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IDENTIFICATION OF COMMON AND SPECIAL SURGICAL

INSTRUMENTS AND DRUGS

I. GENERAL INSTRUMENTS III. ANESTHETIC DRUGS

1. Operating scissors 1. Atropine
2. Bard-parker handles 2. Lidocaine
3. Bard-parker blades 3. Bupivocaine
4. Suture needle (surgical needle) 4. Xylazine
5. Mayo-Hegar Needle holder 5. Neostigmine
6. Artery forceps 6. Diazepam
7. Thumb forceps 7. Ketamine
Allis
8. Tissue forceps 8. Propofol
9. Towel clamps-Backuaus 9. Isoflurane
10. Stomach tube 10. Romifidine
11. Mouth gag 11. Detomidine
12. Trocar & canula 12. Butorphanol
13. Retractors 13. Buprenorphine
14. I/V cniula for large animals 14. Flunixin meglumin
15. Scalp vein set 15. Mepivacaine
16. Baby Autoclave 16. Thiopental sodium
17. Spinal needle 17. Endotracheal tube-Horse
18. Surgical gloves 18. Endotracheal tube-Dogs
19. Stomach tube- LA 19. Rocuronium
20. Mathew Needle holder 20. Halothane
21. Olsen-Hegar Needle holder VI. Suture materials
1. Silk
II. Surgical cloths 2. Catgut (Surgical gut)
1. Surgical drape 3. Swaged suture (Mersuture)
2. Surgical Gloves 4. Polyglactin - 910
3. Disposable Gown 5. Polydioxanone
4. Reusable gown 6. Polyamide
5. Surgical cap (Head cover) 7. Polypropylene

6. Face mask 8. Cotton

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 7. Scrub suite

V. SPECIAL INSTRUMENTS

A) Teat Instruments

1. Larson’s Teat plug

2. Teat bistuary
3. Lichty teat knife or Teat Bistuary
4. Teat tumor extractor
5. Teat Dilator
6. Teat scissors
7. Teat slitter
8. Hudson’s Teat spiral
9. Teat siphon cum infusion tube

B) Operative surgery Instruments

1. Weingart rumenotomy Frame
2. Improvised Electrical Dehorner
3. Doyen’s Intestinal forceps/clamps
4. Jacob’s chuck

5. Steinmann pin

6. Emasculator

7. Burdizzo castrator

8. Buhner’s Vulval suture needle

9. Retractor

10. Hoof cutter

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 11. Gigli wire saw

2. DEHORNING OF CALVES (DEBUDDING OR DISBUDDING)

Dehorning of calves is the removal of horn buds.

A) Indications
 To enhance the appearance of animal
 To make the animal less dangerous for the handler and other cattle
 To prevent horn diseases like horn cancer and fractured horn
 To lessen the carcass loss due to bruising of the skin
 To reduce the incidence of infected lacerations
 To prevent misdirected or over grown horns, causing cutaneous injurious due to pressure.

B) Restraint and Anesthesia

Adequate restraint of the unwilling patient is crucial for rapid and efficient dehorning. Nose leads
and halter on cattle are useful. With practice one learns to improvise and cope to control the animal
satisfactorily.

Anesthesia is a must for dehorning as per law and no “brief – grief” technique is to be practiced.
 Sedation (Xylazine 0.1mg/kg i/m) and control the animal in lateral recumbency
 Ring block at the base of the horn can also be given.
 The cornual nerve block is very useful. The needle is inserted midway between the base of
the horn and lateral canthus of the eye, inferiolateral to the frontal crest where the nerve is
superficial.

Thermocautery: For this purpose, various types of equipments like, Electric dehorner, Propane
dehorner, Small/large Barnes or Improvised electrocautery is also available.
After restraint and anesthesia, clip the hairs around the horn bud. Then apply the dehorner is and
move it back and forth to remove horn bud completely. Along with the horn bud,1- 1.5cm of skin

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surrounding it is also removed to prevent small horn growth at latter stage.. It requires no
hemostasis, since the cautery seals vessels.

Post operative care

 Avoid wound contamination
 Advise daily dressing.

Complications
 Hemorrhage is the most possible complication. Cautery from a thermal dehorner can be
used to control the hemorrhage.
 Infection is a serious complication although it is rare proper procedure
 Maggot wound may be a problem if done during fly season. Rainy and dusty conditions may
also be avoided
 If done during fly season appropriate fly control should be instituted.

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3. AMPUTATION OF TAIL (DOCKING)

Amputation of tail is surgical excision of tail.

Indications
 To improve the appearance of the animal
 Sacral fracture and subsequent neurological deficit
 Coccygeal fracture or dislocation
 Neoplasm of tail
 Tail gangrene or necrosis
 Chronic ulcers
 Irreparable injuries
 Necrotic vertebrae
 To facilitate easy matting in long tailed female sheep.

Surgical Anatomy
Tail is composed of the vertebrae, muscles, fascia and skin. In bovines the number of coccygeal
vertebrae varies from 18 to 20, in sheep 3 to 24 and in camels 15 to 20. The blood vessels of the
tail are the middle coccygeal artery which runs through the vertebral arches and lateral coccygeal
veins.

