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374 Cards in this Set
- Front
- Back
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What 2 diseases are included in the term phycomycosis?
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-pythiosis
-conidiobolomycosis |
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Pythiosis is caused by what organism?
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Hypho myces destruens
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Conidiobolomycosis is caused by what organism?
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Entomophthora coronata
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Where do the phycomycoses occur?
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With 250 miles of the gulf coast of US
-tropical and subtropical areas of the world |
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Pythiosis usually what portion of the anatomy?
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Lower extremities
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Pythiosis infects horses in what environment?
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Horses spending time in ponds--can have involvement of the upper limbs and mammary glands
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Anatomically, where does conidiobolomycosis occur?
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Nasal passages
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What is the appearance/clinical signs of pythiosis?
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-extremely invasive
-lesions are granulomatous with rough texture, gray to yellow exudate (nicknamed "leeches) -pruritis -causes excessive granulation tissue |
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What is the appearance/clinical signs of conidiobolomycosis?
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-single or multiple, ulcerated nodules or granulomas in the nasal passages
-thickening of nasal septum |
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How do you dx these phycomycoses?
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-clinical signs
-geographic location -appearance -histopath (don't put specimens on ice) |
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The presence of an intensely pruritic granulating lesion calls for what type of action?
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Rapid action..to delay can be the difference between success or euthanasia
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What tx is effective for pythiosis (but not effective for conidiobolomycosis?
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Immunotherapy
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How is the pythiosis vaccine utilized?
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To reduce the size and extent of the lesion and then sx remove the smaller lesion
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Is radical sx indicated in a case of pythiosis?
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Only if all infected tissue can be removed
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What other method can be used to tx pythiosis?
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Cryotherapy
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What other drugs can be used to tx pythiosis?
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-amphotericin B: parental/topical
-phycofixer -iodine tx (Iv or oral) |
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What is the cause of summer sores?
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Cutaneous habronemiasis- alleric reaction to the larvae
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Cutaneous habronemiasis is usually related to what predisposing condition?
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Wounds
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Where, anatomically, does Cutaneous habronemiasis tend to occur?
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-prepuce
-penis -medial canthus of the eye |
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Where do habronema musca live?
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adults love on the stomach mucosa
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Habronema microstoma adults live where?
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stomach mucosa
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Where do Drashia megastoma live?
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Granulomas of the stomach wall
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How is Cutaneous habronemiasis diagnosed?
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-typical lesion in typical locations
-bx and identification for definitive dx |
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How are Cutaneous habronemiasis managed?
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-remove the larvae (tx w/ ivermectin)
-topical meds (abx ointment w/added ivermectin, corticosteroid and DMSO) -control or remove excessive granulation tissue -control the allergic response |
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In the normal life cycle of the habronema parasite, thje larvae are deposited where?
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Around the mouth...they find their way to the oral mucosa and then the stomach
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Where are the larvae deposited in the abnormal life (and hence the cause of Cutaneous habronemiasis)?
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Flies feed on wound exudate on in thin skinned areas, larvae deposited in these areas
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What steps can you take to control flies and the spread of habronema?
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-remove manure
-install spay systems -screen stalls -repellents applied to horses |
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What other steps can be taken to interrupt the fly life cycle?
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Remove adults from stomach
(equine anthelmentics) |
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What are the causes of a bone sequestrum?
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-trauma (causing periosteal damage)
-open wounds cxausing drying of the periosteum -application of caustics to periosteum or bone |
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Osteomyelitis develops as a result of what 2 conditions?
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-poor drainage of wounds that involve bone
-hematogenous infections (most common in foals) |
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Continued irritation from either physical or infectious causes can lead to what condition?
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Periosteal proliferation
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What steps do you take in the medical management of a bone sequestrum?
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-radiographs
-protect with bandage until granulation tissue covers the bone -establish good drainage -use systemic abx -don't use caustics or healing powders |
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Typically, are sequestrum sx removed?
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Yes, to promote normal healing
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What technique may be needed during sx for removal of a sequestrum?
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Intraoperative radiographs
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A positive suction drain might be placed after the removal of a sequestrum, when is the drain removed?
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usually 48 hrs, when it quits draining
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True or false, healing of the coronary band is a simple process.
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False, difficult to predict
-abnormal hoof development can be a result of a coronary band wound |
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How soon after injury should the coronary band wound be debrided?
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wait several days, allows a more accurate determination of devitalized tissue
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Regeneration of the normal coronary band usually results when how much is removed?
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Less than a 1 inch segment
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Optimum healing of the coronary band requires the application of what?
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A snug bandage
caustic or irritating dressing are contra indicated |
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Why are wounds involving the tendon sheath a concern?
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owners don't realize the severity and delay tx
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When repairing a tendon sheath wound with sx primary closure, what 2 prophylactic steps should you consider?
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-placing a drain
-parenteral abx |
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What are the steps in sx repair of a tendon sheath wound more than 10 hours old?
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-ensure there are adequate to close the wound
-thorough flushing -sterile dressing w/ abx for 3 days -close as primary closure -continue on abx and drainage |
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How do you medically manage a small puncture wound of the sheath that recently occurred?
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-abx
-consider regional limb perfusion |
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What steps do you take to medically manage a wound of the tendon sheath that doesn't have adequate tissue to close sx?
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-maintain drainage
-sterile bandage -parenteral abx -periodic flushing/.cleansing -fair prognosis if drainage is maintained |
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How do your tx an established infection in a tendon sheath?
