EYE CANCER IN CATTLE - Bovine Ocular Squamous Cell Carcinoma (BOSCC) and its Surgical Management.

Animals also  battle with cancer. This segment  is on Eye cancer in cattle.

Eye cancer in cow is a very painful and a fatal disorder which start as small nodular growth in the adnexa of eye. Squamous cell carcinoma is regarded as the most frequently diagnosed cancerous tumour in the bovines. Bovine ocular squamous cell carcinoma (BOSCC) represents the most economically important neoplasm in large animals. The malignant tendencies of this disease make early recognition critical.

I got opportunity to see  a wide variety of Ocular Squamous cell carcinoma cases in working bullocks and dairy cattle. UV rays from scrotching sunlight could be the main source of eye cancers  in working bullocks and free grazing dairy cattle especially in states like Maharashtra and northern Karnataka. 

Prolonged exposure to ultraviolet light, lack of pigment and lack of  hair at the affected site are common factors associated with the development 

of a squamous  cell carcinoma.These tumours in all species develops through a series of premalignant stages  before proceeding to carcinoma. Squamous cell carcinomas are solitary lesions , however  multiple tumours may develop in conjunction with solar injury.Human negligence and callous attitude can lead to severe inflicting injuries to the eye which ultimately culminates in eye cancer. 

I would like to share my experience during my tenure in Animal Rahat, PETA , the largest working animal welfare organization dedicated for working bullocks. We witnessed many animals in a northern Maharashtra village with eye cancer on the right eye. When enquired , it was a shocking finding that the abuse of the eyes by rubbing a combination of pepper and salt to make the animals run during bullock races and sugarcane season had led to high incidence of eye cancer . I am of the opinion that Willful persuasive extension education should be part and parcel of the veterinary practice and I strongly believe that it is the duty of every vet to educate the animal owner / farmer about what the animal is going through. Thus eye cancer  not only drastically reduce the performance of the animal and considerable economic importance to the farmer , but also has serious welfare constraints in animal ethology point of view.The cancer growth may start at the medial canthus, lateral canthus or on eyelid . 

Third eyelid is the most common site of origin of eye cancer.  The stage of presentation of the case decides the chances of saving an affected eye.

Cases presented in initial stages can be fully recovered and the eyes can be saved. But many cases come in advanced chronic stage with extensive tumor mass eating up the entire globe.

Treatment of cancer eye depends on its location and the degree of involvement of ocular  structures. Veterinarians easily remove lesions on the third eyelid by cutting out the free  border of the third eyelid using local anesthesia and tranquilization. Lesions removed in this way are very unlikely to recur. Applying hyperthermia (high temperature) or cryotherapy (freezing) to kill the remaining tumor cells in the tissue of the lids but the procedure can not be employed for all cancers.

Three terms are widely used by the veterinarian in this context are Extripation or Exenteration, Evisceration, Enucleation

Enucleation is removal of the entire globe, including the cornea, sclera, and a portion of the optic nerve .

Evisceration surgery involves removal of the contents of the globe while leaving the sclera and optic nerve in place. The cornea can be retained in some evisceration cases.

Exenteration of Eye or  Extripation of Eye ball  is the removal of the globe, as well as the complete or partial removal of the soft tissues of the orbit.

 The ultimate goals of these surgeries are to safely and effectively remove the diseased eye or orbital contents using advanced surgical techniques, eliminate the severe underlying ocular pathology

 Removal of the entire eyeball is indicated when tumors have spread to the extent that the eyeball is blind; the tumor has invaded deeper structures surrounding the globe; or the eyelid is involved to the extent that it cannot be repaired after removal of the tumor. It may appear to be a drastic procedure, but success of the extirpation is to  accomplish it quickly and humanely.

ANETSHESIA AND RESTRAINT

I prefer standing surgery as the wonderful cock tail of Butorphanol, Xylazine Ketamine @ 0.01,0.2 and 0.04 mg/ kg bw Intra muscular troute will give excellent sedation for 30 minutes. Four point retrobulbar block ensures a painless surgical procedure equally rewarding for the surgeon and for the animal.

