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41 Cards in this Set
- Front
- Back
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What are the 4 things to check for a Primary Survey? |
1. Airway 2. Breathing 3. Circulation 4. Debilitating illness |
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What should be included in a minimum database for assessing debilitating illnesses in an emergency? (Hint: 5) |
1. Renal parameters 2. PCV/TP 3. ALT 4. Glucose 5. Electrolytes
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What is involved in a secondary survey? |
1. Respiratory assessment 2. Cardiovascular assessment 3. Neurological assessment 4. Abdominal assessment |
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When do cyanotic membranes occur (what SpO2)? What can you use to help measure this? |
Hyperaemic when SpO2<90%. Cyanotic membranes at SpO2<80%
Use of a Pulse oximeter is useful! |
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How would you locales inspiratory noise and expiratory effort in small animals? And Restrictive pattern? |
Inspiratory noise: upper resp tract
Expiratory effort: lower resp tract
Restrictive Pattern: Pleural space disease |
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When auscultating the lungs what do crackles, wheezes and dullness signify (individually, not all at once ;] ) |
Crackles: parenchyma disease Wheezes: bronchial disease Dullness: pleural space disease |
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How can you assess tissue perfusion when performing a cardiovascular assessment? |
MM colour Pulse quality CRT temperature Blood pressure lactate level |
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What is the difference between absolute and relative hypovolaemia? Give examples of each please. |
Absolute hypovolaemia: loss of blood volume or fluid. -- splenic rupture or severe vomiting/D+
Relative hypovolaemia: cardiogenic or venous obstruction. -- most common of this is GDV |
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When is hyper dynamic shock most common and what are some of the clinical signs? |
Most commonly seen in SEPTIC animals.
C.s.: Pyrexia, bounding pulses, hyperaemic membranes, tachycardia, rapid CRT |
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Discuss seizure control in terms of a neurological assessment in an emergency situation. What on emergency bloods should you check? |
Seizure control: administer O2 and gain IV access (Diazepam, midazolam, propofol)
Emergency bloods: electrolytes, glucose, urea/creatinine, ammonia, calcium. |
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While doing a quick abdominal survey, what are common issues associated with young dogs, entire females and older dogs? |
Young dogs: foreign body/ intussusception Entire females: pyometra Older entire males: prostate (likely BPH)
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What are two types of abdominal effusion? |
1. Transudate/modified transudate: low protein and low cell count -- consider heart, hypoalbuminamia, neoplasia.
2. Exudate: high protein and high cell count -- need to exclude bacterial peritonitis |
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Tell me about what you can do in Gastric Dilation Volvulus :) |
Attempt to pass a stomach tube (DON'T force!) Electrolyte imbalances, shock and arrhythmia. Can decompress with needle if needed
Try to stabilize with fluids, antibiotics, pain relief +/- lidocaine (NO NSAIDs!)
Once stabilized, will require surgical correction! |
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When does uroabdomen most commonly occur in small animal medicine? What helps you determine this? |
Most commonly seen following an RTA/HBC
Bloods will show increased renal parameters and potassium.
Should place an indwelling catheter and measure creatinine and potassium in fluid and compare to blood.
Deal with complication like HYPERkalaemia. |
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How many testicles does a horse have? |
2! haha cheeky :D |
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You have a 2 year old Quarterhorse stallion, what castration would you perform and why? |
Standing open -- healthy and young male.
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You need to perform a castration on a 7 year old entire donkey, what type of castration? |
ALWAYS closed and ALWAYS under general anaesthesia. |
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What are pre-surgery considerations you should...consider? |
1) Tetanus anti-toxin or up to date booster. 2) Antibiotics -- penicillin usually does the trick 3) NSAIDs |
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What are 4 surgical options for performing a castration on a horse? |
1.) Standing open under sedation and local anaesthesia 2.) Closed technique under GA (german technique too) 3.) Semi-open(closed) under GA 4.) Laparoscopic |
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Discuss the procedure for an Open Castration. |
- Take local anaesthetic and a 1.5' 21G needle to inject 10-15mL of 2% lidocaine into the body of the testicle, and then 5mL along the intended line of incision. - Perform a complete scrub after infiltration of local. Wear gloves! - Bold incision through skin and emasculate (nut to nut) using surgeon's minute. Try to get straight line and not diagonal! - Leave to drain
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Discuss the procedure for a closed castration/ |
- Only performed on anaesthetized horses! Put in dorsal recumbency but req a full C.E. before GA. - Incise skin and fascia but leave the testicle in the tunic (don't incise!), use dry swab to expose the tunic. Put a finger through and separate cremaster muscle. Emasculate the cremaster separately. Helps to reduce haemorrhage. - Place a ligature of 0/1 PDS and the emasculate. - Some people expose the second testicle through the same skin incision. This is only a good idea if you've kept a sterile field :) - Tip: add 10mL of 2% lidocaine in to the chord beforehand to reduce stimulation and helps prolong the GA length. |
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When is the semi-open/closed castration useful in horses? |
Handy if you're concerned about contents of tunic/presence of hernia. - Done under GA and results in more secure haemostasis BUT increased risk of infection.: not great in the field! - Same as before but cut through the vaginal tunic to exteriors testicle. Then digitally perforate the mesochorium. Clamp spermatic cord and apply forceps. Transfix and ligate ligament, vessels and tunic. Close tunic once you've ligated the cord. - Having closed both tunics after castration you need to close the dead space OR leave if uncertain about haemostats. |
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Why is the German technique useful and how is it different? |
Useful in older stallions that have huge, gigantic balls. Standard closed may result in a lot of haemorrhage.
