 6 days postoperatively, is warm to the touch, is associated with an elevated body temperature, or is reddened and/or draining.

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45
Q

Abscess or infection must be treated with:

A

Drainage, warm compresses and systemic anabiotics.

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46
Q

Factors that contributed to wound dehiscence include:

A

Use of inappropriate suture to close a wound, inappropriate suturing technique, tension on the incision line, incision infection, seroma formation, and disease and/or drug therapy leading to delayed wound healing.

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47
Q

Removal of skin sutures

A

Suture scissors, simple to use and allow removal with minimal discomfort. Suture should be grasped with thumb forceps. Gentle traction is placed on the suture, suture is cut near the skin surface. Suture is manually pulled out of the skin after cutting.

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48
Q

Metal staples removal

A

Staple remover should be used to allow removal with minimal discomfort. Placed under the stapler according to manufacturer instructions and squeezed to bend stable ends up and out of the skin.

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49
Q

The technician must have a working knowledge of common surgical procedures to:

A

Properly prepare the animal for surgery, act as an efficient surgical assistant, have a discussion with the owner, and manage immediate and long-term post operative care.

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50
Q

Elective surgeries

A

Performed at the veterinarian’s and the owner’s convenience, usually in healthy animals.
Some are done to improve the animals quality of life, not necessarily urgent.

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51
Q

Non-elective surgeries

A

Must be done urgently. Usually emergency procedures performed on compromised animals.

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52
Q

Indications for tail docking and declaw removal in puppies

A

Primarily performed for a static reasons and to meet breed standards set forth by the AKC.
Or to prevent drama. E.g. hunting dogs

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53
Q

Indications for tail docking and dewclaw removal in adult dogs

A

Aesthetics, drama, infection and neoplasia

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54
Q

Indications for Onychectomy:

A

An elective procedure done to prevent cats from scratching owners and household items.

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55
Q

Three techniques used to declaw a cat:

A

The nail trimmer technique (Rescoe), the scalpel blade, and the carbon dioxide laser technique

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56
Q

The nail trimmer technique (Rescoe)

A

Guillotine type nail trimmer is positioned snuggly onto the dorsal surface of the total between the 2nd phalanx and 3rd phalanx. Cutting edge is positioned at the cranial edge of the footpad. As it is advanced, pad is moved caudally while nail is rotated dorsally and caudally. 3rd phalanx excised, taking care not to cut the footpad, a portion is usually left behind but the entire germinal layer is removed to prevent regrowth.

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57
Q

The blade technique

A

Amputate the entire third phalanx using a 12 scalpel blade. Phalanx is disarticulated dorsolaterally, by cutting through the joint capsule between the 2nd and 3rd phalanges then by cutting the collateral ligaments. The nail is cut away from the underlying tissue and digital pad. Pad is moved out of the way by positioning the blade more dorsal to prevent inadvertent laceration of the pad.

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58
Q

The laser technique

A

Similar to the blade tech nique except he uses laser energy to dissect the 3rd phalanx free from the 2nd phalanx. The site usually does not bleed so a Turnock it is not necessary.

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59
Q

Postoperative considerations for Onychectomy:

A

Administer pain medication postoperatively. Bandages, kept in place for 24 hours, hospitalize well bandage is in place. Use paper or paper alternative litter. Don’t re-introduce normal litter until 10 days after. Monitor pause for a hemorrhage, swelling, drainage and redness.

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60
Q

Early complications of cat declawe

A

Loose bandages, self bandage removal and postoperative bleeding. Infection, generally evident within the first 3 weeks of surgery.

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61
Q

Late complications of Onychectomy

A

Regrowth of the clause, chronic lameness or both.

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62
Q

Other complications of Onychectomy

A

Radial nerve damage secondary to Torna kit placement and skin sloughing secondary too tight, prolonged bandage placement.

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63
Q

Celiotomy

A

Surgical incision into the abdominal cavity. Can be made at several locations: ventral midline, paramedian, para costal, parapreputial and flank. Most commonly used incision is ventral midline.

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64
Q

Elective celiotomy includes:

A

Ovariohysterectomy, Organ biopsy, cystolithotomy, planted cesarean delivery, gastropexy, removal of retained abdominal testicles.

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65
Q

Non-elective celiotomy procedures include

A

Emergency cesarean delivery, GDV, intussusception, G.I. foreign bodies, ruptured spleen, penetrating foreign bodies, severe abdominal bleeding and diaphragmatic hernia.

