eChapters

Introduction

A downer cow is an animal In sternal recumbency and isn’t showing obvious clinical sign of hypocalcemia,hypomagnesmia or any limb or spinal Injury. Most causes are related to parturition, occurring in few days before or upto a week after calving.

Causes for Making an Animal Downer

Animals Inability to stand may be caused by illness or injury. Following may be the reasons

1. The plaster-bandage wrap cast :(Negative cast)

The amputee was restrained on lateral recumbency keeping the amputed leg upwards.

A thin, moistened stockinet was pulled over the stump and it was maintained snugly in place by tying with a string at the top.

The moistened cast stockinet was marked with indeliable pencil indicating prominences with a cross and other sensitive areas with a circle (Fig.1).

Plaster bandages were then wrapped as pen requirement unit I the shell has a thickness of approximately 3mm in proximal third.

After plaster hardened, it was removed either by pulling out or longitudinal splitting with a cutter (Fig.2).

Bone section method

Advantage

Recommended for artificial limb fitting.

Non-weight bearing of stump is marked. Fig- 2a.

Indication

Necrosis, Gangrene, Extensive injury of nerve of hind limb.

Malignant neoplasm

Frost bite. Burns

Incurable peripheral vascular disease.

Indication: Irreparable damage of the meta tarsal joint.

Indication

Irreparable injury.

Frost bite, burn.

Malignant neoplasia.

Incurable peripheral vascular disease.

Necrosis, gangrene, extensive injury of nerve of fore limb.

Definition : It is a technique in which foreiirnb is amputed from elbow joint. Indication : Incurable damage of radius ulna.

Indication: Irreparable damage of metacarpal bone.

Indicaton: Irreversible damage of both the bovine digits & to provide a foot pad for comfortable walking of animal

Joint disarticulation: Unwanted limb is amputed by joint disarticulation method.

Site of amputation along with skin-muscle flap ratio

Fore limb:
Elbow disarticulation
Carpo-metacarpal disarticulation
Fetlock disarticulation

Aim

Study about method of apposing muscle, fascia, skin over amputed stump.

Indication

Proper healing of amputed stump, avoiding infections.

Description

Limb is amputed generally through diaphysis or by disarticulation method. Whatever is the amputation,the surgeon should always keep as much soft tissue as possible to cover the bone extrimities. It is difficult to achieve in large animal, when amputation is immediately below carpus or tarsus.

Aim: Amputation of limb by bone section technique.

Indication: Irreparable injury; Gangrene; Malignant disease.

Site:

Fore-limb: Common site is junction of the lower and middle third of the radius(fore-arm).

Hind-limb: common site is the middle third of the leg region(tibia).

Anaesthesia and control: Fore-limb: general anaesthesia; Hind-limb: epidural anaesthesia. Operated in lateral recumbent position.

Indication

Bilateral digital cancerous growth cauliflower like(fig-1),cancerous growth with continuous bleeding and myasis.

Aim

To remove the cancerous growth from healthy side by surgery. (Fig. 1-2)

Material Required

Amputation saw, thick padded with bandage roll ,a mixture of powder containing resin and naphthalene ball powder, bicycle tube protection sleeper(Fig-3),local anesthesia.

Objetive

To completely exercise a cancerous hoof in presence with cauliflower like growth with regular bleeding & myosis.

Material Required

Amputation saw, thick padded with bandage roll, a mixture of powder containing resin and naphthalene ball powder, bicycle tube protection sleeper (Fig-3), local anesthesia.

Amputation of Claw in Cattle

1. True bone tumours. Neoplasms arising from cells of mesenchymal origin, derived from a common ancestry and whose function is primarily skeletal boen formation. These tumours fall into four main groups according to the predominant cell type present. By reason of the mutability of the cells metaplasia is common and intermediate stages are found.

Definition

Wound with infection with 6 hours of occurrence can be brought to non infected stage by flushing.

