التفاصيل البيبلوغرافية
| العنوان: |
REPAIR OF LEFT DISPLACED ABOMASUM IN A COW WITH THE TPS PROCEDURE USING MAKESHIFT EQUIPMENT. |
| Alternate Title: |
RJEŠAVANJE DISLOKACIJE SIRIŠTA U LIJEVU STRANU KOD KRAVE PRIMJENOM PROCEDURE ZATEZNOG ŠAVA KORIŠTENJEM IMPROVIZIRANE OPREME. (Bosnian) |
| المؤلفون: |
Benchohra, Mokhtar |
| المصدر: |
Veterinaria; 2022, Vol. 71 Issue 1, p91-99, 9p |
| مصطلحات موضوعية: |
RUMEN (Ruminants), COWS, MINIMALLY invasive procedures, WHEAT bran, ABDOMINAL muscles, ABDOMINAL wall, ARTIFICIAL insemination, ASEPSIS & antisepsis |
| Abstract (English): |
Due to the need for veterinary intervention when surgery is required to correct a case of left displaced abomasum (LDA) in cattle, less expensive alternative procedures have been developed. The toggle-pin suture (TPS) procedure offers a lot of benefits, as it is a minimally invasive procedure with a high success rate. The purpose of this report is to show that it is possible to perform the TPS procedure with an available and low-cost material. It is about a case of recurrent indigestion that had lasted about 15 days in a 7-year aged Holstein dairy cow. Examination of the digestive system revealed overload of rumen and decreased motility, but the most significant clinical finding was an area of tympanic hyper-resonant “ping” heard on the left side of the flank, mainly in the middle and dorsal aspect of the abdomen at the level of the 9th to 12th intercostal space, revealed by auscultation and percussion exam. The decision was made to proceed with TPS for the abomasum repair because of the poor body condition of the cow, which may not survive surgery. Then, we proceeded with a supportive treatment in order to prepare the cow for the abomasum repair, scheduled for the next day. The cow received an infusion of NaCl 0.9% and glucose 5%, and a general tonic injected via IM route. The improvised equipment consisted of: a medium trocar/cannula with a diameter of 10 mm to be used for rumen puncture, a 15 cm push rod, 5 cm rods made using a tube for bovine artificial insemination (5 mm diameter), and a lined fishing line (USP n°1) used to tie the rods. Iodine tincture 10% was used for disinfection of the equipment and for puncture site antisepsis. The cow was cast on her right side and rolled onto her back, andher front and rear legs were inserted separately. Auscultation and simultaneous percussion of the body wall between the umbilicus and xyphoid on the right side of the ventral midline for detection of “ping”, reveal the location of the abomasum and the site of trocarization. After local anesthesia had been applied at the elected trocarization points, two incisions of 1 cm each were made in the skin and the abdominal muscle. Then, the trocar/cannula was inserted through the incised points into the abdominal wall and then, in the abomasum; the trocar was removed and the cannula left in place. A bar suture was placed in the cannula and pushed into the abomasal lumen. The cannula was then removed, leaving the suture in place. Similarly, a second puncture was made about 5 cm from the first. Some abomasal liquid was allowed to escape prior to removal of the cannula; afterwards, the gauze was put between the threads, which were tied tightly. The cow was then rolled into the left lateral recumbency and allowed to stand. The recommended daily diet consists of 2 kg of wheat bran and 10 l of water, while avoiding roughage for 3 to 4 days, in order to achieve rumen emptying. The next day, the cow started defecating in large amounts; it got up easily and had a good reflex and appetite. We continued with anti-inflammatory (flunixin) and antibiotic (amoxicillin) drugs. In addition, neostigmine was administered to promote abomasum and small intestine motility. Starting from Day six,, the cow began feeding vetch-oat hay (3 kg twice a day). A week later, the cow showed a decrease in appetite and activity as well the presence of purulent discharge from the puncture site. This was most probably due to local peritonitis caused by the leakage of abomasal fluid into the peritoneal cavity, which led us to prescribe to the cow 3 days of penicillin/streptomycin treatment. At the same time, we cut the nylon thread suspected to be responsible for tissue reaction. With the persistence of slight purulent discharge, a final injection of Naxcel® was administered, following which the cow improved significantly, however, the puncture site remained firm to palpation. Over the course of 60 days of monitoring, the cow showed no problems, indicating the success of our experiment. We conclude that the use of available and inexpensive equipment to perform abomasal fixation by the TPS method is an easy and safe alternative for veterinarians practicing in countries with limited resources. However, we recommend to use a smaller gauge trocar/cannula and rods, and to opt for silk (4-5 USP) thread rather than the fishing line for rod fixation. [ABSTRACT FROM AUTHOR] |
