Caesarean section : The cow

1. Indication physical immaturity of the mother Failure of the uterine cervix fully to dilate Irreducible uterine torsion Preparturient recumbency acute reticuloperitonitis orpericarditis Shistosoma reflexus gross oversize of the fetus Pregnancy toxaemia gross swelling of the vagina and vulva Irreducible mal-presentation hydroallantois , hydrammnios mummified foetus Others diseases and complication Caesarean section : The cow

2. Position of the cow and operative site • Left paralumbar or Upper left flank approaches • Upper right flank laparotomy • Ventral midline approach or paramedian approach • Ventrolateral oblique approach

6. Caesarean section • Left flank • Standing • No omentum, intestine • Reduce shock • Good healing Disadvantage • More assistants • Recumbency • Fetal Delivery

7. Caesarean section • Right flank • Oversize fatal • Standing • Small incision • One assitant • Disadvantage • Omentum & intestinal • Restraint & infection

8. Caesarean section • Ventral midline or paramedian • Emphysema fetal • Easy to find uterine horn • Abnormally uterine content • Disadvantage • Intestine • Lateral recumbency

9. Caesarean section • Ventrolateral oblique approach • lateral recumbency • Vessels Disadvantage • Long incision • Hernia

11. Fetotomy

12. Fetotomy • Embryotomy • Dividing foetus into small pieces • Dead feotus • Common in cattle • Techniques • Percutaneous • Subcutaneoues

13. Indications • Fetal maldisposition • Fetopelvic disproportion • Obstruction by hip-lock • Caesarean section • Fetotomny only in feotal dead • Caesarean section in foetal alive

14. Fetotomy equipment • Tubular embryotome • Fetotomy wire • Handles for wire • Handle for embryotome • Screw to tighten handle • Introducer • Threader • Cleaning brush

16. Fetotomy • Partial or complete • Assistant • Restraint • Skills • Technique • Anterior presentation Head-> forelegs-> thorax-> pelvis-> • Posterior presentation Hind limbs -> body -> forelegs

19. Partial fetotomy • Deviation of the neck • Shoulder flexion • Bilateral hip flexion (Breech presentation) • Hock flexion • Fetal monsters

20. Hip flexion

21. Hock flexion

22. Dystocia in the mare • Incidence less than cattle • 4 % in Thoroughbred • Common in Shetland ponies Causes of dystocia - Anterior presentation - Posterior presentation - Transverse presentation

23. Specific causes of equine dyctocia • Uterine inertia • Bony tissue obstruction • Soft tissue obstruction • Uterine torsion • Downward deviation of the uterus • Fetal monster • Malpresentation • Malposition • Malposture

25. Dorsotransverse position

28. Dystocia in the sow • Incidence 0.25-1.0 % • Gilts or old sows • Welsh gilts -> small pelvis • Large white -> uterine inertia

29. Causes of dystocia • Uterine inertia 37 % • Obstruction of the birth canal 13 % • Deviation of the uterus 9.5 % • Maternal excitement 3 % • Fetal maldisposition 33.5 % • Fetopelvic disproportion 4 %

30. Uterine inertia • Primary uterine inertia 20 % • stillborn • Secondary uterine inertia 49 % • Idiopathic uterine inertia 31 % • Fat sows • Calcium Treatments : oxytocin

31. Obstruction of the birth canal • Bony tissue abnormality • Soft tissue abnormality • Distension of the urinary bladder • Vulval abnormalities • Persistent hymen • Non-dilation of the cervix • Obstruction of the uterine lumen • Downward deviation of the uterus

34. Maternal excitement • Gilts • Delay or inhibit the farrowing process • Late movement • Innate nervousness Treatments : azaperone IM 2 mg/kg oxytocin 20 IU

35. Signs of dyctocia • Discharge and placenta at the vulva • Signs of imminent but no farrowing • Straining but no piglets • Premature cessation of labour • Prolonged farrowing >½-4 hrs. (2.5 hrs.) • Placenta

40. Dystocia in the dog and cat • Incidence cat lower than dog • Exotic breed • Causes • Uterine inertia 36 % • Fetopelvic disproportion 22 % • Fetal maldisposition 11 % • Abnormalities of birth canal 9 % • Other causes 22 %

41. Failure of the expulsive forces • Primary uterine inertia • Scottish terrier • Single pup syndrome and single kitten • Hysteria  Cocker spaniels • Secondary uterine inertia • Abdominal muscle tone -> old or fat animals

42. Obstruction of the birth canal • Bony abnormalities - pelvic fracture -> accidents - Scottish terrier - Brachycephalic toy breeds • Soft tissue abnormalities • Deviation of uterus  Boxer • Torsion of uterus

43. Fetal maldisposition • Posterior presentation • normal whelping 40 % • Bilateral hip flexion • Deviation of the head • Long neck  Collies • Long head  Sealyham and Scottish terrier

44. Fetopelvic disproportion • Small breed • Low litter size • Yorkshire terrier Fetal monster - hydrocephalus - Anasarca - Conjoined twins

45. Diagnosis • Examination of genital system • Inspection of vulva • Vaginal examination • Abdominal palpation • Abdominal auscultation/ Ultrasound • X-rays

50. Treatment of dystocia • Ecbolic therapy • oxytocin 2-5 IU IM 20-30 minutes • Calcium borogluconate 10% 5-15 ml slow IV • Assisted delivery of the fetus • Episiotomy • Manual delivery • Forceps delivery