Bovine Surgery and Lameness

Contents

Preface

Acknowledgements

About the Companion Website

Chapter 1: General considerations and anaesthesia

1.1 Pre-operative assessment

Introduction

Welfare and quality of life

Laboratory tests

Congenital defects

1.2 Instrumentation

Sterilisation

Basic instruments for caesarean section or laparotomy

1.3 Asepsis

Preparation of operative field

Hand disinfection

1.4 Sutures and suturing

Suture materials

1.5 Restraint

Introduction

Techniques

1.6 Pre-medication and sedation

Xylazine (e.g. Rompun 2%® [Bayer]; Sedaxylan [Dechra Veterinary products])

Advantages

Disadvantages

Dosage and antagonists

Chloral hydrate

Advantages

Disadvantages

Dosage

Acetylpromazine (ACP)

Diazepam

Pentobarbitone

Atropine sulphate

1.7 General anaesthesia

Indications

Disadvantages of GA

Equipment

Intravenous anaesthesia (induction) agents

Indications and dosage

1.8 Local analgesics

Lignocaine

Procaine

Bupivacaine

Cinchocaine and Mepivicaine

1.9 Regional analgesia

Analgesia of the head

Cornual nerve block

Infratrochlear block

Supraorbital block

Auriculopalpebral block

Retrobulbar block

Peterson's block

Analgesia of the flank

Paravertebral block

Line block, T block or inverted L (7) pattern

Inverted L block (`reverse 7´ left flank; `7´ right flank)

Analgesia of the pelvic and mammary regions

Epidural block

Caudal (low) block

Cranial (high caudal) block

Internal pudendal block

Block of dorsal nerve of penis

Intratesticular block

Teat block

Analgesia of the distal limbs

Intravenous regional analgesia (IVRA) of digit

Distal limb local anaesthesia (not IVRA)

Chapter 2: Fluid and supportive therapy

2.1 General principles of fluid therapy

Considerations

2.2 Shock

2.3 Hydration status

2.4 Acid-base status

Metabolic alkalosis

Metabolic acidosis

Estimating acidosis in calves

Calculating and correcting base deficits

Acidotic neonates

2.5 Other electrolytes

2.6 Oral fluid therapy

Indications

Contra-indications

Equipment

Restraint

Method

2.7 Intravenous fluid therapy

Indications

Contra-indications

Equipment

Restraint

Method

Hypertonic saline

2.8 Blood transfusions

Indications

Contra-indications

Equipment

Restraint

Method

Possible complications

2.9 Transfaunation

Introduction

Indications

Equipment

Procedure

Possible complications

2.10 Antimicrobial therapy

Introduction

Antimicrobial selection

2.11 Peri-operative analgesia

Introduction

Pain assessment

Chemotherapeutic approaches to analgesia

Alternative therapeutic approaches to analgesia

Practical benefits of routine use of post-operative analgesia

Chapter 3: Diagnostic techniques and procedures

3.1 Abdominocentesis

Indications

Restraint

Equipment

Technique

Limitations

Fluid analysis and diagnostic tests

3.2 Rumenocentesis

Indications

Restraint

Equipment

Technique

Possible complications

Animal selection (herd test)

Limitations

3.3 Liver biopsy

Indications

Restraint

Animal selection

Equipment

Technique

Tissue handling and tests

Possible complications

3.4 Bronchoalveolar lavage (BAL)

Indications

Restraint

Equipment

Technique

Sample handling

Limitations

3.5 Trans-tracheal aspiration

Indications

Restraint

Technique

Complications and limitations

3.6 Pleurocentesis

Indications

Technique

3.7 Pericardiocentesis

Indications

Technique

3.8 Bladder catheterisation

Indications

Technique

Possible complications

3.9 Coccygeal venepuncture

Indications

Technique

Possible complications

Chapter 4: Head and neck surgery

4.1 Disbudding and dehorning

Indications

Anaesthesia, analgesia and selection of techniques

Chemical cautery

Surgical and heat cautery

Restraint

Technique of disbudding

Technique of dehorning

Haemostasis

Technique of cosmetic dehorning

Possible complications of disbudding or dehorning

4.2 Trephination of frontal sinus (for empyema)

Indication

Anatomy (Figures 4.4 and 4.5)