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-establish liberal drainage with a penrose drain inserted into the sheath
results in a pasture sound animal |
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Wounds can be caused by what types of circling materials?
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-wire
-rubber bands -twine |
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What happens if the encircling material is too tight?
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-leg swells
-skin sloughs -material becomes buried |
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How is an encircling wound dx?
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-presence of a lesion that goes completely around the leg
-swollen limb -wound that does not heal -exploration to find the offending material |
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What is the best method to explore a wound..ie for a foreign body?
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The bare, thoroughly scrubbed finger
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What imaging techniques are helpful in exploring wounds?>
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U/S
rads |
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What conditions can cause an abscess?
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-localization of a hematagenous infection
-2ndary to poor draining wound |
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What forms the purulent exudate found in abscesses?
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Living and dead WBCs, bacteria and cellular debris
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How do you dx an abscess?
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Classic signs of inflammation
Confirmed by test puncture of U/S |
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How do you tx an abscess?
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-wait until it matures (initially hard and firm, then fluculant)
-clip, shave ,scrub -test puncture -analgesia or local -incise to provide ventral drainage -may need to use a drain |
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What is the term for a wound that doesn't heal but doesn't get worse?
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Indolent wound
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What are the potential causes of indolent wounds?
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-animal in poor nutritional health
-epithelial fatigue (large wounds) -chronic infection -over exuberant attempts to control granulation tissue |
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Management of indolent wounds includes correcting the underlying problem and/or stimulating epithelialization...how is this accomplished?
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-sx undermine wound edges
-stimulate wound edges with scarlet red -insert pinch graphs -use occlusive dressings |
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Wounds that pump air are most likely located where?
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In the axilla
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Wounds of which portion of the respiratory tract can cause subcu air?
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Of the trachea
early removal of a tracheotomy tube |
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What type of bacterial organism can cause subcu air?
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Clostridium
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Which drug should not be given IM due to the risk of Clistridial infection?
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Banamine
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What are the clinical signs of clostridium infection?
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-high temp
-marked depression -anorexia -swelling with tissue destruction |
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What is the tx for a wound that pumps air or involves the respiratory tract?
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No tx needed, air will absorb in 3-4 days
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What is the tx for a subcu air wound 2ndary to clostridium?
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-establish drainage and debride
-abx (PCN) -anticipate muscle slough -warn owner of severtiy- death is likely |
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What is the most common skin tumor of horses?
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Sarcoids
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When do sarcoids develop? (age)
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3-6 year old horses, incidence decreases after 15
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Sacroids have been linked to what antigen?
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Leukocyte antigen W 13
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Which breeds are commonly affected by sarcoids?
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-arabains
-applaloosa -quarter horse more common in donkeys than horses esp males |
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Are sarcoids benign or malignant?
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Described as benign but some act as if malignant
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What virus is a possible cause of equine sarcoids?
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BPV 1 and 2
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Why is there frequently a re-occurrence of sarcoids after sx removal?
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Viral DNA can be found on normal skin, may cause re-occurance
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What are the common areas of sarcoid development?
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-face and muzzle
-ears -periocular region -distal limbs -neck -ventral abdomen -areas of previous injury |
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In the US and Australia the more common areas of development of sarcoid are where?
England and Switzerland? |
US/Aus: distal limbs/face
Eng/Switz: trunk |
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What is the appearance of an occult sarcoid?
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Mild cutaneous scaling and alopecia
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A sarcoid that is raised and scaly with hair loss and thickened skin is what type of sarcoid?
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Verrucous or warty
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What are nodular sarcoids?
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Freely moveable, raised masses with normal or ulcerated skin
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What is the appearance of fibroblastic sarcoids
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Proliferative, ulcerated masses...confused with excessive granulation tissue
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Which type of sarcoids are uncommon but most aggressive, infiltrating along fascial planes
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Malevolent sarcoids
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All sarcois can become more malignant or aggressive...typically when does this occur?
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After injury or irritation such as bx, tx or attempted removal
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How is a definitive dx of sarcoids made?
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Histopath
PCR to detect BPV |
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Which management technique of sarcoids has good results?
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Cryosurgery
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What is the purpose of a thermocouple when performing cryosx?
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Monitor tissue temp of surrounding veina, arteries, nerves, bones
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What must you warn the owner about when it comes to the results of cryosurgery?
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To expect sloughing
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Which product is commonly used for chemical cautery of sarcoinds?
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Podophylline
also: -efudex -topical formalin -tea tree oil -indian mud |
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When would immune stimulation be used to tx sarcoid?
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When cryosx would be disfiguring (around eye and ear)
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What products are used for immune stimulation
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-acid fast bacterial cell wall filtrates
-BCG (human tb vaccine -mammalian tuberculin (50% effective) |
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What other agents are thought to stimulate the immune response?
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-caprine serum fraction immunomodulator
-equistim, given intralesional or iv every 2 weeks |
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Autologous tissue implantation involves places frozen cubes of the sarcoid where?
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Under the skin under the mane
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What drug can be used to tx sarcoid, that interferes with cell development?
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Cisplatin
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Sarcoid can also be tx with laser sx . What other method has been reported as one of the mose successful txs?
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radiation tx
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Squamous cell carcinoma commonly develop where on the horse?
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Mucocutaneous junctions
can develop in any cutaneous area |
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What are the common sites of SCC development in light colored animals?
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-eyes and adnexa
-perineum of mare -prepuce -glans penis -head |
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What is the appearance of a SCC?
