Handling of Dystocia in Animals by Cesarean Section
Handling of Dystocia in Animals by Cesarean Section
Handling of Dystocia in Animals by Cesarean Section
by CESAREAN SECTION”
Assignment on a course: Advanced Veterinary
Obstetrics( VOG-7112 )
Submitted by: Kiflie Dereje Ayele; Mar.,2023
Type of study area: Masters of veterinary in “
Veterinary Obstetrics and Gynecology”
Year of study: First year ,First semester.
Academic institution: University of Gondar ,
college of Veterinary Medicine & Animal Sciences.
SECTION
Figure-6: (A)
incision sites in
sow (B )
incision sites in
sheep
VI. Factors in selection of
Surgical Approaches
1. Exteriorization of the uterus
➢ Labour power to carry and pull out large fetus
➢ Risk of contamination by dead emphysematous fetus
2. Inability(cow)to stand throughout the procedure
3. Risk of herniation or evisceration
4. Closure: easy/difficult due muscle tension
5. Risk of bloat or aspiration pneumonia
6. Restraints needed
7. The rumen aids in retaining the abdominal viscera
8. Cosmetic incision
It is important to EXTERIORIZE the
uterus , held remain outside by an
assistant or uterine forceps.
This is to limit the contamination
of the peritoneal cavity with
uterine contents (especially by
dead fetus)
Incisions on Uterus be:
a) On the greater curvature . Distant from either the cervix or apex of
the horn. From either the metatarsus or metacarpus to the hoof is
sufficiently long to permit extraction of the calf.
b) Between caruncles (to avoid bleeding). Bleeding of large vessels be
ligated. Remove Fetal membranes at the time of surgery.
c) Layers Suturing
➢ Uterus: Continuous inverting patterns of either (a)double row
lambert (b)double row cushing pattern(Figure-8) (c)continuous
locking or Ford interlocking (Figure-7&9)
➢ Peritoneum: simple continuous pattern(Figure-10).
➢ Abdominal muscles: continuous lock (Figure-7&9) or horizontal
interrupted(Figure-12).
➢ Chromium cat gut(Uterus , Peritoneum & Abdominal muscles)
➢ Skin: simple interrupted (Figure-14) or horizontal interrupted
(Figure-12) using nylon sutures
➢ Infuse penstrep b/n the suture layers.
Figure-7:
continuous interlock
sutured uterus
Figure-16
(C) Recumbent Paralumbars Approaches:
a) Recumbent left paralumbar laparotomy (RLPL)
b) Recumbent right paralumbar laparotomy(RRPL)
Compared with standings:
➢ Exteriorization is more difficult
➢ Closure is more difficult
➢ Alternative to standing laparatomy
➢ Same Layers to standing laparatomy
(D) Recumbent Ventrals Approaches:
a) Recumbent ventral midline celiotomy(RVMLC)
b) Recumbent ventral paramedian laparatomy(RVPML)
c) Recumbent Ventrolateral laparatomy(RVLL)
Compared With Standing & Recumbent Laparatomys:
Indicated:
▪ Excellent exteriorization
▪ Incision is not visible in a standing cow(Cosmetic incision)
Contraindicated:
▪ Wound infection due to ventral incision location
▪ Herniation/evisceration due to ventral incision location
▪ A three-layer closure is a must(by an everting interrupted
horizontal mattress pattern)
Layers Incised
▪ Layers(RVPML & RVLL):skin, the external and internal rectus
abdominis muscle ,peritonium , omentum and uterus.
▪ Layers(RVMLC):skin, linea-alba,peritonium,omentum and
uterus
VIII.Pre-operative Procedures
A. Restraints
B. Equipments
C. Surgical field preparations
D. Drugs
A. Restraints: crush/chute & rope and sedatives. Avoid Sedation,
if necessary , xylazine – IM or IV (0.05-0.1 mg/kg)
B. Equipments(sterile): scalpel blade & handle,scissors
,foreceps, needle(suturing & treatment), suturing material
(absorbale & non-absorbable),gauze ,glove ,plastic sleeve,etc.
C. Surgical field:
➢ Washed & shaved: In flank incision from transverse processes to
milk vein and from last rib to tuber-coxae.
➢ Apply 7.5% povidone-iodine.
➢ Sterile drapes should be applied etc.
D. Drugs
1) NSAIDs/analgesics
2) Antibiotics: Recommended if any vaginal manipulation or
prolonged dystocia , due the cervix is open and uterine
fluids are contaminated. Timing is important to ensure the
drugs are at high concentrations at the time of surgery .
3. Anesthesia Locale(Types of Local Nerve blocks): a
line or inverted-L is required for an oblique incision as the
paravertebral will not cover the ventral aspect. all the
following are reasonable options:
i. Epidural
ii. paravertebral block
▪ Proximal paravertebral block
▪ Distal paravertebral block
iii. Inverted-L block or line block
i. Epidural: can help minimize straining if the cow is actively in
labor. Use 2-8 mg/kg BW or 5 ml of 2% lidocaine , in the
sacrococcygeal space (the most movable space when the tail is
pumped up and down). A 1.5″ 18 gauge needle is inserted in
that space at a 45o angle toward the tail.
ii. Paravertebral anesthesia(Figure-17&18):
▪ Proximal paravertebral block: For this block, the spinal nerves
T13, L1 and L2 are blocked directly as they exit the spinal cord. At
each site, ~20 ml of lidocaine is injected. A 1.5″ 18 gauge Needles
are inserted above the transverse processes T13, L1 and L2 and
walked off the dorsal margin of each bone.
▪ Distal paravertebral block: This block is also aimed at spinal
nerves T13, L1 and L2 but is coming at them from a more distal
position. As the nerves traverse caudally, the injection sites are at
the tips of L1, L2 and L3. At each site, 10-20 ml is injected.
Figure-17
Figure-18