Farm Animal Surgery

598 Pages·2004·95.83 MB·English

by  Susan L. Fubini DVM

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SAUNDERS
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FARM ANIMAL SURGERY ISBN0-7216-9062-9
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Pharmacology is an ever-changing field. Standard safety precautions must be followed, but as new
research and clinical experience broaden our knowledge, changes in treatment and drug therapy
may become necessary or appropriate. Readers are advised to check the most current product
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To our parents and our families:
Debbie, Ricky, Mike, and Marc
and
Rory, Logan, Jimmy, Rebel, and Mason
for their love and support.
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CONTRIBUTORS
David E. Anderson, DVM, MS, Dipl ACVS Jennifer M. Ivany, DVM
Associate Professor, College of Veterinary Medicine Clinical Instructor
The Ohio State University, Columbus, Ohio Department of Veterinary Clinical Sciences
The Ohio State University, Columbus, Ohio
Gary M. Baxter, VMD, MS, Dipl ACVS
Associate Professor, Department of Clinical Sciences William W. Muir, DVM, PhD, Dipl ACVA,
Veterinary Teaching Hospital ACVECC
Colorado State University, Fort Collins, Colorado Professor
Section of Perioperative Medicine, Anesthesia and Pain
William H. Crawford, MVSc, DVM, BSA, BA.S
Management
Young-Crawford Veterinary Clinic
Department of Veterinary Clinical Sciences
Innisfail, Alberta, Canada
The Ohio State University, Columbus, Ohio
André Desrochers, DMV, MS, Dipl ACVS
Charles W. Nydam, DVM
Associate Professor
Nydam Veterinary Clinic, PC
Département de sciences cliniques
Stamford, New York
Faculté de médecine vétérinaire
Université de Montréal Daryl Van Nydam, DVM, PhD
St-Hyacinthe, Quebec, Canada Senior Extension Associate
Department of Population Medicine and Diagnostic
Thomas J. Divers, DVM, Dipl ACVIM, ACVECC
Science
Professor, Department of Clinical Sciences
College of Veterinary Medicine
College of Veterinary Medicine
Cornell University, Ithaca, New York
Cornell University, Ithaca, New York
Stephanie Nykamp, DVM
Earl M. Gaughan, DVM, Dipl ACVS
Resident
Department of Clinical Sciences
College of Veterinary Medicine
College of Veterinary Medicine
Cornell University, Ithaca, New York
Auburn University, Auburn, Alabama
Anthony P. Pease, DVM
Robert O. Gilbert, BVSc, MMed Vet, Dipl ACT,
Resident, Department of Clinical Sciences
MRCVS
College of Veterinary Medicine
Professor and Associate Dean
Cornell University, Ithaca, New York
Clinical Programs and Professional Service
College of Veterinary Medicine Gillian A. Perkins, DVM, Dipl ACVIM
Cornell University, Ithaca, New York Lecturer, Department of Clinical Sciences
College of Veterinary Medicine
Scott R. R. Haskell, DVM, MPVM
Cornell University, Ithaca, New York
Assistant Clinical Specialist
Department of Animal Science Paul J. Plummer, DVM
College of Veterinary Medicine Resident, College of Veterinary Medicine
University of Minnesota, St. Paul, Minnesota University of Tennessee, Knoxville, Tennessee
Bruce L. Hull, DVM, Dipl ACVS Judy Provo-Klimek, DVM, MS
Professor, College of Veterinary Medicine Department of Anatomy and Physiology
The Ohio State University, Columbus, Ohio College of Veterinary Medicine
Kansas State University, Manhattan, Kansas
Nita L. Irby, DVM, Dipl ACVO
Lecturer, Department of Clinical Sciences
College of Veterinary Medicine
Cornell University, Ithaca, New York
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viii Contributors
Peter C. Rakestraw, DMV, MS, PhD, Dipl ACVS Ava M. Trent, DVM, MVSc
Assistant Professor Associate Professor
Department of Large Animal Medicine and Surgery College of Veterinary Medicine
College of Veterinary Medicine University of Minnesota, St. Paul, Minnesota
Texas A&M University, College Station, Texas
Steven S. Trostle, DVM, MS, Dipl ACVS
Jerry R. Roberson, DVM San Luis Rey Equine Hospital
Professor, Department of Surgery and Medicine Bonsall, California
College of Veterinary Medicine
Beth Valentine, DVM, PhD
Kansas State University, Manhattan, Kansas
Associate Professor
Allen J. Roussel, Jr., DVM, MS, Dipl ACVIM Department of Biomedical Sciences