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-papillary to cauliflower like to multi nodular with varying amounts of ulceration and inflammation
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True or false...SCC usually invade locally but are slow to metastasize
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True
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What type of sx approach is best for a SCC?
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Wide surgical excision
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What tx technique, post sx, reduces recurrence?
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Radiation tx
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What other methods can be used to tx SCC?
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-cryosurgery
-hyperthermia -radiation -laser sx |
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What is one of the more common neoplasms of the horse?
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Melanoma
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Do melanomas of the horse metastasize fast or slow?
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Slow
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What type of sx approach is best for a SCC?
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Wide surgical excision
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What tx technique, post sx, reduces recurrence?
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Radiation tx
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What other methods can be used to tx SCC?
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-cryosurgery
-hyperthermia -radiation -laser sx |
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What is one of the more common neoplasms of the horse?
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Melanoma
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Do melanomas of the horse metastasize fast or slow?
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Slow
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In which color of horse do melanomas tend to occur?
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Gray and chestnut
> 10 years old associated with fading hair color |
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Melanoma can occur in any area but frequently occur where?
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-perineum
-tail head -anus -external genitalia -parotid salivary gland -can be only internal with no external evidence |
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What determines the prognosis of melanoma?
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size: smaller less likely to metastasize
(over 4cm more likely to mets) color: non-gray horses more likely to develop metastatic form |
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How is melanoma dx?
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-gross appearance
-coat color -are of involvement -histopath usually not needed |
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When is surgery or treatment of a melanoma indicated?
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When there is interference w/ function or a lesion is aesthetically displeasing
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What approaches to tx melanoma are available?
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-cryosurgery
-cisplatin -5-fluorouacil by injection or cream -BCG -vaccine -cimetidine |
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What is verrucous dermatitis?
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A Chronic villus proliferative growth
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The names given to verrucous dermatitis vary with the location..where does
canker grease heel scratches grapes occur? |
canker: frog
grease heel: heel area scratches: pastern grapes: pastern and fetlock |
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What is the degree of lameness from verrucous dermatitis?
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Animal is usually not lame
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Wet predisposes a horse to verrucous dermatitis?
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Filthy conditions
usually horses on wet conditions |
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How is verrucous dermatitis dx?
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These conditions have a very typical appearance (canker and thrush involve same part of foot, thrush is erosive)
-histopath for definitive |
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What is the tx for verrucous dermatitis?
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-radical sx excision of all diseased tissue
-perform under general anesthesia -control hemorrhage with bandage |
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Which topical medication is probably the best to apply under the bandage?
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Phycofixer
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What is the cause of a keloid?
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Improperly managed wound
-secondary to irritation for prolonged periods |
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What is the dx/appearance of a keloid?
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Large, raised thickened scar
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How is a keloid corrected?
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Sx excision and closure of the defect
-daily application of an emollient |
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What is the etiology of pressure sores?
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Result from a animal spending a considerable amount of time lying down- usually from laminitis
-typically over boney prominences |
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How do you tx pressure sores?
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-keep wounds clean
-antiseptic/abx -maalox and zinc oxide paste -use appropriate bedding (no pine shavings) deep straw or peat moss |
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What is a usual cause of burns?
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-barn fire
-trailer bedding catches fire |
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Tx includes controlling which complications?
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-laminitis
-shock -respiratory infection |
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Topical meds are used to control what infection?
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Psedomonas
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Which topical meds are used?
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-silver sulfadiazine
-gentamicin -dilute vinegar (lower pH inhibits pseudomonas) -debride area -skin grafts many times are needed |
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What are the indications for large animal castration?
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-remove less desirable traits from the genetic pool
-reduce management problems -improve meat quality (pigs) -arrest scent gland development in goats |
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What is a drawback to castration?
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Decreased rate of gain and feed efficiency (steers have to be fed longer to have the same carcass quality)
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How can decreased rate of gain be corrected?
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Implants: trenbolone acetate, estradiol
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Castration can be performed at any age: what is a potential complication with a younger animal?
Older animal? |
Younger: herniation
older: hemorrhage Equine: usually around 2 years of age |
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When is castration usually performed on bovine?
Ovine, caprine, porcine? |
Bovine: less than 500 pounds (the younger, the less stress
Ovine, caprine, porcine: first 2 weeks of life |
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Pre-operatively, what should you evaluate as far as husbandry considerations?
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-pigs should be in clean dry areas
-animals should not have access to spoiled sweet clover (source of dicumarol) |
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Specifically, what do you examine on the animal, pre-op?
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-testiclea
-external inguinal rings |
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What are the advantages of performing castration with the colt standing?
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-procedure is more rapid
-no chance of injury when going down or up with general anesthesia -anesthetic complications are reduced |
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What are the disadvantages to castration in the standing colt?
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-increased chance of injury to the surgeon
-restraint is not as reliable -sx complications are more difficult to manage |
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How is the standing horse restrained?
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-lead rope and twitch
-tail tie overhead |
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In the past, what drug was given to paralyze the horse for castration, but did not have any analgesia?
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Succinylcholine
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Current anesthetic regimens include which drugs?
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-xylazine
-suritel -ketamines |
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How long do these anesthetic drugs last?
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15-20 mins
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How should the horse be positioned for recumbent castration?
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-left lateral for right handed surgeon
-right lateral for left handed surgeon |
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What position is typically used for calf castration?
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recumbent--calf cradle or on ground
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Ovine and caprine are positioned how for castration?
