Surgery of Exotic Animals

Surgery of Exotic Animals
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Surgery of Exotic Animals The first book to provide veterinarians with in-depth guidance on exotic animal surgical principles and techniques As the popularity of exotic animals continues to grow, it is becoming increasingly important for veterinarians to be knowledgeable and skilled in common surgical procedures for a wide range of exotic species. Written for practitioners and board-certified surgeons with a working knowledge of domestic animal surgery, Surgery of Exotic Animals is the first clinical manual to provide comprehensive guidance on surgical principles and common procedures in exotic pets, zoo animals, and wildlife. Edited by internationally recognized leaders in exotic animal surgery and zoological medicine, this much-needed volume covers invertebrates, fish, amphibians, reptiles, birds, and both terrestrial and marine mammals. Contributions from a team of surgery and zoo specialists offer detailed descriptions of common surgeries and provide a wealth of color images demonstrating how each procedure is performed—including regional anatomy and surgical approaches. An invaluable one-stop source of authoritative surgical information on exotic species, this book: Provides illustrated guidance on surgical principles and common surgeries performed in exotic species Describes general principles, instrumentation, equipment, suture materials, and magnification surgery Covers a wide range of procedures such as small and large mammal dental surgery, avian soft tissue surgery, reptile orthopedic surgery, and primate surgery Includes chapters on surgical oncology, megavertebrate laparoscopy, and minimally invasive surgery techniques Surgery of Exotic Animals is an indispensable clinical guide and reference for all private veterinary practitioners; exotic, zoo, and wildlife veterinarians; laboratory animal veterinarians; veterinary students; and veterinary technicians.

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Группа авторов. Surgery of Exotic Animals

Table of Contents

List of Tables

List of Illustrations

Guide

Pages

Surgery of Exotic Animals

List of Contributors

Preface

About the Editors

1 General Principles, Instruments, and Equipment

Introduction

Presurgical Considerations

Patient Support

Data Base

Preoperative Fasting

Hemodynamic Support

Perioperative Antibiotic Therapy

Surgeon Aseptic Preparation

Patient Preparation

Patient Draping

Thermal Support

Instrumentation and Equipment. Hemostatic Aids

Electronic Hemostatic Devices. Electrocautery

Electrosurgery

Vessel Sealing Devices

Harmonic Scalpel

Carbon Dioxide Laser

Magnification

Focal Light

Retractors

Instrumentation

Suction and Irrigation

References

2 Suture Materials

Introduction

Suture Materials

Absorbable Suture Materials

Biologic Absorbable Suture Material. Chromic Gut

Synthetic Absorbable Suture Materials

Polydioxanone

Poliglecaprone 25

Polyglactin 910

Polyglyconate

Glycomer™ 631

Polyglycolic Acid

Polyglytone 6211

Lactomer™

Nonabsorbable Suture Materials

Biologic Nonabsorbable Suture Materials. Silk

Nylon

Polypropylene

Stainless Steel

Barbed and Antibacterial‐Coated Suture

Tissue Healing

Sutures in Exotic Animals. Rodents

Rabbits

Ferrets

Birds

Reptiles and Amphibians

Fish

Invertebrates

Conclusion

Acknowledgments

References

3 Magnification Surgery

Introduction

Optics and Principles of Magnification

The Operating Microscope

Preoperative Preparation of the Microscope and Operating Room

Surgical Loupes

Choosing Surgical Loupes

Comparing the Operating Microscope and Surgical Loupes

Illumination

Instrumentation

Microsurgical Instrumentation

Care and Handling of Instruments

Microsuture

Principles of Microsurgical Techniques

Posture

Preparation and Mindset

Hand Position

References

4 Invertebrate Surgery

Introduction

Porifera (Sponges)

