Transcript Document

Chapter 23 and 24
Porcine Management and Surgical
Procedures
Dr. Dipa Brahmbhatt VMD MPH MS
Objectives
• Piglet management
• Prepare the surgical patient for surgery.
• Perform local anesthesia, or assist the veterinarian in
administering local anesthesia.
• Assist or perform induction and maintenance anesthesia.
• Provide anesthetic monitoring.
• Manage patient recovery and immediate postoperative care.
• Discuss the basic risks and possible complications associated
with anesthesia and surgery.
• Implement preventive measures when indicated.
Reading Assignment
Chapter 23, 24: Porcine Surgery
Piglet Diseases
• Frequently observe pigs for signs of disease so
prompt treatment is possible
• congenital defect seen is herniation (2%),
followed by cryptorchidism (1-2%
Diarrhea (scours) and dehydration
A dehydrated piglet
Diarrhea (scours)
Normal, bright yellow,
solid fecal material
E. coli
• Should affect < 3% of litters
• Mostly 1-5 days of age
• Main defense
-Antibiotics in milk
• Treat entire litter with antibiotics
-Gentamicin
-Spectinomycin
• Access to water
Difficulty walking and standing,
trembling or comatose
• Hypoglycemia
-Low blood sugar
• Streptococcus suis
-Strep suis
-Strep meningitis
Swollen hock joint
Swollen joints
• Bacterial infection
• Identify/treat early
-Penicillin
• Severely swollen
-Treatment ineffective
-Euthanize
Other conditions
Vomiting
Rough hair coat,
sluggishness, huddling
Greasy, Sticky and Dirty Skin
• Staphylococcus hyicus
invades skin
• Antibiotic therapy when
symptoms appear
• Wash piglet; treat
topically
• Minimize cuts in skin and
dirty equipment
Management
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Day of Birth: clip needle teeth
Day 1: dock tails
Day 2: castrate
Piglets should not be removed from the sow
longer than 1 hour
Neonatal care and procedures
• PE
• eyes closed calms the
piglet
Neonatal care and procedures
• injection of iron (usually iron dextran: 150200mg) IM
– Piglet's own reserves and the mother's milk
together supply enough iron for only a week
before the piglet becomes anemic
– Naturally from eating soil and plants
– Anemia: “baby pig thumps”: tachycardia
– Give 1-3 days and 2-3 wks or oral
supplementation creep feed
• castrated, teeth and tails are clipped: 1-3 days
Iron injection
• Within 3 to 4 days after birth.
• Without supplemental
– anemic by 7 days of age,
– compromising their well
being
– retarding their growth
• given when piglets are handled
for other purposes e.g.
vaccinations and removing sharp
teeth.
• Giving iron shots is an art.
– Most people are never 100%
accurate; ie. little or no
backflow of the compound
Clinical signs of Anemia
•
•
•
•
•
•
Lethargic: no energy, sleepy
Rough hair coat
Wrinkled skin
Dyspnea: Hard breathing
Poor growth
Blood hemoglobin level: < 10
mg/dl
Iron injection
• neck.
• all air bubbles are
out by holding the
syringe vertically,
tapping lightly and
pushing the plunger.
Iron injection
• skin taut by pulling the
ear forward.
• prick the skin, holding
the syringe as shown.
• Pull it up, then continue
into the muscle.
• Withdraw quickly,
allowing skin to cover
the site, preventing
backflow
Lower (mandibular) permanent teeth of the pig.
Note the large canine teeth or “tusks”
Clipping needle teeth
• These teeth are popularly referred to as the canine teeth.
• 8 needle teeth
• I3 and C1
Clipping of Needle Teeth
• Purpose
– to prevent injury to
littermates and to the sow’s
teats
• Complications
– Tongue laceration
– Stomatitis
• Equipment
– Needle tooth clippers or
cutting pliers
– Disinfect between piglets
• Age : 1 to 7 days
Teeth clipping
• above the gum line
– Avoid the tongue and
be sure to cut above
the gums to prevent
bleeding and
infection.
• the flat side of the of the
nippers is placed parallel
to the gum line
• 1-2 mm from gum line
Tail docked
• tend to bite the tails of litter mates
• Infection/ abscess > paralysis
• tails are docked (clipped) soon after
birth
• docking should be done during the
first 24 hours after birth
– minimize stress on the piglets
– easily held
– less likely to investigate a newly
docked tail
– Cartilage not hardened
Tail docked
• Side clippers (dull)/ baby
pig emasculators
• Hold the pig by the hind
feet and cut 1/2 to 1 inch
from the ham.
