caesarean section : the cow indication indication –physical immaturity of the mother –failure of...
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Caesarean section : The Caesarean section : The cowcow
IndicationIndication– physical immaturity of the mother physical immaturity of the mother – Failure of the uterine cervix fully to Failure of the uterine cervix fully to
dilatedilate– Irreducible uterine torsion Irreducible uterine torsion – Preparturient recumbency Preparturient recumbency – acute reticuloperitonitis oracute reticuloperitonitis or pericarditis pericarditis – Shistosoma reflexusShistosoma reflexus – gross oversize of the fetus gross oversize of the fetus – Pregnancy toxaemia Pregnancy toxaemia – gross swelling of the vagina and vulva gross swelling of the vagina and vulva – Irreducible mal-presentation Irreducible mal-presentation – hydroallantois , hydrammnios hydroallantois , hydrammnios – mummified foetus mummified foetus – Others diseases and complicationOthers diseases and complication
Position of the cow and Position of the cow and operative siteoperative site
Left paralumbar or Upper Left paralumbar or Upper left flank approachesleft flank approaches
Upper right flank laparotomy Upper right flank laparotomy Ventral midline approach or Ventral midline approach or
paramedian approach paramedian approach Ventrolateral oblique Ventrolateral oblique
approach approach
Caesarean sectionCaesarean section
Left flank Left flank – StandingStanding– No omentum, intestineNo omentum, intestine– Reduce shockReduce shock– Good healingGood healing
Disadvantage Disadvantage More assistantsMore assistants Recumbency Recumbency Fetal DeliveryFetal Delivery
Caesarean sectionCaesarean section
Right flank Right flank – Oversize fatalOversize fatal– StandingStanding– Small incisionSmall incision– One assitantOne assitant
– DisadvantageDisadvantage Omentum & intestinalOmentum & intestinal Restraint & infectionRestraint & infection
Caesarean sectionCaesarean section
Ventral midline or paramedianVentral midline or paramedian– Emphysema fetalEmphysema fetal– Easy to find uterine hornEasy to find uterine horn– Abnormally uterine content Abnormally uterine content
– DisadvantageDisadvantage IntestineIntestine Lateral recumbencyLateral recumbency
Caesarean sectionCaesarean section
Ventrolateral oblique approachVentrolateral oblique approach– lateral recumbency lateral recumbency – Vessels Vessels
DisadvantageDisadvantage Long incisionLong incision Hernia Hernia
Fetotomy Fetotomy
EmbryotomyEmbryotomy Dividing foetus into small piecesDividing foetus into small pieces Dead feotusDead feotus Common in cattleCommon in cattle TechniquesTechniques
– PercutaneousPercutaneous– Subcutaneoues Subcutaneoues
IndicationsIndications
Fetal maldispositionFetal maldisposition Fetopelvic disproportion Fetopelvic disproportion Obstruction by hip-lockObstruction by hip-lock Caesarean section Caesarean section
– Fetotomny only in feotal Fetotomny only in feotal deaddead
– Caesarean section in Caesarean section in foetal alivefoetal alive
Fetotomy equipmentFetotomy equipment
Tubular embryotomeTubular embryotome Fetotomy wireFetotomy wire Handles for wireHandles for wire Handle for embryotomeHandle for embryotome Screw to tighten handleScrew to tighten handle Introducer Introducer ThreaderThreader Cleaning brush Cleaning brush
FetotomyFetotomy
Partial or completePartial or complete AssistantAssistant Restraint Restraint SkillsSkills TechniqueTechnique
– Anterior presentationAnterior presentationHead-> forelegs-> thorax-> pelvis-Head-> forelegs-> thorax-> pelvis-
>>– Posterior presentationPosterior presentation
Hind limbs -> body -> forelegsHind limbs -> body -> forelegs
Partial fetotomyPartial fetotomy
Deviation of the neckDeviation of the neck Shoulder flexionShoulder flexion Bilateral hip flexion (Breech Bilateral hip flexion (Breech
presentation)presentation) Hock flexionHock flexion Fetal monstersFetal monsters
Dystocia in the mareDystocia in the mare
Incidence less than cattleIncidence less than cattle 4 % in Thoroughbred 4 % in Thoroughbred Common in Shetland poniesCommon in Shetland ponies
Causes of dystociaCauses of dystocia- Anterior presentation- Anterior presentation- Posterior presentation- Posterior presentation- Transverse presentation- Transverse presentation
Specific causes of equine Specific causes of equine dyctociadyctocia
Uterine inertiaUterine inertia Bony tissue obstructionBony tissue obstruction Soft tissue obstruction Soft tissue obstruction Uterine torsionUterine torsion Downward deviation of the uterusDownward deviation of the uterus Fetal monsterFetal monster MalpresentationMalpresentation MalpositionMalposition MalpostureMalposture