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Upright with weight borne in the buttcoks, rear legs flexed
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How are larger pigs restrained for castration?
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handler grabs rear leg and pulls backwards, one knee on neck one behind front legs, holds both legs
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What anesthetic technique is used for mature boars?
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Sodium pentobarbital into the testical or pentothal or surital in the ear vein
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What is meant by closed castration?
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Testicle is removed by dividing spermatic cord including the common vaginal tunic at the same time
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What tool is commonly used in a closed castration?
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Emasculator
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What is meant by open castration?
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Common vaginal tunic is incised, testicle is removed, vaginal tuni left in place or removed following removal of testicel
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On a standing horse, where is local anesthetic injected for castration?
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-line block on the most ventral aspect of each side of the scrotum, inject local into the parenchyma of each testicle
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How is the emasculator positioned?
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perpendicular to the long axis of the cord and nut to nut
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On what structure do you apply tension prior to cutting with an emasculator?
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Tension on the common vaginal tunic
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When the horse is in lateral recumbency, which testicle is removed first?
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The lower one
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The Henderson castrating tool is used with what device?
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Power drill (ouch!)
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When is primary closer usually used after castration?
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When the horse is cryptorchid, after removal of the non-retained testicle
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Is removal of only the testicle more common in younger or older horses?
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Younger
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In mature horses, the castration procedure includes removal of the testicle and what other structure?
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A major portion of the scotum
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In the bovine, what is the preferred method of incising the scrotum?
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Verticle incision over each testicle producing an anterior and posterior skin flap
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What tool is used to make these incisions?
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Newberry castration tool
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In which direction is the scrotum incised for show animals
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Saggital direction
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On bovine less than 500 pounds, how are the testicles removed?
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Traction until the cremaster muscle, common vaginal tunic ans spermatic vessels rupture
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In bovine greater than 500 pounds, how are the testicles removed?
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-incise cut, apply traction to rupture the spermatic cord
-emasculator -scraping sprematic cord to divide it |
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What is the purpose of an emasculatome?
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Bloodless castration- divides spermatic vessels without incisinf the skin (Burdizzo)
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When using an emasculatome, how many times is each spermatic cord crushed?
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Twice
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What infection is a big risk when using emasculator bands?
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tetanus
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When is chemical castration recommended?
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For new born calves
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What precaution should be taken when castrating older goats?
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use sedation and local anesthetic
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In pigs, how do you check for inguinal hernias?
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Have handler apply pressure to chest and abdomen
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True or False...when castrating mature boars, general anesthesia is used?
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True
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Post castration, which abx is given to horses?
|
22,000 units procaine Pen G
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What meds should be given to horses that have no tetanus protecttion?
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Tetanus antitoxin and toxoid
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What is a potential complication to giving tetanus antitoxin?
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Theiler's disease in older horses
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What advice would you give to a horse owner regarding exercise post castration?
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Adequate exercise starting the after
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What is the most common complication of castration?
|
Swelling and edema
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Post op swelling is associated with a lack of drainage,, where?
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Lack of ventral drainage
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What is the tx for swelling/edema?
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Open incision of increase its size
-nsaids -adequate exercise |
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What are the clinical signs of post op infection?
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-fever
-swelling -lameness -discharge |
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The infection call champignon is caused by what?
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Strep
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Champignon has be associated with infection where?
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End of spermatic cord and large amount of granulation tissue
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What is the term for a post castration infection caused by staph?
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Scirrhous cord
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What is a scirrhous cord?
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Scrotal infection heals but a chronic infection involving the stump of the spermatic cord causes enlargement and eventual drainage
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What other organism can infect post castration?
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Clostridium
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Post castration infections are predisposed by what 2 conditions?
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-ligatures (non-absorbable or slow absorb)
-lack of drainage |
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How do you tx a post castration infection?
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-adequate drainage
-removal of infected tissue -abx -exercise |
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When should you be concerned about hemorrhage post castration?
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-bleeding with a fast drip for more than 15 minutes
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What is the common cause of hemorrhage with castration?
|
Testicular artery within the spermatic cord
less common: vessels in cremater m., scrotal vessels |
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Hemorrhage is usually due to what?
|
-faulty emasculator (too sharp)
-improper application |
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How do you tx a hemorrhaging vessel?
|
-sedate
-locate -clamp and ligate -can leave clamp on for 24 hrs |
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What approach can you take if the bleeding vessel can;t be located?
|
Pack scrotum with gauze, suture to skin, can use drugs to decrease fibinolysis
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What aren't PCV and total protein good indicators of blood loss?
|
6 hr delay before protein drops
12-24 hrs before PCV drops |
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What is the tx for herniation of the omentum?
|
Ligate and remove omentum
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Typically, when does herniation involving the intestine occur?
|
within te first 3-4 hours post castration
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Intestinal herniation is usually secondary to what condition?
|
-straining: colic, animal casted and straining to get up
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Which breeds are over represented for post castration herniation?
|
-draft
-SB -TN walking |
|
|
What are other predisposing factors for post castration herniation?
|
-pre existing inguinal hernia
-inguinal hernia as a foal -inguinal rings that admit more than 2 fingers |
|
|
How can herniation be prevented?
|
Ligation of spermatic cord prior to removal of testicle
-closed castration -closure of ext inguinal ring at time of castration |
|
|
How do you manage a herniation?
|
-protect from contamination
-clean, replace the bowel, close scrotum -Abx -analgesia |
|
|
What are the clinical signs of peritonitis?