Surgical Procedure

Anesthesia – Epidural anesthesia

Surgery in bovine is done in standing position under epidural anesthesia. In sheep and camels it is
done in sternal recumbency. A suitable tourniquet is applied at the base of the tail. The exact point
of disarticulation is determined by palpation. Routine aseptic procedures are adopted.

Flap Method
 A tourniquet is applied at the base of the tail to prevent hemorrhage
 A semilunar incision is given on the dorsal and ventral surface of the tail

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  If the procedure is for necrosis of tail, the incision should be in the healthy zone, proximal to
the necrosed area
 This incision should be planed, 2 to 3 cm, caudal to the intervertebral space to disarticulate
the joint and to have sufficient skin for closure
 Flap out the skin cranially, identify the exact, intervertebral space and disarticulate exactly
in the, intervertebral space, using the blade
 Hemostasis achieved by ligating the coccygeal veins and arteries
 The tourniquet is loosened, to identify additional significant vessels for Hemostasis
 The skin reapposed over the coccygeal vertebrae with simple interrupted sutures
 Tourniquet is completely released after surgery.

Post operative Care

 The tail dressed with an antibiotic ointment daily till the healing is complete.
 In case of suspected infection a course of parenteral antibiotic may be given.
Amputation of tail in sheep is rarely done. Healing of the docking wound in fattening sheep may
have a complicated course due to adiposity.
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4. CERVICAL ESOPHAGOTOMY IN RUMINANTS

Cervical Esophagotomy is surgically opening the cervical esophagus mostly for the removal of
foreign bodies that could not be removed by non-invasive intraluminal retrieval methods.

Indications
 Presence of foreign body
 Esophageal perforations
 Esophageal fistula
 Esophageal diverticula
 Esophageal neoplasia.
Causes of esophageal obstruction
A) Intraluminal blockages are due to;
Vegetables (turnip, carrot, potato, onion etc), Fruits (large lemon, apple, mango, seeds),
Phytobezoars, Foreign bodies (leather pieces, wood balls, polythene bags and rubber
sheets)
b) Extra luminal causes are;
Large periesophageal abscess, Cicatricle strictures, Vascular ring anomalies, Enlarged
meditational lymph nodes and Tumors which lead to partial obstruction due to pressure.

Restraint and Anesthesia - Animal restrained in lateral recumbency after deep sedation and local
infiltration anesthesia is also given.

Surgical Procedure
 Surgical treatment is indicated if the conservative treatment fails
 A stomach tube may be placed in the esophagus before surgery to the level of obstruction.
 The neck is prepared for aseptic surgery.
 A longitudinal incision is made on the cervical area, over the site of obstruction
 The esophagus is approached between the sternocephalicus muscle and the trachea.
 After exposure of the esophagus, attempt should be made to push the obstructing mass, by
direct manipulation, towards the pharynx. If the attempt fails, esophagotomy may be done.

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  After exposing the esophagus, the operative field is suitably packed off, to avoid any
possible contamination
 If the esophagus appears normal, incise directly over the foreign body and If the wall is
damaged, incision made on the healthy tissue and the foreign body pulled out and removed
and the area washed with sterile saline.
 Esophagus closed by 2-layer technique. The first layer closed by knot- in the- lumen-
technique (in-out, out-in), to prevent contamination of the wound by ingesta
 The next layer closed by simple interrupted pattern using polypropylene.
 The skin closed by simple interrupted pattern using silk.
Post operative Management
 Withhold feed for 5 – 15 days
 Adequate fluid therapy
 Administration of broad-spectrum antibiotics
 Slowly start liquid and solid foods.

Post operative Complications

Dehiscence of suture line, perforation and fistula formation and stenosis of esophagus

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5. LAPAROTOMY OR CELIOTOMY SITES IN BOVINES
Laparotomy sites are for entry into the abdomen. Selection of a site is governed by:

 Species
 Facilities for restraint
 Available anesthesia
 Type of surgery to be done
 Location of the affected organ
 Preference of the surgeon

For Laparotomy, provision and maintenance of sterile condition is extremely important. Wound
infection will affect the success of the surgeon. For surgery in bovines in the field conditions, the
surgeon has limited facilities and lack of skilled assistance. Proper restraint, quiet surroundings and
use of mild sedation and local anesthesia are mostly sufficient. Most abdominal surgical
procedures in bovines are done under standing or lateral recumbent positions. In camels, sternal or
lateral recumbency is required.

Incision Sites in Bovines

I. Flank Laparotomy
A. Cranial high flank
B. Mid high flank
C. Caudal high flank
D. Low flank
E. Ventral oblique
F. Paracostal

II. Ventral incision sites:

A. Post xiphoid incision
B. Cranial paramedian incision
C. Caudal paramedian incision

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 D. Midline incision
X. Xiphoid cartilage
V. Subcutaneous abdominal vein.
C&D. Cranial and caudal paramedian
E. Post xiphoid

Left flank Laparotomy is to gain access to the rumen, reticulum, spleen, uterus, bladder and
kidney.