Procedure

The infected wound at fracture site is cleaned / flushed thoroughly using sufficient quantity with antiseptic solution.

The site is applied with topical antiseptic / antibiotic and the size of the wound is reduced by placing interrupted stitches for skin closure.

For drainage of inflammatory fluid, the counter opening is made as the distal part of the swelling of the dependent part of flushing catheter is placed inside to carry out regular flushing of the wound without removing the immobilizer.

The fracture site is immobilized as per the conventional procedure using POP cast leaving two window over the opening of counter opening site.

Aim: Regular flushing of compound and fracture using topical antibiotic or antiseptic required to bring the open wound and fracture either to a aseptic stage or to reduce the degree of infection and pus formation.

Procedure

After through cleaning the exposed bone as well as the wound of the compound fracture the wound is placed inside its part.

A thick walled rubber tube / plastic tube threaded with two end of a suture with a straight needle is carried to a higher site from the fracture within the wound.

The suture and needle is brought out, the sutures separated and again threaded and the flushing catheter is fixed with suture. Fig.1.(a) and Fig. 2. (a), (b).

The wound is protected with a thick absorbant sterile cotton padding, keeping the flushing catheter out through a small hole within the bandage. Fig. 1 (b) and Fig.2.(c)

The limb is immobilized as per the recommended procedure depending the level of fracture, outer end of the flushing catheter is kept outside, of the immobilization for carrying out regular flushing of the wound.

Management of Compound Fracture

An open fracture is an injury that occurs when a broken bone is exposed through the skin. This may mean that the bone is actually sticking out of the skin, or it may mean that the skin and soft-tissue is disrupted and exposes a path to the site of the fracture. Often called a compound fracture, an open fracture necessitates different treatment from the usual closed fracture.

Surgically Cleaning the Bone

Surgically cleaning the bone is one of the first steps for treating an open fracture. Most patients who sustain an open fracture undergo a surgery called “irrigation and debridement.” Irrigation means washing the bone and the site of the injury. Debridement is described in the next step.

Determining the extent of injury can be difficult just by looking at an open fracture. This is especially true in high-energy injuries including automobile collisions and gunshot wounds. With these types of injuries, even small penetrations in the skin can cover very large areas of soft-tissue damage around an open fracture. Therefore, when surgically cleaning the bone, it is important to do this in the operating room (OR) under anesthesia — trying to sufficiently assess and clean the bone in the emergency room, without adequate anesthesia, may be insufficient.

Contracted Leg in Calves

Definition

A shortening or contraction of the deep and superficial digital flexor tendons and associated muscles, sometimes also the carpal flexors, leading to abnormal flexion of the fetlock, possibly also of the pastern and carpal joint.

Hip joint is a ball and socket joint which involves cotyloid cavity of os-coxae and head of femur. Hip dislocation can be corrected by external immobilization of the area with POP cast and keeping the animal in a mobile sling for several weeks.

The dislocation involves cotyloid cavity and head of femur and the affected limb deviate outward. (Fig.1)

The fracture site is immobilized extending joint below and joint above level initially with plaster of Paris.(Fig.2)

Cloth bandage is applied over it for support involving joint above and joint below which should not be too tight or too loose.(Fig.3)

Second layer of cloth padding is provided over the first layer to provide more strength and further immobilization.(Fig.4)

Final immobilization is done by application of rubber belt or suspensory bandage. (Fig.5)

At the end the entire animal is kept in mobile sling for proper immobilization for some weeks and housed in limited space(Fig.6)

To know the method of immobilization of the limb after repair of the transected gastrocnemius tendon (tendo achiles).

Procedure

The immobilization procedure of limb after gastrocnemius tendon repair is done in 2 stages.

1^ST Stage

Immobilization of limb for avoiding movement at tendon suture site.

It is done by placing the sutured area within a pre- fabricated metal frame so as to keep the limb undisturbed at the suture site.

The frame is given in Figure 1.

The purpose of addition of the metal frame is to immobilize the limb keeping the fetlock and foot away from in a flexed manner to avoid weight bearing during healing period.

