DVM Large Animal Surgery 3 — Questions and Answers
Question 1: Which anesthetic drug combination is most commonly used for total intravenous anesthesia (TIVA) in standing equine procedures?
- Propofol and fentanyl
- Ketamine and medetomidine
- Detomidine-butorphanol-ketamine (triple drip) (Correct answer)
- Xylazine and thiopental
Correct answer: Detomidine-butorphanol-ketamine (triple drip)
The triple drip (guaifenesin, ketamine, xylazine or detomidine) or detomidine-butorphanol-ketamine combinations are standard TIVA protocols providing adequate sedation and analgesia for field anesthesia in horses.
Question 2: A cow develops milk fever (hypocalcemia) 12 hours post-cesarean section. Which of the following best explains this complication?
- Blood loss-induced hypoalbuminemia
- Perioperative stress reducing parathyroid hormone secretion (Correct answer)
- Calcium sequestration into the involuting uterus
- Intraoperative IV fluid dilution of serum calcium
Correct answer: Perioperative stress reducing parathyroid hormone secretion
Periparturient hypocalcemia results from an acute demand for calcium that exceeds the cow's ability to mobilize it, often exacerbated by the stress response of surgery impairing normal parathyroid hormone-mediated calcium regulation.
Question 3: What is the purpose of the Caslick's operation in mares?
- To reduce uterine prolapse risk after foaling
- To correct pneumovagina by suturing the dorsal vulvar lips (Correct answer)
- To improve ovulation rates in subfertile mares
- To prevent dystocia in maiden mares
Correct answer: To correct pneumovagina by suturing the dorsal vulvar lips
Caslick's operation involves suturing the dorsal portion of the vulvar lips to close the pneumovagina, preventing aspiration of fecal material and air into the reproductive tract that leads to endometritis.
Question 4: In horses, which condition is characterized by accumulation of gas in the cecum unresponsive to medical treatment?
- Proximal enteritis
- Cecal impaction
- Cecal tympany (Correct answer)
- Right dorsal displacement of the large colon
Correct answer: Cecal tympany
Cecal tympany involves gas distension of the cecum; when medical decompression fails, surgical cecostomy or typhlotomy may be required to relieve the pressure.
Question 5: Which ligament must be transected during a standing bovine caesarean section via the left paralumbar flank?
- Broad ligament of the uterus (Correct answer)
- Round ligament of the uterus
- Intercornual ligament
- Lateral suspensory ligament of the udder
Correct answer: Broad ligament of the uterus
The broad ligament may need to be partially incised to exteriorize the gravid uterine horn through the flank incision during caesarean section in cattle.
Question 6: What is the most significant complication of perineal urethrostomy in goats and sheep?
- Urethral stricture formation (Correct answer)
- Ascending urinary tract infection
- Rupture of the urethra distal to the stoma
- Hydronephrosis
Correct answer: Urethral stricture formation
Urethral stricture at the stoma site due to scar formation is the most common long-term complication of perineal urethrostomy in small ruminants, often leading to recurrent obstruction.
Question 7: When performing a herniorraphy for umbilical hernia in a foal, which layer is most critical to close to prevent recurrence?
- Skin
- Subcutaneous tissue
- External fascia and linea alba (Correct answer)
- Peritoneum alone
Correct answer: External fascia and linea alba
Secure closure of the fibrous hernia ring, including the external fascia and linea alba, is essential to eliminate the defect and prevent herniation from recurring.
DVM Large Animal Surgery 3
Which anesthetic drug combination is most commonly used for total intravenous anesthesia (TIVA) in standing equine procedures?