Coelenterates

Gastropod Mollusks

Cephalopod Mollusks

Annelids

Crustaceans

Arachnids

Limulus

Insects

Echinoderms

Urochordates

References

5 Fish Surgery

Perioperative and Postoperative Surgical Management. Water

Analgesia, Anesthesia, and Fluids

Antibiotics

Surgical Table

Surgical Modalities

Wounds

Skin Surgery

Orthopedic Surgery

Ophthalmic Surgery

Cataract Surgery

Enucleation

Coelomic Surgery

Swim Bladder Surgery

Reproductive Surgery

Urinary Surgery

Digestive Tract Surgery

Minimally Invasive Surgery

Telemetry and Microchip Implantation

References

6 Amphibian Surgery

Introduction

Perioperative and Postoperative Considerations

Wound Healing

Skin Surgery

Orthopedic Surgery

Ophthalmic Surgery

Coelomic Surgery

Urogenital Surgery

Gastrointestinal Tract Surgery

Minimally Invasive Surgery

Telemetry and Microchip Implantation

References

7 Reptile Orthopedic Surgery

Introduction

Anatomy and Physiology

Diagnostics

Trauma

Bone Composition, Bone Healing, and Fracture Repair

Bone Healing

Principles of Fracture Stabilization

External Coaptation

Internal Fixation

External Skeletal Fixation

Shell Fractures

Joint Disease

Proliferative Spinal Osteopathy

References

8 Surgical Approaches to the Reptile Coelom

Chelonian Coelom. Prefemoral Approach

Scope‐assisted Celiotomy in Large Chelonians

Plastron Osteotomy

Partial Plastron Ostectomy

Lateral Plastron Osteotomy Combined with Prefemoral Approach

Snake Coelom. Lateral Approach

Lizard and Crocodilian Coelom. Ventral Paramedian Approach

Paracostal Approach

Postfemoral Approach for Renal Biopsy in Iguanids

References

9 Reptiles: Soft Tissue Surgery

Anatomy

Surgery of the Female Reproductive Tract

Ovariectomy

Salpingotomy

Ovariosalpingectomy

Orchidectomy

Reproductive Organ Prolapse

Non Reproductive Cloacal Organ Prolapses

Cystotomy

Gastrointestinal Procedures

Gastrotomy

Enterotomy

Intestinal Resection and Anastomosis

References

10 Avian Orthopedics

Biology of Bone Healing

Patient Evaluation

Fracture Management Options. Cage Confinement

Coaptation

Bandages and Splints. Body Wrap

Figure‐of‐Eight Bandage

Modified Robert Jones

Lateral Splint

Spica Splint (Femoral Fractures)

Curved Edge/Metacarpal Splint

Tape Leg Splint

Schroeder–Thomas Splint

Surgical Stabilization

Internal Fixation

Intramedullary (IM) Pin

Orthopedic Wire

Bone Plates

Nonlocking Plate Application

Locking Plate Application

Interlocking Nails (ILNs)

External Skeletal Fixation (ESF)

Linear ESF

Biphasic ESF

IM‐ESF Tie‐In

Ring Fixators and Hybrid Fixators

Bone Grafting

Fracture Conclusions

Luxation Management Options

Luxation of the Shoulder

Luxation of the Elbow

Luxation of the Carpus

Luxation of the Hip

Luxation of the Stifle

Luxation of the Tarsus

Luxation of the Metacarpophalangeal Joint

Arthrodesis

Luxation Conclusion

Angular Limb Deformities (ALD)

Perosis (Achilles Tendon Luxation)

Postoperative Care

Monitoring for Healing and Complications

Beak Repair

Scissor Beak

Mandibular Prognathism

Beak Fractures

References

11 Approaches to the Caudal Coelom (Abdomen) of Birds

Anatomy

Patient Preparation

Skin Incision

Left Lateral Celiotomy

Right Lateral Celiotomy

Ventral Celiotomy

Transverse Celiotomy

References

12 Avian Reproductive Procedures

The Male Reproductive Tract

Orchidectomy

Vasectomy

The Female Reproductive Tract

Surgery of the Ovary

Surgery of the Oviduct and Uterus (Shell Gland)

