Difference between revisions of "Exploratory Laparotomy - Donkey"

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{{review}}
 
  
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==Introduction==
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==Indications for Exploratory Laparotomy==
  
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This section offers an overview of the types of surgery commonly performed at [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary]. A standard equine surgical text should be consulted for a more detailed explanation of the surgical techniques discussed. References to surgeries specific to the donkey are included below.
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[[Image:Pus in uterus donkey.jpg|right|thumb|250px|<small><center>Uterus distended with pus exteriorised ready for surgical removal. (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
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[[Image:Drainage of pus donkey.jpg|right|thumb|250px|<small><center>Drainage of pus intra-operatively. (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
  
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A review of the last 160 surgeries performed under general anaesthetic at [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary] shows that the <u>majority</u> are '''routine castrations''' and the '''removal of dermal masses'''. In addition, operations on the '''hoof and distal phalanx''' are relatively common due to keratomas and/or septic pedal bone.
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Exploratory laparotomy may be required in the donkey, as in the horse, for emergency or elective purposes, such as surgical [[Colic - Donkey|colic]], caesareans, and uro-genital surgery.
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In young donkeys we also see a number of '''tenotomy''' operations necessitated
 
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by flexural deformities of the distal inter-phalangeal joint. <u>Less common</u>
 
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are dental surgeries requiring the '''removal of cheek teeth''', the removal of
 
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'''chondroids from the guttural pouch, exploratory laparotomy, enucleation of
 
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the eye'''and '''wound management'''. '''Exploration of the frontal and/or maxillary
 
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sinus''' is frequently required under local anaesthetic and sedation.
 
  
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Different populations of donkeys have different surgical problems. For
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As discussed, [[Colic - Donkey|colic]] in the donkey, especially [[Impaction Colic - Donkey|impaction colic]], may present with more subtle clinical signs than in a horse. However, acute signs of pain with nasogastric reflux and distended viscera are occasionally seen, and may indicate prompt surgical intervention. It is important to make an assessment of '''triglyceride levels and pancreatic enzymes''' as speedily as possible, as concurrent [[Hyperlipaemia - Donkey|hyperlipaemia]] and/or [[Pancreatitis - Donkey|pancreatitis]] will reduce the prognosis even if recognised and treated. '''Pancreatitis''' can present with signs of peracute pain in the anterior abdomen, which may be exacerbated by external ballotment behind the ventral sternum. In addition, peritoneal tap samples may show high levels of [[Neutrophils|neutrophils]], amylase and lipase.
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example, in [http://drupal.thedonkeysanctuary.org.uk Donkey Sanctuary] projects overseas, which concern a younger
 
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population of working, breeding animals, there is a higher incidence of
 
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work-related wounds and dystocias.
 
  
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The age range of donkeys presented for surgery can be a challenge Many
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==Examination==
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donkeys are presented for castration in their 20s, and geriatric donkeys often
 
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require surgical procedures. As in the horse, donkeys with increasing age show
 
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different problems. At The Donkey Sanctuary we have seen no instances of
 
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[[Squamous Cell Carcinoma - Donkey|squamous cell carcinoma]] of the external genitalia, nor melanomas in grey
 
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animals. Pedunculated lipoma causing [[Colic - Donkey|colic]] is rare, despite the tendency of
 
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the donkey to be obese.
 
  
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<big>'''[[Donkey - Surgery General Principles|General Principles]]
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The examination of the donkey with suspected surgical colic may be hampered due to the small size of the patient. A '''rectal examination''' is nearly always possible even if sedation is required. If this is truly impossible, '''ultrasound examination''' of the abdomen externally should be performed to assess viscera size, position and motility.
  
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'''[[Donkey - Castration|Castration]]
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A '''peritoneal tap''' provides useful information; however most UK donkeys carry considerable fat deposits above the linea alba. If ultrasound is available, the depth of the peritoneal fat may be measured and an appropriate needle or (more safely) a teat cannula used.
  
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'''[[Donkey - Flexural Deformity|Treatment of Flexural Deformity]]
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In aged donkeys, a good assessment of [[Dental Problems - Donkey|dental disorders]] and possible [[Foot Disease (Chronic) - Donkey|chronic hoof disease]] should be made before surgery is contemplated. Our records show that internal neoplasia is also a significant complicating factor in [[Geriatric Donkey|geriatric donkeys]]. This should be taken into account and discussed with the donkey owner, especially if there has been a history of progressive weight loss, or unexplained changes in haematological/biochemical parameters. Despite all the warnings, donkeys have been successfully operated on for correctable surgical lesions, for example, small intestine strangulation and large colon displacements.
  
