Caesareans...?

RE: Caesareans...?

Fable — Mon, 04 Apr 2022 19:20:34 GMT

With a dead rotten calf the only caesarean you should be trying is with the cow down and a right paramedian approach so you can fully exteriorise the uterus. I haven’t been brave enough to try this yet, but several colleagues have had success. I agree that it is almost never worthwhile to do a traditional caesarean when the calf has been dead for more than a few hours.

I’m also a fan of the line or inverted L block for regional anaesthesia. I learned how to do the paravertebral blocks, but like Michael says I do not find this way quicker. Never had an issue with sensitivity following a line block even in massive beef cows with thick abdominal muscles. I definitely start my surgical prep first, administer the block and do a final prep prior to cutting.

Generally wouldn’t expect a straightforward caesar to take more than an hour. It’s the foetotomies that I hate because these can take anywhere from a few minutes to hours. If an obstetrical procedure is taking that long though, you do need to start considering whether it is in the best interests of the animal and the producer to keep going. A 6 hour procedure charged appropriately here would be at least $1,500 and there would be little, if any return on investment from such an exercise.

RE: Caesareans...?

Julian Earl — Mon, 04 Apr 2022 12:52:35 GMT

Thanks ichael for takingthe trouble to reply, but we shallhave toagree to differ especially about Para-vertebral anaesthesia! the Belgians?/ Who?/ What the heck do they know?? I am far from sure tha ta line block is, as you suggest fool-proof? It can be tricky to know exactly where the line starts and ends, plus to be sure that the entire line is at the iorrect depth?To the peritoneum andt all individual muscle layer? he only way to be sure is the hard Way...,y cutting and discovering the depth or eve nlength of the line block isinadequate! A correct- PV should automatically cover both of those real potential issues!

Of course every time you introduce the needle in the flank for your line block you might well be introducing infective bacteria? or do you scrub up the skin before administering the line block? Thank you.

If they are taking you longer than 10 minutes in a sheep youare wasting time somewhere! Ina Cow, A lot quicker than local infiltration as well! Makes some iunstable?/ Ihave genuinely never evewr witnessed that! I might concede more bleeding from the muscle sometimes but have never been 100% convinced of this comment! What counts s effective pain relief and time taken! Practice makes, if not perfect, certainly made more efficient!

Also re. never wrong...! Okay I have to concede/ agree that with a dead emphysematous calf, there has to be a big question mark over doing a Caesar compared to n embryotomy but as you say, with care the cow can still pull through. Liberal flushing of the op-site after removing the foetus is critical there , surely??

Cheers

RE: Caesareans...?

Michael Woodhouse — Sun, 03 Apr 2022 22:27:30 GMT

[quote userid="3094" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans/236769#236769"]ne thing that I forgot to include is that it is never wrong to do caesarean![/quote]

Almost true - avoid if wild and dangerous, avoid if fetus rotten (you get away with it sometimes, but mortality vastly increased).

[quote userid="3094" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans/236769#236769"]WRONG?? Thanks Michael, I think? About what exactly?[/quote]

I'll tell you -

[quote userid="3094" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans"]you should measure the amount of Lubigel that you need to use or have used by the bottle[] and not by the squirt or proportion of s bottle.[/quote]

Why so much? I use lube but in most cases a single bottle will do many lambings or calvings. There is a specific presentation where it's dead and dry where lube really helps, but most of the time I apply a couple of times.

[quote userid="3094" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans"]In addition, learn to do a paravertebral anaesthetric for caesareans[/quote]

No. It's slower, uses more anaesthetic, makes some cows unstable, increases the bleeding, occasional pockets where they feel it. The Belgians who pioneered the caesarean agree. I went through a couple of years of doing them, but back to a line block. 80-100ml in a cow and join the dots. Fast and easy. Foolproof.

Similarly some people like routine epidurals - I personally never use them.

[quote userid="3094" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans"]It can ake the big difference between a successful calving and acaesarean taking maybe 3 to 6 hours [/quote]

WHAT?! A sheep caeser is a 20-30 min op, a cow caeser a 40-60 min job. In 16 years don't think I've had an obstetric job last more than 2 hours.

I also do quite a lot of farm animal obstertrics - one morning last week we had 3 sheep caesers on the go at the same time at the surgery (I did one of them), I went out to calve a cow, then do another cow caeser on a different farm. Was still in the pub for 12.00 as had a girl for an interview.

My success factors would be

1. speed - rapid decision to operate, efficient surgery (longer operating time = increased mortality risk). Line blocks fall into this

2. sterile - sterile gloves, sterile kit. Scrubbed in assistant (farmer) with gloves and gown. Sterile chains for calf.

3. always double layer closure of uterus using catgut

4. tear oblique muscle - less blood, less post op swelling, self closes so no guts fall out, faster closure.

RE: Caesareans...?

Julian Earl — Sun, 03 Apr 2022 06:56:41 GMT

[quote userid="3169" url="~/001/veterinary-clinical/farm-animal/f/discussions/30251/caesareans/236766#236766"]always happy to talk large animal obstertrics, even if I think you are wrong......[/quote]

WRONG?? Thanks Michael, I think? About what exactly?

ne thing that I forgot to include is that it is never wrong to do caesarean! Not Necessarily the best choice of course, but not absolutely wrong if you finish with a live cow and a calf on the floor! If the environment and/or the cow are plastered with cow-faeces etc., then a caesar is not necessarily ideal but that can at least be addressed before you start? As best as possible anyway? One has been called out to remove the calf from the mother so that is what a Caesarean does, If thefarmer reuses due to the cost versus high risk then euthanasia becomes his only option instead.

So please humour me Michael and enlighten me about my apparent mistake here/ Thank you my friend!

RE: Caesareans...?

Jill Butterworth — Sat, 02 Apr 2022 20:25:20 GMT

Thank you Julian, I will heed your advice if I get any sheep lawnmowers for my paddock. Glad to hear you have had good support from SVS. All the best.

RE: Caesareans...?

Michael Woodhouse — Fri, 01 Apr 2022 20:40:37 GMT

Julian, not sure what you want from this thread? My suggestion would be to split this into two issues - always happy to talk large animal obstertrics, even if I think you are wrong......