Clinical signs of frontal sinus empyema

Restraint, anaesthesia and trephination landmarks

Technique

Post-op care and possible complications

4.3 Entropion

Introduction and signs

Anaesthesia

Techniques

4.4 Third eyelid flap

Indications

Techniques (Figure 4.7)

Possible complications

4.5 Eyelid lacerations

Introduction

Restraint and clinical signs

Technique of repair

Possible complications

4.6 Ocular foreign body

Indications and signs

Techniques of removal

Prognosis

4.7 Neoplasia of eyelids

Introduction

Clinical signs

Treatment

(a) Excisional surgery of third eyelid

(b) Cryotherapy

(c) Other techniques

Possible complications

4.8 Enucleation (ocular exenteration)

Indications

Restraint and anaesthesia

Technique of ocular exenteration

Possible complications

4.9 Insertion of a nose ring in a bull

Introduction

Restraint

Technique of insertion

Possible complications

4.10 Tracheotomy

Introduction

Clinical signs

Anatomy

Restraint and anaesthesia

Technique

Post-operative care

Possible complications

4.11 Oesophageal obstruction (`choke´)

Aetiology and signs

Surgical techniques of oesophagotomy

Possible complications

Chapter 5: Abdominal surgery

5.1 Topography

The intestinal tract

Position and course

Abdominal viscera (see also Figure 5.7 later)

5.2 Exploratory laparotomy (celiotomy), left flank

Indications

Technique

Visible and palpable features

5.3 Exploratory laparotomy, right flank

Visible and palpable features (see Figure 5.8)

Closure of flank laparotomy incision

Intra-abdominal and systemic antimicrobial therapy

Possible complications

5.4 Rumenotomy

Indications

Traumatic reticulitis/reticuloperitonits

Incidence

Aetiology

Clinical signs

Diagnosis

Conservative treatment

Signs resulting from sequelae of traumatic reticuloperitonitis

Technique of rumenotomy

Weingart frame method (Figure )

McLintock cuff method

Suture method

Closure of ruminal incision

Prevention of traumatic reticulitis/reticuloperitonitis

Vagal indigestion (Hoflund syndrome)

Introduction

Anatomy

Clinical signs

Treatment

5.5 Temporary rumen fistulation

Indications

Chronic recurrent rumen tympany in calves

Signs

Technique

Chronic ruminal tympany in adult cattle

Diagnosis

Treatment and prognosis

5.6 Left displacement of abomasum (LDA)

Anatomy

Aetiology

Signs

Diagnosis

Differential diagnosis

Conservative technique

Surgical techniques (LDA)

Right flank approach (Dirksen modified omentopexy or pyloropexy; Hanover method)

Possible complications

Left flank approach (Utrecht technique)

Left and right laparotomy approach

Right paramedian approach

Percutaneous fixation (toggle or bar suture)

Endoscopic LDA correction

Two-step laparoscopic toggle technique (Janowitz technique)

One-step laparoscopic toggle technique (Christiansen technique)

Potential complications (of all techniques)

5.7 Right dilatation, displacement and volvulus of abomasum (RDA)

Signs and diagnosis of RDA

Conservative treatment of RDA

Signs of abomasal volvulus

Surgical treatment of RDA and abomasal volvulus

5.8 Other abomasal conditions

Abomasal impaction

Introduction

Treatment

Abomasal tympany and volvulus in calves

Signs

Treatment

Abomasal ulceration

Introduction

Signs

Treatment

5.9 Caecal dilatation and dislocation

Definition and anatomy

Incidence and signs

Treatment

Prognosis

5.10 Intestinal intussusception

Introduction

Signs

Diagnosis

Treatment

5.11 Other forms of intestinal obstruction

Signs

Treatment

5.12 Peritonitis

Introduction

Signs and diagnosis

Treatment

5.13 Umbilical hernia and abscess

Introduction

Signs

Diagnosis

Indications for surgery

Surgical technique

Possible complications

Treatment of encapsulated umbilical abscessation by surgery

5.14 Alimentary conditions involving neoplasia

Squamous cell carcinoma (SCC)