Professor and Associate Department Head College of Veterinary Medicine
Large Animal Medicine and Surgery Oregon State University, Corvallis, Oregon
College of Veterinary Medicine
David Van Metre, DVM
Texas A&M University, College Station, Texas
Assistant Professor
Guy St. Jean, DMV, MS, Dipl ACVS Department of Clinical Sciences
Professor of Surgery and Head College of Veterinary Medicine and Biomedical
Department of Veterinary Clinical Sciences Sciences
School of Veterinary Medicine Colorado State University, Fort Collins, Colorado
Ross University, West Farm, St. Kitts, West Indies
Richard Wheeler, DVM, Dipl ACT
Donald F. Smith, DVM, Dipl ACVS Poudre River Veterinary Clinic
Professor and Dean Fort Collins, Colorado
College of Veterinary Medicine
Eugene C. White, DVM
Cornell University, Ithaca, New York
Assistant Professor
Susan M. Stehman, MS, VMD School of Veterinary Medicine
Extension Veterinarian Tufts University, North Grafton, Massachusetts
Department of Population Medicine and Diagnostic
J. Brett Woodie, DVM, MS, Dipl ACVS
Science
Assistant Professor, Department of Clinical Sciences
College of Veterinary Medicine
College of Veterinary Medicine
Cornell University, Ithaca, New York
Cornell University, Ithaca, New York
Adrian Steiner, FVH, MS, Dipl ECVS
Amy Yeager, DVM
Professor, Wiederkäuerklinik
Instructor, Radiology
Universität Bern, Switzerland
College of Veterinary Medicine
Ahmed Tibary, DMV, MS, DeS, PhD Cornell University, Ithaca, New York
Diplomate American College of Theriogenologists
Associate Professor of Large Animal Theriogenology
Department of Veterinary Clinical Science
College of Veterinary Medicine
Washington State University, Pullman, Washington
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FOREWORD
If it is the duty of this current generation of veterinary (Hannover Veterinary University), and Jit Singh
scholars to stand on the shoulders of their predecessors, (Haryana Agricultural University). Through their com-
then surely Professors Fubini and Ducharme have met bined efforts, and the efforts of their students, they did
their obligation admirably. more to advance the understanding of important ill-
The advent of bovine medicine in North America is nesses of the dairy cow over two decades than any group
often traced to Professors James Law and D.H. Udall in the history of bovine medicine.
of Cornell University, and their students, Walter J. Farm animals are unusually suited to the successful
Gibbons and Myron G. Fincher. Later, Francis H. Fox surgical repair of a multitude of interesting and chal-
(Cornell University) and William Boucher (University of lenging conditions. Combining an unusually docile
Pennsylvania) became recognized as the most learned demeanor with an extraordinary tolerance to major inter-
and influential professors of modern bovine medicine. vention, surgery on these animals can be as rewarding as
However, as the pace of advances in farm animal med- any in the veterinary profession.
icine started to moderate in the 1960s and 1970s, the Although orthopedic, reproductive, and mammary
development of surgery as a clinical specialty—and the gland surgery present many challenges for the large
embracing of farm animal surgery as a full participant in animal surgeon, abdominal surgery in the dairy cow is in
this effort—catapulted the understanding of abdominal a class by itself. The practitioner or surgical specialist who
disorders and other diseases to new levels. Surgical inter- frequents the bovine abdomen for more than the most
vention offered a dynamic perspective on pathophysio- routine procedures must have a clear and unambigu-
logical processes in real time, while correction and repair ous understanding of surgical anatomy and of related
were still possible Moreover, it offered new possibilities anatomic pathology to ensure a consistently successful
for the advancement of diagnostics and therapeutics that outcome. Equally important is a good working knowl-
otherwise would not have been available to internists. edge of fluid and electrolyte therapy, and of contempo-
What Bruce Hull calls the golden age of food animal rary medical management of the metabolically impaired
surgerywould not have been possible without the deter- dairy cow.
