Week 7 - Ruminant/Camelid/Swine Anesthesia

0.0(0)
studied byStudied by 0 people
learnLearn
examPractice Test
spaced repetitionSpaced Repetition
heart puzzleMatch
flashcardsFlashcards
Get a hint
Hint

Neonates, functionally, have what type of GI tract?

Get a hint
Hint

- Monogastric

Get a hint
Hint

The rumen may hold upwards of _________________ of ingesta. Fermentation produces ______________ liters of gas per hour. Salivary glands produce ________________ liters of saliva daily. Fermentation and salivation continue under anesthesia.

Get a hint
Hint

- 100 L

- 30-50 L

- 50-80 L

Card Sorting

1/66

encourage image

There's no tags or description

Looks like no tags are added yet.

Study Analytics
Name
Mastery
Learn
Test
Matching
Spaced

No study sessions yet.

67 Terms

1
New cards

Neonates, functionally, have what type of GI tract?

- Monogastric

2
New cards

The rumen may hold upwards of _________________ of ingesta. Fermentation produces ______________ liters of gas per hour. Salivary glands produce ________________ liters of saliva daily. Fermentation and salivation continue under anesthesia.

- 100 L

- 30-50 L

- 50-80 L

3
New cards

Describe the appropriate fasting for ruminants prior to anesthesia.

- Fast adult ruminants for 24 - 48 hours

- Withhold water for 8 - 12 hours

4
New cards

What are options for catheterization in adult catlte/ruminants?

- Jugular catheterization is relatively easy

- Tail veins in adult cattle (caution, but may be used)

5
New cards

Ruminants are profoundly sensitive to _______________________. They should be dosed at __________ the equine dose.

- Alpha-2 adrenergic agonists

- 1/10th the equine dose

6
New cards

Alpha-2 adrenergic agonists may cause ________________________ in sheep

- Pulmonary edema (Acute injury caused by hydrostatic stress (due to pulmonary vasoconstriction) which may result in significant hypoxemia, resolving over several hours)

7
New cards

What are some options for IV or IM sedation of ruminants?

- Xylazine IV or IM

- Dexmedetomidine IM

- Detomidine IV

- Butorphanol IM

- May add morphine for additional sedation/restraint

8
New cards

What are some options for IV or IM restraint of ruminants?

- Xylazine IV

- Romifidine IV

- Dexmedetomidine IM

- Detomidine IV

- May add butorphanol or morphine for additional sedation/restraint

9
New cards

What are some options for IV induction of ruminants?

- Ketamine and Guaifenesin (IV as fast as possible)

- Xylazine IV followed by ketamine IV later (either 20 or 45 minutes later depending on low or high dose of xylazine)

- Midazolam and Ketamine IV

- Telazol IV

- Propofol IV

- Alfaxalone IV

10
New cards

Describe proper ET intubation of ruminants.

- Calves, sheep, and goats: Similar technique as used in camelids -> Visualize arytenoids

- Adult cattle: Digital palpation of the larynx and guidance of the tube by hand

11
New cards

Why should "triple drip" not be used for a duration over 60 minutes in ruminants?

- It is being given at a rate faster than they can metabolize it, so over one hour it will "fill up" places it can redistribute it to, resulting in high plasma concentrations and prolonged recovery

12
New cards

What are options for anesthetic maintenance of ruminants?

- GKX (Triple drip)

- Inhalants (most common method as with other species)

13
New cards

If muscles fasciculations are observed in sheep during maintenance of anesthesia, what can be done to manage this?

- Lidocaine CRI

14
New cards

Describe the appropriate blood pressure of ruminants.

- Small ruminants, calves similar to other species

- Adult cattle are relatively hypertensive (MAP 90-120 mm Hg) and hypotension is relatively uncommon

15
New cards

What is particular about the respiratory management of ruminants?