5.15 Anal and rectal atresia

Introduction

Diagnosis

Surgery

Rectal atresia treatment

5.16 Rectal prolapse

Introduction

Aetiology and signs

Treatment

Submucosal resection

Amputation

Possible complications

Chapter 6: Female urinogenital surgery

6.1 Caesarean section (hysterotomy)

Indications

Contra-indications

Flank approach

Restraint, preparation and anaesthesia

Technique

Post-operative care

Post-operative complications

Alternative surgical techniques

6.2 Vaginal and cervical prolapse

Introduction

Predisposing factors

Treatment of pre-parturient chronic case

Technique 1. Perivulvar suture using Bühner's method (see Figure 6.3)

Technique 2. Transverse sutures

Treatment of post-parturient case

Technique 3. Modified Caslick's operation

Technique 4. Cervicopexy (see Figure 6.4)

Introduction

Technique

6.3 Uterine prolapse

Introduction

Treatment

After care

Complications

Amputation of the uterus (hysterectomy)

Introduction

Technique 1

Technique 2

Post-operative problems

6.4 Perineal laceration

Classification

Clinical signs and indication

Technique

Possible complications

6.5 Episiotomy

Indication

Technique

6.6 Ovariectomy

Indications

Technique

Flank approach

Vaginal approach (cows only) (see Figure 6.7)

Possible complications

6.7 Bladder eversion

Signs

Repair

Possible complications

Chapter 7: Teat surgery

7.1 Introduction

Restraint and anaesthesia

Anatomy (see Figures 7.1 and 7.2)

7.2 Obstruction of teat orifice, streak canal or Furstenberg's rosette

Aetiology

Signs

Treatment of obstruction of streak canal

Treatment of obstruction in the area of Fürstenberg's rosette with theloresectoscope/thelotomy

7.3 Milk stones and teat lumen granuloma

Introduction

Signs

Treatment

7.4 Teat base membrane obstruction

7.5 Traumatic lacerations of teat

Introduction

Treatment

Non-perforating horizontal lacerations with skin flaps

Non-perforating longitudinal teat lacerations (not involving teat sinus)

Perforating teat lacerations (involving teat sinus)

Surgical technique

7.6 Imperforate teat

7.7 Incompetent teat sphincter

7.8 Teat amputation

Supernumerary teats

Technique

Amputation due to disease (cows)

Technique

Amputation due to injury

Technique

Chapter 8: Male urinogenital surgery

8.1 Preputial prolapse or eversion

Introduction

Predisposing factors

Preputial trauma

Conservative treatment

Surgical treatment: circumcision

1. Resection and anastomosis technique (performed with the penis extended)

Technique of surgical amputation (penis not extended)

Preputial amputation with ring (penis not extended)

Intrapreputial adhesions

8.2 Penile haematoma

Introduction

Signs and pathology

Differential diagnosis

Conservative treatment

Surgical treatment (see Figure 8.4)

After-care

Possible complications

8.3 Urolithiasis

Introduction

Clinical signs

Treatment

Urethrotomy

Urethrostomy

Penile amputation

Possible complications

8.4 Ruptured bladder

Introduction

Treatment

Surgical repair of bladder

Alternative salvage technique relying on spontaneous healing

Possible complications of bladder surgery

8.5 Prevention of intromission

Introduction

Penile-prepuce translocation

8.6 Vasectomy

Introduction

Restraint and anaesthesia

Standing method

Recumbent method

Surgical technique

Post-op care

8.7 Epididymectomy

Introduction

Restraint and anaesthesia

Technique

8.8 Congenital penile abnormalities

Corkscrew penis or spiral penis

Introduction

Signs

Surgical repair

Technique 1. Penile tunica albuginea (see Figure 8.12)

