DVM Large Animal Surgery 4 — Questions and Answers
Question 1: Which approach is preferred for surgical repair of a fractured third metacarpus in a horse intended for return to performance?
- External coaptation with a full limb cast alone
- Internal fixation with dynamic compression plates and screws (Correct answer)
- Stall rest without surgical intervention
- Intramedullary nailing
Correct answer: Internal fixation with dynamic compression plates and screws
Dynamic compression plating provides rigid internal fixation that allows controlled bone healing and is necessary for cortical fractures of the cannon bone in performance horses where return to work is desired.
Question 2: A bull presents with a penile hematoma ('broken penis'). What is the most appropriate initial treatment?
- Immediate surgical repair of the torn tunica albuginea
- Cold hydrotherapy, NSAIDs, and rest for 2–3 weeks (Correct answer)
- Amputation of the distal penis
- Urethrostomy to divert urine flow
Correct answer: Cold hydrotherapy, NSAIDs, and rest for 2–3 weeks
Conservative management with cold therapy, anti-inflammatory drugs, and sexual rest for several weeks allows resolution of the hematoma in many bulls; surgery is reserved for cases that fail to respond.
Question 3: What is the most common complication following repair of a cervical vertebral stenotic myelopathy ('Wobbler syndrome') by ventral stabilization in horses?
- Jugular vein thrombosis
- Implant failure (Correct answer)
- Esophageal fistula formation
- Recurrent laryngeal neuropathy
Correct answer: Implant failure
Implant failure due to the biomechanical demands of the equine cervical spine is a recognized complication of ventral stabilization procedures such as interbody fusion using a Bagby basket.
Question 4: In cattle, which technique is used to surgically correct a displaced abomasum from the left flank while the animal is standing?
- Blind stitch (toggle-pin suture) only
- Left flank laparotomy with omentopexy or abomasopexy (Correct answer)
- Ventral midline approach under general anesthesia
- Right flank pyloropexy
Correct answer: Left flank laparotomy with omentopexy or abomasopexy
Left flank laparotomy allows the surgeon to decompress the abomasum, return it to the correct position, and fix it by omental or abomasal suture to the right abdominal wall to prevent recurrence.
Question 5: Which condition in horses is characterized by necrosis of the digital cushion and palmar/plantar structures, often requiring partial digit amputation?
- White line disease
- Canker (Correct answer)
- Septic pedal osteitis
- Solar abscess
Correct answer: Canker
Canker is a chronic, proliferative, anaerobic infection of the frog and digital cushion that, in advanced cases unresponsive to debridement, may require partial or complete digit amputation.
Question 6: Which suture material is most appropriate for closing the uterine incision during a bovine caesarean section?
- Chromic catgut in a Lembert pattern (Correct answer)
- Monofilament nylon in a simple continuous pattern
- Stainless steel wire in a simple interrupted pattern
- Braided polyester in a horizontal mattress pattern
Correct answer: Chromic catgut in a Lembert pattern
Chromic catgut or synthetic absorbable suture in an inverting pattern (Lembert or Utrecht) is standard for uterine closure in cattle, providing adequate holding strength while being absorbed before subsequent pregnancies.
Question 7: A horse develops postoperative ileus following small intestinal resection and anastomosis. Which pharmacological agent is most appropriate?
- Atropine
- Lidocaine IV infusion (Correct answer)
- Metoclopramide IM
- Butylscopolamine
Correct answer: Lidocaine IV infusion
Intravenous lidocaine infusion has prokinetic and anti-inflammatory effects that promote resumption of intestinal motility and reduce pain in horses with postoperative ileus.
DVM Large Animal Surgery 4
Which approach is preferred for surgical repair of a fractured third metacarpus in a horse intended for return to performance?