- They have a smaller residual capacity (therefore small tidal volume) and lung volume than other species -> If they become apneic they will become hypoxic faster relative to other species)

16
New cards

How is blood pressure measured in ruminants?

- Direct (Auricular artery often relatively easy to access)

- Indirect

17
New cards

What is the appropriate respiratory rate of ruminants under anesthesia?

- Relatively rapid RR

- Adults: 20 - 30 breaths/min

- Juveniles: 25 - 40 breaths/min

18
New cards

How can anesthetic depth of ruminants be assessed?

- Ocular reflexes/rotation (eyes rotated ventrally indicates light anesthesia while central eyes indicate surgical anesthetic plane)

- Nystagmus indicates light anesthesia

19
New cards

In ruminant anesthesia, where should the patient's head/mouth be?

- Should be lower to facilitate drainage and reduce risk of aspiration with regurgitation

20
New cards

When recovering a ruminant from anesthesia, how should they be positioned? When/how should the ETT be removed?

- Roll patient to sternal recumbency

- Maintain the ETT until at least a swallow is observed. When removing, leave the cuff partially inflated so it can act as a "squeegy" to clean out the trachea during extubation

21
New cards

Describe the GIT of a camelid.

- Three compartment stomach

- Functionally like ruminants with the same risks of regurgitation and aspiration under anesthesia

- Less prone to bloating under anesthesia relative to ruminants

22
New cards

Describe how camelids are catheterized for anesthesia.

- Jugular vein catheterization (remember it is in close proximity to the carotid artery)

- The jugular vein has valves to prevent pooling of blood while grazing and venous blood will often look quite red as they are adapted for high altitude and their hemoglobin has a high affinity for oxygen -> When drawing, observe for "pulsing" blood as an indicator of if you have hit an artery

23
New cards

Estimate the weight of the following patients:

A. Female llama

B. Male llama

C. Female alpaca

D. Male alpaca

A. 100-150 kg

B. 125-160 kg

C. 45-70 kg

D. 55-80 kg

24
New cards

What fasting should be performed in camelids prior to anesthesia?

- Fast for 8 - 12 hours

- Withhold water for 6 -8 hours

25
New cards

What "premedication" is commonly required in camelids?

- Preanesthetic sedation is not typically required

- They are prone to vagal stimulation, so you can pretreat with atropine or glycopyrrolate IM

26
New cards

What are some options for IV sedation of camelids (including route of administration)?

- Acepromazine IM or IV

- Butorphanol IM or IV

- Nalbuphine IM or IV

- Xylazine IM or IV

- Dexmedetomidine IM

- Detomidine IV

- Midazolam IM

27
New cards

What are some options for IV restraint of camelids (including route of administration)?

- Xylazine IM or IV

- Dexmedetomidine IM or IV

- Detomidine IV

- Midazolam IM

- Xylazine/Butorphanol

- Midazolam/Butorphanol

- Xylazine/Ketamine

- BKX IM (Butorphanol, Ketamine, Xylazine)

- "Ketamine stun" (Same as BKX but higher doses and longer duration IM)

- Telazol

28
New cards

What are some anesthetic induction techniques in camelids?

- Thiopental

- Ketamine/Guaifenesin

- Ketamine/Xylazine

- Midazolam/Diazepam and Ketamine (+ morphine immediately prior to induction - Dr. M's preferred choice)

- Propofol

- Propofol and Ketamine

- Alfaxalone

29
New cards

What are options for IV anesthetic maintenance of camelids?

- "Triple drip" (GKX) IV (limit infusion to 60 mins or less)

- Propofol IV (may include ketamine or xylazine to decrease propofol dose)

30
New cards

If utilizing propofol in a camelid for anesthetic maintenance, _______________ is highly recommended.

- Intubation

31
New cards

What breathing system is commonly used in camelid anesthesia?

- Circle (non-rebreather in some crias with mask induction in crias)

32
New cards

Describe the appropriate oral intubation of camelids.