|
-fever
-depression -increased pulse -colic -dehydration -diarrhea -anorexia |
|
|
How do you Dx peritonitis?
|
Abdominocentesis
|
|
|
Peritonitis is thought to be caused by what?
|
reaction to blood in the abdominal cavity
|
|
|
How would you Tx peritonitis?
|
-broad abx
-nsaids -anti-endotox meds -indwelling drains |
|
|
If the penis is damaged and prolapsed during castration, when can it be repaired?
|
After the edema reduces and the penis can be placed cadual to the preputial orifice
|
|
|
What is a hydrocele?
|
Accumulation of sterile fluid in the common vaginal tnic
|
|
|
Is a hydrocele seen more open with an open or a closed castration?
|
open- when the common vaginal tunic i s not removed
|
|
|
In which species is hydrocele more common?
|
Mules
|
|
|
What is the tx for hydrocele?
|
None needed
|
|
|
What are the potential reasons for a horse to retain obnoxious behavior post castration?
|
-older stallion w/ learned behavior
-extra testicular source or testosterone (adrenal) |
|
|
What is the term for failure to remove all genetic tissue?
|
Proud cut
|
|
|
What are the synonyms for retained testicle?
|
-cryptorchid
-high flanker -rig or ridgling -original |
|
|
Usually, where is a retained testicle in the ruminant?
|
Subcu, close to the external inguinal ring
|
|
|
Are retained testicles corrected in swine?
|
No -usually abdominal
|
|
|
In the foal, what structure can be confused with the testicle?
|
Bulb of the gubernaculum
|
|
|
Horses with retained testicles are brought in for what reason?
|
Management issues
|
|
|
True or False...it's considered unethical to surgically reposition a testicle within the scrotum.
|
True
|
|
|
Why would rectal palpation be helpful in the dx of a retained testicle?
|
Can sometimes palpate the testicle in the abdomen or vas deferens through the internal inguinal ring
|
|
|
What other Dx technique can help to locate a retained testicle?
|
U/S
|
|
|
What else should you be looking for during a pre op exam for retained testicle?
|
Scars from previous sx (attempts at locating)
|
|
|
What hormone levels can be checked to confirm the presence of a retained testicle?
|
-estrogen
-testosterone |
|
|
An increase in testosterone, with a testicle present, can be seen after an injection of what.
|
HCG
|
|
|
Is it more common to have unilateral or bilateral cryptorchid?
|
Unilateral
|
|
|
A retained Left testicle is usually located where?
A right testicle? |
Left: abdomen
Right: inguinal ring |
|
|
What sx approach is used if there is a question about the location of a retained testicle?
|
Through the inguinal ring
|
|
|
When would a parainguinal approach be used?
|
Easier to reconstruct the area
|
|
|
What sx approaches are used in the case of bilateral retained testicles?
|
Ventral midline or paramedian
|
|
|
What structures complicate the midline approach?
|
Penis and prepuce- incision must be made lateral to them
|
|
|
What sx approach can be used on a standing animal?
|
Flank
|
|
|
In the case of a single retained testicle, which is removed first the retained of the normal testicle?
|
The retained is removed first
|
|
|
What 3 methods can be used to locate a retained testicle?
|
-tension of inguinal extension of gubernaculum
-use sponge forceps to pick up vaginal process in inguinal canal -insert fingers in ruptured vaginal process and feel for gubernaculum |
|
|
If the retained testicle is not located through the inguinal ring, what step is taken next?
|
-enter the abdominal cavity
|
|
|
How do you locate the vas deferens?
|
At the neck of the bladder
|
|
|
The abdominal fascia or inguinal ring are closed with a blunt hernia needle, what other method can be used?
|
Pack the inguinal canal with gauze, remove in 24-48 hours
|
|
|
What is the most current method (the new buzz thing) for removing a retained testicle?
|
-laporoscope
|
|
|
When performing laporoscopic sx for a retained testicle, what position is the animal in and what additional technique is needed?
|
30 degree trendelenberg
positive pressure ventilation |
|
|
What type of inguinal hernia usually occurs in domestic animals?
|
Indirect intestines pass through the inguinal ring
|
|
|
An acute, irreducible inguinal hernia usually occurs when?
|
Post breeding in a stallion
|
|
|
An acute irreducible hernia requires what emergency procedure?
|
Resection and anastomosis of the incarcerated bowel
|
|
|
What are the clinical signs of an inguinal hernia?
|
-acute abd pain
-rectal exam shows intestines passing through the inguinal ring -scrotum distended and sometimes can feel intestines inside |
|
|
A bull with a congenital scrotal hernia should not be used for what?
|
breeding
|
|
|
What are the signs of a scrotal hernia?
|
-palpable enlargement in the inguinal area
-intestines can be forced back through the enlarged inguinal rings |
|
|
True or false...a congenital scrotal hernia may self correct
|
True- helps to put on a truss
|
|
|
What effect can a chronic reducible inguinal hernia have on breeding stallions and bulls?
|
Reduction in fertility
|
|
|
What are the clinical signs of a chronic reducible inguinal hernia in a bull?
|
Hour glass appearance of the scrotum
|
|
|
What are the clinical signs of a chronic reducible inguinal hernia in a stallion?
|
-some have recurrent digestive problems
-some have slight rear leg lameness |
|
|
On which side do inguinal hernias usually occur in bulls?
|
the left
|
|
|
When repairing a hernia, if the bowel is not viable, what procedure must be doen?