| Abstract (Bosnian): |
Zbog potrebe za veterinarskom intervencijom kod hirurškog rješavanja dislokacije sirišta u lijevu stranu (LDA) kod krava, razvijene su jeftinije alternativne procedure. Procedura zateznog šava (TPS) ima mnogo prednosti, s obzirom da se radi o minimalno invazivnoj proceduri s visokim procentom uspiješnosti. Cilj rada je pokazati mogućnost izvođenja TPS procedure koristeći dostupan i jeftin materijal. Prikazujemo slučaj sedmogodišnje holstein mliječne krave sa recidivirajućim poremećajem varenja u trajanju od 15ak dana. Pregledom probavnog sistema je otkriveno uvećanje buraga uz smanjen motilitet, a najznačajniji klinički nalaz je predstavljalo područje timpaničnog hiper-rezonantnog “pinga”, koji se čuo na lijevom boku, najizraženije u središnjem i dorzalnom aspektu abdomena od visine 9.-12. interkostalnog prostora, a koji je otkriven auskultacijom i perkusijom. Donijeli smo odluku da dislokaciju sirišta tretiramo TPS procedurom s obzirom na teško fizičko stanje u kojem se krava nalazila i mogućnost letalnog ishoda operativnog zahvata. Da bismo kravu pripremili za operativni zahvat koji je bio zakazan za naredni dan, započeli smo sa suportivnom terapijom. Aplicirali smo infuziju 0.9% NaCl, 5% glukozu i sredstvo za jačanje intramuskularno. Improvizirana oprema se sastojala od: srednjeg troakara/kanile promjera 10 mm koji su korišteni za probijanje buraga, štapića dužine 15 cm za provlače nje, više štapića dužine 5 cm napravljenih od cjevčice koja se koristi kod vještačke inseminacije krava (prečnika 5 mm) i ribarskog najlona (USP n°1) za vezivanje štapića fiksatora. Za dezinfekciju opreme i mjesta uboda je korištena 10% jodna tinktura. Kravu smo oborili na desnu stranu, potom na leđa i odvojeno fiksirali prednje i stražnje noge. Auskultacija i simultana perkusija zida između umbilikusa i ksifoidnog nastavka s desne strane ventralne srednje linije otkrile su “ping” koji je lokalizirao sirište i mjesto za trokarizaciju. Nakon aplikacije lokalnog anestetika na mjesta trokarizacije, na koži i abdominalnom mišiću su napravljene dvije incizije dužina 1 cm. Prvo smo kroz rezove na abdominalnom zidu i samo sirište ubacili troakar/kanilu, potom izvadili troakar i ostavili plasiranu kanilu. Zatezni šav je postavljen u kanilu i gurnut u lumen sirišta. Onda je izvađena i kanila, a šav je ostao na svom mjestu. Na sličan način smo na oko 5 cm od prvog reza načinili drugi ubod. Prije vađenja kanile smo evakuirali dio tečnosti iz sirišta, a kasnije postavili gazu između konaca, koje smo čvrsto svezali. Potom smo kravu odvaljali na lijevu stranu i podigli je na noge. Preporučena dnevna prehrana se sastojala od 2 kg pšeničnih mekinja i 10 l vode bez krmiva u trajanju od 3 do 4 dana kako bi se omogućilo pražnjenje buraga. Sljedećeg dana je krava počela obimno defecirati, lako se podizala, imala dobar refleks i apetit. Produžili smo antiinflamatornu (flunixin) i antibiotsku (amoxicillin) terapiju. Pored toga smo uveli i neostigmin, kako bi stimulirali motilitet sirišta i tankog crijeva. Počevši od šestog dana, kravu smo počeli hraniti sijenom od grahorica i zobi (3 kg dvaput dnevno). Sedmicu kasnije, krava je pokazala gubitak apetita i aktivnosti uz prisustvo purulentnog iscjetka sa mjesta uboda čiji je razlog najvjerojatnije lokalni peritonitis uzrokovan curenjem tečnosti iz sirišta u peritonealnu šupljinu. Nakon toga smo propisali penicillin/streptomycin u trajanju od 3 dana. U isto vrijeme, prerezali smo najlonski konac za koji smo smatrali da je izazvao reakciju tkiva. S obzirom na perzistiranje blagog purulentnog iscjetka, u konačnici smo aplicirali Naxcel® injekciju nakon čega se stanje krave znatno poboljšalo, s tim da je mjesto uboda ostalo tvrdo na palpaciju. U narednih 60 dana, koliko je krava monitorirana, nisu se pojavili nikakvi problem, čime je potvrđen uspjeh eksperimenta. Zaključak je da je upotreba dostupne i jeftine opreme za fiksaciju sirišta TPS metodom jednostavna i sigurna alternativa za veterinare koji praksu obavljaju u zemljama s ograničenim sredstvima. Naša je preporuka da se koriste troakar/kanila manjeg promjera i štapići, a da se umjesto ribarskog konca za fiksaciju štapića koristi svileni konac (4-5 USP). [ABSTRACT FROM AUTHOR] |
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