- Utilize a mouth speculum or gauze loops

- Adequate anesthetic depth is importnat

- Utilize lidocaine spray and a long laryngoscope blade

- 5-14 mm ETT

- Use a stylet

33
New cards

Describe the appropriate nasal intubation of camelids.

- Pass the ETT (1 size smaller than would be used for oral) through the ventral nasal meatus and avoid the pharyngeal diverticulum

- Use a stylet (pre-bent aluminum rod), lubricant, phenylephrine, and potentially a laryngoscope

34
New cards

How can one confirm they have successfully intubated a camelid?

- Evacuated bulb technique

- Steaming/clearing of tube

- Synchronous movement of chest and rebreathing bag

- Capnography

35
New cards

What is the typical HR of a camelid under anesthesia?

- With atropine: 60-90 bpm

- With Xylazine (w/o atropine): 30-40 bpm

- Crias: 100-120 bpm

36
New cards

What are methods for measuring BP in camelids?

- Direct (More accurate; caudal auricular artery or medial saphenous artery)

- Oscillometric (better than nothing)

- Doppler

37
New cards

Regarding the respiratory system, camelids tend to be relatively _______________ under anesthesia.

- Tachypneic

38
New cards

What are ways/locations to assess pulse oximetry in camelids?

- Tongue

- Tail (Reflectance probe)

- Gum/dental pad (Reflectance probe)

- Vulva/prepuce

39
New cards

What are ways to assess anesthetic depth in a camelid?

- Response to pain

- Ocular reflex (slow palpebral may be present, odd "blink" at surgical plane may be seen and can be confusing - not like a normal blink but can still be surprising)

40
New cards

What are ways to position a camelid under anesthesia?

- Lateral recumbency (padding, extend down forelimb, protect dependent eye)

- Dorsal recumbency (support head to prevent hyperextension of neck)

- Position/pad head and neck to allow secretions/regurgitant material to drain from the mouth (reduce risk of aspiration)

41
New cards

What is an appropriate fluid therapy plan for camelids under anesthesia?

- 5-10 mg/kg/hr of LRS, plasmalyte, etc.

42
New cards

What drugs can be used for cardiovascular support of camelids under anesthesia?

- Dobutamine

- Calcium gluconate (over 30-60 mins) if tachycardic and hypotensive

43
New cards

What are options for thermal support of camelids under anesthesia?

- Blankets

- Bair hugger

- Hot dog

- Fiber may help, but may also hinder

44
New cards

Camelids are prone to what following extubation? Why?

- Upper airway obstruction

- Obligate nasal breathers - If they don't get the soft palate back into normal position, they can get into trouble -> An advantage of nasal intubation

45
New cards

How should camelids be positioned during recovery?

- Sternal recumbency with head elevated

46
New cards

How long should a camelid's ETT be maintained during recovery? What should you do when extubating?

- As long as possible, monitoring for chewing and coughing

- Keep head elevated and make sure they are moving air adequately (rarely, may need to re-anesthetize and re-intubate in cases of airway obstruction)

47
New cards

What are options for reversal of alpha-2 agonists?

- Atipamezole IV

- Yohimbine IV

- Tolazoline IV

48
New cards

What are options for local anesthetics in camelids and their maximal doses?

- Lidocaine (10 mg/kg)

- Bupivicaine (2 mg/kg)

- Liposome encapsulated bupivicaine (Nocita) (5.3 mg/kg)

49
New cards

What are methods to perform an epidural in camelids?

- Sacrocaudal injection (perineal anesthesia while the animal is still standing - I.e., castration or urethrostomy, low dose)

- Lumbosacral

- May add adjuncts of morphine and xylazine

50
New cards

Venous access can be particularly challenging in what species commonly seen at the VTH?

- Swine

51
New cards

What are some peculiarities regarding swine management and anesthesia to be aware of?