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66
Q

Exploratory celiotomy

A

Often performed to treat abdominal masses of unknown origin and to obtain biopsies for disease diagnosis

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67
Q

Pre-operative considerations for a celiotomy

A

Area should be clipped widely. Sick or traumatized animals may have to be stabilized.
Ensure that the appropriate supplies are available.

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68
Q

Postoperative considerations for Celiotomy

A

Examine incision for the first 24 hours for swelling, drainage, excessive redness, dehiscence and evidence of self trauma.
Some may be in app attend or may vomit after. Intestinal and pancreatic manipulation can lead to intestinal issues, nausea and/or pancreatitis.

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69
Q

Indications for Gastro intestinal surgery

A

Foreign body lodgment, Neil plasia, biopsy, GDV, G.I. trauma, G.I. obstruction

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70
Q

Pre-operative considerations for G.I sx

A

Patient should be stabilized and dehydration addressed before sx. Intubate as soon as possible with a cuffed endotracheal tube. Ensure that extra instruments and gloves are available. Prophylactic antibiotics are used if G.I. tract is entered.

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71
Q

Characteristics of intestinal devitalization

A

Lack of motility; gray, green or black discoloration; severe thinning of the visceral wall; lack of bleeding on cut section; lack of fluorescein die uptake; lack of Doppler blood flow

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72
Q

Gastric Dilatation-Volvulus

A

Dilatation of the stomach with ingesta and gas, with rotation of the stomach into an abnormal position. Life-threatening, typically in deep chested, large and giant breed dogs.

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73
Q

Classic clinical signs of GDV

A

Vomiting, retching and bloating.

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74
Q

The enlarged stomach compresses the caudal vena cava and affects venous return to the heart, leading to -

A

Hypovolemic shock

75
Q

Pre-op considerations for GDV:

Large-bore catheters should be placed immediately in the front legs or jugular vein because –

A

Venous return from the caudal half of the body is impaired by the dilated stomach.

76
Q

Primary indication for OVAH

A

Prevention of pregnancy and subsequent production of unwanted litters

77
Q

Other indications for OVAH

A

Endocrine in balance, infection, injury, cyst, tomorrow, prevention of unwanted behavior and congenital abnormalities

78
Q

Endocrine disturbances are associated with -

A

Varied clinical manifestation I stare lady, skin lesions, memory tumors, pseudocyesis and nymphomania

79
Q

OVAH before the 1st heat cycle-

A

Greatly reduces the chance of memory neoplasia in dogs.

80
Q

Uterine disease that may require OVAH include

A

Metritis, pyometra, uterine prolapse, endometrial hyperplasia, neoplasia, injury, neglected dystopia and congenital abnormalities

81
Q

OVAH skin incision in the dog

A

Extends caudally 3 to 6 cm from the umbilicus

82
Q

OVAH skin incision in cats

A

From 2 cm caudal to the umbilicus caudally 3 to 4 cm

83
Q

Leaving ovarian tissue behind can lead to -

A

Recurrent heat cycles and stump pyometra because of the presence of hormones that can influence any remaining uterine tissue.

84
Q

Intraoperative complications of OVAH include

A

Hemorrhage and anesthetic problems

85
Q

Left ovarian pedicle is evaluated by

A

Retraction of the descending colon to the right and viewing the pedicle just caudal to the left kidney

86
Q

Right pedicle is evaluated by

A

Retraction of the descending duodenum to the left and viewing the pedicle just caudal to the right kidney

87
Q

The uterine stamp is visualized

A

Between the urinary bladder ventrally and the colon dorsally

88
Q

OVAH is the recommended treatment for

A

Pyometra

89
Q

Conservative management for open pyometra it should be discouraged because of

A

The risk of septicemia and endotoxemia, and the incidence of reoccurrence is high.

90
Q

Conservative management of closed pyometra is is not recommended because

A

Of the risk of uterine rupture, septicemia and endotoxemia, and possibly death.

91
Q

Which dogs should be evaluated carefully for pyometra?

A

Intact female dogs with fever, lethargy, polyuria, polydipsia, vaginal discharge, abdominal pain, abdominal enlargement, inappetence, vomiting and/or diarrhea

92
Q

Left untreated, pyometra can result in

A

Septicemia and/or endotoxemia and possible death. Additionally, uterine rupture and peritonitis are possible

93
Q

Cysto to collect urine in animals suspected of having pyometra should be

A

Avoided

94
Q

Preparation for a pyometra surgery

A

Prepped for a ventral midline celiotomy. Incision should extend from the xiphoid to the pubis so that excess of tension is not placed on the uterus during manipulation.