mined efforts of a handful of dedicated surgeons. Indi- The usefulness of any textbook depends on the cred-
viduals such as Bruce Hull (The Ohio State University), ibility and experience of the authors and editors. Profes-
William Donawick (University of Pennsylvania), Dale sors Fubini and Ducharme bring as much experience to
Nelson (Illinois State University), and the late Donald the table as any in the country, with the possible excep-
Horney (University of Guelph) worked closely with their tion of Hull.
internal medicine counterparts and, importantly, with Through frequent reference to what is recorded here,
a creative and energetic cadre of private practitioners. as well as liberal sharing of improvements and new chal-
While farm animal surgery was progressing in North lenges, farm animal surgery will continue to prosper as a
America, parallel advances were being made overseas, led discipline to the betterment of the food animal industry
by such people as A. Weaver (Glasgow University), F. and the society it serves.
Nemeth (Utrecht University), A. De Moor (University
of Gent), G. Dirksen (Munich University), M. Stöber Donald F. Smith
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PREFACE
During our professional careers, we have been fortunate knowledge base. These include Dr. Donald Smith, our
to interact with many talented large animal clinicians. In current Dean and an outstanding food animal surgeon,
addition, we have had our share of complications in Dr. Richard Hackett, our department chair and steadfast
our surgical endeavors. To quote Rick Hackett (a saying friend, and Dr. Francis Fox, a legendary food animal and
apparently passed down from Al Gabel), “If you are not ambulatory clinician. We lost two very close colleagues
having a problem, you are not doing enough.” We want in recent years whose meaningful assistance were instru-
to share the knowledge we have gained, including what mental in our specialty development: Dr. Don Horney,
we are still learning from our failures. Our aim in Farm a food animal surgeon from the University of Guelph,
Animal Surgery is to document and illustrate our col- and our beloved friend and colleague, Dr. Bill Rebhun,
lective experiences so it is useful for large animal veteri- an internist whose footsteps we follow every day while
narians, veterinary students, and residents-in-training. caring for dairy cattle in the northeast.
Farm animal surgery as a specialty has become more We would also like to thank our current colleagues at
sophisticated, and many techniques are being adapted for Cornell, many of whom contributed to the book and
use in cattle or small ruminants. A clinician must decide make coming to work here every day a pleasure: Lisa
on a range of management options when facing a surgi- Fortier, Laurie Goodrich, Alan Nixon, Brett Woodie,
cal problem. These options must consider the medical Michael Schramme, Gillian Perkins, Tom Divers,
problem as well as practical and financial limitations. Our Dorothy Ainsworth, and Julia Flaminio. We would like
intent was to publish a comprehensive description of the to acknowledge our excellent residents, many of whom
various surgical procedures available in farm animals. are wonderful friends, and our students, who teach us
References are provided for related medical conditions much more than they know.
and very specialized procedures. Many colleagues have We are grateful to Elsevier and Teri Merchant, espe-
assisted us, and we hope we have accomplished this task. cially for her patience and advice, and to Anne Littlejohn
European and Canadian authors have provided a vital, for her secretarial and editorial expertise, and for her
more global perspective. Many figures were generously attention to detail.
provided by colleagues from different institutions and
different departments at Cornell. Susan L. Fubini
We would like to recognize those individuals largely Norm G. Ducharme
responsible for our career development and farm animal
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HISTORY OF FARM
ANIMAL SURGERY
Bruce L. Hull
Early records indicate that sheep were domesticated However, general anesthesia use for veterinary surgery
as early as 7000 BCand that cattle have been domes- did not occur with much frequency until 40 years
ticated since 6000 BC. Cave art in the Upper Paleolithic later. Dadd also advocated spaying cattle in 1832. This
period in the Franco-Cantabrian region depicts horses practice began in the United States and was later
and ruminants. Bovine castration was practiced as far taken to Europe. In the 1800s, Louis Pasteur suggested
back as 7000 BC. The 539 BC code of rules for veteri- aseptic surgery by stating, “If I had been a surgeon,
nary work specifically referred to surgery of the ox. I would never introduce an instrument into the human
Although the domestication of horses lagged behind body without having passed it through boiling
other species, much of the early surgeries described in water.”
domestic species were for horses, not other species. Early In the early 1700s, 200 million cattle died in Europe
literature suggests that this fact was due to the horse’s from rinderpest. As a result of this great plague, two
value in battle, whereas cattle, sheep, and goats were sal- schools of veterinary medicine were established in France
vaged for food. Castration was the only early surgery per- (Lyon in 1761 and Alfort in 1765) during the 1760s.
