Thoracotomy in Cattle & Horses
Upcoming SlideShare
Loading in...5
×
 

Thoracotomy in Cattle & Horses

on

  • 1,841 views

Thoracotomy (Rib resection) in cattle and horses for management of pericarditis and pleuritis

Thoracotomy (Rib resection) in cattle and horses for management of pericarditis and pleuritis

Statistics

Views

Total Views
1,841
Views on SlideShare
1,836
Embed Views
5

Actions

Likes
0
Downloads
16
Comments
0

3 Embeds 5

http://www.docshut.com 2
http://www.slashdocs.com 2
http://www.docseek.net 1

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • In horses, very uncommon, but if dx, same principles apply
  • Fibrin bridges within 3 days between visceral and parietal pericardial surfaces
  • Minimal to no separation between epicardium & pericardium

Thoracotomy in Cattle & Horses Thoracotomy in Cattle & Horses Presentation Transcript

  • RIB RESECTIONINDICATIONS & PROCEDURE Dane Tatarniuk, DVM
  • Question 1 What are the two most common indications for rib resection?
  • Question 1 What are the two most common indications for rib resection?  Pericarditis  Pleuritis / Pleuropneumonia  Pericarditismore common indication in bovine  Pleuritis more common indication in equine
  • Pericarditis Etiology  Traumatic reticulitis  10cm between reticulum & pericardium  Wire, nails, etc.  Pointed objects 5 to 14cm in length  Trauma to external chest  Cardiac neoplasia  Lymphoma
  • Pericarditis Pathophysiology  Bacteria inoculation  septic inflammation  increased permeability  fluid exudation  influx neutrophils & fibrin  Fibrin bridges within 3 days  Collagen replaces fibrin by day 6  Extensive fibrosis by 1 month  Constrictive & restrictive pericarditis
  • Pericarditis Clinical symptoms  Jugular vein distension  Brisket edema  Submandibular edema  Cardiac abnormalities
  • Pericarditis Diagnostics  Auscultation  Splashheart beats  Muffled heart sounds  Ultrasound  4-6th intercostal spaces, level of elbow  Effusion : anechoic  Exudate : granular, waving strands  Thickened sac : organized fibrin, collagen  Radiographs  Cardiomegaly appearance
  • Pleuritis  Cows  Pleuritiswith pyothorax or pleural fluid  Daily lavage, maintain drainage
  • Question 2 Do cattle have complete or incomplete mediastinum?
  • Question 2 Do cattle have complete or incomplete mediastinum?  Complete Complete mediastinum  Only lung on affected side collapses following thoracotomy  Other lung unaffected  Respiration usually stays normal Horses  Incomplete mediastinum  Walled off – then OK
  • Pericarditis  Pericardiocentesis  Higher risk  Caudal to left elbow, sternum to mid-chest  Tie left front forward  18 gauge, 6 inch needle  Slowly advance needle  Watch for needle to move synchronous with heart beat  Aspirate blood – back up  Collect fluid for cytology, culture  Rumen bacteria
  • Pericarditis  Percutaneous pericardial drain  Earlier stages of pericarditis (mostly fluid, little fibrin)  Large bore sterile chest tube  Similar insertion as for pericardiocentesis  Egress fluid continuously  Ingress lavage daily  Pull tube once fluid flushes clear
  • Thoracotomy  Standing, local lidocaine block  Incision over 5th or 6th rib  6th rib  Preferred - posterior to shoulder  5th rib  Adductionof limb during movement  Subcutaneous air under forearm, scapula  More prone to cellulitis
  • Thoracotomy Incision started at costo-chondral junction  Extend dorsally 20cm  Lower than CC junction  Lateral thoracic artery & vein Overlying thoracic muscles incised  Dorsally  Latissimus dorsi muscle  Serratus ventralis muscle  Ventrally  Pectoralis profundus muscle  Aponeurosis of obliquus externus abdominis muscle
  • Thoracotomy Periosteum incised by scalpel Periosteum retracted cranially & caudally with periosteal elevators
  • Thoracotomy Gigli wire placed 18cm above CC junction Transect Rib wide and thin Disarticulate rib at CC junction
  • Thoracotomy Incise pleura  Carefully Exteriorize pericardium and suture to skin edge  Same principle as rumenostomy Can drain pericardial fluid with needle, suction Incise pericardial sac Manually remove fibrin, clots Lavage sac liberally with saline Leave open or close with drain
  • Thoracotomy  Post-operative  Cover thoracotomy site with sterile towel or combine roll  Held in place with umbilical tape  Broad spectrum antibiotics  Incision examined, flushed daily  Wound kept open as long as fetid material egresses  Can take wound up to 1 month to close
  • Prognosis Cattle  15% survival for pericarditis  71% survival for pleuritis Horses  88% survived surgery  46% returned to intended use
  • QUESTIONS ?