 Regurgitation Aspirationof rumen contents Bloat, compromises breathing Inadequate ventilation Due to drugs relaxing ...
 Recommendations-   Withhold feed prior to general anesthesia-   Intubate with a cuffed endotracheal tube-   Assist or co...
 Potential   problems:-   External pressure from improper    positioning or poor perfusion can produce    myopathy-   Neu...
 Proper    positioning Padding all pressure points Lower forelimb stretched forward to avoid  radial nerve paralysis in...
 Potential problems- Hypotheria- Immature liver and kidneys- Hypoglycemia Recommendations- Heating pad used with caution...
 Potential  problems- Strong laryngeal reflex- Laryngeal spasm- Aspiration Recommendations- Stiffer clear plastic endotr...
-   Suction saliva if necessary-   Lidocaine sparingly if needed for    laryngospasm-   Intubate and extubate in sternal  ...
Xylazine- One tenth of equine dose IV- Low conc. 20 mg/ml- Smaller ruminants dilute to 1 mg/ml- Goats are more sensitive t...
 Xylazine/ketamine-   Xylazine .02 -.08 mg/kg IV, wait 5 minutes    and apply casting rope and halter to assist    in to ...
 Xylazine-ketamine-guaifenesin-   50 mg xylazine-   500 mg ketamine in 500 ml of 5%    guaifenesin-   .5-1 mg/kg/hour max...
 Considerations    of IV maintenance-   Intubation may be necessary to prevent    regurgitation and aspiration-   Drug ov...
-   Not recommended for juveniles or small    ruminants-   Use only 5% guiafenesin, 10% causes    RBC hemolysis-   IV nece...
 Sheep  and goats- Withhold food 12-24 hours- Don’t withhold water, just avoid excessive  intake Calves, lambs, kids- Wi...
 Adult  cows and bulls-   Withhold food for 36-48 hours-   Withhold water for 13 hours-   Bradicardia may occur due to wi...
 Recommendations- Individual variation-   .5-2% halothane or 1-2%  isoflurane- Monitor pulse quality, heart rate, respira...
1. xylazine/ketamine IM- Xylazine .08-1 mg/kg wait 10 minutes for  sedation and give ketamine 8-10 mg/kg Im- Adv:a. Good i...
- Disadva. hypotension, respiratory depressionb. Sting of IM ketaminec. Not recommended for >300 lbs due to   volume neede...
2. 5% guaifensesin/ketamine IV- Mix 1 mg of ketamine per 1 ml guaifenesin  solution- Dose at .5-1 ml/kg- Wait max 1 minute...
- disadv:a. IV catheter necessary due to guaifenesinb. GG can cause RBC hemolysis
3. Diazepam/ketamine- Diazepam .1-.2 mg/kg IV wait 5  minutes, ketamine 2.2-4.4 mg/kg IV- Adv:a. Good induction for neonat...
- disadv:a. Diazepam may cause   excitement, especially in adults4. xylazine/ketamine- Xylazine .08-.1 mg/kg wait for seda...
1.     Phenylbutazone- PBZ or Bute-    injectable, tablets, oral paste-    NOTE: must be given IV only by injection.     A...
2. Flunixin meglumine ( banamine)- Injectable, oral paste- Injectable must be given IV or IM.  Administered BID or TID. Po...
3. Ketoprofen ( ketofen)- Injectable, human formulation ( alleve) has  been given orally but not approved route of  admini...
4. Diclofenac ( surpass)- Topical cream to be rubbed over affectedareas
1.    Acepromazine-    Injectable, tables-    Tranquilizers, NOTE: do not administer this     medication to an already exc...
2. Xlazine ( rompun)- Injectable- Potent sedative and analgesic which may  be administered IV or IM- Ruminants highly sens...
3. Butorphanol ( torbugesic)- Injectable- Commonly used to manage colic pain.  May be administered IV or IM4. Detomidine (...
 Due  to complex bacterial ecosystem in the  ruminant and horses GI tract, there are few  antibiotics which may be safely...
 Glucosamine/chondroitin   sulfate (    cosequin)-   Powder-   Often requires 30-60 days administration    before benefit...
1. Polyglycosylated aminoglycan ( adequan)- Injectable IM or intra articulare- For treatment and or minimization of wear  ...
3. clenbuterol- ventipulmin- Oral syrup- Bronchodilator for COPD, treatment of  lower airway diseases4. Omeprazole – gastr...
