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Large Animal Surgery

Large Animal Surgery. Equine Respiratory Sx Guttural Pouch Diseases. Amy Fayette November 2005. What are the indications for surgery. Exercise intolerance Poor performance Abnormal resp noise Mucopurulent nasal discharge Serosanguineous nasal discharge

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Large Animal Surgery

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  1. Large Animal Surgery Equine Respiratory Sx Guttural Pouch Diseases Amy Fayette November 2005

  2. What are the indications for surgery • Exercise intolerance • Poor performance • Abnormal resp noise • Mucopurulent nasal discharge • Serosanguineous nasal discharge • External distortion of facial region

  3. What is the most common respiratory tract diagnostic technique • Endoscopy

  4. What is your diagnosis for this soft fluctuant mass • Epidermal inclusion cyst

  5. How can you treat an epidermal inclusion cyst • Aspiration or surgery

  6. What is the problem with using aspiration • Recurrence

  7. What kind of noise is expected with redundant alar folds • Expiratory

  8. How do you diagnose redundant alar folds • Place large temporary mattress sutures and see if the noise disappears

  9. What is the treatment for redundant alar folds • Surgery

  10. What is the most common complication of surgery for redundant alar folds • Highly vascular-> hemorrhage

  11. How can you help to decrease the hemorrhage produced by this procedure • Large carmalts • Ice cold saline

  12. What is your diagnosis • Wry nose

  13. What are the clinical signs of diseases of the nasal septum • Decreased or complete obstruction • Stridor • Discharge • Facial distortion

  14. What are the preop considerations before operating on the nasal septum • Collect 4-8 L of blood • Tracheotomy

  15. What is the aftercare required for surgery of the nasal septum • 5-6 days systemic ATBs • 10 days NSAIDS • Remove packing 2 days post op • Remove tracheostomy tube • Clean and flush with saline

  16. What is your diagnosis • Ethmoid hematoma

  17. What are the CS of progressive ethmoid hematomas • Epistaxis • Serosanguinous nasal exudate • Stridor

  18. What is the suspected cause of ethmoid hematomas • Nasal gastric tubing

  19. What is this instrument • Funnel screw

  20. What is this instrument • Trephine

  21. What is the main post op complication for surgical removal of ethmoid hematomas • Hemorrhage

  22. What is an ethmoid hematoma made up of on histopath • Outer: resp epithelium • Central: hemosiderin-filled macrophages

  23. What is an alternative treatment for ethmoid hematomas • Chemical ablation with formalin

  24. What is the cause of primary sinusitis • UR tract infection

  25. What is the causes of secondary sinusitis • Dental disease • Facial fx • Cysts • Neoplasia

  26. What are the CS of sinusitis • Nasal discharge: serosanguineous • Coughing • Facial deformity

  27. What is the treatment for sinusitis • Sinusotomy (trephination)

  28. What is the aftercare instructions for sinusotomy • Leave open and flush daily • ATB and NSAIDS

  29. What is the prognosis for sinusitis after sinusotomy • Good-excellent

  30. What is this instrument • Cribbing strap

  31. What is cribbing • Grasp object with incisors • Contract neck muscles • Pull backward

  32. What is another name for cribbing • Windsucker

  33. What are the causes of cribbing • Boredom • Confinement • Isolation • Lack of roughage • Learn from others?? • Genetic??

  34. What are the consequences of cribbing • Colic ?? • Abnormal wear of incisors • Weight loss

  35. What are some non surgical treatments for cribbing • Remove fixed objects • Bitter tasting substances • Cribbing straps • Acupuncture • Shock- aversion • Naloxon

  36. What is the possible surgical treatments for cribbing • Removal of sternomandibularis, sternothyroideus, omohyoideus • Neurectomy of the ventral branch of accessory nerve

  37. What aftercare should be followed after surgery for cribbing • ATB and NSAIDS • Change the environment

  38. What dose of NSAIDS should be given • Should be a bit painful if they try to repeat the behavior so low doses

  39. What is the most common cause of noise • Recurrent laryngeal hemiplegia

  40. What is Recurrent laryngeal hemiplegia • Progresive neurogenic atrophy of the recurrent laryngeal nerve

  41. What is the signalment for Recurrent laryngeal hemiplegia • 1-10 years old • Large breed horses • Hereditary

  42. What causes Recurrent laryngeal hemiplegia • Perivascular injection • Guttural pouch mycosis • Trauma • Strangles • OP toxicity • Plant poisoning • Lead toxicity • CNS disease

  43. What is the typical history for Recurrent laryngeal hemiplegia • Noise • Exercise intolerance

  44. How is Recurrent laryngeal hemiplegia diagnosed • Palpation • Slap test • Endoscopy during treadmill exercise

  45. What is the slap test • Slap withers during endoscopy • Observe adduction of the contralateral arytenoid cartilage

  46. What is the most common surgical treatment for recurrent laryngeal hemiplegia • Laryngoplasty (Tie back)

  47. What are some potential complications with the tie back procedure • Seroma • Cough • Dysphagia

  48. What should be done if an animal is coughing following tieback • Remove sutures

  49. How can you decrease dysphagia after tie back • Feed off the ground

  50. What other surgical procedures can be performed for recurrent laryngeal hemiplegia • Ventriculectomy • Reinervation of cricoarytenoid muscle • Arytenoidectomy

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