Salpingohysterectomy

Salpingohysterotomy

References

13 Surgery of the Avian Gastrointestinal Tract

Anatomy and Physiology

Surgery of the Mouth

Surgery of the Esophagus

Surgery of the Stomach

Proventriculotomy and Ventriculotomy

Proventriculotomy or Ventriculotomy Through the Isthmus

Gastrotomy in Carnivores and Piscivores

Gastrotomy in Ratites

Ventriculotomy

Surgery of the Intestines

Surgery of the Cloaca. Cloacotomy

Cloacopexy

Ventplasty

Duodenostomy Feeding Tube

Liver Biopsy

Pancreatic Biopsy

Postoperative Management

References

14 Surgery of the Avian Respiratory System and Cranial Coelom

Surgery of the Upper Respiratory Tract. Choanal Atresia Correction

Sinusotomy

Approach to the Rostral Diverticulum and Maxillary Chamber

Approach to the Preorbital Diverticulum

Approach to the Infraorbital Diverticulum

Approach to the Suborbital, Postorbital, Preauditory, or Mandibular Diverticulum

Surgery of the Lower Respiratory Tract. Air Sac Cannula Placement

Tracheotomy

Tracheal Resection and Anastomosis

Lateral Approach to the Syrinx

Devocalization

Lung Biopsy and Partial Pneumonectomy

Hyperinflation of the Cervicocephalic Air Sac

Surgery of the Cranial Coelom. Cranial Celiotomy

Bifid Sternum Surgical Management

References

15 Minimally Invasive Surgery Techniques in Exotic Animals

Introduction

Instrumentation

Patient Positioning

Laparoscopy. Patient Preparation

Complications

Coelioscopy in Birds and Reptiles. Avian Coelioscopy

Reptile Coelioscopy

Specific Laparoscopic Techniques. Liver Biopsy

Pancreatic Biopsy

Renal Biopsy

Intestinal Biopsy

Other Diagnostic Techniques

Feeding Tube Placement

Ovariectomy/Ovariohysterectomy

Avian Salpingohysterectomy

Endoscopic Avian Vasectomy

Chelonian Oophorectomy/Ovariectomy/Ovariosalpingectomy

Cryptorchid and Abdominal Castration

Endoscopic Avian Orchidectomy

Endoscopic Green Iguana Orchidectomy

Endoscopic‐Assisted Chelonian Orchidectomy

Cystotomy

Thoracoscopy

Thoracoscopic Procedures. Thoracoscopic Lung Lobectomy, Partial Lobectomy, and Lung Biopsy

Hilar Lymph Node and Mediastinal Mass Biopsy and Removal

Nephrectomy in a Rabbit

Summary

References

16 Orthopedic Surgery in Small Mammals

Anatomy and Physiology

Diagnostics

Joint Disease

Trauma

Bone Composition and Bone Healing. Bone Composition

Bone Healing

Principles of Fracture Stabilization

Fractures

Repair of Specific Fractures

Fractures of the Humerus

Fractures of the Radius and Ulna

Fractures of the Metacarpal Bones

Fractures of the Pelvic Bones

Fractures of the Femur

Fractures of the Tibia and Fibula

References

17 Rabbit Soft Tissue Surgery

Introduction

Celiotomy

GI Surgery

Anatomy

Gastric Surgery

Intestinal Obstruction

Gastrostomy

Surgical Management of Intestinal Obstruction

Liver Lobe Torsion

Urinary Tract Surgery

Anatomy

Urolithiasis

Nephrolithiasis. Nephrectomy

Nephrotomy

Pyelotomy

Ureterolithiasis. Tube Nephrostomy

Ureterotomy

Ureteral Stenting

Subcutaneous Ureteral Bypass (SUB) Device

Ureteroneocystostomy

Cystolithiasis. Cystotomy

Transvesicular Percutaneous Cystolithotomy (TPC)

Urethrolithiasis. Tube Cystostomy

Urethrotomy

Renal Biopsy

Nephrectomy

Partial Cystectomy

Transurethral Urinary Bladder Eversion and Prolapse

Inguinal Urinary Bladder Herniation

Postoperative Considerations

Reproductive Tract Surgery

Anatomy of the Female Reproductive Tract

Ovariectomy

Ovariohysterectomy

Anatomy of the Male Reproductive Tract

Open Orchiectomy

Closed Orchiectomy

Abdominal Orchiectomy

Thoracic Surgery

Thymoma and Thymic Lymphoma

Lung Lobe Abscesses

Ventral Thoracotomy

Lateral Thoracotomy

Postoperative Care

Enucleation and Exenteration

Ear Surgery. Anatomy

History and Clinical Signs

Diagnostic Evaluation

Medical Management

Auricular Surgery. Partial Pinnectomy

Auricular Hematomas

Ventral Bulla Osteotomy (VBO)

