ATRESIA ANII IN CALF AND SURGICAL MANAGEMENT

Atresia ani (Imperforate anus) is a condition in which  an animal either has a very small opening or no anal opening at the time of birth due to a failure of the anal membrane to break down. 

Typical signs of intestinal atresia include decreased appetite, progressive bilateral abdominal distention, the absence of feces, episodes of straining to defecate, and occasionally, blood-tinges mucous can be found around the rectum

Treatment

Only treatment for  atresia ani  is the Surgical correction. This consists of  surgically opening the blind-ended sac ending at the rectum and suturing around the newly created orifice. Lower epidural anesthesia at C1- C2 (Inter-coccygeal ) junction with 1-1.5 ml lignocaine epidural can desensitize the perineum . Further infiltration at the surgical site of incision can ensure painless  surgical procedure.

Ventral recumbancy with raised hind quarters with tails stretched backwards helps in easy access to the surgical site. Anal reconstruction is done by using close interrupted sutures apposing skin and rectal mucosa.

In field level surgical corrections needs to be attempted at early stage for better success rates. In villages the farmers resort to many cruel corrections methods such as excising with knife , poking with nails and tearing the anus with sharp objects to create opening . The is extremely unscientific and can results in irreparable trauma to the animal. Recently I got this case of nearly one month old calf with atresia anii and the farmer poked the anus with a sharp stick . even though it relieved some meconium it has lead to severe proctitis and adhesion.

 The animal was having toxemia on presentation due to not passing dung for over 2 weeks. An emergency surgery followed by deliberate post-operative care saved the calf.

YOU CAN WATCH THE VIDEO 

CLINICAL VETERINARY SURGERY VIDEO SERIES- SURGICAL MANAGEMENT OF DEEP SEATED CHRONIC SUB MANDIBULAR ABSCESS IN A COW

Sub mandibular abscess is not uncommon in cows .Generally abscess get matured in due course of time .Hot fomentation, topical iodine preparation and poultice can hasten the abscess. Which discharges the contents as liquid pus. Pus matures through serous, sero-sanguine , mucous and liquefactive stages. Thick inspissated pus is a characteristic of chronic abscess . Sub-mandibular abscess can either open outside or inside oral cavity. Sub mandibular abscess can also lead to ranula and sub mandibular salivary gland infections. Chronic abscess can get fibrosed leading to hard circumscribed mass pressing the adnexa leading to pressure necrosis of vital structures. 

Surgical excision is indicated for chronic hard fibrosis induced  abscess which when left un attended can lead to functional impairment to the part involved.  

Standing surgeries can be challenging in field but the use of Xylazine Butorphanol Ketamine (XBK) combination at 0.05,0.25 and 0.1 mg/ kg bw gives excellent standing analgesia .Dose of xylazne can be further reduced to half and proportional variation with ketamine and butorphanol in pregnant cows .

PLEASE WATCH THE VIDEO OF A CASE OF CHRONIC DEEP SEATED SUB MANDIBULAR ABSCESS IN A COW.

PRINCIPLES OF BEHAVIORAL RESTRAINT AND PAINLESS INTRAMUSCULAR INJECTION IN CATTLE

In Veterinary Practice giving injection is our routine and many  times we find it difficult in giving a less pain shot to the patients who were already compromised with pain .Of all the three methods of restraints, Behavioral restraint is the most evolved , the most rewarding, the most challenging compared to physical and  chemical restraint. Equal co-operation is needed from both handler and the clinician to make an effective painless injection. 

When an animal is presented to a vet , it is already in a tensed state and in case of injuries the mental state of the animal will be totally critical. Above this a rough handling  can lead to severe response from the patients like biting, violent head tilt, kicking  and in some cases  serious injuries to the Vet/ animal handler or collapse of the animal because of violent physical restraint methods. Small manipulations can be effectively done using an effective behavioral restraints. I am sure you all will find this blog useful. Feel free to interacts with comments and suggestion as I believe I too am in an evolving stage.