|
resection and anatomosis
|
|
|
In the case of a chronic hernia, how is the repair done?
|
-dissect hernia sac from scrotal fascia
-twist the hernia sac on itself to force intestines into the abdomen |
|
|
True or false...closure of an inguinal hernia should include unilateral castration?
|
True
|
|
|
When would you consider an ischial urethrostomy in a male?
|
Removal or uretheral or bladder calculi
|
|
|
Where is the incision made for a ischial urethrostomy in a male?
|
Just below the anal sphincter
|
|
|
When performing an ischial urethrostomy how do you identify the urethra?
|
Pass a catheter in the urethra
|
|
|
How do injuries to the penis occur?
|
-kicks
-movement of mare during breeding -jumping and being stranded on a fence or post -poorly managed stallion ring |
|
|
What is paraphimosis?
|
Swelling of the penis and prepuse which causes the penis to be retained outside of the preputial orifice
|
|
|
What is the tx for paraphimosis?
|
manual support
-massage -nsaids -diurectics -mild exercise -abx |
|
|
What device can be used to maintain the penis in the prepuce?
|
A probang
|
|
|
What is phimosis?
|
Swelling of the penis and prepuce which causes the penis to be retained inside the preputial orifice
|
|
|
In which speciess is phimosis common?
|
Bulls
|
|
|
What is penile paralysis?
|
Animals lose the ability to retract the penis into the prepuce
|
|
|
What driug can cause penile paralysis?
|
Phenothiazine (in stallions)
and failue to adequately tx paraphimosis |
|
|
What is reefing?
|
Removal of abnormal growths or scar tissue that do not extend deeper than the dermis
|
|
|
What device is used post op reefing to prevent erection?
|
a breeding ring
|
|
|
what are the indications for amputation of the penis?
|
-carcinoma involving structures deeper than the skin
-penile paralysis |
|
|
What type of incision is made for penile amputation?
|
Triangular
|
|
|
What sx technique is preferred in the case of paralysis of the penis?
|
Boltz technique
|
|
|
What pre sx procedures are completed prior to the Bolts technique?
|
-castration
-removal of any granulomatous growths |
|
|
Describe the Boltz technique
|
Retract the penis so the glans is just inside the preputial orifice, suture in place
|
|
|
What final step is most important in the Boltz technique?
|
After the horse is standing, adjust the stay sutures so the glans is just inside the preputial orifice
|
|
|
Mare urogenital
|
Mare urogenital
|
|
|
What is a bimanual exam of the mare?
|
1 hand in the rectum
1 hand in the vagina |
|
|
What is pneumovagina?
|
Involuntary aspiration of air into the vagina
|
|
|
What are the causes of pneumovagina?
|
Faulty seal of the vulva because of poor closure or incompetence
-tipped vulva: old, multiparous mares -inversion of lips, perineal lacerations |
|
|
What 3 sx procedures are used to control pneumovagina?
|
-casslick
-gadd -perineal body transection |
|
|
When performing a Caslick's, where is the strip of vulvar skin removed from?
|
At the mucocuntaneous junction
|
|
|
Once the skin strip is removed, how are the edges sutures?
|
Simple continuous pattern
|
|
|
How is breeding accomplished with a Caslick's?
|
Caslick is removed then resutured, or a breeding suture is put in place
|
|
|
What are the post op complications of a Caslick's?
|
-incomplete seal
-urine pooling -suture sinus (eliminated by not going through the vaginal mucosa with the suture) |
|
|
A variation of the Caslick's procedure that does not compromise the seal of the vagina is accomplished in what way?
|
Removal of mucosa (and not skin) with insertion of surtures slightly anterior to the mucocutaneous junction.
|
|
|
What is the difference between Caslick and Gadd?
|
(Gadd = episioplasty or perineal body reconstruction)
-sx removal of a right angle shaped piece of mucosa from the dorsal aspect of the vestibule -increases size of the perineal body which improves the natural seal |
|
|
For what conditions is the perineal body transection technique used?
|
-pneumovagina
-urovagina |
|
|
What is the basis for the perineal body transection technique?
|
Division of the attachments between the rectum and caudal reproductive tracts
-returns the vulva to a more normal conformation |
|
|
When do perineal lacerations of the mare occur?
|
2ndary to problems associated with delivery of a foal
|
|
|
First degree perineal lacerations include what layers?
|
Skin and mucous membrane
|
|
|
Second degree perineal lacerations include what layers?
|
Perineal body but not rectum
|
|
|
Third degree perineal lacerations include which layers?
|
-vulva
-perineal body -dorsum of the vagina and rectum |
|
|
What type of repair do first degree perineal lacerations require?
|
None--heal without complications
|
|
|
When should a second degree perineal laceration be repaired?
|
Can do immediately bu t best to wait 5-10 days for inflammation & infection to subside
|
|
|
How is a second degree perineal laceration sutured?
|
-if the mucosa has healed will be like a Gadd technique
-sutures should be placed from deep to superficial -insert skin sutures as in caslick |
|
|
Third degree perineal lacerations occur most frequently in what type of mare?
|
Maiden mares
|
|
|
When should a Third degree perineal laceration be repaired?
|
6 weeks or until the foal is weaned
|
|
|
What immediate care steps are taken for a Third degree perineal laceration?
|
-debride
-tetanus prophylaxis -abx -careful cleaning of wound for several days |
|
|
What dietary changes are needed for pre operative care for Third degree perineal laceration?