- Restraint difficult (Consider forking)

- Intubation difficult

- Venous access difficult

- Malignant hyperthermia risk

52
New cards

Swine require relatively high doses of which anesthetics?

- Alpha-2 adrenergic agonists

53
New cards

What are some options for injectable sedation of swine? Include route of administration.

- Xylazine IV or IM

- Dexmedetomidine IM

- Midazolam IM or intranasal

54
New cards

What are some options for injectable restraint of swine? Include route of administration and duration of effect.

- Xylazine IM followed 5 minutes later with ketamine IM (20-30 minutes duration, may require additional drug IV)

- Xylazine, Butorphanol, and Ketamine administered together IM (30-45 minute duration)

- Telazol and Xylazine administered together IM (60 minute duration with slow recovery)

55
New cards

What fasting is appropriate prior to anesthesia for swine?

- Fast 8 - 12 hours

- Withhold water for several hours

56
New cards

Where are the ideal places to administer IM injections in pigs and why?

- Heavy fat layer often present along the back ("backfat") which is especially prominent in most pot-bellied pigs (don't administer here)

- Common site is the neck (important in commercial pigs, less fat here)

<p>- Heavy fat layer often present along the back ("backfat") which is especially prominent in most pot-bellied pigs (don't administer here)</p><p>- Common site is the neck (important in commercial pigs, less fat here)</p>
57
New cards

Where/how is IV catheterization performed in swine?

- Auricular vein (Can use rubber band at base of ear to get vein to pop)

- Often performed after heavy sedation or anesthetic induction

- Can also attempt cephalic vein in piglets, intraosseous route when all else fails, and a jugular cut down (may be difficult)(

58
New cards

What are methods for induction of swine?

- Mask induction works well in small pigs or after heavy sedation

- Xylazine/Ketamine or Midazolam/Ketamine IV also works well if you have venous access

- Propofol or Alfaxalone IV in smaller pigs or as a "top off" to aid in intubation

59
New cards

What about the pig's anatomy makes intubation difficult?

- Tracheal diameter is smaller than laryngeal opening

- ET Tube gets caught on floor of the larynx due to angle of pharynx/nasopahrynx/larynx

<p>- Tracheal diameter is smaller than laryngeal opening</p><p>- ET Tube gets caught on floor of the larynx due to angle of pharynx/nasopahrynx/larynx</p>
60
New cards

If recovery of swine is slow and alpha-2 adrenergic agonists were use as part of the anesthetic plan, what should you consider?

- Reversal of alpha-2 adrenergic agonists

61
New cards

What is malignant hyperthermia?

- Genetic (autosomal recessive), rare hypermetabolic syndrome in humans and pigs

62
New cards

What breeds are most susceptible to malignant hyperthermia?

- Breeds with high rate of growth and heavy muscle mass most susceptible (Pietran, Landrace, Spotted, Large White, Hampshire, Poland-China)

63
New cards

What can trigger malignant hyperthermia?

- Stress

- Environmental: high temperature, capture, movement

- Pharmacologic: Inhalant and injectable anesthetics

64
New cards

What is the physiologic mechanism of malignant hyperthermia?

- Single amino acid mutation in ryanodine receptor type 1 (RYR1) associated with calcium channels in skeletal muscle, meaning cells cannot control calcium efflux and calcium activates myosin to cause muscle contraction, and muscle metabolism "goes nuts"

65
New cards

What are components of diagnosing/signs of malignant hyperthermia?

- Rapid rise in core body temperature

- Muscle rigidity

- Tachycardia

- Tachypnea

- Extreme hypercapnia

- Hypoxemia

- Metabolic acidosis

66
New cards

How is malignant hyperthermia treated?

- Remove trigger (e.g., inhalant anesthetic)

- Aggressive cool patient

- Hyperventilate the patient

- Dantrolene (expensive, rarely available)

67
New cards

What is the prognosis of malignant hyperthermia?

- Extremely poor, even with aggressive treatment