The limb is immobilized with netted bamboo splint (Fig. 2).

The immobilized limb is placed within the metal frame keeping the fetlock and foot in a flexed manner

Aim

To depict the detail method of tendon suturing of transected gastrocnemious tendon for union.

Procedure

After cleaning, debriding and flushing the transected site thoroughly local antiseptic and antibiotic is applied.

1. To expose the tendon ends clear visual as well as proper exposer the site was enlarged by two vertical incision placed at dorsal and ventral part of the transected site.(Fig.1).
2. The three different tendons and their locations is identified. The both end of tendon of a particular group are brought close together and joins end to end and retained with strong polyester suture putting to interrupted knots at 90 degree to each other.(Fig. 2).
3. Their peritendon cover are pulled over the suturing site from their either ends and are also retained in position with additional interrupted suture running at 90 degree to each other.(Flg. 3). In this way 4 interrupted suture are required for approaching one tendon.
4. In this way all the 3 tendons are joined with their respective other ends with suture. Total no of 12 interrupted suture are required for joining all the 3 structure of the gastrocnemious tendon. At the end the suture tendons are strengthened by placing to interrupted stainless steel suture. (Fig. 4).

Finally a flushing catheter was placed at higher level and the suture site is covered with a thick dry antiseptic absorbent cotton padding.

Definition

Digital tender include superficial digital flexor, DDF & suspensory ligament which is situated in volar & plantar upset of metacarpus and metatarsus. These tendons are generally transected during ploughing or intensional approach (Fig.1).

Sign

After cutting of these tendon the foot became flat and animal bears weight on fetlock is can’t able to walk freely.

Aim: To know the method of immobilization of the limb after repair of the flexor tendon.

Procedure

The immobilization procedure of limb after flexor tendon repair is done in 2 stages.

Objectives

Immobilization of fracture of mandible.

Requirements

‘U’ Plate 4 Pins Electric drill Orthopaedic hammer Pin cutter

Procedure

Under local infiltration of an anesthetic & parenteral sedatives the 4 pins are drilled 2 on either side of the fracture site from one side mandible to other side mandible. During drilling the pin, the holes, importance should be given for the passage of the pin through prefix of the drill hole in metal frame

The fracture end should come accurate apposition during pinning procedure & the symmetry of the fractured mandible should be as norma! as possible.

Sterilised antiseptic gauge bandages are covered, the pin between frame and the body. The pins are retained in position either with nut-bolt or by passing a plastic tube after which the hole of the plastic tube is filled with resin.

Definition: Mandible forms the skeleton of lower jaw and comprises of a body and two rami. The two halves of this bone fuse incompletely at the mandibular symphysis, situated at the midline within the body.

Indication: Immobilization of fractured mandible, minimally or non displaced fractures with an intact opposite hemimandible, vertical ramus fracture.

Anasthesia: Local anaesthesia for large animals. A20 gauze 2.5 cm needle is used to deposit 5-1 Omi of lidocaine at the exit site and into the canal.

Use of conjoined Thomas splint for bilateral tibia fibula fracture for large animal.

Aim

To know the immobilization technique for both tibia-fibula fracture in large animal practice.

Instruments

Conjoined Thomas splint (Fig 1).

Definition

Fracture of Upper 3rd of tibio-fibula Presence as a difficult Problem for the Surgeon to immobilise it Perfectly. As the fracture site generally moves within the imobiliser. Its healing becomes difficult. The aimof immobilisation technique of upper 3rd tibio-fibula fracture is to fix the upper 3rd of tibio-fibula with the anterior half of ring of thomas splint with bandages. This is an important step for achieving no movement of fracture fragment during healing.

Indication

Correction of upper 3rd fracture of tibio-fibula (Fig.1) by thomas splint application.

Purpose

As the immobilisation of upper third part of radius ulna is very difficult ,the purpose of the immobilisation tech. Is to fix the upper third of radius-ulna with the posterior half of ring of Thomas splint with bandages are very important for achieving no movement of fracture fragment during healing.