Many literature are available on physical and chemical restraint of cattle , but hardly we get needed info on behavioral restraint. In this section I will try to cover some facts and findings that I gathered in my practice and effectively got excellent results  in many cases .

Principle of Olfaction :

Cattle can distinguish smell, they can detect pheromones, volatile chemicals that are important in reproduction and feed selection .Olfactory senses in cows are much more developed than in man. So they sense threat and danger by smelling the pheromones of the handler / other animals. Offering your hand in front of the cow gives the animal his/ her own freedom to sniff and this is a mutual introduction which is really rewarding.  By allowing the natural response  you are giving freedom to exhibit natural behavior  , which is in line with the principles of animal welfare.

Principle of Head restraint

By head restraint, we are trying to make the animal control by willful restraint from its side.  Gentle touching the fore head and then holding of the chin with gentle support of horn can be tried in docile animals. Please make it sure that the nose rope pulling doesn’t work in real sense . It evinces breath taking pain and kills the endorphin (The well being hormones which has even adverse effect on milk production in cows  as well ) Looking at the eyes and mutual glancing . I believe that the animals can sense your status  better. (Many wild life attacks are documented to happened because of faulty eye contacts ) Covering the eye lid gently and touching the fore head initiates submissive response in cattle

Principles of Vision. 

Eyes are the mirrors of our soul. So is with the animals too. The angle of vision is different in different species which makes our job so difficult and unique compared to the human doctor. With their eyes positioned on the side of the head, cattle have panoramic vision of 330° and binocular vision of 25°–50°, which allows for good predator awareness . Despite the wide set of their eyes, however, they do have a blind spot directly behind them 

The ears of cattle are very sensitive. Cattle can be calmed by playing soothing music, or stressed by loud noises such as yelling . Dairy breeds are more sensitive to sound and touch than beef breeds, high-pitched sounds, such as the whistle used to control most farm dogs, will increase the animals’ heart rates . Hearing in cattle is important in inter- and intra-species communication .

Cattle flight zones can vary greatly. Feedlot cattle may move away from people, especially strangers,entering their flight zone of 1.5m, whereas less handled range cattle have a flight zone of 30m  Cutaneous sensitivity can be used to calm cattle by scratching under the neck and behind the ears, areas they find difficult to access

Speak to the animal till before you touch and looking at the eyes you can see if the animal is tensed or in an attack mode . Aquaintance with the animal needs keen observation especially understanding his / her own field of vision and perceptions. Once this is clear we can  run our hand across the body and neck .

These steps are pre requesites before yo examine an animal. Once diagnosed and treatment fixed you have to treat with suitable injections

INTRA MUSCULAR INJECTIONS 

IM injections denotes INTRA MUSCULAR (within muscle mass)  and not INTERMUSCULAR(Between the bellies).If you give intermuscular shot it will act as a depot and not easily absorbed in the system and depending on the content of injection it can lead to abscess formation.

 Always  ensure that the needle is perpendicular to muscle mass. This helps in less injury and less neuralgia.There are different sites for giving I/M. but the best painless site is at the gluteus medius muscle ensuring no inury to the iliac vessels. Always ensure that the hub is tightly fixed on the syringe this prevents content spillage and embarrassment in front of the owner.

Depending on the content you can either give thorough post injection massage or not.

And always try to be as gentle and Firm rather than  rough and tough as even we would not tolerate a hard needle prick however beautiful the nurse who pricks.

YOU CAN WATCH THE VIDEO ON PRINCIPLES OF BEHAVIORAL RESTRAINT AND PAINLESS INTRAMUSCULAR INJECTION IN CATTLE.

THANKS FOR VISITING MY BLOG. YOU CAN COMMENT OR PUT YOUR QUERIES TO MY MAIL. I AM MORE THAN HAPPY TO HELP YOU TO HELP AN ANIMAL.