95
Q

Pyometra

Uterine contents

A

Should be cultured for aerobic and anaerobic bacteria and a sensitivity test performed. Done via a septic aspiration of fluid with a needle and syringe before the uterus is contaminated and after it is removed from the surgical field.

96
Q

Post operative considerations for pyometra

A

Monitored as for OVAH
Special considerations include continued antibiotics for 7-10 days.
Electrolyte and metabolic abnormalities can continue postoperatively, monitoring for this is important and should be corrected. IV fluids should be given until stable, eating and drinking.

97
Q

Indications for canine castration

A

To help prevent roaming, aggressiveness, unwanted breeding or a combination of these.

98
Q

Medical problems treated by castration

A

Prostate disorders, anal and perianal tumors, perineal hernias and testicular tumors

99
Q

Which animals should undergo scrotal ablation and why?

A

Older dogs with a well-developed scrotum and animals with scrotal abnormalities. To prevent severe scrotal swelling, improve postoperative aesthetics and/or treat disease

100
Q

Technique for canine castration

A

Testicle push to cranial beneath the pre-scrotal skin. Midline incision made in the pre-scrotal skin sensually and over the cranially displaced testicle. Testicle is exteriorized through the incision by carefully and sizing over the common tunic. Testicle pulled away for ligation as remaining scrotal ligament is gently dissected from the testicle.

101
Q

Ligation of the testicle using a closed technique

A

To ligatures are placed external to the tunics of the pedicle such that the vessel and the vas deference are ligated as a unit. Fast, but if not carefully done, the vascular pedicle can slip inside of the tunics and into the abdomen causing uncontrolled hemorrhage. Best used on a very small patients.

102
Q

Testicle ligation using the open technique

A

Allows individuals ligation of the vas deferens and its blood supply and the pampiniform plexus. Testicle is then removed with sharp severance distal to the ligatures.

103
Q

Canine castration

Incision is closed with

A

A continuous subcuticular suture pattern. Best to bury the suture here due to potential irritation increasing the urge to lick.

104
Q

Scrotal ablation

A

Incision is made circumferentially. Subcutaneous tissue is bluntly dissected it to expose the testicles and associated structure. Castration is carried out via ligation of these structures. Testicle and scrotum are removed and the incision closed in 2 to 3 layers.

105
Q

Indications for feline castration

A

To prevent fighting, roaming, urine spraying and to decrease urine odor.

106
Q

Technique for feline castration

A

Generally placed in dorsal recumbency and see with the legs tied craniad. The scrotum is the site of the primary incision.
Testicle and spermatic cord or exteriorized with gentle traction and stripping. Spermatic cord may be ligated with suture, metal clips or tied in a knot on itself. Vessels can be separated from the vas deferens and tied in a square knot. Testicle is then removed by severing the spermatic cord with a blade distal to the ligation site. Scrotum is left unsutured.

107
Q

Intraoperative considerations for feline castration

A

Avoid putting alcohol on the scrotum. Scrotal hairs are gently plucked. Scrotum is then scrubbed and draped in an a septic manner.

108
Q

Cesarean delivery

A

Involves making an incision into the abdominal cavity and then the uterus to deliver a neonate. Usually performed on animals experiencing dystocia (difficult birth)

109
Q

Common causes of dystocia
Maternal factors:
Contraction forces

A 
Uterine inertia (lack of contractions)
 -First degree 
     Uterine muscle defect
     Oxytocin deficiency
     Premature birth
 -Second degree
Abdominal 
 -Age
 -Pain
 -Hernia of the uterus
 -Uterine rupture
110
Q

Common causes of dystocia
Maternal factors:
Birth canal

A 
Inadequate pelvis
 -Immature 
 -Fracture
 -Breed
 -Disease
Insufficient dilatation 
 -Uterus
 -Cervix
 -Vagina
 -Vulva
111
Q

Common causes of dystocia
Fetal factors:
Oversize fetus

A

Faulty pelvic presentation

  • Caudal simultaneous
  • Head flexion
  • Limb flexion
112
Q

The aim of a Cesarean delivery

A

Successful delivery of live and undamaged puppies or kittens without harm to the dam.

113
Q

Selected anesthetics for a cesarean delivery should have

A

Minimal effects on the newborn and should be safe for the dam.

114
Q

Preparation for a cesarean delivery

A

Clipping is performed before Anastasia. Avoid damaging in large to memory glands and nipples. After induction and maintenance, placed in dorsal recumbency.