5. Ponazuril- marquis- Metered dose oral paste, 28 day regimen- For treatment of EPM, symptoms may  worsen initially as pa...
 Ifit is not labeled for use in production  animals, don’t use it in production animals. There is more latitude in compa...
 Anesthesia-   a state characterized by loss of  sensation- General anesthesia is a loss of sensation  associated with a ...
 Permits  surgery to be safely and humanely  performed on the conscious patient Agents: caine family:  lido, carbo, mepi...
2. Infiltrative “line block”- Laceration or wound repair- Dermatologic procedures, skin biopsy- Castration- Standing lapar...
3. perineural- epineural- anesthetic injecteddirectly over a nerve, desensitizing distalareas innervated by that nerve- De...
5. Epidural- Areas desensitized:  anus, perineum, vulva, vagina- Dystocia correction- Repair of prolapsed vagina/uterus- P...
    General considerations-    Adequate trained staff must be present to restrain     animal during induction and for sur...
 Regurgitation and or bloat can be serious  complications of general anesthesia Elective surgery withhold food for 36-48...
1. acepromazine- tranquilizer2. Xylazine- Profound sedation- head drop and marked  ataxia, up to 1-2 hours- Despite ataxia...
3. detomidine- similar to xylazine but withoutataxia, useful for standing procedures4. butorphanol- predominant function i...
 Masking down with inhalation agent- Patient selection based on size, weight, ability to  tolerate physical restraint- Ri...
 Endotracheal1.   cattle/horses- blind intubation, fully     extend head, align with cervical spine2.   Swine- very diffi...
 Isoflurane- about 3.5% Oxygen delivery- 1 liter/250 lb body  weight, minimum flow 3 liters per minute Fluids/electroly...
 Indicationsa. PCV <20%, HbB < 5 g/dlb. Massive >40% total blood volume   hemorrhage Donor selection- Cross match with a...
 Heart rate- Cattle 60-80 ( < 48 trouble)- Horses 30-48 ( <28 trouble)- Swine 60-100 ( < 50 trouble) Pulse quality/blood...
 Respiration  rate- Spontaneous respiration 6-12 breaths per  minute- Mechanical ventilationa. Assisted requires spontane...
 Capillaryrefill time < 2 seconds Corneal reflex- not applicable to  swine, horses and ruminants onlya. Hyperractive-pai...
 Paralysis-  from direct pressure to  superficial nervesa. Facial paralysis- always remove halter   after anesthetic indu...
 Myositis/rhabdomyolysisa.   Pressure hypotension ( sustain MAP at     <60 mm Hg)b.   Padding inadequate between animal a...
 Malignant   hyperthermia-   Horses and swine-   Monitor body temperature during    anesthesia-   Body temperature > 106
 Ruminants- Sternal recumbency- Extubate only when active swallow reflex  is present Horses- Prone to violent recovery, ...
 Considerationsa.   Safety of personnelb.   Aestheticsc.   Carcass disposal
 Techniques- Medication optiona. To sedate or notb. Euthanasia solution +/- succinylcholine   (paralytic agent)c. Barbitu...
 Carcass    disposal-   Local regulations/zoning restrictions may    dictate options-   Animal disposal companies-   Buri...
Special Considerations For Anesthesia In Ruminants
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Special Considerations For Anesthesia In Ruminants

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Special Considerations For Anesthesia In Ruminants

  1. 1.  Regurgitation Aspirationof rumen contents Bloat, compromises breathing Inadequate ventilation Due to drugs relaxing the pharyngoesophageal and gastroesophageal sphincters and suppressing the swallowing reflex. Anesthesia also decreases gut motility
  2. 2.  Recommendations- Withhold feed prior to general anesthesia- Intubate with a cuffed endotracheal tube- Assist or control ventilation with 100% Oxygen- Maintain in lateral recumbency only when necessary. Sternal recumbency allows eructation and facilitates ventilation
  3. 3.  Potential problems:- External pressure from improper positioning or poor perfusion can produce myopathy- Neuropathy due to pressure
  4. 4.  Proper positioning Padding all pressure points Lower forelimb stretched forward to avoid radial nerve paralysis in lateral recumbency Upper limbs supported at height of proximal joint in lateral recumbency Support circulating blood pressure and volume when necessary ( maint 10ml/kg/hr) Maintain light anesthesia
