Porcine Management and Surgical Procedures Dr. Dipa Brahmbhatt VMD MPH MS

1. Chapter 23 and 24 Porcine Management and Surgical Procedures Dr. Dipa Brahmbhatt VMD MPH MS

2. Objectives Piglet management Prepare the surgical patient for surgery. Perform local anesthesia, or assist the veterinarian in administering local anesthesia. Assist or perform induction and maintenance anesthesia. Provide anesthetic monitoring. Manage patient recovery and immediate postoperative care. Discuss the basic risks and possible complications associated with anesthesia and surgery. Implement preventive measures when indicated.

3. Reading Assignment Chapter 23, 24: Porcine Surgery

4. Piglet Diseases • Frequently observe pigs for signs of disease so prompt treatment is possible • congenital defect seen is herniation (2%), followed by cryptorchidism (1-2%

5. Diarrhea (scours) and dehydration A dehydrated piglet Diarrhea (scours) Normal, bright yellow, solid fecal material

6. E. coli • Should affect < 3% of litters • Mostly 1-5 days of age • Main defense -Antibiotics in milk • Treat entire litter with antibiotics -Gentamicin -Spectinomycin • Access to water

7. Difficulty walking and standing,trembling or comatose • Hypoglycemia -Low blood sugar • Streptococcus suis -Strep suis -Strep meningitis Swollen hock joint

8. Swollen joints • Bacterial infection • Identify/treat early • -Penicillin • Severely swollen • -Treatment ineffective • -Euthanize

9. Other conditions Vomiting Rough hair coat, sluggishness, huddling

10. Greasy, Sticky and Dirty Skin • Staphylococcus hyicus invades skin • Antibiotic therapy when symptoms appear • Wash piglet; treat topically • Minimize cuts in skin and dirty equipment

11. Management • Day of Birth: clip needle teeth • Day 1: dock tails • Day 2: castrate • Piglets should not be removed from the sow longer than 1 hour

12. Neonatal care and procedures • PE • eyes closed calms the piglet

13. Neonatal care and procedures • injection of iron (usually iron dextran: 150-200mg) IM • Piglet's own reserves and the mother's milk together supply enough iron for only a week before the piglet becomes anemic • Naturally from eating soil and plants • Anemia: “baby pig thumps”: tachycardia • Give 1-3 days and 2-3 wks or oral supplementation creep feed • castrated, teeth and tails are clipped: 1-3 days

14. Iron injection • Within 3 to 4 days after birth. • Without supplemental • anemic by 7 days of age, • compromising their well being • retarding their growth • given when piglets are handled for other purposes e.g. vaccinations and removing sharp teeth. • Giving iron shots is an art. • Most people are never 100% accurate; ie. little or no backflow of the compound

15. Clinical signs of Anemia Lethargic: no energy, sleepy Rough hair coat Wrinkled skin Dyspnea: Hard breathing Poor growth Blood hemoglobin level: < 10 mg/dl

16. Iron injection • neck. • all air bubbles are out by holding the syringe vertically, tapping lightly and pushing the plunger.

17. Iron injection • skin taut by pulling the ear forward. • prick the skin, holding the syringe as shown. • Pull it up, then continue into the muscle. • Withdraw quickly, allowing skin to cover the site, preventing backflow

18. Lower (mandibular) permanent teeth of the pig. Note the large canine teeth or “tusks”

19. Clipping needle teeth • These teeth are popularly referred to as the canine teeth. • 8 needle teeth • I3 and C1

20. Clipping of Needle Teeth • Purpose • to prevent injury to littermates and to the sow’s teats • Complications • Tongue laceration • Stomatitis • Equipment • Needle tooth clippers or cutting pliers • Disinfect between piglets • Age : 1 to 7 days

21. Teeth clipping • above the gum line • Avoid the tongue and be sure to cut above the gums to prevent bleeding and infection. • the flat side of the of the nippers is placed parallel to the gum line • 1-2 mm from gum line

22. Tail docked • tend to bite the tails of litter mates • Infection/ abscess > paralysis • tails are docked (clipped) soon after birth • docking should be done during the first 24 hours after birth • minimize stress on the piglets • easily held • less likely to investigate a newly docked tail • Cartilage not hardened