YOU CAN WATCH THE VIDEO BELOW

Exenteration of Eye ball 

REGIONAL ANESTHESIA OF EYE IN CATTLE

4 Point Retrobulbar Nerve Block: The 4-point retrobulbar block is technically easier and can be done more rapidly as compared with the Peterson eye block. In this technique, an 18 gauge, 9-cm long needle is introduced through the skin on the dorsal, lateral, ventral and medial aspects of the eye, at 12, 3, 6, and 9 o´clock positions, respectively. Introduction of the needle through the

conjunctiva should be avoided to reduce the occurrence of ocular contamination. The needle is directed behind the globe using the bony orbit as a guide. When the needle is introduced into retrobulbar sheath, the eye will move slightly with the tug of the  needle. After this location is reached and aspiration is performed to assure that the needle is not in a vessel, 5-10 milliliters of lidocaine (2%) is deposited at each site. Mydriasis indicates a successful block.

Other ocular nerve blocks in cattle are

Auriculopalpebral Nerve Block: The  auriculopalpebral nerve can be palpated as it crosses the zygomatic arch, roughly 5-6 centimeters behind the supraorbital process. Inject 5 milliliters of 2% lidocaine HCl subcutaneously on the dorsal aspect of the zygomatic arch at this location.

Peterson Nerve Block: This is a complicated one .

After performing a small local skin block over the intended site of puncture, a 3.8-cm long 14 gauge needle is inserted through the skin as a cannula for introduction of an 18-gauge 9-cm long needle for the nerve block. The cannula is inserted caudal to the junction of the supraorbital process and zygomatic arch and is introduced through the skin. Then, the 18-gauge, 9-cm long needle is introduced through the cannula needle and is directed in a horizontal and slightly dorsal direction until the  coronoid process is encountered. The needle is “walked off” the rostral aspect of the coronoid process and advanced in a ventromedial direction along the caudal aspect of the orbit until the needle encounters the bony plate encasing the foramen orbitorotundum. Once the needle is advanced to the foramen, it is advised that the needle be drawn back  a few millimeters to reduce the risk of intrameningeal injection. After aspirating to assure the needle is not in the internal maxillary artery, 10-15 milliliters of lidocaine (2%) is deposited, with an additional 5 milliliters of lidocaine deposited as the needle is slowly withdrawn. Mydriasis indicates a successful block.

Retrobulbar block: An alternative to the 4-point retrobulbar block is the single retrobulbar block In this technique, the 9-cm long 18-gauge needle is bent into a ½ circle. The needle is inserted immediately ventral to the dorsal orbital rim and directed such that the needle impacts into the bone of the orbit. Then the needle is advanced as it is rotated ventrally in a progressive

manner such that the needle remains in close proximity to the bone. After the needle is inserted to the caudal aspect of the eye, 20 ml of 2% lidocaine HCl is administered after aspiration to ensure that the needle is not positioned in a vessel or other fluid structure. Successful deposition of lidocaine causes mild proptosis of the globe.

Ring Block: Additional local anesthesia of the eyelids is recommended as the Peterson and retrobulbar blocks typically  result in incomplete analgesia of the eyelids. Five to ten milliliters lidocaine (2%) is infiltrated subcutaneously 2.5 centimeters from the eyelid margins as a ring block.

Surgical procedure of Exenteration

A transpalpebral ablation technique is utilized to remove the eye. The upper and lower eyelids are sutured closed or  alternatively, eyelids can be closed using multiple towel . A circumferential skin incision is made approximately 1 centimeter from the edges of the eyelids . Using a combination of blunt and sharp dissection, Mayo scissors are used to dissect through the orbicularis oculi muscle, fascia, and subcutaneous tissue surrounding the eye. The interior of the bony orbit is used as a guide. The medial and lateral canthal ligaments are sharply transected to allow access to the caudal aspect of the orbit.

As there is a large vessel associated with the medial canthus and optic stalk which need to be ligated after the resection. A vascular clamp can aid in hemostasis while additional excision

of remaining orbital tissue is undertaken. In cases where neoplastic infiltration of the bony orbit has occurred, affected areas of ocular periosteum should be thoroughly excised. I had not encountered any bony lesions extending from BOSCC so far.

The skin incision can be closed in a variety of patterns with a nonabsorbable suture such as No. 3 nylon. Common patterns include the Ford interlocking, cruciate or simple continuous after sufficiently obliterating the dead space with iodine impregnated gauze rolls. This needs to be changed for 5 dyas till the cavity dries and heals up.   

