Technical Procedures
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This document discusses several technical veterinary procedures commonly performed on horses, including nasogastric intubation, abdominocentesis, bronchoalveolar lavage, transtracheal wash, urinary catheterization, arthrocentesis, and regional analgesia/anesthesia. For each procedure, the document outlines the indications, required equipment, basic steps of the procedure, and potential complications. The goal of these procedures is to provide fluid/medication administration, diagnostic sampling, treatment of various medical conditions like colic or respiratory disease, and pain relief for lameness exams or other procedures. Aseptic technique and minimizing complications like infection or tissue damage are important considerations for all technical equine medical procedures.
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Technical Procedures
- 2. NASOGASTRIC INTUBATION • Indications • Fluid/Medications • Choke relief • Dx/Tx colic • Equipment • NG tube • Bucket/Water • Pump • Procedure • Pass tube through nostril with head and neck held at an angle • Allow horse to swallow tube into epiglottis • Verify placement in stomach • Complications • Epistaxis • Aspiration pneumonia
- 3. ABDOMINOCENTESIS • Indications • Colic • Weight loss • Diarrhea • Equipment • 18-20g 1 ½” needle/teat cannula • #15 scalpel blade/lidocaine local block • Procedure • =/- U/S, aseptic prep of site, lidocaine block • Site-5 cm caudal to xiphoid, R of midline • Needle pushed through gauze to obtain clean sample • Complications • Enterocentesis • Splenic aspiration • Cellulitis • Abscess
- 4. BRONCHOALVEOLAR LAVAGE (BAL) • Indications • Dx of diffuse, noninfectious pulmonary disease • Recurrent airway obstruction • Inflammatory airway disease • Exercise-induced pulmonary hemorrhage • Equipment • BAL catheter or gastroscope • Procedure • Standing sedation for catheter/scope passage • Sample is spun, cells collected & mounted on slide • Complications • Excessive coughing • Non-diagnostic sampling • Bronchial hemorrhage • Sample from wrong site-catheter kink
- 5. TRANSTRACHEAL WASH • Indications • Infectious pneumonia • Mixed sample-lower respiratory tract • Equipment • Aseptic technique supplies • Transtracheal wash stylet • Light wrap materials • Procedure • Standing sedation, prep cranial & middle 1/3 of neck • TTW stylet inserted between tracheal rings & advanced distally • 20-50 ml Sterile Saline injected, then aspirated as stylet is removed • Complications • SQ emphysema &/or cellulitis • Wrong sample area • Minor bleeding/localized infection • Catheter breakage
- 6. URINARY CATHETERIZATION • Indications • Collect sterile samples • Check bladder integrity • Post operative care • Equipment • Aseptic supplies • Roll cotton/mild soap • Sterile lube • Foley/Urinary catheter • Females-tail wrap
- 7. MALES • Sheath Cleaning • Removes smegma • Removes beans from urethral fossa • Catheterization • Approx dist=60 cm • May use syringe to aspirate fluid
- 8. FEMALES • Tail Wrap • Neoprene • Shipping/Showing • No long term use • Roll Gauze • Medical procedures/foaling • Tail Wrap • Diarrhea/foaling/tail paralysis • Complications for all • Strangulating tissue death and loss of part or all of tail
- 10. FEMALES • Catheterization • Tail wrapped/tied/held • Perineum is cleaned • Approx dist=5-10cm • May aspirate fluid • Common Complications-both sexes • Irritation of tissues • Secondary bladder infection
- 11. ARTHROCENTESIS • Indications • Joint fluid sampling • Diagnostic/Therapeutic anesthesia • Localized medication administration • Equipment • Aseptic supplies +/- clippers • Sterile needles/syringes • Sterile anesthetics/medications • Light wrap materials • Procedure • Depends slightly on site • Complications • Joint inflammation/pain (flare) • Joint infection • Laminitis
- 12. REGIONAL ANALGESIA/ANESTHESIA • Indications • Lameness exams • Regional anesthesia for procedures • Equipment • Aseptic technique supplies • Sterile syringes/needles • Anesthetic solution • Procedure • Clean technique near ground • Aseptic technique higher limb/joints • Light wrap over injection site possible • Complications • Joint inflammation/pain • Skin inflammation/pain • Local infection