Dear friends,
We operate cows regularly for plastic and the procedure we follow is briefly as follows:
1. pre-operative long acting penicillin injection IM 24lakhs units/100kg
2. ketoprofein iv, 3ml/100kg
3. mild sedation with xylatsine if needed. Cow has to stand up so 0.25ml/100kg IM should be ok. If the cow is very weak then it may go down with even mild sedation
4. Local anesthetic to the incision site using lidocain. It takes 50-80ml of lidocain to get a good local anesthetic effect, all layers (skin & muscles have to be reached)
5. Long enough incision to the left flank through skin & muscle layers
6. Once in abdomen, check if there are signs of peritonitis or loads of ascites fluid. Also check the abdominal surface for any attachments to the peritoneum or to liver. If severe peritonitis present, prognosis will be poor.
7. If you proceed, then suture the rumenal wall to the skin using any strong enough suture material and continuous suturing. This is very important because by fixing the rumen to the skin, e.g. outside of the abdomen, prevents leakage from the rumen into abdomen and therefore prevents further infection
8. Cut the rumenal wall in the center - in between the suturing, make sure cut is big enough to start with because plastic is usually in big lumps and impossible to remove if the opening is too small.
9. Remove all plastic from the rumen
10. Note that because of the anatomy and physiology of the ruminant digestive system, e.g. the four stomachs, it is highly unlikely that any major plastic accumulation would have proceeded further from rumen. Therefore, if you empty all the plastic from the rumen and check it well with your full arm inside, you should get a good idea if there are penetrating foreign bodies etc.
11. squeeze out all the good rumen material from the plastic and make a "porridge" of this healthy rumen material and medicinal rumenal boosters and warm water. Pour this back to the rumen using a funnel.
12. Flush the rumenal wall well with sterile water before closing it with size 2 vicryl, NON-cutting needle.
13. After closing the rumen, flush again well with sterile water/NS before removing the stay sutures that hold the rumen outside fixed to the skin.
14. Flush rumenal wall & abdomen again
15. Close all three layers with one strong suture layer (you need very strong material for this, material that is meant for large animal surgery is best) in a way that the skin edges evert. That means that any discharge that might form can more easily drain out. The risk with three layer suturing is that there will be empty space between the layers and pus or tissue fuids can accumulate into these pockets, creating further problems. All layers in one suture, single interrupted (go in 7 cm from the wound edge through all layers, come back out again 7 from the edge on the other side of the wound, through all layers, go in 3cm from the edge just through the skin, come out 3 cm from the edge, only through the skin) sutures that are first placed all and then in the end tightened one by one.
16. Flush the closed wound immediately well with tap water, spray any wound spray to prevent flies
17. Flush the wound with tap water twice a day until healed
18. Remove sutures after 8 days
19. Give a 5 day course of penicillin
Hopefully this helps.
best regards,
Ilona
Dear Claire,I have discussed the matter with two of our long time surgeons and they say the chances are 80/20% the 20% stands for recovery. The operation is very troublesome for the animal and the chances of infection are very high as some dirty matter might leak into the abdominal cavity during surgery.In other cases the bloating will come back as the normal digestion and rumination is not recovering. Also the plastic can still be in the other stomachs and nothing can be done about that.Regards,Clementien
Dear Friends,
A bull we rescued because of a wound recently died after being unable to eat for many days. We were not surprised to find more than 40 kg of plastic in his stomach.
We made a short slide-show about the bull and the autopsy to use in our education programms (if you would like to use the series of photos please let me know and I am happy to send them to you).http://www.youtube.com/watch?v=vlFCNJ42QBk
I wanted to take this opportunity to find out more about rumenotomy surgeries and their success and mortality rates. At Animal Aid we do not perform the surgery because we do not have doctors who have performed it successfully before, nor have we come across a doctor who had been a part of successful rumenotomy surgeries. They have for the most part said it is very risky and most of the cows die from the surgery or post-surgery.
I would be very happy to learn that we have been wrong in avoiding the surgery all this time. That it is a simple surgery with great success rates and we should immediately prepare our doctors to perform the surgery on the next cow who is suffering from plastic consumption.
I would really appreciate information from you about the surgeries YOUR doctors have performed. Do any of you perform them regularly? If so, what is the mortality / success and recovery rate???
Thank you for your help, I really appreciate it.
Claire
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