Post-operative Care: The animal should be kept in a confined area for several days after surgery to allow for appropriate hemostasis to occur. Daily observation of the surgical site and assessment of general well being is recommended until suture removal. Sutures should be removed in 14 to 21 days to allow for complete healing of the skin. 

Histopathologically infiltrating tumour cells characterized by  numerous mitotic figure, diffusely dilated lymphatics along with Multifocal necrosis and haemorrhages throughout  the neoplasm is a common feature

CESAREAN SECTION IN COWS -TWO COMPLICATED CASES - TWINNING AND FETAL MONSTER

Greetings to all well wishers and visitors  of my blog. 

I would like to dedicate this segment to the large animal field veterinarians who are the real heroes in field. They are the guardian angels and saviors addressing  silent cries of "expectant mothers", attending Dystocia cases  in odd hours . Animals are also exactly like us in evincing labour pain.No species can deliver a young one without pain and that is the rule of life. Even though the act of  parturition is much more independent in animals, assistance is inevitable in cases where the mother won't be able to deliver due to various well reasonable causes. To many of my fellow veterinarians , especially to those who are posted in remote villages this is a routine. 
Cesarean section is potentially indicated in cases of difficulty in parturition or dystocia  when a calf cannot be delivered by manual extraction. The decision on whether to perform a  cesarean section is based on the facts whether the calf is alive, the availability of operating space in the cow’s pelvis, whether the cervix is open, access to restraint facilities and the importance of future cow fertility.
It is very unfortunate that 9 out of 10 cases presented to a  surgeon will be in last stage of handling with excess tear to the vaginal mucosa, excessive intra uterine bleeding and in some cases severe injuries to the calf and mother by unscientific manipulations using wrong traction, excessive and misplaced hooks and snares done by less trained para vets and local animal handlers . 
I strongly believe the zen saying  "Even though pain is inevitable.. suffering is certainly optional"  and much awareness is needed in Indian village conditions to educate the para vets and animal handlers to carefully and cautiously handle cases of dystocia so as to present the cases well in advance to a qualified vet and  thus save the mother and calf .

I had a very eventful week with two interesting C- sections performed at field level

I AM POSTING TWO CASES OF CAESAREAN SECTION PERFORMED AT FIELD LEVEL WITH VIDEOS FOR THE BENEFIT OF THE BUDDING LARGE ANIMAL PRACTITIONERS . 
Also a brief discussion on the methodologies and procedures is also added to this segment. You are free to post your comments and suggestions.
The surgeon usually has little choice when selecting the operating environment for a caesarean operation. Many successful operations have been performed under less than ideal circumstances in pastures,sheds, and fields . If a hospital facility is  not available, attention must be given to choosing the cleanest possible surroundings, as the operating environment has been shown to be a significant source of organisms that contaminate the wound. Also the location for surgery should be selected carefully with the objectives of ensuring good lighting, facilities for restraint and a suitable floor surface.

CASE NO -1              
CESAREAN SECTION TO RELIEVE DYSTOCIA – TWINNING
A triparous cow was presented on terminal gestation with severe straining. A para vet had tried to relieve the foetus and two limbs were found locked inside the birth canal with severe trauma to the vagina. Extensive use of snares and hook resulted in severe stress to that animal . An emergency C- Section relieved two calves . One was a live male calf and the other a still born  freemartin twin.

                        CLICK TO  WATCH THE VIDEO  BELOW 

                                           
CASE NO -2

CESAREAN SECTION TO RELIEVE DYSTOCIA – MALFORMED FOETAL MONSTER- SCHISTOSOMUS REFLEX

A 6 yr old biparous cow was presented with intermittent straining after 9^th month of gestation  propelling tortuos intestinal loops from the vagina. On examination foetal intestines were  identified. Per rectal examination revealed foetal parts locked inside the uterus leading to dystocia and pervaginal examination identified rib cage and forelimbs struck in the birth canal . An emergency C- section relieved the mother . An 18 kg weighing malformed dead  foetus abnormal limbs and (two under developed ) and concurrent schistosoma reflex leading to protrusion of intestines with ill developed thorax was removed. Timely C- Section saved the mother and post operatively the animal had an uneventful recovery. Schistosoma reflex is a monster and cause of dystocia requiring a cesarean section. Charecterised by acute angulation of the spine so that the head lies close to the tail , thoracic and abdominal cavities have no ventral wall.