Right flank Laparotomy is to gain access to abomasum, small and large intestine, uterus, kidney
and bladder.
Ventrolateral oblique incision placed in front of the stifle, and extends cranioventrally in a slightly
oblique direction lateral to the milk vein. It is especially useful in accessing the uterus for
hysterotomy.
Ventral midline celiotomy used for caesarean section and in this site the large branching milk
vein is avoided.
Right paracostal Approach through low flank is to gain access to the abomasm.
Post Xyphoid Approach is a crescent shaped incision behind the xyphoid to approach the
diaphragm.
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6. UMBILICAL HERNIORRHAPHY
Umbilical Herniorrhaphy is performing the radical surgery for the repair of Umbilical Hernia.

Restraint and Anesthesia - Animal restrained dorsal recumbency after sedation and local
anesthesia is also given.

Clinical Signs
 A discrete spherical mass is obvious at the umbilicus
 The hernial contents are usually fat and omentum
 A large hernial sac may contain loops of small intestine
 A circular or oval hernial ring can be palpated without pain if the contents are
reducible
 The presence of adhesion or abscess will prevent reduction.

Surgical procedure
 After 24 hours of fasting, the animal is controlled in lateral recumbency and liberal operative
area is prepared for surgery
 A fusiform incision is made on both sides of the swelling
 The skin in between the incisions is dissected out and discarded
 The skin lateral to the incisions is undermined to expose the hernial ring
 After debriding the edges the ring is closed by placing a series of overlapping mattress
sutures, using heavy non-absorbable suture material
 The exposed edges of the ring are then anchored with the abdominal wall, using a
continuous suture pattern
 Mattress or simple interrupted sutures, using non-absorbable material, appose the skin
flaps.

The technique of application of Overlapping Mattress Sutures (Mayo Mattress)

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  It is useful in midline abdominal closures in large animals and in repair of abdominal hernial
defects in all domestic animals
 The suture is begun by passing the needle from the outside to the inside (out-in) of the
incision on one side
 The needle is then similarly inserted (out-in) on the opposite side
 Pas the needle 0.7 to 1.5 cm and passed from within to the outside (in-out)
 Finally the needle is returned to the original side and is passed from within to the exterior
(in-out) in the same transverse plane
 As the knot is tied, the area of tissue sutured will overlap the second
 The surgeon’s knot may be required to overcome distracting forces
 The exposed edge of the ring is then to the adjacent muscle using a continuous suture.

Post operative Management

 Controlled exercise
 Less bulky diet for about a week
 Antibiotics for about a week
 Skin sutures removed on the post operative day.
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7. Rumenotomy in Farm Animals

Rumenotomy is surgically opening the rumen mostly for the removal of foreign bodies. The
procedure is the same for cattle, buffaloes, camels and small ruminants.
Indications
 Persistent ruminal impaction
 For the removal of the FBs and hairballs
 Frothy bloat
 Traumatic reticuloperitonitis
 Repair of diaphragmatic hernia
 Exploratory purpose.
Site of operation
The site is in the left mid-flank, 5cm ventral to the lumbar transverse process. Incision is made near
the last rib, in large size animals, for easy access to the reticulum.

Control and anesthesia

The animal is controlled in standing position. Paravertebral block or inverted “L” block or “T” block
analgesia is induced using procaine hydrochloride. In addition tranquillization may be needed for
difficult animals.

Preparation
The whole left abdominal wall is cleaned with soap and water. The left flank thoroughly shaved and
cleaned. After scrubbing and preparation drape is applied.

Surgical Technique
The skin incision should be long enough to allow the surgeons arm inside the abdomen. The
incision extends 3 to 5 cm ventral to the transverse process of lumbar vertebrae to a distance of 20
to 25 cm. The skin incised with a smooth but firm motion. The pressure of the scalpel should be just
adequate to ensure complete penetration of the skin.

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Then the fascia, oblique muscles and transverses abdominis muscles with peritoneum are incised
to enter the abdomen. The length of the incision from the skin to the peritoneum should be in the
descending order to facilitate closure.
Abdominal Cavity Exploration
The abdominal cavity should be thoroughly explored before opening the rumen for any pathological
lesion.
1) Left cranial abdomen is explored for splenic abscess, left wall of rumen, reticulum and
diaphragm for any adhesion and reticular abscess.
2) Caudal abdominal cavity explored first, the dorsal and ventral sac of rumen, urinary bladder,
uterus, left kidney and intestinal masses.
3) Right cranial abdomen is reached by passing the arm ventral to the superficial layer of greater
omentum and directed cranially to locate the pylorus, body and fundus of the abomasum, the
omentum, right wall of the reticulum, and left lobe of the liver(for any abscess).

Fixing of the Rumen

Weingarth Rumenotomy Frame fixed to the dorsal commissure of the incision by its thumb screw.
Now a portion of the rumen is exteriorized, and grasped with the rumen forceps and hooked to the
Weingarth Rumenotomy Frame. In the same way, fix the other forceps in the ventral part and
tense the exposed part of the rumen and incise it. Then the rumen hooks are placed into the cut
edges of the rumen and pulled and hooked onto the ring.