  5. 5.  Potential problems- Hypotheria- Immature liver and kidneys- Hypoglycemia Recommendations- Heating pad used with caution- Dextrose in fluids ( 2.5% dextrose/LRS)- Avoid xylazine and barbituates- Recommend isoflurane- Nursing up to anesthesia and as soon after as they can swallow- Diazepam for sedation and premed
  6. 6.  Potential problems- Strong laryngeal reflex- Laryngeal spasm- Aspiration Recommendations- Stiffer clear plastic endotracheal tubes- Stylets are useful, laryngoscopes- Full extension of head and neck for full visualization
  7. 7. - Suction saliva if necessary- Lidocaine sparingly if needed for laryngospasm- Intubate and extubate in sternal recumbency- Extubate only if swallowing- Pull endotracheal tube to larynx before deflating cuff
  8. 8. Xylazine- One tenth of equine dose IV- Low conc. 20 mg/ml- Smaller ruminants dilute to 1 mg/ml- Goats are more sensitive than sheep- Bulls are more sensitive than cows- .02-.1 mg/kg IV- Yohimbine .1 mg/kg, give ½ dose slowly and repeat if necessary
  9. 9.  Xylazine/ketamine- Xylazine .02 -.08 mg/kg IV, wait 5 minutes and apply casting rope and halter to assist in to sternal recumbency- Ketamine- 2-4 mg/kg IV good induction in healthy animals
  10. 10.  Xylazine-ketamine-guaifenesin- 50 mg xylazine- 500 mg ketamine in 500 ml of 5% guaifenesin- .5-1 mg/kg/hour max 1 liter of solution per hour
  11. 11.  Considerations of IV maintenance- Intubation may be necessary to prevent regurgitation and aspiration- Drug overdose may cause apnea- Respiration may need to be assisted- Limited anesthetic plane- To be used following xylazine, ketamine induction if needed- Used in adults > 300 lbs
  12. 12. - Not recommended for juveniles or small ruminants- Use only 5% guiafenesin, 10% causes RBC hemolysis- IV necessary as guiafenesin is very irritating if perivascular
  13. 13.  Sheep and goats- Withhold food 12-24 hours- Don’t withhold water, just avoid excessive intake Calves, lambs, kids- Withhold food 2-4 hours- Don’t prevent water of prevent nursing- Calves, lambs and kids less than 1 month of age are monogastric and less prone to regurgitation
  14. 14.  Adult cows and bulls- Withhold food for 36-48 hours- Withhold water for 13 hours- Bradicardia may occur due to withholding food
  15. 15.  Recommendations- Individual variation- .5-2% halothane or 1-2% isoflurane- Monitor pulse quality, heart rate, respiratory rate- Palpebral reflex should be maintained. Bovine eye rotates ventrally and medially in light anesthesia- Ventilation may need assisstance- Periods of apnea are commona. Verify anesthesia is not excessiveb. Assist ventilation for gas exchange
  16. 16. 1. xylazine/ketamine IM- Xylazine .08-1 mg/kg wait 10 minutes for sedation and give ketamine 8-10 mg/kg Im- Adv:a. Good induction in healthy adults when IV access is not possibleb. Longer duration of anesthesia than with IV inductions to facilitate induction
  17. 17. - Disadva. hypotension, respiratory depressionb. Sting of IM ketaminec. Not recommended for >300 lbs due to volume neededd. Goats sensitive to xylazine
  18. 18. 2. 5% guaifensesin/ketamine IV- Mix 1 mg of ketamine per 1 ml guaifenesin solution- Dose at .5-1 ml/kg- Wait max 1 minute for effect- Maintain sternal for intubation- Adv:a. No premed necessaryb. Titrate to effect if necessary
  19. 19. - disadv:a. IV catheter necessary due to guaifenesinb. GG can cause RBC hemolysis
  20. 20. 3. Diazepam/ketamine- Diazepam .1-.2 mg/kg IV wait 5 minutes, ketamine 2.2-4.4 mg/kg IV- Adv:a. Good induction for neonates, small ruminants, and debilitatedb. No cardiovascular depression at these dosesc. May mask with isoflurane also
  21. 21. - disadv:a. Diazepam may cause excitement, especially in adults4. xylazine/ketamine- Xylazine .08-.1 mg/kg wait for sedation and place IV catheter, ketamine 2-4 mg/kg IV- Adv: good induction in healthy animals
  22. 22. 1. Phenylbutazone- PBZ or Bute- injectable, tablets, oral paste- NOTE: must be given IV only by injection. Administered BID. Causes severe tissue reaction, necrosis if administered perivascular, intramuscular, subcutaneous- Comments: used commonly for musculoskeletal pain at 1-4 mg/lb- Chronic use and or high dose results in ulceration of GI tract
  23. 23. 2. Flunixin meglumine ( banamine)- Injectable, oral paste- Injectable must be given IV or IM. Administered BID or TID. Potent analgesic may mask a surgical colic. Binds endotoxin. Chronic use and or high dose results in ulceration of GI tract or renal failure