Dystocia in the sowDystocia in the sow
Incidence 0.25-1.0 %Incidence 0.25-1.0 % Gilts or old sowsGilts or old sows Welsh gilts -> small pelvisWelsh gilts -> small pelvis Large white -> uterine inertiaLarge white -> uterine inertia
Causes of dystociaCauses of dystocia
Uterine inertia Uterine inertia 37 %37 % Obstruction of the birth canalObstruction of the birth canal 13 %13 % Deviation of the uterusDeviation of the uterus
9.5 %9.5 % Maternal excitementMaternal excitement 3 %3 % Fetal maldispositionFetal maldisposition 33.5 33.5
%% Fetopelvic disproportionFetopelvic disproportion 4 %4 %
Uterine inertiaUterine inertia
Primary uterine inertiaPrimary uterine inertia 20 %20 %– stillbornstillborn
Secondary uterine inertiaSecondary uterine inertia 49 %49 %
Idiopathic uterine inertiaIdiopathic uterine inertia 31 %31 %– Fat sowsFat sows– Calcium Calcium
Treatments : oxytocinTreatments : oxytocin
Obstruction of the birth Obstruction of the birth canalcanal
Bony tissue abnormalityBony tissue abnormality Soft tissue abnormalitySoft tissue abnormality
– Distension of the urinary bladderDistension of the urinary bladder– Vulval abnormalitiesVulval abnormalities– Persistent hymenPersistent hymen– Non-dilation of the cervixNon-dilation of the cervix– Obstruction of the uterine lumenObstruction of the uterine lumen– Downward deviation of the uterusDownward deviation of the uterus
Maternal excitementMaternal excitement
Gilts Gilts Delay or inhibit the farrowing processDelay or inhibit the farrowing process Late movementLate movement Innate nervousnessInnate nervousness
Treatments : azaperone IM 2 mg/kgTreatments : azaperone IM 2 mg/kg
oxytocin 20 IUoxytocin 20 IU
Signs of dyctociaSigns of dyctocia
Discharge and placenta at the vulvaDischarge and placenta at the vulva Signs of imminent but no farrowingSigns of imminent but no farrowing Straining but no pigletsStraining but no piglets Premature cessation of labourPremature cessation of labour Prolonged farrowing >½-4 hrs. (2.5 Prolonged farrowing >½-4 hrs. (2.5
hrs.)hrs.) Placenta Placenta
Dystocia in the dog and catDystocia in the dog and cat
Incidence cat lower than dog Incidence cat lower than dog Exotic breedExotic breed Causes Causes
Uterine inertiaUterine inertia 36 %36 % Fetopelvic disproportionFetopelvic disproportion 22 %22 % Fetal maldispositionFetal maldisposition 11 %11 % Abnormalities of birth canalAbnormalities of birth canal 9 %9 % Other causesOther causes 22 % 22 %
Failure of the expulsive Failure of the expulsive forcesforces
Primary uterine inertia Primary uterine inertia – Scottish terrierScottish terrier– Single pup syndrome and single kitten Single pup syndrome and single kitten – Hysteria Hysteria Cocker spaniels Cocker spaniels
Secondary uterine inertia Secondary uterine inertia – Abdominal muscle tone -> old or fat Abdominal muscle tone -> old or fat
animalsanimals
Obstruction of the birth Obstruction of the birth canalcanal
Bony abnormalitiesBony abnormalities
- pelvic fracture -> accidents- pelvic fracture -> accidents
- Scottish terrier- Scottish terrier
- Brachycephalic toy breeds- Brachycephalic toy breeds Soft tissue abnormalitiesSoft tissue abnormalities
– Deviation of uterus Deviation of uterus Boxer Boxer– Torsion of uterusTorsion of uterus
Fetal maldispositionFetal maldisposition
Posterior presentationPosterior presentation– normal whelping 40 %normal whelping 40 %– Bilateral hip flexion Bilateral hip flexion
Deviation of the headDeviation of the head– Long neck Long neck Collies Collies– Long head Long head Sealyham and Scottish Sealyham and Scottish
terrierterrier
Fetopelvic disproportionFetopelvic disproportion
Small breedSmall breed Low litter sizeLow litter size Yorkshire terrierYorkshire terrier
Fetal monsterFetal monster- hydrocephalus- hydrocephalus- Anasarca- Anasarca- Conjoined twins- Conjoined twins
DiagnosisDiagnosis
Examination of genital systemExamination of genital system– Inspection of vulvaInspection of vulva– Vaginal examinationVaginal examination– Abdominal palpationAbdominal palpation– Abdominal auscultation/ UltrasoundAbdominal auscultation/ Ultrasound– X-raysX-rays
Treatment of dystociaTreatment of dystocia
Ecbolic therapy Ecbolic therapy oxytocin 2-5 IU IMoxytocin 2-5 IU IM 20-30 minutes 20-30 minutes Calcium borogluconate 10% 5-15 ml slow IVCalcium borogluconate 10% 5-15 ml slow IV
Assisted delivery of the fetus Assisted delivery of the fetus – EpisiotomyEpisiotomy
Manual deliveryManual delivery Forceps delivery Forceps delivery