Transruminal exploration
 Find out the position, size and consistency of rumen, reticulum and abomasum by palpation

 Explore the rumenoreticular fold, esophageal orifice and Reticulo-omasal orifice for lesions

 Explore meticulously the reticulum for FBs and remove all of them

 Then try to invert the reticulum to determine the presence, location and extent of adhesions.
Adhesions that limit the mobility of reticulum would be typical of TRP. Probe all the cells of
reticulum at the site of adhesion in search of FBs

 The reticular wall may be sweeped with a magnet to find out the leftover ferromagnetic FBs

 To enhance the diagnosis an ultrasound probe may be carried into the reticulum for
confirmation of reticular abscess, tumor, etc. Any active abscess inside the reticulum is
lanced using curved bistuary or BP blade

 The hand may be introduced through the Reticulo-omasal orifice into the omasal canal to
evaluate the omasum and the abomasal lumen and mucus

 The adhesion of the ventral sac of rumen is suggestive of localized peritonitis due to
perforated rumen or abomasal ulcer.

Replenishing the Rumen

Before closure the rumen for effective restoration of normal microflora, ruminal cud is introduced.
The ruminal cud is usually obtained from slaughtered animals or regurgitated ingesta form live
animals. Rumen may be reloaded with concentrates and teff hay cut into small pieces.

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It would be ideal to introduce 8 boli of symbiotic preparation (combination of Probiotics and
Prebiotics) along with the cud, followed by 3-4 boli daily orally. It will increase the viability of
ruminal flora, establish the anaerobic environment, reduce the operative stress and restore early
normalcy. The pH of the rumen, if disturbed should be corrected.
Closure of Rumen, Muscles and skin
The rumen wound edges should be thoroughly cleaned with sterile normal saline, without
contaminating the peritoneum. The surgeon must rescrub again before suturing the wound. The
rumen is sutured with No. 2 or 3 chromic catgut using Cushing followed by Lembert pattern.
Muscles and peritoneum closed by interrupted horizontal mattress followed by a simple continuous
pattern for reinforcement, using No. 2 or 3 catgut.
Skin closed by simple interrupted sutures using silk or cotton thread.

Postoperative care
It includes dressing of the skin wound, a course of antibiotics and suture removal on the 10 th
postoperative day. Any failure in asepsis during surgery might produce a discharging sinus at the
site. In some cases subcutaneous emphysema may get absorbed spontaneously in a few days.
Postoperative Complications
1) Sinus Wound
Sinus wound at the operative site - Any operative failure in maintaining asepsis during surgery
might encourage infection and result in tubular inflammatory tracts leading from the rumen with one
or more external openings upon the cutaneous surface.
The Sinus wound may be removed surgically from the deeper layers and sutured.

2) Subcutaneous Emphysema
Subcutaneous Emphysema occur as a result of entry of air into the abdominal cavity during surgery
and subsequently when the rumen gets filled up with ingesta the air forces through the muscle
sutures to the subcutaneous area. It gets absorbed spontaneously in a few days.

3) Peritonitis may be a major complication if there is compromise in maintaining sterile

precautions.

Prognosis
Prognosis depends upon the location of the reticular perforation and duration of illness.
1) Foreign body perforation that does not affect the thoracic cavity or the right side of the reticulum
gives a favorable prognosis.

2) Even if the adhesion is extensive in the cranial abdomen, if it is not involving the vagal nerve the
rumen motility will not be affected and the prognosis is favorable.

3) Single abdominal abscess of the reticulum or liver, if drained or resected the prognosis is
favorable.

4) Perforation of the right wall of the reticulum and adhesion involving the ventral branch of vagus
results in vagal syndrome and the prognosis is guarded.
5) If the foreign body has perforated the diaphragm, the possibilities are septic pericarditis,
Myocarditis or thoracic abscess and the prognosis is poor.

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 This cow was brought from about 40
km away with the complaint of
ruminal impaction and recurrent
tympanites. It was admitted in our
University Veterinary Clinic. On the
next day Rumenotomy was
performed and a variety of foreign
bodies were removed.
This animal made uneventful
recovery and was discharged.

8. SURGICAL REMOVAL OF THE EYE IN SHEEP

Indications

 Extensive trauma to the eye and adnexa.

 Intractable infection
 Painful intractable glaucoma.
 Extensive ocular tumors
 Congenital defects that results in exposure damage
 Uncontrollable endophthalmitis or panophthalmitis.

Surgical Procedures

A. Enucleation is the removal of the globe, the nictitating membrane and the eyelid margins.

 Subcutaneous closure at the rim using absorbable sutures. Aseptically prepare and close the
eyelids with simple continuous suture
 Incise the skin 0.5 cm away from the eyelid margin, around the closed eyelids
 Dissection continued subcutaneously towards the orbital rim without perforating the conjunctiva
 The extra ocular muscles are severed close to the globe, using curved Metzenbam scissors
 After transecting the rectus and oblique muscles, the globe is grasped and gentle traction is
applied, so that the retractor muscle forms a cone around the optic nerve
 A curved hemostat applied on the optic nerve and blood vessels and transected and ligated
 Skin closed using non-absorbable sutures and a pressure bandage applied for 24 hours
 The pressure of the suture and that of the bandage is adequate to stop the hemorrhage.
 Drains are not necessary, unless there is preexisting infection
 Antibiotics given for 5 to 7 days after surgery.

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B. Exenteration is removal of the globe, nictitating membrane, orbital contents and eyelid margins. In
exenterating the globe and as much of the orbital contents as possible are removed

 For exenteration surgery, the dissection is done to remove the extraocular eye muscles and
conjunctiva and all of which are removed along with the globe.
 This procedure is performed to stop a noxious disease process e.g. neoplasia or uncontrollable
infection.
 In this procedure the postoperative defect is greater because more orbital contents are
removed than with enucleation.
 The other procedures are similar to enucleation.

