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Therio - Bovine - Obstetrics & Dystocia 2

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drraythe's version from 2017-09-10 02:32

Obstetrical examination/ Delivery/ Post-birth

Question Answer
**WHERE should you perform your obstetrical exam?NB!!! DO NOT PLACE ANIMAL IN A CRUSH UNLESS YOU HAVE NO OTHER OPTION!!! RATHER PLACE AT THE END OF THE RACE (chute), WHERE YOU CAN PULL HER OUT IF YOU NEED TO….
When should you be gathering the info (Anamnesis) for the ob. exam?While examining the animal
Important questions to ask during Hx (anamnesis)Age
Parity (# of previous births)
Previous breeding Hx esp. any dystocia’s
*Duration, nature + intensity of labor
*Time of appearance + rupture of fetal membranes
*Any fetal parts emerged from the vulva?
*Any examination or assistance been undertaken???
When is it appropriate to delay the general exam? Omit?Can be postponed until after delivery of the fetus if necessary, UNLESS… urgent attention required to save the dam (eg. Milk fever). DO NOT omit!!!
How do you test the withdrawal reflex?Pinch the coronet
How do you test the sucking reflex?Place fingers in mouth
How do you test the anal reflex?Touch perineal region, should elicit tightening of anal sphincter
How do you test the corneal reflex?Gently touch eye, should retract eyeball or move head if able
What pulses can you try to check to see if fetus is still alive?Femoral pulse, & pulse in umbilical arteries (& heartbeat) (esp if Ca presentation) (also check reflexes to make sure still alive)
*If the fetus does not respond to reflexes, should you start to try to cut it up & remove it?NB! Failure of reflexes do not prove that the calf is not alive!!!!!
When might a rectal exam be necessary during an OB exam?May be essential in the Dx of uterine torsion
When you are restraining a cow's head for your OB exam, how should you tie her up?Tie the head LOW so if she goes down, she doesnt hang herself
If you need to sedate a cow for an OB exam, what can you use? What other effect does it have? When should you NOT use this?Xylazine (5mg/100kg BW im), may increase myometrial contractions. NOTE THAT Brahman cows are SENSITIVE TO XYLAZINE!!
What drug do you use for an epidural for the cow? (Not sure if need to know dose, prolly not)Lidocaine (dose depends on size of cow, but in general 3-6ml (avg. 5mls)… basically 1ml/100kg)
What happens if you give too much lidocaine in your epidural?The cow can go down
What are the 2 locations you can choose to do an epidural?(1) Btwn the last sacral & 1st coccygeal vertebrae
(2) Btwn 1st & 2nd coccygeal vertebrae
Practical way to find where to perform epidural?Manipulate tail while feeling for “gap” btwn. Vertebrae (Usu. Where small tuft of upright hair)
(Prolly wont ask us details) how do you insert needle for epidural? What gauge is usually used? What do you do once you have the needle in?Angle needle (18G) in cranial direction w/ bevel facing up. Push hard!! Once you're in, if you Place small bleb of Lignocaine in hub… should be sucked in (might even hear sucking sound). Attach syringe + depress plunger… if ANY resistance… stop + re-angle needle
What is the calving aid you can never have too much of?Lube!
If you don't have a head snare, how can you make a war bridle? (What is a war bridle?)Just a rope that goes in the mouth & then around behind the ears
*Why must you use extreme caution w/ a calving jack?Massive force exerted w/ a calving jack!!!! May damage cow/fetus!!! BE CAREFUL!!!!
Before resorting to jacks or C-sections, how do you do a trial traction?2 strong men for 10 minutes pulling w/ calving chains
What kinda position do you want the calf to be in when you're pulling?At a slight angle, bc that is where the hips biggest diameter is
**What should you ALWAYS DO before you start pulling on a calf?CORRECT MALPOSTURES 1ST
When pulling, how many points of contact should you maintain w/ the calf?AT LEAST THREE! Ropes /chains on each leg, & then either a war bridle or eyehooks
How do you place chains/ropes on calf's legs?wrapped above & below fetlock
How can you "walk" a fetus out of a vagina?In normal delivery 1 forelimb is always slightly ahead of the other, the fetal body rotating slightly towards the side of the more advanced limb. Traction is applied to the more ventral limb until no further progress; hold the limb in this position. Apply traction to the other limb. Then alternate this traction until the fetus is "walked" out
When would be a good time to try to pull? What should the nature of your pull be like?When the cow is straining, try to pull steady, not in jerks
At what point can you put traction on both limbs simultaneously?Once the shoulders are delivered
What direction should you be pulling, & when?1st pull horizontal until the shoulders are delivered, where after a ventral direction should be applied
What is the MOST common thing to get stuck? 2nd most common thing?#1: Head
#2: Hips
**Why do you want to avoid hiplock (stuck hips) at all costs?Obturator nerve damage → Downer cow
How should you try to be pulling a calf that is in or is close to hiplock?Alternate directions… ie. Left then right while pulling ventrally. May need to pull calf to 1 side & then the other to ‘pop’ 1 hip & then the other into the pelvic canal
*When baby is 1st delivered, what should you do right away?Clean nose+mouth
Should you hang a calf upside down to help fluids drain?Eeeh prolly not, be careful. If you do, FOR A SHORT TIME ONLY!! NB! PRESSURE ON LUNGS
If your calf comes out & all its white fur is brownish yellowish, what do you think happened?"Meconium staining"
**What is the 1ST THING you look for on your post-partum exam? What else should you look for?Presence or absence of another fetus…. If you leave a fetus behind…. Dr May will hunt you down! Also, look for Vaginal tears (partial thickness/full thickness), uterine tears, partial eversions, & separation of fetal membranes
If the cow is not standing post-partum, what concerns/ thoughts on czs might you have?Possible nerve damage (obturator), pelvic fracture, or metabolic disorder
