L23b: surgical approach to abdomen (large animals) not finished *

MCQ: A dairy cow presents with symptoms consistent with hardware

disease (traumatic reticuloperitonitis). A rumenotomy will be

performed to remove the foreign body. Where should the

laparotomy incision be performed?

left paralumbar

What suture pattern will be used to close the skin incision?

forward interlocking

what types of surgeries require antimicrobials?

1. enterotomy

2. cesarean

3. foot/joint infection

what would be considered a clean surgical wound?

• uninfected operative wounds without inflammation

• respiratory, ailmentary, genital, or uninfected urinary tracts are not entered

what would be considered clean/contaminated surgical wound?

operative wounds in the respiratory, ailmentary, genital, or unifected urinary tracts are electively entered

what would be considered contaminated surgical wound?

open, fresh, accidental wounds with major breaks in sterility

what would be considered dirty surgical wound?

old traumatic wounds with retained devitalized tissue or those that involve existing clinical infection or perforated viscera

MCQ: What laparotomy approach has the highest risk of wound infection?

1. paramedian

2. ventral midline

what antibiotics can you use for pre-op and post-op?

1. oxytetracycline

2. penicillin

3. ceftiofur

what NSAIDs are liscensed for use in cattle in the US?

1. flunixin meglumine

2. ketoprofen

what cattle can we not administer ketoprofen in?

dairy cattle over 1 year

what cattle can we not administer flunixin meglumine in?

veal calves

what NSAID in the US can we administer in cattle for pain?

none officially but there are different loopholes

what needle type do you want for suturing inside the large animal body?

round body needle

what needle type do you want for suturing skin in large animals?

cutting needle

when can you use an everting suture pattern?

skin

when can you use an inverting suture pattern?

hollow viscera (ex: uterus)

tension sutures

minimize movement, strangulation, and marginal necrosis

walking sutures

• buried tension sutures

• reduce dead space

what are anesthesia techiques for standing anesthesia?

1. restraint

2. line block

3. inverted L block

4. paravertebral

who would a paravertebral block not be good for?

overweight animals

what are anesthesia techniques for when the animal will be recumbent for the procedure?

1. cast and sedation

2. cranial epidural

3. general anesthesia

how will the animal be positioned for a flank surgical approach?

standing

how will the animal be positioned for a paracostal surgical approach?

standing

when may you use a paracostal oblique surgical approach?

c-section

how will the animal be positioned for a ventral midline surgical approach?

dorsal recumbency

how will the animal be positioned for a paramedian surgical approach?

dorsal recumbency

how will the animal be positioned for a ventrolateral surgical approach?

lateral recumbency

what surgical approach is the red line?

paralumbar fossa

what surgical approach is the green line?

oblique

what surgical approach is the teal line?

ventrolateral

what surgical approach is the dark blue line?

ventral midline

what surgical approach is the yellow line?

paramedian

what surgical approach is the peach/tan line?

paracostal

MCQ: An exploratory laparotomy is performed on a cow with

metabolic alkalosis. What surgical approach is most

appropriate?

right paralumbar

what structures are on the left of the cow?

■ Rumen, reticulum

■ Spleen, left kidney, caudate lobe and gallbladder, diaphragm

■ Omental bursa contents

what structures are on the right of the cow?

■ Duodenum, pylorum, abomasum

■ Small intestine, caecum, colon

■ Kidneys, liver, gallbladder and diaphragm

how should you close the transverse abdominis and peritoneum to retain the intestines?

close ventral to dorsal

how long do sutures need to stay post-surgery in large animals?

2-3 weeks

what structure do you need to be aware of when doing a paramedian surgical approach in cattle?

milk veins

what order do you close the layers for a paramedian surgical approach?

1. rectus abdominis muscle

2. external rectus sheath

3. skin

what order do you close the layers for a ventral midline surgical approach?

1. linea alba

2. subcutaneous

3. skin

MCQ: An exploratory laparotomy is to be performed on a cow

with a suspected caecal dilation or torsion. What

surgical approach is most appropriate?

right paralumbar

how long before the procedure should you give antimicrobials pre-op in equine?

60 minutes

what antimicrobials do you give in equine before surgery?

1. aminoglycosides (gram +)

2. penicillin (gram -)

when do you remove a wound stent in equine after surgery?

12 hours