bovines.

1. Submitted by:
Arvinder pal singh
J-14-BV-891

2.  OPD No :3457 Date of admission:1/2/18
 Date of discharge :2218
 Doctor on duty :Dr. SHARAD KUMAR
 Name & RO :rajinder kumar, meran sahib.
 Species :bovine SEX :Female

3. History:
H/o dystocia observed since yesterday .
animal has completed the gestation period ,
animal has parturated three times earlier
healthy calves
Per vaginal examination :
Oedema observed in birth canal and probably
emphysema observed in fetus.foul smell was
observed.

4. Diagnosis :
Vaginal delivery not possible [refer to surgery for c-
section]
Treatment :
Inj. DNS -5L i/v
inj,. NSS -5L i/v
Inj. Enrocin-12ml i/m-3 days i/m

5.  Commonly termed as C-Section in which uterus is exteriorized
to take out the young one from the pregnant dam.
 CS is delivery of fetus , usually at parturation by
laparohysterotomy.
 This operation is performed when mutation, forced extraction
and fetotomy are deemed inadequate or too difficult to be
employed to relieve the impending or present dystocia.

6. Latin word
‘caedere’
‘section’
‘to cut’.
to light, strike,
or “to cut into,
separate,
divide”.
means
means

7. Maternal reasons:
• A relatively oversized fetus
• Inadequate cervical dilation
• Abnormal pelvic conformation
• Prepubic tendon rupture
• Uterine rupture
• Uterine torsion
• Uterine inertia
• Hydrops of the amnion or allantois
• Congential or traumatically induced vaginal
Constriction.

8. Fetal indications:
• Fetal malposition that is not correctable per Vagina
• Absolute fetal oversize
• Fetal monsters
• Emphysematous fetuses.

9. Ancillary indications:
• Elective cesarean section for the delivery of embryo
transfer calves
• The production of gnotobiotic Calves
• Terminal cesarean sections.

12.  --Standing left paralumbar celiotomy:
 Incision : caudal 3rd of paralumbar fossa

13. • Left flank incision is the most common technique
and is most appropriate for the standing animal.
• A right flank incision is uncommon; however, it is
indicated if the left flank approach is obstructed by
adhesion as a result of previous surgery

14. Left flank
laparotomy:
• The risk of small intestine
coming out from the site of
wound is negligible (merit).
• The rumen may cause
hindrance to access of the
uterus (demerit).
Right flank
laparotomy:
• Allow good access to a calf
in the right uterine horn
(merit).
• The risk of the small
intestine to come out from
the laparotomy wound is
higher (demerit).

15. ventro-lateral celiotomy :
 Restrain : lateral recumbancy
 Incision : parallels the superficial mammary vein , before
cutting an angle by the udder

17. • A ventro lateral incision is particularly indicated for
the removal of an emphysematous foetus.
• The cow should be in right lateral recumbency for
ventro-Iateral laparotomy.
ADVANTAGES:
 It gives good exposure of the uterus.
• Another advantage is, it minimizes the risk of
contamination from uterine contents to the
abdominal cavity or peritoneum.
DISADVANTAGES :
• Repair of the abdominal muscle layers are more
difficult because the muscles remain under tension
and sutures may tear the muscles.
• Risk of post-operative soiling of wound is more.

18. Left oblique celiotomy :
 Discovered by parish-et –al
 Standing celiotomy
 Incision : extends cranoiventrally at an 45 angle to end 3 cm
caudal to the last rib

19.  Ventral midline celiotomy:
 Restrain : dorsal recumbancy
 Incision : starting at the udder and extended towards the
xiphoid cartilage
 Paramedian celiotomy;
 Restrain : dorsal recumbancy
Midline or paramedian incision :
• It is not commonly used in the field condition because general
anaesthesia or heavy sedation is required and respiratory
function of the dam is compromised in this condition.
• Risk of post operative soiling of wound or herniation is higher.
• However this technique gives excellent access to the uterus.