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'''[[Donkey - Exploratory Laparotomy|Exploratory Laparotomy]]</big>
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==Urogenital surgery==
  
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==Rectal prolapse==
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Surgical correction of urogenital problems has been used at [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary] for the following conditions: caesarean section, ovariohysterectomy for pyometra, ovary removal, bladder stone removal, and cryptorchidism. The approach required will depend on the surgery to be performed.
  
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Rectal prolapse is commonly seen in working donkeys overseas that are suffering from heavy [[Donkey - Parasites|parasitism]], diarrhoea and malnutrition. Classification and treatment for the condition is as for the horse. There are two reports of rectal prolapse in donkeys in Egypt by Abd El-Kamm (1995).
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We have used
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*flank laparotomy for unilateral ovarian removal
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* paramedian approach for cryptorchidism
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* ventral abdominal approach for colic and caesarean operations
  
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==Sialolithiasis==
 
  
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There are two reports in the literature about this condition by Kay (2005) and Misk and Nigam (1984). Both reports are from clinics dealing with working donkeys in Egypt and Morocco respectively. Kay suggested that there was over-representation of donkeys with sialoliths but the reason for this is unknown.
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The indications for, and treatment of, bladder stones and cryptorchidism are similar to those in the horse.
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<big>
  
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==Mandibular clefts==
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[[Pyometra - Donkey|'''Pyometra''']]
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[[Ovariectomy - Donkey|'''Ovariectomy''']]
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[[Caesarean Section - Donkey|'''Cesarian Section''']]
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</big>
  
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There are two reports of mandibular clefts and bifid tongues in the literature relating to the donkey and mule (Farmande and Stöhler, 1990; Bouayad et al, 2006). Surgery was performed in four cases, of which two were not returned by their owners for follow-up, one died, but one managed well.
 
  
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==Maggot therapy for wound treatment==
 
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[[Image:Maggot therapy donkey.jpg|right|thumb|250px|<small><center>Maggot therapy – treatment of a deep injection abscess. (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
 
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[http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary] has had two successful experiences using sterile maggots to treat
 
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deep infected necrotic wounds in donkeys. Sterile larvae of the common greenbottle, ''Lucilia sericata'', supplied by the Surgical
 
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Materials Testing Laboratory (SMTL) were used to debride wounds where conventional therapy had failed (Bell and Thomas 2001; Thiemann, 2003).
 
  
 
==References==
 
==References==
  
 
* Thiemann, A. (2008) Surgery In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 16
 
* Thiemann, A. (2008) Surgery In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 16
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* Abd El-Karim, R.(1995). ‘Two cases of rectal prolapse in the donkey’.''Equine Veterinary Education 7'' (1). pp 12-14.
 
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* Bell, N.J., Thomas, S. (2001). ‘Use of sterile maggots to treat panniculitis in an aged donkey’. ''Veterinary Record 149''. pp 768-770.
 
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* Bonfig, H., Ingenhorst, I. (1992). ‘Surgical removal of a pedunculated uterine tumour in a donkey mare’. ''Tierarztl Prax'' 20(1). pp 65-68.
 
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* Bouayad, H., Rifai, S., Kay, R.S., Knottenbelt, D.C., and Smith, M. (2006). ‘Bifid tongue and Mandibular cleft in three mule foals’. ''Proceedings of the 9th Congress of the W.E.V.A.'' pp 334-346.
 
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* Bourassi, M., Kay, G. (2006). ‘Dystocia in donkeys carrying mule foals in Morocco: an evaluation of 32 cases’. ''Proceedings of the 9th Congress of the W.E.V.A.''
 
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* Carmona, A.G., Sevilla, M.A.T., Sevilla, H.C., and Cabanas, A.L. (1997). ‘Correccion de la contraccion del tendon flexor profundo por medio de un herraje ortopedico en equidos’. ''Vet.Mex.'' 28 (2). pp175-177.
 
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* Daniels, L.E., Conine, T.A., and Jackson, D.A. (1990). ‘A rehabilitation team approach to correct flexural deformities in a donkey foal’. ''Canadian Veterinary Journal 31''. pp 297-299.
 
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* Du Preeze, P.M. (1999). ‘Castration - update on techniques’. ''Proceedings of the Annual Conference of the British Equine Veterinary Association,''Newmarket, p 137.
 
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* El Maghraby, H.M., Fahmy, M.F. (1995). ‘Orbital tumours in 2 Donkeys’. ''Equine Practice'' 17 (5). pp 26-30.
 
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* Farmand, M., Stohler, T. (1990). ‘The median cleft of the lower lip and mandible and its surgical correction in a donkey’. ''Equine Veterinary Journal'' 22 (4). pp 298-301.
 
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* Green, P. (2001). ‘Castration techniques in the horse’. ''In Practice'' 23 (5). pp 250-261.
 