– avoids rectal prolapse
• Leave a flap of skin and
dip the stub in iodine
Lumbosacral Epidural Anesthesia
• C –section: Safe for fetus
• Cranial epidural: lidocaine 2%
• Location
– Connect wings of
Ileum
– Vertical line from
Patella insert 1 – 1.5 inches caudal to line on dorsal midline
• Sedate
• Restrain: hog snare
• Clip hair, skin aseptically prepared, 5 ml 2% lidocaine SQ 1-2 inches
Lumbosacral Epidural Anesthesia
Procedure: sterile gloves, 18 – 20G spinal needle, 3 inch: small swine and 100 kg – 4 inch,
200 kg – 5 to 7 inch. Use trocar if they bent.
• Lidocaine: 0.5 – 1 ml/ 4.5 kg BW, max 20 ml
• Anesthesia 5 – 10 min after injection
• Max at 20 minutes and lasts for 2 hours
• Low dose: caudal analgesia and high dose: cranially to lumbar 1
• Xylazine: 2 mg/kg: surgical anesthesia caudal to umbilicus and paralysis HL, begin 20 - 30
min and lasts for 2 – 3 hrs.
• > 3mg/kg HL paresis
• With 2% lidocaine lasts for 5 hours
General Anesthesia
Valuable breeding stocks and valued pets
General Anesthesia
• Risks
– Hyperthermia
• Do not efficiently sweat
– Malignant hyperthermia
• Under general anesthesia
– halothane
• fatal
• Rare in potbellied pigs
• Porcine stress syndrome
– Halothane gene
General Anesthesia - RISKS
– Prone to hypoventilation
– Airway obstruction
• Small narrow trachea:
dorsal – pharyngeal recess
• Laryngospasm
– Spray lidocaine
– ET tube ventrally until
arytenoid cartilage than 180⁰ turn
dorsally
• Laryngeal edema
– Respiratory depression: Worse with obesity
Preanesthetic Preparation
• Hx, PE, CBC if possible
• Food withdrawn
– Adults: 6 – 12 hours
– Piglets: 1 – 3 hours
• Atropine: 0.044 mg/kg IM
– Caudal to base of ear
Induction Drugs: withdrawal time
Route
Use
Recovery
Telazol/Ketamine/Xylazine
IM
Anesthesia: 20 – 30 min.
Induction
60 90
min.
1st: Atropine/Acepromazine
followed by Ketamine 20 min. later
IM
Anesthesia: 10 – 15 min.
Supplement analgesia
1st: Atropine/Xylazine
followed by Ketamine 10 min. later
IM
Anesthesia: 10 – 15 min
1st Xylazine than telazole 5 min. later
IM
Analgesia and muscle
relaxation: good, surgical
anesthesia: light
Sodium Pentobarbital
Intra
testicular
Anesthesia: 5 min
Inhalant gases: halothane (malignant
hyperthermia), isoflurane, sevoflurane
Thiobarbiturates
Small or heavily sedated
hog
IV
Auricular vein, safest
choice especially if
predisposed to MH
Drowsy ~
24 hr.
Anesthesia Monitoring
• HR: 50 – 150 bpm.
• Pulse assessment: auricular
and femoral artery
• Fluids: 10 mg/kg/hr
Figure 2. Top panel shows pig
anesthetized with medications that
do not trigger malignant
hyperthermia (note relaxed rear
legs). Bottom panel shows the same
pig developing an MH reaction after
receiving halothane. Please inspect
the rigidly extended hind limbs.
Modified with permission from
Harrison GG. The Discovery of
Malignant Hyperthermia in Pigs—
Some Personal Recollections.
Malignant Hyperthermia: A Genetic
Membrane Disease (Ohnishi, ST and
Ohnishi, T, eds) Boca Raton, FL: CRC
Press, p. 32, 1994.
• Hyperthermia
– MH > 107 ⁰F
• d/c inhalant, 100% O2,
cool body, DANTROLENE
(2.2 mg/kg IV) – muscle
relaxant, fluids with
bicarb., steroids
– > 103 ⁰F
– Muscle rigidity
– Tachycardia
– Tachypnea
– Metabolic acidosis
– Ketamine: increase body
temperature
Anesthesia Recovery
• Cool quiet environment
• Extubate: strong attempts to swallow, deflate
cuff
• Ventilate
• Prepare with tracheostomy
– # 10 blade
– Hemostats
– Cuffed tracheostomy
References
• K Holtgrew-Bohling , Large Animal Clinical
Procedures for Veterinary Technicians, 2nd
Edition, Mosby, 2012, ISBN: 97803223077323
• http://virtuavet.wordpress.com/
• http://edis.ifas.ufl.edu/an025
References
• http://cal.vet.upenn.edu/projects/swine/bio/g
row/nursing/hm.html
• http://www.ncsu.edu/project/swine_extensio
n/ncporkconf/2002/lay.htm
• http://www.avma.org/issues/animal_welfare/
default.asp