115
Q

Important to remember that increased weight of the gravid uterus

A

On the diaphragm may compromise the normal breathing capacity. Intermittent manual respiration or a ventilator should be considered.

116
Q

OVAH at the time of delivery by En Block resection

A

Entails clamping both ovarian pedicles and the uterine body, cutting the gravid uterus out of the dam, then going back and ligating all vasculature in the dam. Gravid uterus is given to an assistant, who cuts each neonate carefully from the uterus and ligates or clamps the umbilicus.

117
Q

Removal of the uterus and ovaries at the time of neonate delivery does not

A

Affect milk production or motherly instinct.

118
Q

Indications for cystotomy

A

Most common: removal of cystic calculi/bladder stones.
Also to remove tumors, correct congenital defect, repair traumatic rupture of the bladder. Placement of a cystostomy tube to provide an alternate outlet in case of tumor, calculi or scar tissue obstructing urine flow.

119
Q

Cystostomy tube

A

A tube exiting the urinary bladder and abdominal wall.

120
Q

Pre-operative considerations for cystotomy

A

If urinary flow was obstructed, should be stabilized before anesthesia.
Severe metabolic and/or electrolyte abnormalities might be present.
Imaging studies may be necessary to identify the extent of the disease and its exact location.

121
Q

Preparation for Cystotomy

A

Abdomen is widely clipped from the xiphoid to the pubis.
Males: hair is a clip from the prepuce. Preputial orifice and penis or gently flushed with a 1% povidone iodine solution. Incision will curve laterally to avoid the prepuce.

122
Q

Bladder expression before celiotomy may result in:

A

Inadvertent bladder rupture and should be avoided when urinary bladder wall fragility is expected.

123
Q

Which artery and vein will be encountered during a cystotomy in a male?

A

The caudal superficial epigastric artery and vein lateral to the prepuce.

124
Q

After cystotomy the animal should be placed on IV fluids to:

A

Help dilute blood clots and flush the urinary bladder.

125
Q

Cystotomy: Postop

A

Urine production monitored. If the incision was close to or involved the proximal urethra, post up swelling can obstruct urine flow. Blood clots can accumulate in the bladder and migrate into the urethra obstructing urine flow.
Some straining can be expected.

126
Q

During the first week after Cystotomy

A

Mild hematuria, with or without blood clots, and frequent urination can be expected.

127
Q

An animal that couldn’t urinate before cystotomy and had BW abnormalities, should

A

Have blood work reassessed serially to ensure that values are returning to normal.

128
Q

If the animal is not producing urine or is producing minimal urine and abdominal distention is detected, a complete bio chemistry panel, CBC and paracentesis should be performed. Fluid taken from the abdomen should be

A

Spohn for a PCV determination. Value is higher than Ciara and values indicate a problem and should be reported to the vet.

129
Q

Indications for a perineal urethrostomy

A

Multiple episodes of obstruction in association with feline urologic syndrome. Less common: rupture of the penile urethra secondary to dramatic catheterization or blunt trauma, structure of the penile urethra and obstruction secondary to cancer.

130
Q

Presentation for urinary obstruction depends on

A

The duration and completeness of the urinary obstruction. Common factor is straining

131
Q

If brought for an examination early

A

There is little chance that other organ systems are affected.

132
Q

Brought in 12 to 24 hours after a complete obstruction

A

Severe electrolyte abnormalities, cardiac arrhythmias, kidney dysfunction and shock can be present

133
Q

Clipping for urostomy

A

Hair on the perineum and external genitalia is clipped

134
Q

Perineal urethrostomy -cat

A

Placed in ventral recumbency with the perineum elevated approximately 30°. The tail is extended directly over the dorsal midline and immobilized with tape. A purse-string suture is placed in the anus to eliminate contamination. Standard skin prep is performed

135
Q

Scrotal urethrostomy in male dogs

A

Placed in dorsal recumbent sea, area is prepped as for castration and a scrotal ablation.

136
Q

Perineal urethrostomy in cats

A

Elliptical incision made around the scrotum and prepuce. Testicles removed if the cat is intact. Penis is dissected free from its pelvic attachments. Catheter is placed in the urethra, longitudinal incision made through the penile urethra extending craniad to the level of the pelvic urethra. Urethral mucosa is sutured to the skin. Remaining portion of the penis is amputated during urethral suturing, urinary catheter is removed. Results in a new permanent opening that will accommodate the excess mucus and crystals. Bladder expressed at completion to ensure good urine stream is obtained.