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* Kay, G. (2005). ‘Sialolithiasis in donkeys’. In: ''Veterinary care of donkeys.'' Matthews, N.S., and Taylor, T.S. (eds). International Veterinary Information Service. www.pubmedcentral.nih.gov/articlerenderfcgi?articl=14449901
 
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* Misk, N.A., Nigam, M.V. (1984). ‘Sialolith in a Donkey’. ''Equine Practice'' 6(4). pp 49-50.
 
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* Nelson, A.M., Baker, D.C. (1998). ''Veterinary Pathology'' 35(5). pp 407-409.
 
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* Pugh, D.G. (2002). ‘Donkey reproduction’. ''AAEP proceedings'' 48. pp 113-114
 
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* Thiemann, A.K. (2003). ‘Treatment of a deep injection abscess using sterile maggots in a donkey’. World Wide Wounds website. November 2003 (www.worldwidewounds.com)
 
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* Thiemann, A.K., Makhambeni, M.M.S. (2006). ‘Five cases of ovariohysterectomy in the donkey’. '''Proceedings of the 9th congress of the W.E.V.A.'' pp 487-489.
 
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* Vendrammi, O.M., Guintard, C. , Moreau, J., and Taintuner, D. (1989). ‘Cervix conformation: a first anatomical approach in Baudet de Poitou jenny asses’. ''Animal Science'' 66. pp 741-744.
 
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* Walmsley, J.P. (1995). ‘Flexural deformities of distal interphalangeal joints in a group of young donkeys’. ''Equine Veterinary Education 7''(1). pp 4-6.
 
  
  
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{{infotable
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|Maintitle = [[Sponsors#The Donkey Sanctuary|This section was sponsored and content provided by '''THE DONKEY SANCTUARY''']]
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[[Category:Donkey]]
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[[Category:Surgery_-_Donkey]]

Latest revision as of 12:28, 12 June 2010

Indications for Exploratory Laparotomy

Uterus distended with pus exteriorised ready for surgical removal. (Image courtesy of The Donkey Sanctuary)
Drainage of pus intra-operatively. (Image courtesy of The Donkey Sanctuary)

Exploratory laparotomy may be required in the donkey, as in the horse, for emergency or elective purposes, such as surgical colic, caesareans, and uro-genital surgery.

As discussed, colic in the donkey, especially impaction colic, may present with more subtle clinical signs than in a horse. However, acute signs of pain with nasogastric reflux and distended viscera are occasionally seen, and may indicate prompt surgical intervention. It is important to make an assessment of triglyceride levels and pancreatic enzymes as speedily as possible, as concurrent hyperlipaemia and/or pancreatitis will reduce the prognosis even if recognised and treated. Pancreatitis can present with signs of peracute pain in the anterior abdomen, which may be exacerbated by external ballotment behind the ventral sternum. In addition, peritoneal tap samples may show high levels of neutrophils, amylase and lipase.

Examination

The examination of the donkey with suspected surgical colic may be hampered due to the small size of the patient. A rectal examination is nearly always possible even if sedation is required. If this is truly impossible, ultrasound examination of the abdomen externally should be performed to assess viscera size, position and motility.

A peritoneal tap provides useful information; however most UK donkeys carry considerable fat deposits above the linea alba. If ultrasound is available, the depth of the peritoneal fat may be measured and an appropriate needle or (more safely) a teat cannula used.

In aged donkeys, a good assessment of dental disorders and possible chronic hoof disease should be made before surgery is contemplated. Our records show that internal neoplasia is also a significant complicating factor in geriatric donkeys. This should be taken into account and discussed with the donkey owner, especially if there has been a history of progressive weight loss, or unexplained changes in haematological/biochemical parameters. Despite all the warnings, donkeys have been successfully operated on for correctable surgical lesions, for example, small intestine strangulation and large colon displacements.

Urogenital surgery

Surgical correction of urogenital problems has been used at The Donkey Sanctuary for the following conditions: caesarean section, ovariohysterectomy for pyometra, ovary removal, bladder stone removal, and cryptorchidism. The approach required will depend on the surgery to be performed.

We have used

  • flank laparotomy for unilateral ovarian removal
  • paramedian approach for cryptorchidism
  • ventral abdominal approach for colic and caesarean operations


The indications for, and treatment of, bladder stones and cryptorchidism are similar to those in the horse.

Pyometra

Ovariectomy

Cesarian Section


References

  • Thiemann, A. (2008) Surgery In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) The Professional Handbook of the Donkey, 4th edition, Whittet Books, Chapter 16


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SURGERY - DONKEY


This section was sponsored and content provided by THE DONKEY SANCTUARY

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