Small Animal Surgical Emergencies

1 Cover

2 Title Page

3 Copyright Page

4 Dedication Page

5 Contributors

6 Preface

7 Acknowledgements

8 About the Companion Website

9 Daisy’s Story

10 1 Triage and Initial Stabilization of the Emergency Small Animal Surgical Patient Introduction Triage and Initial Assessment Respiratory Assessment Cardiovascular Assessment Dehydration Neurologic Assessment Urinary Assessment Vascular Access Analgesia, Sedation and Anxiolytics

11 2 Operating Room Nursing Tips for Emergency Surgical Procedures Gastrointestinal System Urinary System Respiratory System Cardiovascular System Reproductive System Wound Management Ocular Emergencies Oral Emergencies Specific Oral Surgical Emergencies Orthopedic Emergencies

12 Section I: Gastrointestinal System 3 Emergency Stabilization of the Acute Abdomen Patient Introduction Pathophysiology of Acute Abdomen Differential Diagnoses Primary Assessment Systematic Approach to Initial Stabilization: Cardiovascular System Systematic Approach to Initial Stabilization: Respiratory System Systematic Approach to Initial Stabilization: Central Nervous System Abdominal Examination Minimum Database Interpretation and Management Peritoneal Fluid Analysis and Indications for Emergency Laparotomy Diagnostic Imaging for the Acute Abdomen Conclusion 4 Esophageal Foreign Bodies Introduction Anatomy Pathophysiology of Esophageal Injury (Figure 4.3) Presentation Emergency Stabilization Diagnostics Non‐surgical Treatment Surgical Treatment Postoperative Care Complications Prognosis for Esophageal Bone Foreign Bodies Fishhooks and Needles Esophageal Stick Injuries 5 Gastrointestinal Foreign Bodies Introduction Classification of Foreign Bodies Pathophysiology Signalment, History, and Physical Examination Laboratory Findings Imaging Surgical Techniques Postoperative Care Prognosis 6 Intussusception Introduction Clinical Presentation Diagnosis Initial Stabilization Surgical Management Postoperative Care and Complications Prognosis 7 Rectal Prolapse Etiology Clinical Evaluation Treatment 8 Gastric Dilatation and Volvulus Introduction Pathogenesis Pathophysiology Clinical Presentation Stabilization and Diagnostic Evaluation Operative Techniques Postoperative Care Complications Outcome and Prognosis 9 Intestinal Volvulus Definition and Pathophysiology Presentation Diagnostics Treatment Complications and their Management Prognosis 10 Colonic Torsion Introduction Pertinent Anatomy Signalment and Clinical Presentation Diagnostics Emergency Stabilization Surgical Management Postoperative Care and Prognosis 11 Peritonitis Anatomy Etiology Diagnosis Considerations for Patient Care Surgical Therapy Prognosis Summary 12 Surgical Intervention Post‐Celiotomy Introduction Secondary Septic Peritonitis Postoperative Hemoabdomen Portal Hypertension 13 Biliary Emergencies Anatomy Physiology Etiology Disease Processes that Cause Biliary Obstruction or Rupture Diagnosis Surgery Surgery of the Bile Duct Surgery for Traumatic Injury of the Gallbladder, Hepatic Ducts, and Common Bile Duct Surgical Treatment of Bile Peritonitis Postoperative Monitoring and Treatment Prognosis 14 Hemoperitoneum Introduction History and Clinical Signs Physical Examination Emergency Stabilization Diagnostics Medical Management Surgical Management Traumatic Hemoperitoneum Spontaneous Hemoperitoneum Postoperative Care Complications Prognosis 15 True Abdominal Hernias Introduction Umbilical Hernias Inguinal/Scrotal Hernias Prognosis 16 Traumatic and Incisional Hernias Anatomy Traumatic Hernias Incisional Hernias 17 Perineal Hernias Anatomy Etiology of Perineal Hernias History and Signalment Physical Examination Findings Treatment of Uncomplicated Perineal Hernia Adjuncts to Herniorrhaphy Emergency Presentations 18 Pancreatic Abscessation Introduction Anatomy Clinical Presentation Emergency Stabilization Diagnostics Surgical Management Postoperative Care Postoperative Complications Prognosis Alternative Approaches 19 Hepatic Emergencies Anatomy Physiology Preoperative Diagnostics and Treatment for Suspected Liver Diseases Surgical Techniques Methods of Hemostasis Postoperative Complications and Management Specific Liver Diseases Conclusion 20 Bleeding Gastrointestinal Ulcers Introduction Etiology History and Clinical Signs Physical Examination Diagnostics Medical Management Surgical Management Additional Treatments Prognosis 21 Enteral Feeding Tubes Introduction Increasing Voluntary Consumption Indications for Enteral Assisted Feeding Assisted Enteral Feeding Tubes Types of Enteral Diets Delivery of Enteral Tube Feeds Monitoring of Enteral Tube Feeds Enteral Tube Related Complications Summary

