Cesarean Section (also known as Hysterotomy)



Practice Tip to Facilitate Procedure

Infiltration of lidocaine for local anesthesia can easily accumulate dosages approaching toxicity. The total body dosage of lidocaine should not exceed 4 mg/kg body weight (1 mL per 5 kg body weight). Lidocaine toxicity can be treated by administration of IV fluids and supportive care.

Dinoprost, a PGF2-alpha drug, is not recommended for use in llamas and alpacas because of the risk of hypertension and death.




POTENTIAL COMPLICATIONS


Complications of laparotomy include peritonitis, hemorrhage, incisional seroma or hematoma, incisional infection, incisional dehiscence, and incisional hernia. These complications are infrequent when aseptic technique, careful tissue handling, and accurate reconstruction of tissues using appropriate materials and techniques are used. Interestingly, incisional hernias appear to be more common in llamas and alpacas with paralumbar incisions as compared with other ruminant species. An abdominal support bandage is recommended to be used for 10 to 14 days after surgery to support the incision in an attempt to minimize this risk.


Complications of hysterotomy include peritonitis, uterine adhesions, paraovarian adhesions, retained placenta, metritis, endometritis, and infertility. Early decision for C-section will optimize the condition of the dam, fetus, and tissues and therefore minimize the risk of complications. Retention of the placenta is not uncommon, but the placenta is expected to pass within 24 hours after surgery with minimal to no treatment. Closprostenol (250 μg total dose, IM) may be administered on the day of surgery to encourage lysis of the CL and continuation of placental separation from the endometrium. Caution should be observed with the use of oxytocin. Oxytocin should only be used in the presence of an open cervix (5 units, IM). Oxytocin has been associated with abdominal pain in llamas and alpacas, and the dosage and response to therapy should be closely monitored.


PATIENT MONITORING/AFTERCARE


Antibiotics and nonsteroidal anti-inflammatory drugs are administered routinely before surgery and continuing for 3 days after surgery. Therapy may be prolonged if uterine laceration, abdominal contamination, or emphysematous fetus were present. Close attention should be paid to the dam for 5 to 7 days after surgery to monitor for the onset of peritonitis. Antimicrobial therapy should include both Gram-positive and Gram-negative spectrum. When C-section is performed early in dystocia and sterile technique is used, the re-breeding success rate is expected to be good.


REFERENCES


Anderson DE. 1999. Common surgical procedures in camelids. Journal of Camel Practice and Research; 6(2):191–201.


Bravo PW. 2002. Female Reproduction. In: Bravo PW, The Reproductive Process of South American Camelids, Seagull Printing, Salt Lake City, pp. 1–31.


Cebra CK, Cebra ML, Garry FB, Johnson LW. 1997. Surgical and nonsurgical correction of uterine torsion in New World camelids: 20 cases (1990–1996). J Amer Vet Med Assoc; 211:600–602.


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Nov 6, 2016 | Posted by in GENERAL | Comments Off on Cesarean Section (also known as Hysterotomy)

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