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CLINICAL VETERINARY SURGERY VIDEO SERIES- CESAREAN SECTION IN A PUG

Cesarean section (Hysterotomy) is a life saving operation for the mother and the foetus. The time of presentation of case is crucial in determining the success of the procedure. Hysterotomy is done on an emergency basis for cases of dystocia refractory to medical management.  Normal gestation period of dogs ae 62-65 days. In this case a 5 yr old Pug was presented with history of straining for past 18 hrs 
On laparotomy,the gravid uterus was exteriorised and  2 dead foetus of normal growth were removed from each horn. 

One foetus was seen blocking the body  resulting in the complete compression of the lumen and the birth canal .This could have been the cause of death for the rest of the pups.In this case the animal had crossed 69  days of gestation and 18 hours of intermittent straining complicated by a faulty blocking foetus at the body of the uterus  had resulted in death of foetuses.  This  emergency casarean section saved her life.

YOU CAN WATCH THE VIDEO

MODIFIED SCHRODER THOMAS SPLINT FOR MANAGING ULNAR FRACTURE IN DOG

SCHROEDER-THOMAS SPLINT
 

Wide variety of fracture fixation can be effectively done under field condition using  the Schroeder-Thomas splint in small animals. This was modified from  its use in humans to more adequately fit the shape and conformation of the limbs of animals. The splint itself is a traction device that has proved useful in the treatment of fractures in small animals.  The Schroeder-Thomas splint can be used to immobilize any fracture distal to the mid femur or mid humerus. It is also a useful device for immobilization of joints distal to and including the knee and distal to and including the elbow
CONSTRUCTION

The first important component for the splint is the upper ring, which encompasses the thigh or shoulder. It is important, to bend the ring in an approximately 450 angle and flatten the ring so that it will conform to the dog's body.     The frame of the splint is made of aluminum rods. Aluminium hangers can be straightened and can be effectively used.  This external frame should be sufficiently stiff that it will not bend and deform.  It is important not to hyperextend the dog's leg when making the measurement. This can be used in both fore limbs and hind limbs .I am very effectively using this in my daily practice.

A NOTE ON THE REAL SUFFERING BULLS IN INDIA

EVERY LIVING BEING HAS A STORY TO TELL.....

I thought of scribbling something on this gentle beasts of burden. I was fortunate enough to work with largest animal rights organisation, PETA for a couple of years. There I got a golden opportunity to work for those toiling souls on roads of Maharashtra.What astonishes me is the dead cruel attitude of the callous mind sets of course justified by many excuses of rituals , customs and tradition. 
YOKE GALL is a painful surgical condition affecting from over load. The cruel treatment devised by the animal handlers were putting more load to make the pus pocket "flat". I had witnessed a cardiac arrest in bullock due to over load.Lack of veterinary care is indeed a pain for the nation.

YOKE GALL- The pus pockets under subcutis

The most common working animal in India is the gentle bullock. Bullocks are forced to haul tons of loads often exceeding the legal weight limit. Pushed to their limit, bullocks often suffer from swollen joints, torn muscles and severe wounds. The huge lump on a bullock’s neck could be an infected yoke gall injury caused by an ill-fitting yoke. They struggle for many miles each day in extreme heat, often with no rest. They stumble on rutted dirt roads, and many become lame. An inadequate diet also takes its toll on bullocks. Bull races and bull fights are the most common ab(uses) of these animals in the country.  During bull races, bulls are deprived of food, water and shade; yanked by nose ropes; and forced to run by having their tails bitten and twisted, being struck and having irritants rubbed into their mouths. There is no end to human cruelty to this Shiva's "NANDI"

THE HEIGHT OF INSANITY- PAIRING DIFFERENT SPECIES TOGETHER 

Punishable offence under Section 11 (1) (a) Prevention of Cruelty to Animals Act, 1960

 

CLINICAL VETERINARY SURGERY VIDEOS- UROLITHIASIS IN A BULLOCK

A case of Urolithiasis in a 15 yr old Bull. He was struggling for past 4 days and was in critical condition. Before the bladder rupture, we could save him by an emergency urethrotomy and catheterisation.

