Vaginal Prolapse & Cesarean Section Flashcards Preview

RUSVM Large Animal Surgery > Vaginal Prolapse & Cesarean Section > Flashcards

Flashcards in Vaginal Prolapse & Cesarean Section Deck (30):
1

What is the proper incision length on the uterus for a cesarean section in a cow?

the length from the tip of the toe (of the fetus) to the hock

Avoid extreme tension to prevent tearing of the uterus

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2

T/F: Dairy heifers and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse

False

Older beef cattle and animals receiving excessive estrogenic content of feed are predisposed to developing vaginal prolapse

3

What is the surgical approach of choice for cesarean section in sows?

flank approach

  • Can’t use ventral midline because of extensive mammary chains
  • In sows, make two incision in uterus - one in each horn, along greater curvature
  • Very rare to perform C-section on a pig - uterine malposition is usually the main indication

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4

What suture pattern is shown here?

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shoelace retention sutures

  • Simple; can use umbilical tape
  • Must take out at first sign of labor in pregnant cow!

5

T/F: Regarding cesarean sections in cattle, even if a live calf is delivered at surgery and the procedure goes well, the prognosis is still guarded

False

If a live calf is delivered at surgery, and the procedure goes well, there is a good prognosis!

Survival rate for a FOAL is guarded.

6

On average, there is a ____% decrease in fertility following cesarean section in cattle

15%

Due to adhesion of serosa of uterus and damage to endometrium

7

Identify this piece of equipment:

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vaginal prolapse retainer

  • Use a caudal epidural
  • Non-invasive, simple; plastic retainer
  • Sutured to the skin at the level of the tuber Ischia
  • Can give birth with this in place

8

What is the surgical approach of choice for cesarean section in a cow carrying a contaminated fetus or uterine infection?

Ventrolateral celiotomy

The main advantage of this approach is minimal contamination of the abdomen! The incision site also stays clean post-op; cows don’t lie on it

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9

What are some disadvantages of ventral midline and paramedian approach for cesarean section in large animals?

  • Difficult to exteriorize the uterus
  • Possibility of contamination
  • Increased vascularity – do NOT use in high producing dairy cow with large milk vein
  • Large abdomen – do NOT use in very heavy dairy cow
  • Chance of herniation or evisceration

10

Mares have a collective foaling rate of about ____% following C-section

Mares have a collective foaling rate of about 35% following C-section

(Foaling rate is normally 50-75%)

11

What is the most common reason for C-section in bovines?

oversized fetus

Usually the result of breeding the cow too young.

Small cow + big calf = no bueno.

12

What is being shown here?

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manual reduction of a vaginal prolapse

Also, no gloving. Gross.

13

For a paramedian celiotomy, the incision is made between __________ and __________

For a paramedian celiotomy, the incision is made between the ventral midline and the milk vein. Can go as far caudal as the udder.

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14

For closure of the uterus in the mare, it is important to place __________ suture pattern around the uterus because of their diffuse placentation

For closure of the uterus in the mare, it is important to place hemostatic suture pattern around the uterus because of their diffuse placentation

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15

What is the proper way to close the uterus after cesarean section?

double layer inverting suture patterns using absorbable suture

Cushing, Lembert, Utrecht (most commonly used)

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16

What are the ideal conditions for cesarean section?

  1. Live fetus
  2. Dam is a good surgical risk
  3. Favorable environment

17

Through what layers will you incise during a paramedian celiotomy?

  • Skin
  • Subcutaneous tissue
  • External rectus sheath
  • Rectus abdominis muscle
  • Internal rectus sheath
  • Peritoneum

18

What suture pattern is shown here?

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Modified Caslick Retention Suture

  • Also used for windsuckers/pneumovagina
  • Leave a bit at the bottom so they can urinate
  • Looks like railroad tracks
  • Best if used after parturition

19

Where on the uterus is the incision usually made?

Greater curvature

Less bleeding!

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20

T/F: During a vaginopexy the surgeon tacks the anterior dorsal wall of the vagina to the inside of the sacrosciatic ligament

True

21

What muscle layer is NOT incised in ventrolateral celiotomy that IS incised in a ventral midline approach?

transverse abdominal muscle layer​

22

What is the main indication for performing a low flank celiotomy approach in a cow?

Recumbent cow

  • Almost same procedure as standing but the incision is started more ventrally
  • Incision goes to milk vein if necessary

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23

What surgical approaches are used for cesarean section in bovines?

  • Standing position:
    • ​Left and right flank celiotomy
  • Dorsal recumbency:
    • ​Ventral midline and paramedian celiotomy

24

T/F: The animal can give birth with this in place

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True

This is a prolapse retainer in a sheep

25

What is the most common surgical approach for cesarean section in beef cattle?

Standing Left Flank Celiotomy

40 cm long iincision in middle of flank from 13th rib to tube coxae

DO NOT USE if the fetus is dead! It is hard to prevent leakage of uterine fluid into muscle layers

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26

After cesarean section, it is critical to make sure the calf gets how much colostrum within 12 hours?

10% body weight in colostrum within 12 hours

27

For treatment of vaginal prolapse, which suture pattern simulates the action of the constrictor vestibuli muscle?

Buhner Suture Pattern

  • Preferred because most anatomically/physiologically correct
  • Simulates the action of the constrictor vestibuli muscle
  • Use 15” (long) Buhner needle and umbilical tape - sharp cutting needles
  • Placing antibiotics (for mastitis) on the tape helps to slide easier and prevent infection

28

T/F: Vaginal prolapse is typically non-recurring

False

Vaginal prolapse RECURS like a motherf***er

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29

What are some factors influencing choice of incision site for cesarean section in large animals?

List them all word for word, because why not.

Because there are a shit ton. That's why not.

  1. Experience and preference of the surgeon
  2. Experience and preference of the client
  3. Environment for surgery and post-op
  4. Availability of restraint devices
  5. Availability of assistant – not a one-man show! (unless a flank- maybe can do by yourself)
  6. Physical condition of the dam, will she stand for surgery?
  7. Viability of the fetus - important because of contamination – how to check fetal viability
    1. US – left or right low flank transabdominal
    2. Rectal palpation: Pinch between toes, pull legs, anus, poke in the eye, put finger in the mouth (suckle)
  8. Condition of uterine fluids
  9. Accessibility to the uterus - for leakage, if you need to repair a tear - predisposes to infection with some approaches
  10. Type and use of animal: show animal - use ventral or paramedian
  11. Post-op marketability
  12. Individual variations
    1. Vascularity – milk cow
    2. Obesity
    3. Edema
    4. Udder development – first calf heifer with edema

30

What is the surgical approach of choice for cesarean section in the equines and camelids?

Ventral Midline Celiotomy

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