formed in cattle. Ancient Romans did not castrate cattle The United States did not establish its first school of
younger than 2 years of age. Castration and tail docking veterinary medicine until 1852, when the Veterinary
has been documented in early Africa (exact date is College of Philadelphia was formed. From this beginning
unknown). At a similar time, limb amputation and until World War I veterinary colleges flourished. Schools
lancing of abscesses was talked about in Africa. seemed to close almost as fast as they opened, and by
The American Indians had no domestic animals. The 1933 only 12 remained in North America, including one
discoverer Columbus brought cattle to the New World college in Canada.
on his second voyage in 1493. In 1523 brain surgery to Aside from castration, there was little mention of
remove hydatid cysts in cattle was described. There was bovine surgery before the late 1800s. In 1894, Moller’s
an “expert cow doctor” practicing in Virginia as early as Operative Veterinary Surgery (Dollar’s translation into
1625. Although it can hardly be considered surgery, English) textbook first described details about food
shoeing oxen was recorded in 1780. There were six vet- animal surgery. Moller’s book described at great length
erinary schools in Germany before 1800, and by 1802 personal communications about food animal surgeries
Thomas Jefferson had his ewes’ tails docked. In 1805 originating in Europe, many of which still have variations
Richard Peters recommended using a trocar for bloat and used worldwide today. The book described surgery for
also called for the establishment of a veterinary profes- lumpy jaw, trephination of sinuses, and esophageal
sion in America. surgery. Tapping the pleural and peritoneal cavities was
George Dadd was the first veterinary surgeon to use discussed, as were hernia repair, rumenotomy, and intes-
general anesthesia (ether or chloroform) in about 1850. tinal resection without the benefit of anesthesia. Moller
1
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2 History of Farm Animal Surgery
described amputation of the prolapsed rectum as well as Economics is still the major deterrent to precise and
uterine and udder amputation. extensive surgery in the various food animal species, as
Moller’s work was initially carried to the United States it has been for much of the history of veterinary
by W. L. Williams in Surgical and Obstetrical Operations, surgery. Cattle value has increased as a result of artificial
and later by such classic texts as Veterinary Surgery by insemination and, more recently, embryo transfer tech-
E. R. Frank and Surgical Principles and Techniques by niques, which have spurred new interest in bovine
W. F. Guard. However, these textbooks and many of the surgery. The future of commercial cloning is presently
earlier works were primarily equine. Frank mixes equine uncertain but may drive the development of future sur-
and bovine surgery within chapters devoted to organ gical techniques.
systems, whereas Guard devotes 30 out of 240 pages to It has been a privilege during my 40 years associated
bovine surgery. The Textbook of Large Animal Surgery with farm animal surgery to experience the hand of the
(1974), Techniques in Large Animal Surgery (1982), great masters and witness the breaking of the “golden
Atlas of Large Animal Surgery(1985), and Food Animal age” of food animal surgery.
Surgery (1994) were more recent contributions regard-
ing food animal surgery. There have undoubtedly been
other contributions not mentioned here, as well as more
RECOMMENDED READINGS
specialized books, such as Ruminant Urogenital Surgery,
that have greatly expanded our knowledge of surgery in
Directory of the American Veterinary Medical Association, 39th
the food animal species.
edition. Schaumburg, 1990, The American Veterinary Medical
Since the middle 1900s, food animal surgery has Association.
become a recognized specialty. The American Associa- Dollar JAW: Moller’s Operative Veterinary Surgery. New York, 1894,
tion of Bovine Practitioners and American College of William R. Jenkins Company.
Dunlop RH, Williams DJ: Veterinary Medicine, an Illustrated History.
Veterinary Surgeons were founded in 1965. The
St. Louis, 1996, Mosby.
European College of Veterinary Surgeons was estab-
Frank ER: Veterinary Surgery.Minneapolis, 1939, Burgess Publishing
lished in 1991. These three organizations have helped Company.
focus on the need for specialists in bovine medicine and Guard WF: Surgical Principles and Techniques.Columbus, Ohio, 1953,
surgery and to advance the specialty of bovine practice. WF Guard.