A B

A. Enucleation

B. Exenteration

9. URETHROTOMY - CATTLE
Urethrotomy is incision into the urethra.
Indications
 Urethral calculi
 Growth in the lumen of urethra.
Anesthesia & Control
Epidural or local infiltration with or without sedation, in standing or
dorsal recumbency
Approaches
1. Prescrotal: Incision is given anterior to the scrotum over the urethra and is for obstruction
anterior to sigmoid flexure.
2. Post Scrotal: Incision is given between the scrotum and ischial ach and is for obstructions
between the posterior part of sigmoid flexure and ischial arch.
3. Ischial: Incision is given on the midline just below sphincter ani and extended ventrally for
obstruction at the neck of the bladder.
SURGICAL TECHNIQUE - POST
SCROTAL URETHROTOMY
 About 20 to 25 cm wide
area extending from the
scrotum to the ischial arch
is prepared for the surgery
 After local anesthesia a 10-
15 cm long incision is given
on the midline extending
from the scrotum.

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  After incising the skin and subcutaneous tissue, the muscles are dissected bluntly
 Hemorrhage is generally minimal, which is controlled
 The penis is levered out by the fingers and by passing curved scissors underneath it
 The fascia covering around the penis is removed by gentle dissection, while avoiding the penile
vein
 A considerable part of the penis can be exteriorized by straightening the sigmoid flexure
 The urethra that lies in the urethral groove on ventral aspect of penis is noticed in between the
insertions of the retractor penis muscle
 Examine the urethra thoroughly for palpable, obstructing urolith. A nick is given on the urethra
over the urethrolith and pressed out or if firmly lodged, it may be pulled out by forceps
 Then a suitable sized, sterilized polyethylene tube that snugly fits the urethra is passed upto the
bladder. The other end of the catheter passed down the urethra and anchored with the preputial
sheath to prevent its dislodgement
 The snugly fitted urethra prevents seepage of urine into the subcutaneous tissue, allows healing
of urethral wound without sutures and also prevents narrowing of the urethral lumen
 The skin and subcutaneous tissues are closed with simple interrupted sutures using
non-absorbable suture material. The catheter is allowed to stay in the urethra for about
3 - 4 weeks.
 When the calculus is not located at the sigmoid flexure, it is more likely present midway between
the sigmoid flexure and the ischial arch and may be palpated by passing the index finger along
the penis. Now the incision may be extended to the site of calculi and removed. The entire length
of the urethra up to the ischial arch is then catheterized.
Postoperative care: Fluid therapy continued for azotemic animals or those with significant acid base or
electrolyte derangements. Postoperative antimicrobial therapy is continued for approximately 1
week

10. BULL CASTRATION

Indications

 To improve the meat quality

 Prevention of breeding nuisance. A. Post scrotal Site
 Scrotal hernia and perineal hernia
 To render the males more manageable (docile) B. Sub-Ischeal Site
 Malignant disease or any irreparable injury of testes. C. Ischeal Site
Anesthesia
No anesthesia for closed method (Burdizzo Method)
Local infiltration or sedation in recumbent position for open method
Techniques
I. Closed Method
Several techniques are available for castration of farm animals without surgery. In this ischemia of the
testis with subsequent atrophy occurs. All animals treated with non- surgical castration techniques should
receive tetanus prophylaxis.

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 Figure showing correct position for Burdizzo castrator
application Burdizzo castrator

Burdizzo Method
 In recumbent position, scrotum is palpated and the cord is pushed firmly against the side of the
scrotum
 The Burdizzo castrator or emasculotome is adjusted in such a way, as to crush the entire cord
and only the necessary portion of the scrotum.
 The castrator should not be extended across the median septum of the scrotum
 Each side crushed twice, at a distance of about 1 cm to ensure proper crushing of the cord
 The operated area should be painted with Tr. Iodine.

II. Open Method – Surgical Removal - Bilateral Orchiectomy-calves and small ruminants
Restraint
 Lambs and small goats held between the knees
 Young calves of one month age restrained in lateral recumbency
 Older calves put into squeeze chutes
 Local anesthesia in lambs and kids, diluted from 2% to 0.5%
 Larger animals and pets- Xylazine Sedation.
Surgical Techniques – For Young ruminants weighing less than 150 kg

Bilateral Orchiectomy-
Transverse Excision

I. Transverse Excision
 Preparation of the site

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  Grasp the scrotum and pull distally, displacing the tests proximally
 Excise the scrotum in its distal 3rd to expose the testicles
 Pull the testicles and free the spermatic cord by stripping the fascia proximally.
 Ligate the spermatic card and transect or emasculate
 The wound left open to heal by second intension.