Possible predisposing factors include:
• Excessive mineral intake, which can occur from highly mineralised artesian water or from high
concentrate diets.
• Ingestion of certain plants containing high levels of oxalate, oestrogens or silica.
• Diets high in magnesium.
• Increased presence of mucoprotein in the diet caused by feeding high concentrate low roughage rations,
pelleted rations, or rations high in phosphate.
• Concentrated urine, which is produced when there is no drinking water available or when water is of poor
quality. Water deprivation can be exacerbated by heavy fluid loss from in hot conditions.
• An imbalance in the calcium to phosphorus ratio of the diet.
SIGNS AND SYMPTOMS
Partial obstruction
Animals will probably be off feed, uncomfortable, stretching, and straining to urinate; but will only pass small
amounts of urine or dribble urine which may be blood-tinged.
Total obstruction
Symptoms are as above but more painful; animals may strain to urinate but are not able to pass any urine; and may have a ‘stretched out’ stance or go down.
Rupture of the urethra
The animal may seem more comfortable again for a while but will develop swelling under the skin of the belly; the sheath; under the tail; and will gradually deteriorate over a couple of days.Rupture of the bladder (water belly). The animal may seem more comfortable initially, but one to two days after the rupture its belly will start to fill up with urine and the animal will become depressed and weak; then it will go down and die fairly quickly.If there is an obstruction and it is not relieved, a bladder or urethral rupture will occur usually within 48 hours.
THE PRESENT CASE WAS A UNIQUE ONE WHICH HAD SURVIVED 72 HOURS OF OBSTRUCTION AND GOT SAVED BY URETHROSTOMY

CLINICAL VETERINARY VIDEO- CONGENITAL STRICTURE OF URETHRA WITH CHRONIC URINARY RETENTION IN A KID.

A case of Goat kid presented with chronic retention of urine resulted from stricture of urethra . There was a history of umbilical abscess and the animal was in severe distress . Penile reconstruction was successfully done in this case. 

CLINICAL VETERINARY SURGERY VIDEO- OVARIAN BURSAL ABSCESS IN A SPAYED BITCH

This is a case of Ovarian Bursa Abscess in a spayed bitch. It is a unique case as this was a result of faulty spaying. Stump Pyometra and ovarial bursal adhesion are the common consequences of retained ovary.
In this case the complications arised were multiple with extensive peritonitis from the history.The case was presented after 2 months of spaying from a govt hospital.

CLINICAL VETERINARY SURGERY VIDEOS - CYSTIC ENDOMETRITIS PYOMETRA COMPLEX IN A GREAT DANE BITCH

CYSTIC ENDOMETRITIS - PYOMETRA COMPLEX IN A GREAT DANE BITCH .
This case was referred by a field vet.

Canine pyometra is defined as a chronic purulent post estrum endometritis, with or without polysystemic effects. False/pseudo pregnancy, or pseudocyesis, is a normal physiologic process that occurs in female dogs which may or may not be  associated with reproductive organ  disorders which is seen 45-60 days after a normal estrous (heat) period when progesterone levels, which rise after ovulation, begin to fall . The progressive degenerative process in the development of cystic endometrial hyperplasia is usually proposed as the initiating lesion for pyometra in bitches; this is mediated by progesterone and potentially aggravated by estrogens. CEH is also associated with mucometra; it results from endometrial thickening with the accumulation of viscid uterine fluid caused by hyperplastic and hypertrophic endometrial glands. CEH is not associated with clinical signs unless the uterine content becomes infected; this is referred to as pyometra 

Progesterone  influence hyperplasia of the endometrium and endometrial glands, decreasing myometrial contractions and inhibiting  local leukocyte response to infection. Clinically pseudo pregnant dogs had diffuse thickening of the uterus and additionally, macroscopically visible swellings that corresponded to 2cm diameter regions of pronounced endometrial hyperplasia. THIS CASE HAD 3 LITRES OF PUS IN A UTERUS WHICH WAS 7 TIMES BIGGER THAN ITS NORMAL SIZE.