CLICK TO  WATCH THE VIDEO  BELOW   

SURGICAL  APPROACHES TO CESAREAN SECTION IN COWS  

The options of patient positioning for caesarean operation are:

1. Standing (suitable for left or right paralumbar fossa and lateral oblique approach)

2. Dorsal recumbency (suitable for ventral midline and paramedian approach)
3. Sternal recumbency (suitable for left or right paralumbar fossa)
4. Lateral recumbency (suitable for ventrolateral and low-flank approach).

Standing left paralumbar celiotomy

The standing left paralumbar celiotomy is the most commonly used approach for an uncomplicated cesarean section . The incision is made vertically in the middle of the paralumbar fossa, starting approximately 10 cm ventral to the transverse processes of the lumbar vertebrae and continuing ventrally, far enough to allow removal of the calf .Closure of the abdominal wall is straightforward and relatively easy.

Standing right paralumbar celiotomy

This approach has all the indications and contraindications of the left paralumbar approach The additional and perhaps most important difference between the left and right paralumbar approach is the difficulty in keeping viscera in the peritoneal cavity with the right paralumbar approach. Most practitioners studiously avoid this approach; however, some practitioners feel right horn pregnancies are more manageable with the right paralumbar approach.

  

Standing left oblique celiotomy

This described variation of the left paralumbar celiotomy approach has distinct advantages . In this approach, the incision starts 4 to 6 cm ventral and cranial to the tuber coxae, extends cranioventrad at a 45 degree angle to the ground, and terminates at the last rib .

Recumbent left paralumbar celiotomy    

This approach differs little from the standing left paralumbar approach .Additional assistance is nearly always needed to cast the cow, if not recumbent already, and to place the cow in right lateral recumbency. The incision is made slightly more ventral than in the standing left paralumbar celiotomy.

Recumbent right paralumbar celiotomy

This approach is very seldom used, as it is very similar to that of recumbent left paralumbar celiotomy and has the additional complication of not having the rumen to retain the abdominal viscera.

Recumbent ventral midline celiotomy

This approach is straightforward and is most commonly used on a recumbent animal . If the incision is appropriately placed, the only body wall layers incised are the skin, subcutis, and the linea alba. Additional assistance is required to cast and position the cow for this approach. The cow is typically positioned in dorsal recumbency, leaning toward the surgeon at a 45 degree angle .

Recumbent ventral paramedian celiotomy

This approach is similar in most respects, including the advantages and contraindications, to the ventral midline approach .The abdominal wall incision is placed parallel and approximately 5 cm lateral to the linea .

Recumbant Ventrolateral celiotomy

This approach is similar to the other ventral approaches, but it may be better suited for the older dairy or beef cow .The cow is positioned in right lateral recumbency. The hindlimbs should be extended caudally and the upper limb abducted for the best exposure to the incision site . 

We tried various approaches in the lower flank with varying degrees of inclination and found that lower flank incision from stifle arch to the milk vein is the best.

Positioning of the patient is very important . It is important to exteriorize the uterus. This aids in limiting peritoneal cavity contamination, thereby aiding in the prevention of peritonitis.  After positioning the limb in the incision, the uterus is incised avoiding cotyledons, the limb is grasped directly and traction is placed on the calf. Uterine incisions should be positioned on the greater curvature of the uterus and the incision should be placed distant from either the cervix or apex of the horn. 

We are getting rewarding results with regional anesthesia Xylazine lignocaine mix(0.5 ml + 2.5ml for 350 kg cow ) as lower epidural nerve block followed by inverted L block

ANESTHESIA 

General anesthesia is practically impossible and an effective lower epidural nerve block and inverted L block with lignocaine give rewarding results in recumbent approach. Unfortunately, xylazine has  an ecbolic effect (i.e. it stimulates contraction in the uterus at term), making surgery more difficult, and can cause rumen tympany, which can obstruct the surgical wound

We had extensively tried a combination of 0.5 ml Xylazine + 2.5 ml lignocaine via lower epidural route( C1- C 2  for cows weighing 350 kg. This is probably the best combination to recommend. 