  24. 24. 3. Ketoprofen ( ketofen)- Injectable, human formulation ( alleve) has been given orally but not approved route of administration in animals. Absorption, excretion data unavailable.- Given IM SID
  25. 25. 4. Diclofenac ( surpass)- Topical cream to be rubbed over affectedareas
  26. 26. 1. Acepromazine- Injectable, tables- Tranquilizers, NOTE: do not administer this medication to an already excited, agitated animal. It may create hyper exciteability
  27. 27. 2. Xlazine ( rompun)- Injectable- Potent sedative and analgesic which may be administered IV or IM- Ruminants highly sensitive, use 1/10 the horse dose- In horses, be aware that no matter how drunk the horse looks, it is capable of kicking violently and accurately. Never trust xylazine behind the navel
  28. 28. 3. Butorphanol ( torbugesic)- Injectable- Commonly used to manage colic pain. May be administered IV or IM4. Detomidine ( dormosedan)- Injectable- Commonly used to manage colic pain or for procedures requiring profound sedation
  29. 29.  Due to complex bacterial ecosystem in the ruminant and horses GI tract, there are few antibiotics which may be safely and or effectively administered orally. In production animals always confirm withdrawal time before administration
  30. 30.  Glucosamine/chondroitin sulfate ( cosequin)- Powder- Often requires 30-60 days administration before benefits are observed.- Many cheaper, copycat products are available over the counter but are less effective
  31. 31. 1. Polyglycosylated aminoglycan ( adequan)- Injectable IM or intra articulare- For treatment and or minimization of wear and tear lesions of articular cartilage2. Hyaluronic acid ( legend)- Single dose injectable for intra articular use
  32. 32. 3. clenbuterol- ventipulmin- Oral syrup- Bronchodilator for COPD, treatment of lower airway diseases4. Omeprazole – gastroguard- Oral paste- For treatment of equine gastric ulcers, very expensive
  33. 33. 5. Ponazuril- marquis- Metered dose oral paste, 28 day regimen- For treatment of EPM, symptoms may worsen initially as parasites die in CNS6. Betamethasone and diuretic- Bolus- Used to reduce edema
  34. 34.  Ifit is not labeled for use in production animals, don’t use it in production animals. There is more latitude in companion animals regarding off label use because the medication should not have the potential to enter the food chain.
  35. 35.  Anesthesia- a state characterized by loss of sensation- General anesthesia is a loss of sensation associated with a loss of consciousness- Regional anesthesia/local anesthesia, loss of sensation while consciousness is retained Analgesia- state in which stimuli is not perceived as pain Tranquilization/sedation- chemically induced state of calm
  36. 36.  Permits surgery to be safely and humanely performed on the conscious patient Agents: caine family: lido, carbo, mepivi, bupivi Methods of regional anesthesia:1. Topical- Lidocaine gel effective only on mm, disrupted skin- Proparacaine opthalmic solution
  37. 37. 2. Infiltrative “line block”- Laceration or wound repair- Dermatologic procedures, skin biopsy- Castration- Standing laparatomya. Left sided approach- rumenotomyb. Right sided approach- cesearan section
  38. 38. 3. perineural- epineural- anesthetic injecteddirectly over a nerve, desensitizing distalareas innervated by that nerve- Dehorning- Lameness diagnosis4. Intra articular- for lameness evaluation
  39. 39. 5. Epidural- Areas desensitized: anus, perineum, vulva, vagina- Dystocia correction- Repair of prolapsed vagina/uterus- Perineal surgery- fetotomy
  40. 40.  General considerations- Adequate trained staff must be present to restrain animal during induction and for surgical positioning- Minimize contamination of surgical sitea. Bathe animal if necessary to remove fecal materialb. Wrap feetc. Flush/rinse mouth to prevent material being pushed by endotracheal tube into lungsd. Clip and initiate surgical scrub on standing animal to minimize anesthesia timee. Note: direct relationship between length of anesthesia and risk of post anesthesia complications
  41. 41.  Regurgitation and or bloat can be serious complications of general anesthesia Elective surgery withhold food for 36-48 hours, withhold water for 12 hours Emergency surgery use rumen lavage NOTE: most ruminant surgeries can be performed with regional anesthesiaEquine: elective surgery, withhold food 12hours, water 6 hours