137
Q

Scrotal urethrostomy in male dogs

A

Skin incision is made in the area of the scrotum, followed by a urethral incision over a preoperatively placed urethral catheter, suturing of the urethral mucosa to the skin follows. Penis is not amputated.

138
Q

Most common late postop complication of urethrostomy

A

Stricture, a narrowing of the urethral opening caused by excessive scar tissue formation. Self-mutilation can increase the chance of stricture and must be prevented. Typically manifest as chronic stranguria. Complete obstruction of urine flow maybe noted. Requires reoperation

139
Q

Hernia

A

Protrusion of tissue from its normal cavity through a congenital or acquired defect in the wall of that cavity

140
Q

Common hernias in the dog and cat include;

A

Umbilical, inguinal and diaphragmatic hernias

141
Q

Umbilical hernia

A

Bowel or, more commonly, omentum and intra-abdominal fat protrude through a defect in the abdominal wall under the skin at the umbilicus.
Most commonly congenital, recognized by the presence of swelling at the umbilicus.

142
Q

Inguinal hernia

A

Intestine nine, uterus, broad ligament, intra-abdominal fat and/or another abdominal Oregon protrudes through the inguinal canal as a result of a defect in the constraints of the canal.

143
Q

Pre-operative considerations for inguinal hernia repair

A

Opposite inguinal ring, palpated for weakness. Owners, told that hernias can develop a bilaterally. Also that reoccurrence is rare but possible.

144
Q

Preparation for inguinal hernia repair

A

Abdomen is widely clipped from the umbilicus to and including the inguinal area. Placed and dorsal recumbency, standard skin prep is performed.

145
Q

Technique for inguinal hernia repair

A

Midline incision made in the caudal abdomen between the inguinal folds. Abdominal cavity, not entered. Lateral dissection performed carefully to expose the affected inguinal ring with its hernial sac and external pudental vessels. Hernial sac, emptied of its contents, excised and sutured along with the margin of the inguinal ring. Avoid the external pudental vessels that exit from the caudal medial aspect of the ring. Skin is closed as for celiotomy.

146
Q

Diaphragmatic hernia

A

Abdominal contents protrude through an opening in the diaphragm into the thoracic cavity. Maybe congenital or caused by trauma.
Can be life-threatening or insidious and difficult to identify.

147
Q

Classic signs of a diaphragmatic hernia

A

Tucked up abdomen, intestinal sounds in the chest, muffled heart and lung sounds and dyspnea. Some have only decreased lung sounds over the area of the hernia and mild exercise intolerance. DX confirmed by thoracic radiographs

148
Q

Animals with a diaphragmatic hernia should

A

Have oxygen and cage confinement to achieve maximum oxygenation, minimal stress and constant monitoring for respiratory insufficiency before surgery.

149
Q

Immediate diaphragmatic hernia repair is necessary in cases of:

A

Severe respiratory distress, gas distention of herniated viscus is in the chest or intestinal strangulation

150
Q

One of the most critical times for an animal with a diaphragmatic hernia is:

A

Anesthetic induction

151
Q

Positioning of an animal for a diaphragmatic hernia repair

A

Dorsal recumbent sea on an incline, with the head slightly higher than the hindquarters.

152
Q

Preparation for diaphragmatic hernia repair

A

Skin widely clipped from about 3 inches cranial to the xiphoid to the pubis. Lateral thoracic wall on at least one side clipped and aseptically prepared for potential chest tube placement or thoracocentesis.

153
Q

Technique for diaphragmatic hernia repair

A

Ventral midline celiotomy from xiphoid to near the poopers is performed. Edges of incision are protected with laparotomy pads, a Balfour self-retaining abdominal retractor is placed to enhance visualization. Thorough inspection of abdominal and thoracic viscera is made to rule out organ rupture and vascular compromise.

154
Q

Diaphragmatic defect is sutured in a simple continuous suture pattern to create

A

And air-tight and watertight seal.

155
Q

Lumpectomy

A

Local surgical resection of a mass. Often refers to cutaneous or subcutaneous masses.

156
Q

Indications for lumpectomy

A

Masses of cancerous origin, masses that appear to be changing over time, rapidly growing masses, ulcerative masses or masses that impair function

157
Q

Mastectomy

A

Removal of a memory gland

158
Q

Radical mastectomy

A

Removal of a chain of memory glands on one or both sides

159
Q

Memory tumor malignancy in dogs

A

About 50%

160
Q

Memory tumor malignancy in cats

A

About 80 to 90%

161
Q

In dogs there appears to be no advantage of radical glad resection versus lumpectomy unless:

A

The tumor is incompletely excised

162
Q

Mastectomy

More radical excision is warranted if:

A

The tumor is centralized with in a grande, multiple tumors are present with in a gland or a chain of clans, tumor is large and/or fixed.