- Rather than incise on scrotum, you incise over inguinal region, pull spermatic cord and then see testicle coming through. Semi closed castration and then close the tunic.
- tend to swell less and happier afterwards. - |
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What suggestions to you give an owner post-op for a castration? |
1. Preferably pasture rest alone 2. If HAS to be boxed rested, walk for at least 10min 2-3times daily 3. Do not allow exposure to mares for at least 3-4 weeks - STILL SPERM! 5. Anti-inflammatories for 3-4days |
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Name 10 complications of Castration. |
1) Haemorrhage 2) Eventration 3) Oedema 4) Infection 5) Scirrhous cord 6) Tetanus 7) Champignon 8) Cystic cord 9) Cut proud 10) Penile problems |
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What are the common causes of excessive haemorrhage post-equine castration? How would you treat it? |
Usually b/c of improperly applied or defective emasculator: Reversing emasculator, or including scrotal skin.
- Tx: application of forceps or emasculators (forceps removed the following day). Clamp/ligate artery but may require GA for this. Gauze packing tightly in to inguinal canal and scrotum and suture but make sure they are removed the following day! (increased risk of infection). Lastly, standing laparoscopy
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How do you treat evisceration of the Small Intestine? |
Minimise contamination and further evisceration (weight and peristalsis of gut), pack in to scrotum and suture. Belly wrap, and ALWAYS give antimicrobials, NSAIDs and fluids if possible. |
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What do you do if the horse has eviscerated momentum through the castration wound? |
- Escape of omentum through scrum in NOT an emergency. - Transect the omentum as proximally as possible (can use emasculators). Stand horse in stall for 48hrs and rarely need to use GA.
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When is oedema greatest post-castrato in horses? How can this be avoided? |
Usually greatest around 5-6 days post-op and tends to be ventral.
- Avoid oedema by allowing adequate drainage (large scrotal wound), or with vigorous exercise for several weeks. |
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How can you treat oedema post-op equine castration? |
Excessive oedema can be relieved by: opening sealed wound with scrotal massage or by inserting finger in to scrotal cavity. Rigorous exercise and housing of scrotal wound as well as NSAID's also a great idea! |
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What is Scirrhous cord? |
It is a S.aureus infection leading to micro abscesses due to contamination form the emasculator or ligatures from standing open. |
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How is Scirrhous cord characterized? and what can this infection be confused with (other Ddx)? |
This is from an extension of scrotal infection that results in scrotal oedema, pain and pyrexia.
Ddx: Champignon |
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How do you treat Scirrhous cord? |
May resolve with antimicrobial therapy and re-establishment of drainage. Can also remove the infected stump if the cord had been ligated. |
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What causes Champignon and characterize it. |
Champignon is a persistent Stretococcus infection.
- Look like large, red granulation tissue within the open castration wound. |
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How do you treat Champignon in horses? |
Treatment involves resection of the affected portion of the cord. |
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Saw- horse stance, 3rd eyelid prolapse and collapsed (Equine) |
Clostridium tetani |
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In horses, what cell count in peritoneal fluid constitutes peritonitis? (equine) |
>10, 000 nucleated cells/uL in peritoneal fluid indicates peritoneal inflammation (SHOULD be <100/uL. |
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What is a hydrocele/vaginoceole? Why is is an issue? |
Hydrocele: fluid build up within closed tunic post-castration.
- Horse looks like a stallion post castration. - Standing open predisposes to hydrocele - Occurs frequently in mules - Appears as through horse has an inguinal hernia - Ultrasonographic exam to find hypoechoic fluid filled swelling. - Drainage is only temporary :. incise and separate the fascia after draining. |
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Why castrate male dogs? |
- Social reasons - Reduces wandering - Reduces fighting - Can reduce aggressive behaviour (unless fear driven) - Stops breeding! |
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What are the benefits of dog castration? |
- medical: androgen dependent tumours/growths -BPH preventatic - Neoplasia: testicular, scrotal, anal adenoma -Other: trauma, infection in testicles, pernieal hernia. |
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What are the alternative options to canine castration? |
1.) Tardak (Delmadinone): progestagen injection that lasts ~1month 2.) Ypozane (Osaterone): binds to testosterone receptors in prostate. Helps with the Tx of BPH and doesn't affect the fertility. Oral daily for 6 days and will lasts 5 months. 3.) Suprelorin (Deslorelin): implan licensed for induction of temporary infertility. Is a GnRH agonist. Be careful because causes transient increase in testosterone with variable duration at least 6 months. |