23. Tail docked • Side clippers (dull)/ baby pig emasculators • Hold the pig by the hind feet and cut 1/2 to 1 inch from the ham. • avoids rectal prolapse • Leave a flap of skin and dip the stub in iodine

24. Lumbosacral Epidural Anesthesia C –section: Safe for fetus Cranial epidural: lidocaine 2% Location Connect wings of Ileum Vertical line from Patella insert 1 – 1.5 inches caudal to line on dorsal midline Sedate Restrain: hog snare Clip hair, skin aseptically prepared, 5 ml 2% lidocaine SQ 1-2 inches

25. Lumbosacral Epidural Anesthesia • Procedure: sterile gloves, 18 – 20G spinal needle, 3 inch: small swine and 100 kg – 4 inch, 200 kg – 5 to 7 inch. Use trocar if they bent. • Lidocaine: 0.5 – 1 ml/ 4.5 kg BW, max 20 ml • Anesthesia 5 – 10 min after injection • Max at 20 minutes and lasts for 2 hours • Low dose: caudal analgesia and high dose: cranially to lumbar 1 • Xylazine: 2 mg/kg: surgical anesthesia caudal to umbilicus and paralysis HL, begin 20 - 30 min and lasts for 2 – 3 hrs. • > 3mg/kg HL paresis • With 2% lidocaine lasts for 5 hours

26. General Anesthesia Valuable breeding stocks and valued pets

27. General Anesthesia • Risks • Hyperthermia • Do not efficiently sweat • Malignant hyperthermia • Under general anesthesia • halothane • fatal • Rare in potbellied pigs • Porcine stress syndrome • Halothane gene

28. General Anesthesia - RISKS Prone to hypoventilation  Airway obstruction Small narrow trachea: dorsal – pharyngeal recess Laryngospasm Spray lidocaine ET tube ventrally until arytenoid cartilage than 180⁰ turn dorsally Laryngeal edema Respiratory depression: Worse with obesity

29. Preanesthetic Preparation • Hx, PE, CBC if possible • Food withdrawn • Adults: 6 – 12 hours • Piglets: 1 – 3 hours • Atropine: 0.044 mg/kg IM • Caudal to base of ear

30. Induction Drugs: withdrawal time

31. Anesthesia Monitoring • HR: 50 – 150 bpm. • Pulse assessment: auricular and femoral artery • Fluids: 10 mg/kg/hr • Hyperthermia • MH > 107 ⁰F • d/c inhalant, 100% O2, cool body, DANTROLENE (2.2 mg/kg IV) – muscle relaxant, fluids with bicarb., steroids • > 103 ⁰F • Muscle rigidity • Tachycardia • Tachypnea • Metabolic acidosis • Ketamine: increase body temperature Figure 2. Top panel shows pig anesthetized with medications that do not trigger malignant hyperthermia (note relaxed rear legs). Bottom panel shows the same pig developing an MH reaction after receiving halothane. Please inspect the rigidly extended hind limbs. Modified with permission from Harrison GG. The Discovery of Malignant Hyperthermia in Pigs—Some Personal Recollections. Malignant Hyperthermia: A Genetic Membrane Disease (Ohnishi, ST and Ohnishi, T, eds) Boca Raton, FL: CRC Press, p. 32, 1994.

32. Anesthesia Recovery • Cool quiet environment • Extubate: strong attempts to swallow, deflate cuff • Ventilate • Prepare with tracheostomy • # 10 blade • Hemostats • Cuffed tracheostomy

33. References • K Holtgrew-Bohling , Large Animal Clinical Procedures for Veterinary Technicians, 2nd Edition, Mosby, 2012, ISBN: 97803223077323 • http://virtuavet.wordpress.com/ • http://edis.ifas.ufl.edu/an025

34. References • http://cal.vet.upenn.edu/projects/swine/bio/grow/nursing/hm.html • http://www.ncsu.edu/project/swine_extension/ncporkconf/2002/lay.htm • http://www.avma.org/issues/animal_welfare/default.asp