163
Q

Mastectomy

In cats recurrence is decreased if a

A

Unilateral mastectomy is performed

164
Q

If bilateral radical mastectomy is necessary the procedure must be staged to

A

Allow less tension on the skin closure.

165
Q

Indications for limb amputation

A

Appendicular cancer not amenable to local excision or another treatment modality; severe neurologic dysfunction resulting in repeated trauma to a limb; nonunion fractures that will not result in limb function with orthopedic repair; irresolvable osteomyelitis; vascular disease of the limb i.e. thrombosis or arteriovenous fistula; severe trauma to the lamb; Congenital deformity resulting in a non-functional limb that is not amenable to orthopedic repair

166
Q

Thoracic limb amputation can be done by:

A

Removal of the scapula and entire for alarm, disarticulation of the scapulohumeral joint; ostectomy of the proximal humerus.

167
Q

Forequarter amputation offers the advantages that

A

Major vessels and nerves are well visualized, sectioning of the bone is not required, prominent scapular spine will not be present as the scapular muscle mass atrophies.

168
Q

Pelvic limb amputation can be accomplished by

A

Disarticulation of the coxofemoral joint or by proximal femoral ostectomy.

169
Q

Neoplastic disease of the femur will require

A

Disarticulation to obtain a normal margin of tissue.

170
Q

Most common neurologic disorder in dogs

A

Intervertebral disc rupture

171
Q

Discs are normally found

A

Between the ventral bodies in the spine and act as a shock absorbers during spinal movement and also provide structural support.

172
Q

Over time, disks can undergo degeneration and calcification when this occurs –

A

The normal shock absorber-like effect is impaired, and extrusion/rupture of disc material into the spinal cord can occur which puts pressure on the spinal cord and can cause an array of neurologic deficits or pain.

173
Q

Other neurologic disorders include

A

Atlantoaxial subluxation(abnormal articulation between the 1st and 2nd cervical vertebrae); acute spinal trauma; Lumbosacral stenosis/Mel articulation or cauda equina(compression of the lumbosacral nerve roots); Cervical vertebral malarticulation/malformation(Wobblers); Spinal cyst; cancer of the brain, nerves or spinal cord; malformation of the caudal brainfossa; hydrocephalus

174
Q

Intervertebral disc fenestration

A

Each disc that is calcified or that may become calcified is removed/scraped from the intervertebral space. Performed to help deter rupture of the disc material into the spinal cord, benefit is unproven.

175
Q

Dogs may develop spontaneous intervertebral disc extrusion is in the

A

Cervical spine or the thoracolumbar spine

176
Q

If the desk has already ruptured

A

The ability to ambulate is effective, decompressive procedure can be performed to alleviate compression on the spinal cord.

177
Q

The most common decompressive procedures are

A

Ventral slot for cervical disc rupture; Hemilaminectomy for thoracolumbar disc rupture

178
Q

For acute disc herniation the most commonly affected breed is

A

The Dachshund. Other breeds include the beagle, pekingese, poodle, spaniel and terrier

179
Q

Animals undergoing cervical disc surgery are placed in

A

Dorsal recumbency with the head and neck in slight extension.

180
Q

Animals undergoing thoracolumbar disc surgery are placed in

A

Ventral recumbency

181
Q

Post operative considerations and care of neurologic patients depends on

A

There in neurologic status and the type of neurologic disease that they have

182
Q

Neurologic patients are subject to

A

Bedsores, urinary infections, joint stiffness, muscle atrophy, pneumonia and G.I. ulceration

183
Q

Steps for proper post operative management include

A
  • Passive range of motion exercises atleast 3 times a week.
  • Urinary bladder expression four or five times per day.
  • Flip the completely down animal frequently, every four hours.
  • Monitor daily for fever, cough or respiratory distress.
  • Keep it clean and dry.
  • Observe the stool daily.
  • Observe the vomitus.
  • Monitor animals with lost pain sensation carefully.
  • Animals that cannot walk should not be allowed to roam free.
  • Encourage animals to get up at least three times a day and use their limbs if they have some motor function and a stable spinal injury.

Vet 115 (3 decks)

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