DVM Large Animal Surgery 5 — Questions and Answers
Question 1: Which vessel is at greatest risk of iatrogenic injury during a left flank laparotomy for bovine abomasal displacement correction?
- Left ruminal artery (Correct answer)
- Splenic artery
- Cranial mesenteric artery
- Left gastric artery
Correct answer: Left ruminal artery
The left ruminal artery runs along the left surface of the rumen and can be inadvertently injured when the surgeon is working in the left flank region near the rumen.
Question 2: What is the recommended surgical treatment for a horse with grade IV laryngeal hemiplegia (roarer) competing at high performance levels?
- Permanent tracheostomy
- Prosthetic laryngoplasty (tie-back procedure) (Correct answer)
- Ventriculocordectomy alone
- Medical management with corticosteroids
Correct answer: Prosthetic laryngoplasty (tie-back procedure)
Prosthetic laryngoplasty (arytenoid lateralization/tie-back) is the preferred surgery for high-performance horses with laryngeal hemiplegia, restoring the airway diameter to improve exercise tolerance.
Question 3: Which diagnostic test best confirms the diagnosis of nephrosplenic entrapment of the large colon in a horse prior to surgery?
- Rectal palpation of the ventral colon over the nephrosplenic ligament (Correct answer)
- Abdominocentesis showing serosanguineous fluid
- Abdominal radiography revealing gas pattern
- Complete blood count showing leukocytosis
Correct answer: Rectal palpation of the ventral colon over the nephrosplenic ligament
Rectal palpation is the primary diagnostic tool; the characteristic finding is the left ventral colon positioned dorsal to and over the nephrosplenic (splenorenal) ligament, which can be palpated per rectum.
Question 4: In swine, which surgical technique is used for reduction of rectal prolapse in mild, acute cases?
- Purse-string suture placement around the anus after manual reduction (Correct answer)
- Amputation of the prolapsed segment
- Colopexy via laparotomy
- Submucosal resection
Correct answer: Purse-string suture placement around the anus after manual reduction
For acute, reducible rectal prolapse in pigs, manual reduction followed by placement of a purse-string suture to retain the rectum is the initial treatment; amputation is reserved for irreducible or necrotic prolapses.
Question 5: What is the primary advantage of the ventral midline approach over the flank approach for exploratory laparotomy in horses?
- Decreased risk of wound dehiscence
- Superior visualization and access to the entire abdominal cavity (Correct answer)
- Ability to perform surgery in the standing horse
- Reduced operative time
Correct answer: Superior visualization and access to the entire abdominal cavity
Ventral midline celiotomy provides access to all abdominal compartments, enabling the surgeon to examine, decompress, and correct any region of the gastrointestinal tract.
Question 6: Which antibiotic is commonly administered intraperitoneally during equine colic surgery to reduce the risk of peritonitis?
- Gentamicin (Correct answer)
- Penicillin G
- Ampicillin
- Oxytetracycline
Correct answer: Gentamicin
Gentamicin is frequently diluted in saline and lavaged into the peritoneal cavity during and after equine abdominal surgery to reduce gram-negative bacterial contamination and the risk of peritonitis.
Question 7: What is the most important prognostic indicator for survival after strangulating large intestinal lesions in horses?
- Age and breed of the horse
- Duration and degree of bowel ischemia and systemic endotoxemia (Correct answer)
- Intraoperative blood loss volume
- Type of surgical approach used
Correct answer: Duration and degree of bowel ischemia and systemic endotoxemia
The extent of intestinal ischemia and severity of systemic endotoxemia at the time of surgery are the strongest predictors of survival, as irreversible mucosal injury leads to endotoxin translocation and septic shock.
DVM Large Animal Surgery 5
Which vessel is at greatest risk of iatrogenic injury during a left flank laparotomy for bovine abomasal displacement correction?