Repro2- Equine Repro Surgery
Card Set Information
Repro2- Equine Repro Surgery
The perineum region is bounded by the... (3)
tailhead, semimembranous muscles, ventral commissure of vulva
The vestibule-tubular tract is from the _________ to the __________, over the _________.
vulvar labia; transverse fold; external urethral orifice
The vagina is the tract from the __________ to the _________ around the ___________.
transverse fold; vaginal fornix; cervix
Functional barriers of the perineal anatomy: (3)
labia of vulva, vestibular sphincter, cervix
What is the vestibular sphincter formed by? (3)
pelvis floor, constrictor vestibuli m., pillars of hymen
Muscular body containing both the constrictor vulvae mmm. and anal sphincter mm.
___________ results in a cranial pull on the perineum.
The sphincter is just __________ to the __________.
cranial; transverse fold of the urethra
Describe Caslick's surgery.
trim off muco-cutaneous junction top 50% of vulva(not too much!)
simple continuous closure top 50% of vulva
What is the purpose of a Caslick's surgery?
to fix mild conformational abnormalities and prevent contamination of the uterine environment
What is the post-op care for Caslick's surgery?
remove/cut open before natural cover breeding or foaling!
What is the Gadd procedure?
perineal body reconstruction
What is the goal of the Gadd procedure?
restore thickness and help the vestibulovaginal apparatus exclude debris and bacteria, prevent pneumo- and urovagina
The perineum is an ___________ with a right angle at the ___________ aspect; it is injured usually in _________ mares.
isosceles triangle; dorso-caudal; primiparous
Describe a primary perineal laceration/ RV tear.
vestibular and vaginal mucosa only
Describe a secondary perineal laceration/ RV tear.
injury involves mucosa, submucosa, and muscular layers of perineal body;
rectum NOT affected
Describe a tertiary perineal laceration/ RV tears.
tear through entire perineal body into rectum
What is the success and prognosis for RV repair surgery?
HIGH failure rate for surgery
(send to a good surgeon); if surgery is successful, return to reproduction is very good
What is post-op care of RV repair surgery?
alter diet so manure is soft, like a cow patty (hard fecal balls will tear through), NSAIDs, TMS
With a fresh tertiary RV tear, what should you do?
give mare NSAIDs and TMS for ~7 days, and wait 60 days to repair (need scar tissue to place sutures that will actually hold)
Describe the closure of a RV tear repair. (4)
no tension, evert rectal/anal mucosa into rectum, evert vaginal/vestibular mucosa, 6 bite technique
Goal of RV tear repair surgery?
to re-establish rectal shelf and perineal body thickness
What is the first critical step of RV tear repair surgery?
dissecting in horizontal plane to free up scar from lateral walls of vagina/vestibule to reduce tension when pulling sides of shelf together
Possible complications of surgery to repair RV tear? (3)
constipation, fistula formation, dehiscence
When should you repair a cervical laceration?
make cow or mare prove she cannot conceive first- short external os tears may do OK without surgery;
ALWAYS repair mid-body cervical tears
Reasons for ovariectomy? (2)
4 ovariectomy procedures?
colpotomy, laparotomy, ventral midline celiotomy, oblique paramedian celiotomy
What is an extremely important detail of performing a colpotomy?
go in at 1 o'clock!!!!!
if you going in a 3 o'clock you'll cause the horse to bleed out
What are requirements for laparoscopy approach to ovariectomy? (2)
removal of normal ovaries or tumors <20cm
What is the only muscle you have to divide when performing ovariectomy ventral oblique paramedian approach?
Indications for C-section. (4)
malpresentation (true breech, schistosoma), existing trauma, dried out uterus, foal too large
What is the goal of C-section?
preserve mare's reproductive capacity
How do you diagnose uterine rupture? (7)
fever, endotoxemia, mild colic, abdominal US,
, intra-uterine palpation, infuse dye IV then tap
Why would you perform a total hysterectomy in a mare?
Why would do do a partial hysterectomy?
to restore fertility; masses interfering with normal uterine clearance
Urine pooling occurs when there is...
cranial slope to vagina or damage to vaginal, causing urine to flow cranially.
How do you repair a urine pooling mare?
urethral extension surgery
What are mare repro surgeries that you can do in practice? What should you refer?
: Caslick's, perineal body reconstruction, ovariectomy via colpotomy
: third degree perineal lacerations, urethral extensions, ovarian tumor removal
At what age can colts be castrated?
Will castration alter a colt's behavior?
yes if you castrate them young enough... wait too long, maybe not
When can you turn a horse out with the mares after his castration?
in 1 week
make sure both testicles are descended
What should you NOT do if you only find one testicle?
DO NOT remove descended testicle if you can't find the other testicle
With regard to the testicles, the _________ descends first; this can be a problem because...
epididymis; if you castrate early and only remove the epididymis, they will be proud cut (testicle produced testosterone).
What is usually the only circumstance under which you do an open castration?
older stallions with large testicles/cord... bleeding risk
Describe semi-closed castration.
open the tunic partially just to make sure you have the testicle, and not just the epididymis
What is the purpose of transfixation after castration?
greatly reduces the risk of evisceration
What's the biggest risk associated with transfixation after castration?
increased infection- scirrhous cord
What is imperative before performing a standing castration?
local anesthetic directly into scrotum and testicles (some people say block into the cord- don't listen to them!)
Equine castration complications. (4)
excessive edema, infection, excessive hemorrhage, eventration
Protrusion of abdominal organs through the abdominal wall.
How do you prevent a horse from swelling after castration?
, stretch incision so it can drain
What should you do if there is excess hemorrhage after castration?
(not 4X4...you won't find them) and clamp scrotum--> remove the next day and
How is scirrhous cord fixed?
surgery at a REFERRAL HOSPITAL
Risk factors for eventration? (4)
older horses, breeds predisposed (draft horses), palpably enlarged inguinal rings, closed vs open (??)
How do you handle an eventration after castration?
if not severe compromised- lavage, replace in abdomen, suture scrotum, send to referral
if severely compromised- lavage, wrap in damp towel, send to referral
Testis and epididymis are in abdomen, near the kidney or b/w kidney and inguinal ring.
complete abdominal retention
Epididymis enter the inguinal canal, but testis remains within the abdominal cavity.
incomplete abdominal retention
Testis b/w internal and external inguinal rings- canicular.
How do you diagnose cryptochidism? (4)
palpation/ US, testosterone, conjugated estrogen, hCG stim
What does "proud cut" mean?
left an abdominal testicle inside
Should you fix a retained testicle in the field?
only if you're pretty sure you can feel it in the inguinal ring; send abdominal retention to a referral hospital
Crytorchidectomy techniques. (5)
inguinal, para-inguinal, flank, paramedian/ventral midline, laparoscopy
Scrotal hernia in adults.
bowel w/i vaginal tunic around testicle--> testicular enlargement + colic
Inguinal rupture in foals.
bowel w/i subcutaneous space--> non-reducible swelling +/- colic
What is paraphimosis?
cannot retract the penis back into the sheath
What is priapism?
erection that won't go down- fix quickly before it clots
How do you treat priapism? (3)
anticholinergics, lavage, phallectomy (at referral) if severe damage
How do you treat paraphimosis? (3)
replace, sling, phallectomy (referral) if severe damage