The uterus should be closed with an absorbable monofilament suture on a tapered needle in a continuous inverting pattern. Cushings followed by continuous Lambert pattern is the best . The muscle layers can be apposed all together or in two layers using No -2 chromic catgut using continuous pattern. A well placed subcuticular suture can renforce the closure and can ensure fast healing due to less dead space . Skin can be apposed using Nylon or Polyamide in mattress pattern. A Stay suture can retain the surgical bandage in position. Three comon complications of C- Section are Subcutaneous emphysema, Metritis and retained fetal membrane, Peritonitis and Adhesions. A deliberate post operative antibiotic therapy , supportive fluid therapy, post operative douching area must for a successful C- Section.

Post-Operative Fertility

Under normal circumstances, the three main goals of the caesarean operation in cattle are: a) survival of the cow; b)  survival of the calf;  and  c)  maintenance of post-operative  productivity, which implies not only the maintenance of body  condition and an acceptable level of lactation, but also the ability to conceive again. In our experience 70 % of the cows operated had conceived in the subsequent A live calf should be dried and the navel dressed with antiseptic immediately after delivery. Once surgery is completed, 2-3 litres of colostrum from the dam should be administered to the calf, using an oesophageal feeding tube if necessary. The dam should be introduced to the calf promptly, particularly in the case of a suckler cow and calf, to form a maternal bond.

Ever since I had actively involved in large animal practice as a surgeon and a teacher  in a state with huge livestock reserve like Karnataka , I had the opportunity to attend a variety  of C-Section cases in odd hours.I am thankful to Dr N Nagaraju, my colleague, together with whom , I  had a great time and learning attending a wide variety of dystocia and C- Sections at field level.

C Sections are really exhaustive for the surgeon too, but it is really beyond the scope of words to see the animal coming back to life and nothing is more rewarding than the sigh of relief that we perceive on the face of the animals that get treated from our hands. It is indeed blessed to work for the silent cries and thank Almighty for giving this opportunity.

THANKS FOR VISITING MY BLOG!

BOVINE LAMENESS - PART 1 INTER-DIGITAL FIBROMA CONCURRENT TO CORK SCREW CLAW IN DAIRY CATTLE.

INTER-DIGITAL FIBROMA IN DAIRY CATTLE 

Hoof affections are second largest cause for economic loss in livestock farming . In India, the incidence of foot disorders is 8-10% in Dairy cattle . The over grown hooves is the most common predisposing condition of the hooves that accounts for more than half of the total foot lesions. I get a lot of hoof affections and my recent interest was on preventive management of hoof affections in dairy cattle. Through this starting segment of Bovine lameness series my attempt will be to give some insights on common hoof ailments and their surgical management. Bovine lameness is a SILENT KILLER and huge production loss entity in any organised dairy farming. Pain induced reduction in milk yield is a much focused area for dairy scientist ans Dairy vets .

Interdigital fibroma also termed as Interdigital hyperplasia or corns are firm fibrous masses consisting of hyperkeratotic and parakeratotic skin found in the interdigital space of cattle

 The lesions appear as secondary to chronic skin irritation due to environmental, conformational and hereditary factors. Where lesions become large and/or infected, surgical removal is the preferred treatment. Improved hygiene and appropriate hoof trimming are the keys to prevention of this condition

"Cork screw claw" is the over grown claw with inward curvature making the inter digital space widened. This is a genetic disorder and this predisposes to many inter-digital affections in cow. Dairy cows tend to have a higher prevalance of interdigital fibromas in the rear feet, probably owing to the rear feet contacting more moisture from manure and urine than the front feet. Cork screw claw is generally seen in front limb and due to this reason secondary inter-digital fibroma is common sequelae to cork screw claw in bovines

Surgical management of interdigital fibroma :-

For surgery, animals are best positioned in  chemical restraint. Xylazine Butorphanol and Ketamine combinations proves to be excellent in my experience. A tourniquet should be placed above the fetlock to provide hemostasis.Intravenous regional perfusion or local interdigital injection of a local anesthetic agent should provide adequate surgical anesthesia of the area.Sharp dissection should be accomplished, being certain to remove all proliferated tissue,including tissue immediately adjacent to the coronary band.Care should be taken to avoid damage to the coronary band.

