C-Section/CV Prolapse

Question 1

What is the standard celiotomy approach for C-section in ruminants?

Answer 1

Left side Standing PL Fossa Celiotomy

Question 2

How do we make our incision for left oblique celiotomy in our approach for C-section?

Answer 2

• 10cm cranial & 10cm ventral to cranial aspect of tuber coxae
• extends cranioventrally @45°
• ends 3cm caudal to last rib

Question 3

How long should the second stage last before we should worry & intervene?

Answer 3

20-30min

need to ask owner about time since rupture of chorioallantois,
bc that will tell us how long she’s been in the second stage
& thus, how long the foal has been trying
to switch fromplacental O₂ supply → env’t’l O₂

Question 4

How do we differentiate b/t cervical & uterine prolapse in cows & ewes?

Answer 4

cervical happens in late gestation

uterine happens post-partum

Question 5

What is the pathophysiology behind CV Prolapse?

Answer 5

Last 1/3 of pregnancy…
increased intra-abdominal pressure + relaxation of pelvic canal & perineum
{gravid uterus inc.pressure}
→ HI [E₂] & [relaxin]

→ folding of vaginal floor @vestibulovaginal junx
→ irritation of exposed mucosa → straining

Question 6

What may hinder prolapse reduction?

Answer 6

urinary bladder or SI may be contained w/in prolapse;

UB→ Urethral occlusion → filling/enlargement of bladder → may hinder prolapse reduction

Question 7

What are some predisposing factors for increased intra-abdominal pressure?

Answer 7

• Pregnancy {large uterus in late gestation}
• intra-abdominal fat {obesity}
• Relaxation of pelvic structures
  
  • grazing E₂ plants/compounds
  • admin of E₂ compounds {growth-promoter implants}
  • embryo recovery programs {repeated superovulation}
• sheep:
  
  • recumbency
  • hilly pastures
  • multiple pregnancies

​

Question 8

What are the genetic predispositions for cervicovaginal prolapse?

Answer 8

• cows
  
  • Brahman*
  • Hereford
    ​
• sheep
  
  • kerry hill*
  • Romney Marsh

Question 9

How do we treat cervicovaginal prolapse?

Answer 9

epidural anesthesia

clean prolapsed vagina, lubricate, & dec.swelling…{glycerin, sugar}

empty bladder
lift prolapsed mass to straighten urethra…

if that doesn’t work,
drain bladder w.needle thru vaginal wall

THEN try to reduce…gently. & hold it in place until circulation is reestablished

Question 10

What is a Buhner suture?

Answer 10

deeply placed around vestibulum {buried purse string}

• provides support @vestibule-vaginal junction
• action of constrictor vestibulae m.

suture in vulvar lips {Caslick’s}

⇒ do NOT prevent eversion of vagina into vestibule