13 Section II: Urinary System 22 Stabilization of the Uremic Patient Introduction Diagnosis of Acute Uremia Complications of Acute Uremia Initial Assessment of the Uremic Patient Monitoring the Uremic Patient Treatment of Uremia

14 Section IIa: Urinary System – Urinary Tract Trauma 23 Renal and Ureteral Injury Anatomy Renal Trauma Ureteral Trauma 24 Approach to the Uroabdomen Introduction History and Clinical Signs Initial Evaluation Patient Stabilization Diagnosis of Uroabdomen Surgical Treatment Complications and Prognosis 25 Urethral Injury Initial Assessment Patient Stabilization Diagnosis Treatment

15 Section IIb: Urinary System – Urinary Obstruction 26 Ureteral Obstruction Introduction Diagnostic Evaluation Medical Therapy Instrumentation for Ureteral Surgery Preoperative Preparation Ureterotomy Ureteral Anastomosis Neoureterocystostomy Complications Ureteral Stenting Subcutaneous Ureteral Bypass System Postoperative Care Choosing the Appropriate Ureteral Intervention 27 Urethral Obstruction Introduction Anatomy Signalment and Presenting Complaint Initial Diagnostics and Stabilization Definitive Surgical Techniques for Treatment of Urethral Obstruction in the Emergent Patient Urethral Stenting

16 Section III: Respiratory System

17 Section IIIa: Respiratory System – Upper Airway Disease 28 Stabilization Techniques for Patients with an Upper Respiratory Obstruction Introduction Clinical Evaluation Emergency Stabilization Diagnostics Additional Considerations Summary 29 Tracheostomy Introduction Temporary Tracheostomy Permanent Tracheostomy Equipment Anatomy Surgical Approach Temporary Percutaneous Dilatational Tracheostomy Aftercare and Management Complications of Temporary Tracheostomy Complications of Permanent Tracheostomy Other Complications Prognosis 30 Brachycephalic Airway Syndrome Anatomy and Pathophysiology Presentation Emergency Stabilization Diagnostics Surgical Therapy and Operative Technique Postoperative Care Surgical Complications and Management 31 Laryngeal Paralysis Introduction Anatomy Physiology and Pathophysiology Clinical Presentation Diagnostics Emergency Treatment Medical Management Surgical Management Aftercare Complications Prognosis 32 Laryngeal Trauma Introduction Clinical Signs and Diagnosis Emergency Management of Laryngeal Trauma Surgical Treatment 33 Tracheal Collapse Etiology and Signalment Clinical Signs and Physical Examination Diagnostics Treatment Options Postprocedural Complications and Outcome

18 Section IIIb: Respiratory System – Pleural Space Disease 34 Stabilization Techniques for Patients with Pleural Space Disease Introduction Clinical Signs Patient Stabilization and Diagnostic Evaluation Specific Causes of Pleural Space Disease Stabilization Techniques 35 Diaphragmatic Hernia Pathophysiology Etiology Anatomy Signalment Clinical Signs Physical Examination Diagnostic Testing Treatment Postoperative Care Complications 36 Pyothorax Etiology and Pathophysiology Presentation Emergency Stabilization Diagnostics Medical Management Surgical Treatment Postoperative Care Prognosis 37 Hemothorax Introduction [1, 2] Anatomy Etiology Diagnosis Therapy 38 Pneumothorax Etiology Pathophysiology Presentation Emergency Stabilization Diagnostics Medical Management Surgical Management Postoperative Care Prognosis 39 Lung Lobe Torsion Anatomy Etiology and Pathophysiology Presentation Emergency Stabilization Diagnostics Operative Technique Postoperative Care Postoperative Complications Comparative Medicine Video‐Assisted Thoracic Surgery 40 Surgical Approach to the Thoracic Cavity Introduction Lateral Thoracotomy Rib Pivot Thoracotomy Median Sternotomy Thoracoscopy/Video‐Assisted Thoracic Surgery Lung Lobectomy Techniques