Levlling of the curved claws can be done using an electric hoof trimmer and the inter digital wiring can be done after making fine hole of 3 mm diameter using electric drill.An orthopedic stainless steel wire can be used The toes can be wired together to decrease movement of the claws, but this may not be necessary in housed animals.The entire foot, including the solar surface should be incorporated in a tape bandage with or without gauze. Systemic antibiotics may be indicated if the fibroma is infected.

In some cases even cauterization of the growth can be done followed by antiseptic dressing with povidone iodine or bismuth iodoform paraffin paste. The antiseptic dressing should be continued for a minimum period of 3 to 4 weeks. The animal should be kept on dry floor.Following surgery, the animal should be kept in a dry area for approximately 2 weeks. 

Preventive management:-

• Timely hoof trimming that prevents the widened inter-digital space resulting from over grown hoof and exercise is the best preventive management practices for this condition.
• Ensure that cattle stall is made of firm dry floorings. Proper drainage is a must to avoid water logging resulting in the hoof affections in the cattle.
• Weekly checking the hoof of the animal and cleaning the hoof with 1% potassium permanganate solution can check the spreading of hoof infections.
• Interdigital hyperplasia caused by poor conformation is very likely to recur, since the predisposing conformation problems will usually remain after removal of the growth.
• Animals suspected of having interdigital hyperplasia due to hereditary factors should not be used for breeding.

A 7 yr old Dairy cow in a Hi-tech dairy farm in Karnataka was operated for cork screw claw resulting in to interdigital fibroma . You can watch the video below 

THANKS FOR WATCHING

INTUSSUSCEPTION AND RECTAL PROLAPSE IN PUPPIES: A SEQUELAE TO IMPROPER DEWORMING

Dogs are hosts for wide varieties of worms which includes round worms , tape worms, whip worms  and hook worms. This mainly happen due to the natural behavior of licking, sniffing and snatching any thing on their path like stones, trash, poops and all inanimate objects.

Many times deworming  in pet practice may fail due to improper selection of dewormers , improper dosage and improper procedure of drug administration.

Signs of worms in dogs include Pica or eating inanimate objects , scrotching or rubbing the anus in ground and increased peristaltic movements of intestine , diarrhea and rough hair coat.






















It is a common practice among vets to correct the rectal prolapse manually just by pushing the prolapse mass.  But it is pertinent to mention that CHRONIC RECURRENT RECTAL PROLAPSE MAY BE A SEQUELAE TO AN INTESTINAL OBSTRUCTION AND IN WORM INFESTATIONS THIS MAY BE DUE TO AN INTUSSUSCEPTION.

Chronic worm infestations can lead to hypermotility resuting in Torsion, volvulus or intususseption of intestines. Torsion is the rotation of intestines in their own axis. Volvulus is rotation of intestines in mesenteric axis. Where as intussusception is the telescoping of one portion of intestine to other .

Rectal prolapse is the protrusion of the rectum. The codition may arise from hyper motility of intestines. Chronic rectal prolapse is condition in which the rectum get prolapsed and every time an attempt to push it back in position leads to recurrence. The main cause of chronic rectal prolapse may be intestinal obstruction resulting from intussusception.

                  This 4 month old puppy was presented with chronic rectal prolapse nit responsive to medical

treatment. 

According to the owner he had never dewormed the pup and that the pup was eating mud and stones .It had severe diarrhea and scrotching. C ARM imaging revealed hard firm mass on caudal colon .An exploratory laparotomy revealed complicated intussusception at ileo-caeco-colic junction. The condition was difficult to be corrected and hence enterectomy followed by entero anastomoses was performed.  

YOU CAN WATCH THE VIDEO OF CHRONIC RECTAL PROLAPSE COMPLICATED WITH INTUSSUSCEPTION IN A PUPPY.

To prevent an incidence of rectal prolapse, proper deworming is an inevitable measure . There are many types of dewormers such as  pyrantel palmoate, fenbendazole, albendazole, praziquantel , ivermectin etc.

