DVM Doctor of Veterinary Medicine Large Animal Surgery Questions and Answers

Question 1

A 10-year-old Thoroughbred gelding presents with acute, severe abdominal pain that is unresponsive to analgesics. On rectal palpation, you identify multiple loops of tightly distended, edematous small intestine in the caudal abdomen. What is the most appropriate next step?

Accepted Answer

Immediately refer the horse for an exploratory celiotomy.

Answer

The finding of multiple loops of tightly distended and edematous small intestine on rectal palpation is highly suggestive of a strangulating obstruction, which is a surgical emergency. Delaying surgery significantly worsens the prognosis. While abdominocentesis and nasogastric intubation are important colic diagnostics, the rectal findings alone are sufficient to warrant immediate surgical referral.

Question 2

What is the primary purpose of performing a right paralumbar fossa omentopexy for the correction of a left displaced abomasum (LDA) in a dairy cow?

Accepted Answer

To create a permanent adhesion between the greater omentum and the right body wall, preventing redisplacement.

Answer

A right paralumbar omentopexy involves suturing the greater omentum, which is attached to the greater curvature of the abomasum, to the peritoneum and muscle layers of the right flank. This creates a permanent adhesion that holds the abomasum in its correct anatomical position, preventing future displacement. While decompression is part of the procedure, the pexy is the key to prevention of recurrence.

Question 3

Which of the following is considered the most common and clinically significant long-term complication following a laryngoplasty ('tie-back') procedure in a horse for treatment of recurrent laryngeal neuropathy?

Accepted Answer

Chronic coughing and/or dysphagia.

Answer

By permanently abducting one of the arytenoid cartilages, a laryngoplasty compromises the larynx's ability to fully close and protect the airway during swallowing. This can lead to chronic, low-grade aspiration of food and saliva, resulting in persistent coughing or difficulty swallowing (dysphagia). While suture failure and infection can occur, chronic coughing is a more frequent long-term management challenge.

Question 4

A 2-year-old male Boer goat presents for stranguria and vocalization. You perform a urethral process amputation, which successfully relieves the obstruction. However, the goat re-obstructs 24 hours later. The owner wants to pursue further treatment for this valued pet. What is the most appropriate surgical option to provide long-term patency?

Accepted Answer

Tube cystostomy.

Answer

A tube cystostomy is considered the gold standard for treating recurrent obstructive urolithiasis in small ruminants intended to be kept long-term. It diverts urine flow, allowing the urethra to heal and small calculi to pass without causing obstruction. A perineal urethrostomy is a salvage procedure often complicated by stricture, and bladder marsupialization has a high rate of ascending infection and urine scald.

Question 5

When performing a standing flank laparotomy in a horse, which regional anesthetic technique provides the most complete desensitization of all layers of the body wall, including the peritoneum?

Accepted Answer

Proximal paravertebral block.

Answer

A proximal paravertebral block desensitizes the dorsal and ventral nerve roots of the spinal nerves (T18, L1, L2) as they emerge from the intervertebral foramina. This provides a wide and deep area of anesthesia, including the skin, muscle layers, and peritoneum, which is ideal for a flank laparotomy. A line block and inverted L block do not reliably anesthetize the deeper muscle layers or the peritoneum. A caudal epidural affects the perineal region, not the flank.

DVM - Doctor of Veterinary Medicine Practice Test

DVM - Doctor of Veterinary Medicine Practice Test

DVM Doctor of Veterinary Medicine Large Animal Surgery Questions and Answers