What effect might dystocia have on the calf if it has been going on for a long time, & how can you help this?Swollen head/tongue → May need corticosteroids if severe
What is an Episiotomy?A surgical incision of the perineum & the posterior vaginal wall to quickly enlarge the opening for the baby to pass through. (Done at 10 & 2 o'clock relative to the dorsal vulvar commissure)
When is an episiotomy indicated?In obstetric cases where the vestibulum or the vulva lips are obstructing passage of the fetus. More traction would just lead to fetal distress & tearing of the vulvar lips
Describe the technique of an episiotomyIncision 5cm from the dorsal commissure of the vulva at a 45°angle from the vertical (ie. 10 o’clock or 2 o’clock), avoiding the anal sphincter, w/ or w/o local anesthetic.
Closure in 3 layers: Mucosa (absorbable suture), SQ (absorbable suture), & skin (absorbable or non-absorbable suture)
When giving an epidural you must keep in mind it cant what?Doesnt stop contractions- only pain
What drug can you give for uterine relaxation (but availability is now very limited)?Clenbuterol (Planipart®): β-2 adrenergic agonist, czs uterine relaxation
WHY would you want to give a drug for uterine RELAXATION when the cow is experiencing partus? (3)(1) To delay parturition by 4-10h to allow adequate dilation of the caudal tract
(2) To delay parturition as a management aid ( to avoid night time calving, if given at 22:00 parturition will be delayed until 6:00)
(3) To relax the uterus as an aid to manipulation for C-sections
If you give clenbuterol to a cow for uterine relaxation, if she is a milk cow, how long must you discard her milk for human consumption?3d
Why would you give Oxytocin, & WHEN would you give it?To promote uterine contractions after a dystocia or C-section to help prevent RFM (retained fetal membranes), OR after reduction of a prolapse to try + retain prolapse inside cow!
**What is a big caution about using Oxytocin?NB!! REMEMBER that too much Oxytocin can result in abberrant myometrial contractions & actually contribute to the dystocia….. So only use afterwards to prevent RFM
If there is dystocia, what electrolyte might you consider supplementing her w/?Ca++
If the cow is undergoing prolonged labor, what might be beneficial to supplement her w/?May be beneficial to give glucose IV w/ fluttervalve, or calcium borogluconate + energy source (tradename MFC)
What would you want to supplement to mom in cases of 1° inertia?Calcium should be given iv w/ fluttervalve (Calcium borogluconate) (flutter valve allows slower distribution IV)
If the cow is showing muscle twitching (prepartum or postpartum), what should you give?Calcium should be given IV (Calcium borogluconate)
If you give Ca, what parameter should you be wary of?Make sure heart dosnt slow down too much
Indications for a Caesarian Section?LIVE CALF!!! (or recently dead)
Valuable calf, vaginal delivery impossible, damage to maternal genital tissue, feto-pelvic disproportion, incomplete dilation of the cervix or caudal tract, irreducible fetal mal-alignment, uterine displacement
What is a fetotomy?Method of dividing a fetus that cannot be delivered into pieces which will be able to pass through the birth canal
**When are the ONLY instances (criteria) where you should do a fetotomy?*Only when fetus is dead, only if birth canal is fully dilated
How can you determine calf is dead before performing fetotomy?No reflexes (Remember that it may not be able to react), No heartbeat, Cow has been in stage II of labor for an extended period before farmer called you, Can smell cow as you step out of your pickup
**If you are gonna do a fetotomy, what should you do to help mom?EPIDURAL!
***How do you determine how much embryotomy wire you'll need?NB! NB! Rule of thumb: Measure 4 lengths of your fetotome & cut embryotomy wire there, otherwise too short!!
What are the 2 options for threading your fetotome depending on the cuts you’d like to make & what parts of the calf are protruding?(1) Thread fetotome fully so that you have a loop
(2) Only thread 1 barrel of the fetotome & attach introducer to the free end, so that you can feed embryotomy wire around the calf
If you have a fetal Disposition of Cranial presentation, dorso-sacral position, left/right neck flexion, & the calf is DEAD & unable to be resolved by manipulation, how would you perform the Fetotomy?Remove head & 1 limb (if only head OR limb, you didn't reduce width of fetus).
How can you help stabalize fetotome while cutting?Attach rope/chain to free leg & attach to fetotome to stabilize calf while cutting. Also, Position fetotome (inside cow) on opposite shoulder to the 1 you’re trying to remove & position wire as far back as possible (so you are pulling the wire into the surface you are cutting, & gaining leverage)
What is a partial fetotomy?If you cut 1 part, & Attempt to pull calf out if the malposition was the only problem = partial fetotomy
**How should you properly use a Krey-Schlottler traction hook?NB!! Attach rope to Krey-Schlottler hook which someone else will apply traction to. You need to keep hold of actual hook in case it pulls through tissue & comes shooting backwards!!! ((She mentioned this hook was used to pull out vert. column)
What are the places you cut to do a full fetotomy?Around 1 shoulder+head, then through the abdomen (far back as you can reach), then if there is space, far back on the abdomen as possible near the pelvis, & then split pelvis
*After the Fetotomy is complete, what should you do?NB! Check for uterine tears… uterus was severely compromised before you even got there. Also, give ABx (tetracycline), Anti-inflammatories/painkillers, & Oxytocin
*Bloat in a late pregnant animal is most likely due to...Hypocalcemia
*If you find Hypocalcemia in mom, what should you also check & treat?Check rumen movements (NB! Decreases/absent w/ hypocalcaemia, & cow not eructating, may bloat). May need to drench (per os) w/ rumix (energy source + bact + yeast) + 20l fluid
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