Hofmeyr CFB: Ruminant Urogenital Surgery. Ames, Iowa, 1987,
Although the American and European Colleges of Vet-
Iowa State University Press.
erinary Surgeons are composed primarily of small animal
Kersjes AW, Nemeth F, Rutgers LJE: Atlas of Large Animal Surgery.
and equine surgeons, they have greatly enhanced all Baltimore, 1985, Williams and Wilkins.
veterinary surgery and advanced surgery specialties in all Liautard A: Animal Castration.New York, 1884, William R. Jenkins
animal species. Company.
Merillat LA, Campbell DM: Veterinary Military History of the Uni-
A review of veterinary surgery from the beginning
versity States.Kansas City, 1935, The Haver-Glover Laboratories.
indicates many procedures have been tried for 100 years
Noordsy JL: Food Animal Surgery. Trenton, NJ, 1994, Veterinary
or more. However, recent advances in anesthesia have Learning Systems.
allowed food animal surgeons to be more meticulous in Oehme FW: Textbook of Large Animal Surgery. Baltimore, 1972,
their approach and to practice aseptic technique more Williams and Wilkins.
Smithcors JF: The Veterinarian in America (1625-1975). Santa
easily. Surgeons can perform more delicate surgery and
Barbara, Calif., 1975, American Veterinary Publications, Inc.
more exacting tissue apposition using the newer suture
Schwabe CW: Cattle, Priests and Progress in Medicine.St. Paul, 1978,
materials, which leads to improvements in healing and University of Minnesota Press.
better cosmetic results. Advancements in antimicrobials Swabe J: Animals, Disease and Human Society. New York, 1999,
and fluid therapy have helped improve aftercare and have Routledge.
Turner SA and McIlwraith CW: Techniques in Large Animal Surgery.
provided superior results. Most recently, improvements
Philadelphia, 1982, Lea and Febiger.
in pain medications and increased use of pain manage-
Williams WL: Surgical and Obstetrical Operations.Ithaca, N.Y., 1906,
ment has increased patients’ well-being. published by author.
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PART I
General Considerations
1
C H A P T E R
EXAMINATION OF
THE SURGICAL PATIENT
Gillian A. Perkins
Physical Examination Hydration can be estimated by evaluating a palpebral
or cervical skin tent, moistness of the nose, and depth of
This section focuses on examination of the cow the eye within the socket. A packed cell volume (PCV)
abdomen. Examination of the other body systems is and total protein quantitates the hydration status of the
discussed in the relevant chapters. Every good physical cow. The temperature, pulse, and respiratory rates will
examination begins with a good history. The basic infor- indicate the systemic health of the patient. One must also
mation consists of the cow’s lactation number, days in look for evidence of hypocalcemia, such as muscle fasci-
milk, diet, and pregnancy status. The herd person typi- culations, weakness, sluggish papillary light reflexes, and
cally provides an accurate history—including any fever, cold extremities (e.g., the pinna), which could result in
previous medications or surgery, feed intake, changes in rumen and intestinal hypomotility.
ration, and manure production. The paralumbar fossas and the right paramedian
The physical examination should begin with an abdomen should be evaluated for evidence of previous
evaluation of the overall well-being of the cow and her surgery or toggle-pin fixation. A quick oral examina-
attitude. Many diseases in the cow present as merely tion should be performed to check for oral ulceration
a decrease in milk production and appetite (e.g., left- and abnormal breath (ketosis or lung abscess). Concur-
displaced abomasum, right-displaced abomasum, and rent periparturient disorders such as mastitis and ketosis
ruminal distention), and the cow often appears quiet yet often exist. Therefore an examination of the udder that
somewhat normal. The more acute, severe disorders such includes palpation, a California mastitis test (CMT), and
as lactic acidosis, abomasal volvulus, cecal volvulus, and strip plate analysis, along with urine ketone test, includes
hardware disease will show evidence of dehydration is necessary.
(mild to severe shock), abdominal pain, and general Examination of the gastrointestinal tract includes
malaise. A history of colic and/or presence of abdomi- evaluation of the abdominal shape for evidence of dis-
nal pain at the time of physical examination should alert tension or bloat, auscultation of the rumen and intestinal
the veterinarian to act quickly and suspect causes such as motility, simultaneous auscultation and percussion
indigestion or diseases that require surgical attention, (pinging), ballottement, and rectal examination. Ancil-
such as intestinal obstruction or cecal disease. lary diagnostic tests such as abdominocentesis, rumen
3