|
-dietary management to maintain soft unformed stool
--lush pasture -bran and grain- no long stem hay -pelleted food -mineral/linseed oil |
|
|
How is a Third degree perineal laceration repaired?
|
-Sharp dissection to separate the rectal floor from the vaginal roof at cranial aspect of laceration
|
|
|
What is the modified Goetz technique?
|
Suture is passed thru the vaginal mucous membrane on the right side, 3cm to the right of the cut edge of the rectum passing thru the musculature, but not thru the rectal mucosa and then out thru the cut edge of the rectum
|
|
|
What is the Annes technique for repair of Third degree perineal laceration?
|
-same initial dissection
-horizontal mattress sutures to close the vaginal mucosa, then simple interrupted to close the muscle layer of the rectum and perineal body |
|
|
With the Annes technique, when is the anal sphincter closed?
|
At the second stage 2-3 weeks following intial closure
|
|
|
When is the pull back technique sued?
|
For very shallow third degree perineal lacerations
|
|
|
What are the post op management techniques?
|
-maintenance of non-formed stool
-tetanus prophylaxis -abx -suture removal in 10days if non absorbable |
|
|
what are the possible complication to sx repair of third degree perineal laceration?
|
-excessive straining to defecate
-partial or complete wound breakdown -fistula development at anterior portion of vagina |
|
|
What is the usual cause of a rectovaginal fistula?
|
-birth related injury
--foal's foot is forced thru the dorsal vagina into the rectum |
|
|
What is the best approach for repairing a large (6 inches or more) fistula?
|
-make an incision to produce a thrid degree laceration and repair i
|
|
|
Where is the third incision made?
|
-a horizontal incision is made midway between the anus and the dorsal aspect of the vagina
-interrupted Lembert sutures to close defect in rectum -simple interrupted to close vagina |
|
|
What are the causes of vaginal injury?
|
-difficult birth
-mare backing into a protruding object -pervert human |
|
|
How are vaginal contusions tx?
|
usually resolve w/o complications
|
|
|
Occasionally, how might a hematoma need to be resolved?
|
By drainage
|
|
|
How do you tx vaginal varicies?
|
-may need to be ligated or injected with a sclerosing agent to prevent continued hemorrhage
|
|
|
What are the steps in tx lacerations of the vagina?
|
-determine extent
-extension into peritoneal cavity requires sutures -tetanus prophylaxis -abx |
|
|
What are the possible complications of vaginal lacerations
|
-pelvic abscess
-vaginal adhesions -peritonitis -evisceration |
|
|
Pelvis abscess is usually related to what?
|
Persistant straining
|
|
|
How is a pelvic abscess tx?
|
Requires adequate drainage
|
|
|
What dx technique is used to determine adheesions in the anterior vagina and cervix?
|
U/S
|
|
|
What are the clinical signs or peritonitis?
|
-temp rise (fever)
-anxiety/depression -mild colic/splinted abd -hesitance to move -abdominocentesis shows high WBC and SG > 1.017 |
|
|
What are the possible complications of vaginal lacerations
|
-pelvic abscess
-vaginal adhesions -peritonitis -evisceration |
|
|
Pelvis abscess is usually related to what?
|
Persistant straining
|
|
|
How is a pelvic abscess tx?
|
Requires adequate drainage
|
|
|
What dx technique is used to determine adhesions in the anterior vagina and cervix?
|
U/S
|
|
|
What are the clinical signs or peritonitis?
|
-temp rise (fever)
-anxiety/depression -mild colic/splinted abd -hesitance to move -abdominocentesis shows high WBC and SG > 1.017 |
|
|
What are the possible complications of vaginal lacerations
|
-pelvic abscess
-vaginal adhesions -peritonitis -evisceration |
|
|
Pelvis abscess is usually related to what?
|
Persistant straining
|
|
|
How is a pelvic abscess tx?
|
Requires adequate drainage
|
|
|
What dx technique is used to determine adhesions in the anterior vagina and cervix?
|
U/S
|
|
|
What are the clinical signs or peritonitis?
|
-temp rise (fever)
-anxiety/depression -mild colic/splinted abd -hesitance to move -abdominocentesis shows high WBC and SG > 1.017 |
|
|
What are the possible complications of vaginal lacerations
|
-pelvic abscess
-vaginal adhesions -peritonitis -evisceration |
|
|
Pelvis abscess is usually related to what?
|
Persistant straining
|
|
|
How is a pelvic abscess tx?
|
Requires adequate drainage
|
|
|
What dx technique is used to determine adhesions in the anterior vagina and cervix?
|
U/S
|
|
|
What are the clinical signs or peritonitis?
|
-temp rise (fever)
-anxiety/depression -mild colic/splinted abd -hesitance to move -abdominocentesis shows high WBC and SG > 1.017 |
|
|
What are the possible complications of vaginal lacerations
|
-pelvic abscess
-vaginal adhesions -peritonitis -evisceration |
|
|
Pelvis abscess is usually related to what?
|
Persistant straining
|
|
|
How is a pelvic abscess tx?
|
Requires adequate drainage
|
|
|
What dx technique is used to determine adhesions in the anterior vagina and cervix?
|
U/S
|
|
|
What are the clinical signs or peritonitis?
|
-temp rise (fever)
-anxiety/depression -mild colic/splinted abd -hesitance to move -abdominocentesis shows high WBC and SG > 1.017 |
|
|
Does urine pooling in the vagina indicate a decrease in conception?