  42. 42. 1. acepromazine- tranquilizer2. Xylazine- Profound sedation- head drop and marked ataxia, up to 1-2 hours- Despite ataxia, horses can still viciously and accurately kick.- Analgesia up to 30 minutes- Ruminant dose is 1/10 the equine dose
  43. 43. 3. detomidine- similar to xylazine but withoutataxia, useful for standing procedures4. butorphanol- predominant function isanalgesia5. diazepam- muscle relaxation, sedationand decreased anxiety
  44. 44.  Masking down with inhalation agent- Patient selection based on size, weight, ability to tolerate physical restraint- Risk of injury to patient and or staff during excitement phase of induction Injectable induction- loss of consciousness and muscle relaxation- thiobarbituates, ultra short acting 5-15 minutes- Ketamine/tiletamine- dissociative anesthetics- Guiafenesin- muscle relaxant, used in conjunction with another induction agent
  45. 45.  Endotracheal1. cattle/horses- blind intubation, fully extend head, align with cervical spine2. Swine- very difficult, must use laryngoscope3. Goats/sheep- virtually never place on gas anesthesia, value of animal vs. cost of procedure
  46. 46.  Isoflurane- about 3.5% Oxygen delivery- 1 liter/250 lb body weight, minimum flow 3 liters per minute Fluids/electrolyte replacement- Maintenance 3-5 ml/lb/hr- Replacementsa. Blood loss <40% administer 3 ml crystalloid solution for each ml blood lost( in addition to maintenance needs)b. Blood loss >40% transfusion required
  47. 47.  Indicationsa. PCV <20%, HbB < 5 g/dlb. Massive >40% total blood volume hemorrhage Donor selection- Cross match with agglutination and lysis tests, critical when multiple transfusions are performed- Universal donor is adult male that has never received a transfusion
  48. 48.  Heart rate- Cattle 60-80 ( < 48 trouble)- Horses 30-48 ( <28 trouble)- Swine 60-100 ( < 50 trouble) Pulse quality/blood pressure assessment- Direct palpation- Direct measurement of arterial blood pressure, cannulation, catheterization- Mean arterial blood pressure 80-110 mm Hg ( <60 or > 160 trouble)
  49. 49.  Respiration rate- Spontaneous respiration 6-12 breaths per minute- Mechanical ventilationa. Assisted requires spontaneous respiratory effortb. Controlled does not require spontaneous respiratory effortc. Assisted kicks into controlled when ventilation level falls below a certain level
  50. 50.  Capillaryrefill time < 2 seconds Corneal reflex- not applicable to swine, horses and ruminants onlya. Hyperractive-pain, hypotension, hypoxia, ketamineadministration, inadequate plane ofanesthesiab. Hyporeactive- CNSdepression, excessively deep plane ofanesthesiaNOTE: you can wear out this reflex by
  51. 51.  Paralysis- from direct pressure to superficial nervesa. Facial paralysis- always remove halter after anesthetic inductionb. Radial nerve paralysis- inability to advance the limb, positioning of limbs during lateral recumbency is critical
  52. 52.  Myositis/rhabdomyolysisa. Pressure hypotension ( sustain MAP at <60 mm Hg)b. Padding inadequate between animal and surgery table permits crushing of down muscles by animals body weight, resulting in localized ischemiac. Position: down forelimb should be advanced and up limbs limbs supported
  53. 53.  Malignant hyperthermia- Horses and swine- Monitor body temperature during anesthesia- Body temperature > 106
  54. 54.  Ruminants- Sternal recumbency- Extubate only when active swallow reflex is present Horses- Prone to violent recovery, require close monitoring, possibly physical restraine- Laryngeal spasm at extubation, tracheotomy kit should be kept in proximity of all equine recovery skills
  55. 55.  Considerationsa. Safety of personnelb. Aestheticsc. Carcass disposal
  56. 56.  Techniques- Medication optiona. To sedate or notb. Euthanasia solution +/- succinylcholine (paralytic agent)c. Barbituate and phenytoin ( beuthanasia)d. Vortech CIIe. Sleep away CII- Captive or live bolt bullet
  57. 57.  Carcass disposal- Local regulations/zoning restrictions may dictate options- Animal disposal companies- Burial- Cremation- Landfill- Zoos/wildlife parks will not accept animals euthanized with barbituates, carcass must be dressed out

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