II. Vertical incision – For adult animals

 Lateral wall of scrotum incised vertically
 Testis exteriorized, Spermatic cord ligated and transected
 The wound treated as open wound
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11. CASTRATION IN HORSE / DONKEY

Castration- Horse (Emasculation, Neutralizing

Indications
1. To make the animals docile
2. To control them in the presence of female animals
3. Malignant diseases
4. Irreparable injury
5. Scrotal hernia.
Anesthesia, Control & Preparation
General anesthesia and recumbent position: The upper hind leg is tied cranial, and the surgical site is
aseptically prepared. The additional instrument required is the emasculator.
Surgical Technique
 First the lower testis is grasped between thumb and forefingers
 Skin incision made for the length of the testis through the tunica dortus and scrotal fascia leaving
the common vaginal tunic
 Pressure is exerted by the fingers, to extrude the testis with the common tunic
 Grasp the testis and strip off the s/c tissues from the common tunic as far proximally as possible
using a sterile gauze sponge
 Incise the common tunic over the cranial pole of the testis
 Continue the incision proximally, while hooking the tunic with finger to maintain tension and now the
testis is released from the common tunic.
 Penetrate the mesorchium digitally to separate the spermatic card from the ductus deferens,
common tunic and external cremaster muscle
 The musculofibrous portions the spermatic card (less vascular structures) are severed after ligation
conveniently with the emasculators and the "crush" need only be applied for a short period of time
 The vascular bundle of the spermatic card is ligated using chromic catgut No. 1 or 2 at the highest
point accessible and emasculated distal to the ligatures to remove the testis. Castration is
performed through separate incisions for each testis, with incisions located 1cm from the median
raphe
 Care must always be taken to emasculate correctly without incorporating the skin. Keep the
emasculator in the crushed position for 1 or 2 minutes depending on the size of the card and then
release carefully to avoid secondary hemorrhage. Any redundant adipose tissue or fascia also
should be removed
 The other testicle also removed in a similar manner
 Apply sterile surgical gauze to facilitate drainage of serous fluids

15
 2

formed through separate 2.

incisions
The lower
located
testisapproximately
grasped between
1 cmthe
from
thumb
the median
and fore-
raphe
fingers and the first skin incision is made for the len

3 4

tis grasped and the subcutaneous tissue stripped from the common vaginal
4. Emasculation
tunic of spermatic cord

Postoperative Management
 Antibiotic coverage
 The horse should be confined and kept under close observation for the first 24 hours after surgery
for hemorrhage, and then daily inspected for a week.
 Uneventful healing is the usual result with good drainage and satisfactory exercise.
 The horse should be forcibly exercised twice daily from the 2nd day, until healing
 It should be separated from the mares for a week
Postoperative Complications
Severe hemorrhage ,Excessive swelling, Acute wound infection, Scirrhous cord, Hydrocele,
Persistent masculine behavior, Penile paralysis, Periapism, Edema, and Adhesion of small
intestine.

********************

12. CASTRATION IN DOG

16
 Castration (Orchiectomy) is the most commonly performed surgical procedure for the removal of testes
in dogs.
Indications
 Modification of behavior pattern-male aggressiveness and roaming
 Sterilization or Birth control to reduce overpopulation
 Severe trauma of testis or scrotum
 Refractory orchitis / epididymitis
 Prostatic diseases-cyst, tumor
 Perineal hernia or adenoma
 Scrotal urethrostomy-dogs
 Perineal urethrotomy-cats
 Congenital abnormalities
 Endocrine abnormalities
 Testicular neoplasia

Anesthesia & Control

 General anesthesia is recommended (Atropine-xylazine-ketamine)
 Control and position the animal in dorsal recumbency.

Equipment: Standard surgical pack and suture materials

Technique
The technique depends upon the indication, location of the testis, age of the patient and surgeon’s
preference.
1. Closed Prescrotal Technique
 Place the dog in dorsal recumbency and prepare the prescrotal and scrotal area and drape
 Apply pressure on the scrotum to advance one testicle as far as possible into the prescrotal area
 Incise the skin and subcutaneous tissue on the midline over the displaced testis to expose the
parietal vaginal tunic
 Exteriorize the tunic covered testis and incise the scrotal ligament with scissors and clear the
spermatic fascia with gauze to enable maximal exteriorization of spermatic card
 Double-legate the intact spermatic cord and vaginal tunic using transfixation ligatures using catgut
 Transect spermatic cord distal to the ligatures and return it in to the inguinal region
 Subcutaneous closure - simple interrupted pattern with absorbable suture
 Skin closure- simple interrupted pattern with non-absorbable sutures.

2. Open Prescrotal Technique

In the open technique the parietal vaginal tunic in incised and ligatures are placed on the
spermatic cord and on the vaginal tunic & cremator muscle separately.

1 2

where it attaches to the epididymis and digitally separate the

2. Apply
ligament
a Carmalt
of the forceps
tail of the
andepididymis
transect between
from thethe
tunic
clamp and ligatures

17
3. Scrotal incision technique
It is also practiced for castrating prepubertal puppies or outside the operation theaters.
4. Scrotal Ablation Technique
It is removal of testes along with the scrotum and it is for pendulous scrotum, severe trauma,
neoplasia, Ischemia, scrotal abscess and scrotal urethrostomy.

Postoperative Complications
 Scrotal bruising and swelling. Severe scrotal swelling may necessitate scrotal ablation
 Hemorrhage Bleeding controlled by relegation
 Infection of spermatic cord- Controlled by antibiotics and local irrigation & drainage
 Bleeding within the abdomen is serious and may need a laparotomy and fluid therapy to control.