|
Controversial beliefs
|
|
|
In which mares is urine pooling most common?
|
Older mares in poor general condition
|
|
|
What is the conservative approach to tx for urine pooling?
|
Increase the general condition of the mare to increase vaginal fat
|
|
|
What is the general sx approach to correcting urine pooling?
|
Extend the urethra caudally using the transverse fold and mucosa of the vagina
|
|
|
What 4 techniques are used to correct urine pooling?
|
-Monin
-Brown -McKinnon -Shires |
|
|
How can you tell if the bladder has prolapsed through the urethral orifice?
|
-surface of the prolapse is mucous membrane openings of the ureters can be identified
|
|
|
What are the steps in tx of a bladder prolapse thru the urethra?
|
-epidural
-cleansing -massage to relieve edema -force back through -made need tracheotomy to reduce straining |
|
|
What surface of the bladder is seen if the prolapse is through the vaginal floor?
|
The serosal surface
|
|
|
Why is hemorrhage difficult to control in the case of a uterine prolapse in the mare?
|
Endometrium is so vascular, ligatures are of little value
|
|
|
How is the uterus replaced?
|
-support weight of uterus
-force through vulva and cervix -inject oxytocin |
|
|
What should not be used in repairing a uterine prolapse?
|
No sutures
|
|
|
Why should you give abx after a uterine prolapse?
|
To prevent metritis, a forerunner of laminits
|
|
|
True or False, vaginal prolapse occurs often in the mare.
|
False--seldom occurs
|
|
|
What exam is necessary prior to any sx of the cervix?
|
-uterine exam with bx
|
|
|
Problems with the cervix are usually related to what in the mare?
|
Secondary to foaling or abortion
|
|
|
What types of lesion can occur in the cervix
|
-loss of tone or ability to contract
-lacerations |
|
|
How do you tx a cervical laceration that only involves the mucosa?
|
massage with antibiotic ointments to prevent adhesions
|
|
|
How do you tx a cervical laceration that involves the muscular layer?
|
-prevent adhesions
-delay repair for 30-60 days -may not require sx |
|
|
What possible repair can you do if the cervix loses tone and has no muscular damage?
|
Purse string sutures (not too effective)
-use braided nonabsorbable suture -incise the mucosa at 12 and 6 o'clock |
|
|
How do you repair a cervical laceration involving the musculature?
|
-anesthesia
-remove a wedge of tissue and suture -close with 3 layers of absorbable sutures |
|
|
What is a uterine torsion?
|
Uterus is twisted on its long axis
|
|
|
In ruminants, uterine torsion occurs when?
|
at term
|
|
|
In the ruminant where is the twist located?
|
Caudal to the cervix
|
|
|
In the mare, when does uterine torsion occur?
|
Several months prior to term
|
|
|
In the mare, where is the twist located?
|
Anterior to the cervix
|
|
|
What is the non-surgical approach to fixing a uterine torsion on the mare?
|
Cast the mare:
-on right if twist is clockwise -on left f twist is counter clockwise -roll in same direction as the twist |
|
|
What is the suggested sx approach to a uterine torsion?
|
Standing flank laparotomy
|
|
|
What is the safest procedure for a uterine torsion in the mare?
|
-correct the malposition
-repair abdominal wall -allow fetus to be delivered in normal manner |
|
|
Uterine rupture is almost always due to what?
|
Secondary to difficult delivery
|
|
|
How do you dx a uterine rupture?
|
-manual exam (bare handed)
-signs of peritonitis |
|
|
How do you tx a ruptures uterus?
|
-suture the defect
-aggressive tx for peritonitis |
|
|
If a cesarean is needed in a mare, when is the window of opportunity?
|
Once the horse is in 2nd stage of labor, delivery must be accomplished within 30 minutes
|
|
|
What are the indications for a cesarean?
|
-bicornual pregnancy
-large fetus -malposition -uterine torsion -deformations of the maternal pelvis |
|
|
what anesthetic protocol is used for a cesarean if the fetus is dead?
|
Any safe general anesthetic can be used
|
|
|
What anesthetic protocol is used for a cesarean if the foal is alive?
|
Minimal amounts of barbituates and maintain with gas anesthetic
|
|
|
What is the best site for performing a laparotomy for a cesarean?
|
Ventral midline-provides best exposuree
|
|
|
What is the Marcenac approach to cesarean?
|
-mare in right lateral recumbency, legs extended to rear
-grid incision |
|
|
What 2 other approaches might be used?
|
-paracostal
-paramedian |
|
|
How is the fetus removed?
|
-incision made on the greater curve of the uterus
-legs of the fetus are grasped and delivered |
|
|
What are the post op cesarean management steps?
|
-abx
-tetanus prophylaxis |
|
|
True or False, cystic ovaries are extremely rare in mares.
|
True
|
|
|
What is the most common neoplasm of the mare ovaries?
|
Granulosa cell tumor
|
|
|
How do you dx a granulosa cell tumor of the ovary?
|
-enlarged ovary on rectal exam, stays enlarged through several estrus cycles
-changes in estrual cycle -usually anestrus -occasionally showing nymphomania |
|
|
True or False, nyphomania of the mare is related to the ovaries?
|
False
|
|
|
what are the clinical signs of nymphomania in the mare?
|
-difficult to manage
-psychic estrus but won't stand to be bred -stallion-like behavior and conformation |
|
|
Is an ovariectomy helpful in tx nymphomania?
|
No
|