21.  Generally caesarean section in cattle is performed under the
local infiltration anaesthesia using 2% lignocain
hydrochloride
 Sedation should be avoided (if possible) because it can cause
recumbency during surgery and may be detrimental to foetal
survival.
 If sedation is necessary, xylazine is commonly used (0.05-0.1
mg/kg b.w. I/M).
Unfortunately, xylazine is an ecbolic (increase
contraction of uterus),making surgery more difficult
and cause ruminal bloat which can obstruct the access
to the uterus.

22. Epidural anaesthesia:
Epidural anaesthesia is not essential but is useful to
prevent straining and tail movement during
surgery. Sometime it causes recumbency during
surgery (demerit).

23. The surgical technique is performed in following steps:
1. Opening of the flank
2. Locating the uterus
3. Opening of the uterus
4. Removal of the foetus
5. Management of the placenta
6. Closing of the uterine incision
7. Closing of the laparotomy incision

24.  Preparation of the Surgical site and washing of hand .
 Apply betadine iodine on the site.
 A large bold incision is made into the abdomen.
 Control the bleeding, ligation.
 Follow a blunt dissection.
 Cut a facial layer, and two muscle layers.
 Reach to the peritoneum.
 Hold the peritoneum and make a stab incision.
 Let the peritoneal fluid to drain, and open it.

25.  Try to reflect the omentum.
 Reach to the gravid uterus and exteriorate.
 Palpate the fetal parts.
 Apply a sterilized drap on it.
 Make an incision on uterus avoiding injury to a fetus.
 Hold fetal legs and gently remove it.
 Avoid intra-peritoneal contamination.
If the foetus in anterior presentation, then removed rear
end of foetus first at caesarean section and if the foetus is
in posterior presentation, then remove front end.

26.  Hold the incised uterine edges.
 Remove the fetal membranes gently if possible.
 Remove the uterine fluid.
 Wash it with the normal saline-3 times, Start suturing the uterus with
Lambert followed by Cushing suturing technique in a double layer
using #1 catgut.

27.  Suture two muscle layers separately using #2 catgut by lock
stitch or simple continuous method.
 Suture the peritoneum using #1 catgut, by lock stitch or simple
continuous method.
 Apply some antibiotic powder in-between 2 muscle layers.
 Suture skin layer with a cotton thread using horizontal
mattress method
Management of placenta:
• If the placenta is easily and quickly detachable, it should be
carefully removed from the uterus.
• If not, it should be left in the site even when the cervix is
closed.
• Furea bolus is kept in the uterus.

28.  Skin,
 Subcutaneous fascia
 Combined aponeurosis of the two oblique muscles
which forms the external sheath of the rectus
abdominis
 Transverse abdominis
 Peritoneum.

29.  Peritonitis
 Wound breakdown
 Seroma formation - A pocket of sterile serous
fluid accumulates between muscle layers or
under the skin. This can be confirmed when a
sterile needle is inserted - serum flow-out.
 Retention of the foetal membranes
 Metritis
 Infertility
 Mastitis (E. coli infection)
 Sudden death.

30.  Utmost care should be taken to avoid the spillage of
uterine contents into the peritoneal / abdominal
cavity.
 It should be lavaged with sterile normal saline
containing non- irritant antibiotics to counteract
the infection, reduce the chances of postoperative
adhesions and infection.
 The uterine torsion in case of cattle and buffaloes
should be then corrected. 50-60 units of oxytocin
hasten the uterine involution. A 5% solution of
dextrose and normal saline solution should be
invariably included in the schedule as most deaths
have hypoglycemia and hypochloraemia.

31.  Give a broad-spectrum antibiotic.
 Analgesic, Anti-inflammatory drug.
 Anti histaminic - For 3 to7 days.
 Oxytocin - 100 IU.
 Glucose 5%.
 Haemostatics if necessary.
 Give laxative feeds.
 Daily dressing of a wound.