Technique 2. Fascia lata graft

After-care

Persistent frenulum

Introduction

Surgical treatment

Other congenital anomalies of bovine penis

8.9 Penile neoplasia

Papillomatosis

Signs

Treatment

Malignant squamous cell carcinoma

8.10 Castration

Introduction

Bloodless methods

Rubber ring (elastrator) method

Burdizzo method

Surgical (scalpel) method

Technique

Emasculator method

Torsion method

Traction method

Newberry castration technique

Technique for small bull

Possible complications of surgical methods

8.11 Cryptorchidism and ectopic testicle

Introduction

Ectopic testicle

Cryptorchidectomy

Inguinal testicle

Chapter 9: Musculoskeletal conditions and lameness

9.1 Introduction and welfare

Economic effects

9.2 Mobility (lameness) scoring

Lameness incidence versus prevalence

9.3 Functional foot anatomy

9.4 Main foot lesions: terminology and summary

Lesions and infectious diseases of digital skin

Claw horn lesions

Claw zones

9.5 Hoof trimming technique: corrective (therapeutic) and preventive trims

Trimming variations

9.6 Therapeutic trimming of claw horn lesions

Complicated claw horn lesions

Applying orthopaedic hoof blocks

Types of orthopaedic hoof blocks

Applying a block successfully

Block removal

9.7 Interdigital phlegmon (foul of the foot)

Synonyms

Signs

Aetiology and pathology

Differential diagnosis

Treatment

Prophylaxis

9.8 Digital dermatitis

Synonyms

Signs and incidence

Lesion classification

Bacteriology

Differential diagnosis

Treatment

Prevention

9.9 Interdigital hyperplasia

Synonyms

Signs and pathology

Treatment

Prevention

9.10 Sole ulcer

Synonyms

Signs

Aetiology

Complicated sole ulcers

Treatment

Prevention

9.11 White line disease

Synonyms

Signs

Aetiology and risk factors

Complicated white line lesions

Treatment

Prevention

9.12 Toe necrosis

Synonyms

Definition

Signs

Aetiology

Treatment

Prevention

9.13 Vertical (longitudinal) or horizontal (transverse) wall fissures

Synonyms

Definition

Signs

Treatment

9.14 Fractured pedal bone

Signs

Treatment

9.15 Punctured sole

Synonyms

Definition

Signs

Treatment

9.16 Heel bulb haematoma/abscess

Definition

Signs

Aetiology

Treatment

Possible complications

9.17 Deep digital sepsis

Definition

Signs

Aetiology

Treatment

9.18 Digit amputation

Indications

Preparation

Possible techniques

Aftercare

Possible complications

Advantages of digit amputation

Disadvantages of digit amputation

Alternative amputation techniques

9.19 Resection of flexor tendon

Indication

Technique

9.20 Digit-sparing techniques: curettage and arthrodesis of distal interphalangeal joint

Indications

Techniques

Recommended procedure (technique iv)

Variations

After-care and possible complications

9.21 Osteomyelitis

Introduction

Signs

Treatment and prognosis

9.22 Infectious arthritis (`joint ill´) of calves

Introduction

Signs

Treatment and prognosis

9.23 Antibiotic therapy of bone and joint infections

Management

Surgery

9.24 Contracted flexor tendons

Introduction

Signs

Treatment

Surgery

9.25 Tarsal and carpal hygroma

Synonyms

Definition

Signs

Treatment and prophylaxis

9.26 Patellar luxation

Dorsal patellar luxation or fixation

Signs

Treatment

Possible complications

Lateral patellar luxation

Signs

Treatment

Medial patellar luxation

Signs

Treatment

9.27 Spastic paresis

Introduction

Signs

Aetiology

Treatment

Possible complications

9.28 Hip luxation

Introduction

Signs

Treatment

Craniodorsal dislocation

Dislocation in other directions (see Figure 9.34)

9.29 Stifle lameness

Introduction

Signs and gross pathology of traumatic gonitis

Treatment

9.30 Nerve paralysis of limbs

Crushed tail head syndrome

9.31 Tail amputation

Indications

Treatment

9.32 Limb fractures

Introduction

Long bone fractures

Signs

Treatment

Common problems of bovine long bone fractures

Physeal separation (Salter-Harris fracture)

Introduction

Signs and treatment

Appendix

Further Reading

Abbreviations

Conversion factors for old and SI units

Index

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