Indication

Correction of upper third fracture of radius-ulna by Thomas splint application indicated in higher level fracture.

Defination

Dislocation of carpometarcarpus and tarso metatauses along with upper fracture of MC and MT bone (Fig. 1 and Fig.2). It is considered as difficult fracture and may not be healed appropriately by the usual procedure of lower level fracture repair method. Due to constant movement of fracture ends its treatment should be similar to middle level fracture repair method.

Materials Required

Thick padded cloth

Adhesive gum (fevicol)

Netted bamboo splint

Thomas splint

Defination

Dislocation of carpometarcarpus and tarso metatauses along with upper fracture of MC and MT bone (Fig. 1 and Fig.2). It is considered as difficult fracture and may not be healed appropriately by the usual procedure of lower level fracture repair method. Due to constant movement of fracture ends its treatment should be similar to middle level fracture repair method.

Materials Required

Thick padded cloth

Adhesive gum (fevicol)

Netted bamboo splint

Thomas splint

Aim

Purpose: As there is no institution for preparation ofthomassplintfor large animal till date for which physician are preparing thomas splint hear the patient at the time of need.

These thomas splint are generally prepared with useof bamboo, Gl wire, jute of cottonbandages. These thomas splint are generally weak. These thomas splint work for (2-3) month.

For this reason there is necessity of fabrication of large animal thomas splint with us e of other strong and lightest material for long time stonage and use.

Large animal orthopedic patients are often managed with modified Thomas splints and to achieve an acceptable outcome with this device the following points should be kept in mind.

Animals initially find discomfort with the splint and try to reject it by kicking and often show violent movements. Hence initial acclimatization with the device by close observation and supervision of the patient is essential.

Recumbent animals should be supported in standing position by a sling and they should be managed with the principle “12 hrs on sling and 12 hours on floor”.

Movement of the animal should be restricted.

Aim: To secure the foot on the distal end of Thomas splint.

Procedure

1. Foot is placed upon the distal end of Thomas splint.
2. The foot of the animal is wrapped V’- two round with bandage cloth.(Fig.1)
3. 2^nd round of bandage cloth is wrapped around the distal end of Thomas splint.(Fig.2)
4. In 3^rd attempt, the bandage roll is taken from the ground level of the foot & including the distal end of foot.(Fig.3)
5. The bandage roll is taken through the gap between anterior end of Thomas splint.(Fig.3)
6. In 4th attempt, the bandage roll is taken from the volar or plantar aspect of the limb and passed upon the ground level of foot as well as the distal end of Thomas splint.(Fig.4)
7. Final 2 rounds of bandage cloth is wrapped through entire surface of foot.

Reference: Tyagi R.P.S. and Singh J, (2013), Ruminant Surgery, CBS Publishers, New Delhi, pp-353,354

Definition : These are the splints made out of light metal rods or bamboo for correction and immobilization of middle and higher level fracture in animals.

Purpose:- To know the method of fitting the immobilised fractured hind limb in Thomas splint.

Description

The fractured site is immobilised properly covering the area joint below and joint above from the fractured site.

The immobilised limb is kept within the prepared Thomas splint.

The immobilised limb is kept straight and come close with the front extension bamboo of the Thomas splint.

The foot is fixed to the distal end of the Thomas splint with bandage roll.

In the first attempt the immobilised limb is secured with the front bamboo splint with bandage roll at several places to avoid posterior movement of the immobilised limb.

At the time of fixing the immobilised limb with anterior extension bamboo of Thomas splint, the limb is fixed with the netting of Thomas splint to avoid medial movement of immobilised limb.

Finally the immobilised limb is covered with bandage roll wrapping around both the anterior and posterior extension bamboo of the Thomas splint to avoid outer movement of the immobilised limb.

The method of immobilisation of the hind limb with Thomas splint has been shown in the figure.