******************

13. CESAREAN SECTION IN COW / SHEEP

Indications
I. Maternal reasons
Inadequate cervical dilation, uterine torsion, uterine inertia, uterine rupture, hydrops amnion
/allantiois, vaginal constriction, fetopelvic disproportion (FPD).
II. Fetal reasons
Fetal malposition, fetal oversize, fetal monsters and emphysematous fetus

Anesthesia
Paravertebral block, Local infiltration, Sedation and local infiltration Epidural, Inverted 'L' block.

Surgical Approaches
 Standing Paralumbar celiotomy-Right or Left
 Ventral mid line celiotomy
 Paramedian celiotomy
 Left oblique celiotomy.

Surgical Technique
 Once entry into the abdomen is accomplished, the position and condition of the calf should be
determined.
 Than the surgeon should attempt to manipulate a limb of the calf with intact uterus to the incision
 Now hysterotomy is made outside the abdomen between the cotyledons without injuring them. If
the uterus could not be exteriorized it may be incised inside the abdomen. But the incised uterine
edges should be lifted after delivery to avoid contamination of the peritoneum with the uterine
contents
 After the removal of calf with outside assistance, the placental detachment if complete, it is best
removed at surgery itself. If the placenta is not detached, it is replaced into the uterus and broad
spectrum antibiotic pessaries are placed in the uterus
 Now check for any uterine tear and also for another calf
 The surgeon’s preference dictates the manner in which the uterus is closed. A popular choice is
double row of inversion -- Cushing followed by Lambert using catgut No 2 chromic, after cleaning
with sterile saline
 If the indication of C.S is for uterine torsion, after closure of the uterus, the uterus must be
detorted and confirm the same by an assistant introducing a hand through vagina

18
 Injection of oxytocin 50-60 units or into the wall of healthy uterus hastens involution.
 The abdominal wound is closed routinely. Common practices is horizontal mattress followed by
continuous or continuous lock stitch using No 2 or No3 chromic catgut
 Post operatively or during the operation 5% dextrose given to take care of shock and
hypoglycemia. Parenteral broad spectrum antibiotics given for 5 days
 Suture removal on 8th or 10th post operative day.

19
 1. Low flank Approach 2. Calf removed without
contaminating the peritoneum

I) Post-operative Complications
 Peritonitis and Metritis; Postoperative sepsis and septicemia may be life threatening
 Abdominal adhesions
 Increased number of services for the next conception noticed
If a live calf is delivered at surgery, the cow is in good physical condition and the procedure goes well, a
favorable long term outcome can be expected.

**********************

14. OVARIOHYSTERECTOMY (SPAYING) IN DOG

Indications
 Elective sterilization to prevent estrus and unwanted puppies
 Prevention of mammary tumor or congenital anomalies
 Control of endocrine a abnormalities (Diabetes and Epilepsy).
 Prevention and treatment of uterine problems including; Pyometra, Metritis, Neoplasia of ovary,
uterus or vagina, Uterine trauma rupture, etc.

Aesthesia & Control

General anesthesia and positioned in lateral or dorsal recumbency depending upon the site.

Surgical approaches
1. Right Flank – Oblique mid flank incision with muscle separation method
2. Caudal midline – 3-5 cm long incision from the umbilicus to the pelvic brim.

Surgical Technique

 Skin incision (3-5cm) on the ventral midline from the umbilicus and extended caudally. cats still
smaller incision
 Identify the OAVC make a window in the mesovarium about 5 cm and place the hemostat
(Proximal Clamp-1) proximal to the ovary
 Place a small hemostat (Middle Clamp-2) across the suspensory ligament to aid in caudal
retraction. Place moderate tension on the suspensory ligament gradually until it breaks
 Place a hemostat (Distal Clamp-3) across the proper ligament between the ovary and the uterine
horn (Triple clamp)
 Place a circumferential ligature around the proximal clamp and tighten the ligature as the clamp is
removed in the groove of crushed tissue created by the clamp -1 (proximal)
 Place a transfixing ligature between the circumferential ligature and the middle clamp and
transect between the ovary and the clamp - 2 (middle)
 Never include ovarian tissue in the ligature

20
  Grasp the ovarian pedicle with thumb forceps and remove the middle clamp and inspect the
OAVC for bleeding. It bleeding occurs, place a second circumferential ligature on the OAVC
proximal to the first
 Follow the left uterine horn distally to the bifurcation to locate the right uterine horn and follow it
proximally to the right OAVC
 Legate and transect the right OAVC as described per for the left OAVC
 Exteriorize the uterine body and locate the cervix and individually ligate large vessels in the
broad ligament close to the cervix and transect or manually separate the ligament
 Double ligate the entire uterus proximal to the cervix and transect cranial to the ligation, check for
hemorrhage and leave the uterine stump into the abdomen
 Close the abdominal incision routinely

1 2

1. Anatomy of female 2. Ovariohysterectomy-Dog

reproductive system-Dog

Postoperative Complication

1. Hemorrhage may be due to; Coagulation defect, Failure of ligation or transfixation, Premature removal of
clamp during ligation, Failure to ligate vessels in the broad ligament, Tearing of the OAVC while breaking
the suspensory ligament,
Incidence of hemorrhage may be reduced by maintaining meticulous surgical technique.