Common dewormers for dogs and efficacy are as under

Dewormer	Hook/ Round worm	Whip worm	Tape worm	Dose mg/kg bw
Pyrantel pamoate	+++	--	--	5-10
Fenbendazole	+++	++	--	50 for 3 days
Praziquantel	++	+++	++	8
Milbemycin	+++	+++	++	0.5
Praziquantel with febantel	+++	++	--
Praziquantel with pyrantel pamoate	+++	+++	+++
Ivemectin	++	++	--	0.02

Right age of deworming in puppy is at 15 days with pyrantel pamoate liquid every 12 days for four times. followed by this a dose of pyrantel pamoate and fenbendazole at months 2,4 and 6. After this every six months deworming can be done using combinations of praziquantel / pyrantel pamoate/ febantel and ivermectin . It is also very important to  alter the combination/ drug every time as the worms also get resistance to wards a single dewormer. In pregnant bitches fenbendazole is the only safe dewormer and this can be used at 10-15  day of gestation to avoid trans placental infection to pups.

  

You are free to post your comments and suggestions . 

HANDLING AND RESTRAINT OF CATS AND CLINICAL VETERINARY SURGERY VIDEO ON FELINE HIND LIMB AMPUTATION

I am thankful to all readers of my blog for  much encouraging response . I am getting mails especially from Veterinary  students, post graduate students of Veterinary Surgery  and field vets of the country and few across the globe. There was a request to post something on feline restraint and feline surgery and this is my humble attempt to share some thing on feline surgery with special reference to handling and restraint of cats .

I am dedicating this segment to all Cat lovers and budding feline vets.

In veterinary practice Cats always fascinated me by their unique nature of Fexibility, Agility  and Unpredictability . Cats are very sensitive and highly freedom loving animals which makes them hyper excited when attempted to restraint.. Handling cats always take much of our energy because of their extreme flexibility . Many times I get cases in which helpless situation arises like owner himself/ herself bring an excited animal and confirming the fact that no one can handle their pets. DILATED PUPILS, PROTRACTED CLAWS AND VOCALIZATION are the indications of a stressed self defensive cat.
Like any other animal, behavioral restraint is the best form of restraint. But in case of an injured animal presented with much stress, careful physical restraint becomes inevitable.

I had learned from my practice that much patience , firmness and tactics are needed for effective handling . Also NEVER EVER UNDERESTIMATE  FELINE FLEXIBILITY.

1.       Principles of blind folding. Vision is the first alarming stimulation for a hyper excited cats . It has been scientifically proved that blind folding in the presence of owner can reduce the stress level in cats .

2.       Cuff holding . The best way to restraint a cat is tight and firm holding of the cuff. This should never be shared by two people as the cats escape and attack effectively  by multiple handling .

       FIRM  CUFF HOLDING AND PRESSING THE BACK BY GENTLE SPINAL RESTRAINT : This is gentle pressing of the vertebral column all along with your fore arm with well restrained cuff of cat in our fist.
This will ensure a firm grip and the animal can be restrained for injections. With this procedure a Surgeon can himself or herself give the injections with out assistance.

Like in all species iintramuscular injections should be always perpendicular with needle insterted to the mid belly of muscles. I prefer inseting only 1/3^rd of the hypodermic needle for a painless injection.

Post handling stress. Majority of the injury to the handlers happen after the handling as the animal will be much tensed and tries for self defense. 

Always safely place back in cage after the injection and let loose the animal for natural recovery. Remember cats needs much freedom . Don’t over handle a cat as it reduces its immunity.A good dose of neglect had found to be excellent in recovery of the feline patients . Domestic Cats are also prone for capture myopathy like their wild counter part and hypothermia is a common findings after surgical manipulations.

YOU CAN WATCH A VIDEO ON HANDLING AND RESTRAINT OF CATS 

CHEMICAL RESTRAINT

An injured cat with complete compound metacarpal fracture was presented . A proximal meta tarsal amputation was done on the cat on contrary to a mid  femoral amputation as the situation demanded a less invasive surgery.

Various anesthetic combinations are availiable for restraints if cats. I personally recommend the combination of a dissociative anesthetic , a muscle relaxant and a morphine pain killer for a much rewarding anesthetic retraint. Ketamine @ 10 mg/kg bw + Diazepam @ 0.5 mg/kg bw and Butorphanol @ 0.2 mg/kg bw give surgical plane of anesthesia for nearly 45-55 minutes. This can be further enhanced by a top up of 1/3^rd dose after 40 minutes .

YOU CAN WATCH THIS VIDEO ON META-TARSAL AMPUTATION IN A CAT

Ketamine , Diazepam Butorphanol cocktail is excellent for short  medium surgical procedures in cats 

You can forward your feedback, suggestions and recommendation for improvement.