*******************

15. APPLICATION OF PLASTER CAST FOR FRACTURE

Indication
Fracture repair

Aesthesia & Control

Sedate and control in lateral in lateral recumbency with affected limb, upper most.

Application of Plaster Of Paris Cast

21
  Clean the whole limb including the foot and dry
 Any wound if present, clean and apply antiseptic dressing
 The interdigital space should be padded with cotton
 Tie a rope at the end of the limb to facilitate reduction and proper alignment of fractured
fragments and to keep the limb in normal position during the application of cast
 After reduction of the fracture, boric acid power is liberally applied to the limb followed by
placement of 2layers of ordinary bondage and cotton padding. Excessive padding also
should be avoided.
 During POP cast application thick aluminum or iron splint may be incorporated.
 Alternatively bamboo splint may by applied over the cotton padding and POP cast may be
applied over this
 The pop cast is submerged in warm water using both hands till the air bubble stop emerging
 Gently squeeze the pop cast to remove excess water and apply without creating wrinkles or
crease the POP layers
 The cast should be applied with optimum pressure but not excessive pressure since tight
cast would compromise circulation and cause pressure sores
 Each turn of the POP should overlap pervious turn by half of its width
 Each layer should be smoothened with hands to provide a good bond with the preceding
layer
 It is better to apply a moderately heavy plaster cast than a light one which breaks too
easily
 During the whole process the limb should be kept straight and supported to prevent bowing
deformity
 At the knee and hock joint apply the POP in the “figure of eight” fashion to prevent breakage
of cast
 Sufficient hardening time should be allowed before releasing the animal. The traction rope
should be untied and removed
 In case of compound fracture a mark should be left at the site using a plastic bottle cap
before cast covers the wound. After 48 hours a window can made here for future dressing
of the wound.

After care

 Animal should be kept in close confinement for 8 to 10 weeks

 Care should be taken to avoid wetting of the cast
 In large animals, the POP cast is removed in 8-10 weeks depending open the course of
healing.
 The cast may be removed by a hand operated or electrical saw taking care, not to injure
the skin below

***********************
16. INTRAMEDULLARY PINNING FOR FEMUR FRACTURE
The Intramedullary (IM) pins or nail fixation is a sound and economical method of internal fixation. The
biomechanical advantage of IM pins is the resistance to bending force. The biomechanical disadvantage of
IM pins are; poor resistance to compressive (axial) and rotational forces.

The various pin types available are,

 Steinmann pins
 Kirschner wires
 Rush pins
 Kuntscher nails (k-nail)

22
  Interlocking nails

Indications
Generally all type of fractures can be handled. IM pins are most often used for diaphyseal fractures of the
humerus, femur, tibia, ulna, metacarpal and metatarsal bones.

Aesthesia & Control

Sedation or general
anesthesia and restrain in lateral
in lateral recumbency with
affected limb, upper most.

The techniques of IM pin

fixation
I. Normograde or Closed
method II. Retrograde or
Open techniques
Instrumentation
Steinmann pins, Jacobs
chuck, Hand chuck and Pin cutter. The above special instruments have to be added to the general surgical
pack for sterilization.

Approach to the Shaft of the Femur

A B

A. The skin incision is made along the craniolateral border of the shaft of the bone from the level of the
greater trochanter to the level of the patella. The subcutaneous fat and superficial fascia are incised directly
under the skin incision.

B. The skin margins are undermined and retracted and the superficial leaf of the fascia lata is incised long
the cranial border of the biceps femoris muscle. This incision extends the entire length of the skin incision. If
muscle fibers are encountered, the incision should be directed more cranially.

23
 C D

C. Caudal retraction of the biceps femoris reveals the shaft of the femur. It is
necessary to incise the fascial aponeurotic septum on the lateral shaft of the bone
to adequately retract the vastus lateralis.

D. The vastus lateralis and intermedius muscles on the cranial surface of the shaft are retracted by freeing
the loose fascia between the muscle and the bone.

Application – Retrograde Technique

Select the pin that equals 60 to 70% of the marrow cavity
To place a pin in a retrograde fashion first expose the femur and insert the pin in the medullary
canal of the proximal bone segment
Drive the pin proximally to exit the segment
Replace the pin chuck on the proximal portion and withdraw it until distal pin point is within the
medullary canal
Now reduce the fracture and drive the pin distally to seat in metaphyseal bone.
Check the pin insertion length with the use of second pin outside the limb

Intra medullary pinning in Dog

Check for pin interference in the distal joint by flexing and extending. Crepitation or decreased
range of motion may indicate pin interference
Radiographs will confirm the presence of a pin in the joint. Accordingly the pin may be adjusted
to the correct position
When satisfied with the pin position cut the excess pin below the
level of the skin by pushing the soft tissues over the pin.
Suture the soft tissue over the pin
The muscles closed by interrupted sutures and then a subcutaneous closure may be given and
the skin wound closed routinely
PIN Removal

24
Sedate the patient and prepare the area aseptically, instill local anesthetics and make a small skin
incision over palpable end of the pin. Dissect the soft tissues, grasp the pin with a pin remover
and remove it. Place 1 or 2 sutures and close the skin wound.

25