Ear Canal Ablation and Lateral Bulla Osteotomy

Abscess Management

Postoperative Care

References

18 Ferret Soft Tissue Surgery

Surgical Abdominal Anatomy

Hepatobiliary System

Gastrointestinal Tract

Pancreas

Spleen

Adrenal Glands

Urogenital System

Celiotomy and Closure

Surgical Procedures. Adrenalectomy

Partial Pancreatectomy

Splenectomy

Gastrointestinal Surgery

Gastrointestinal Foreign Body Removal

Pyloric Outflow Obstruction

Oral Cavity Disease

Abdominal Organ Biopsy

Urogenital Surgery

Urolithiasis

Preputial Masses

Miscellaneous Procedures. Tail Amputation

Anal Sacculectomy

Cardiac Pacemaker

Vascular Access Port

References

19 Rodent Soft Tissue Surgery

Introduction

Reproductive Tract Surgery. Orchidectomy

Anatomy

Percutaneous Orchidectomy

Hystrichomorph Rodents

Non‐Hystrichomorph Rodents

Abdominal Approach for Orchidectomy

Paraphimosis

Ovariectomy and Ovariohysterectomy

Cystic Ovaries

Ovarian Tumors

Pyometra

Anatomy

Ovariectomy

Ovariohysterectomy

Cesarean Section

Uterine Prolapse

Cutaneous and Subcutaneous Masses. Mammary Tumors

Anatomy

Mastectomy

Other Cutaneous and Subcutaneous Masses

Cervical Lymphadenitis in Guinea Pigs

Other Subcutaneous Abscesses

Gastrointestinal Surgery. Gastric Trichobezoars

Cheek Pouch Eversion

Other Gastrointestinal Surgery

Urinary Tract Surgery

Urolithiasis

Ureterotomy

Cystotomy

Urethrotomy

Intraabdominal Masses

Thoracic Surgery

Lateral Intercostal Thoracotomy

Ventral Midline Thoracotomy

Enucleation and Exenteration

Ear Surgery

Tail Degloving

Pododermatitis

Recovery

References

20 Soft Tissue Surgery in Hedgehogs

Ovariohysterectomy and Mammary Tumor Removal

Orchiectomy

Posthitis and Paraphimosis

Neoplastic Disease in Hedgehogs

Proptosis and Enucleation

Leg and Foot Injuries

Intervertebral Disc Disease

References

21 Surgery of the Sugar Glider

Introduction

Orchiectomy

Penectomy

Abdominal Surgical Approach

Ovariectomy and Ovariohysterectomy

Patagial Surgery

Tail Amputation

Removal of the Paracloacal Glands

References

22 Small Mammal Dental Surgery

Incisor Extraction. Intraoral Approach

Extraoral Approach (Osteotomy)

Elodontoma Treatment

Cheek Tooth Extraction. Intraoral Approach

Extraoral Approach (Apical Osteotomy)

Mandibular Osteotomy (P3‐M3 in Rabbits)

Maxillary Osteotomy (P2‐P3 in Rabbits)

Maxillary Osteotomy (P4‐M1 in Guinea Pigs)

Surgery of Mandibular Abscesses

Apicoectomy

Alternative Methods of Abscess‐Treatment

Surgery of Rostral Maxillary Abscesses. Extraoral Tooth Extraction (P2, P3) and Sinusotomy in Rabbits

Lateral Fenestration of the Nasolacrimal Duct

Dorsal Rhinostomy

Surgery of Retrobulbar Abscesses. Extraoral Tooth Extraction Combined with Orbital Exenteration or Partial Resection of the Zygomatic Arch in Rabbits

Treatment of Jaw Fractures

Stabilization of a Mandibular Symphysiolysis

Condylectomy

Alveolectomy and Mandibulectomy. Segmental, Partial, or Complete

References

23 Large Mammal Dental Surgery

Introduction

Preprocedure Considerations

Terminology

Box 23.1 American Veterinary Dental College classification of tooth injury

Elephants

Tusks

Partial Pulpectomy

Tusk Extraction

Molars. Odontoplasty

Molar Extraction

Extraction Site Maintenance

Chronic Alveolar Osteitis and Osteomyelitis

Surgical Fistulation

References

24 Primate Surgery

Personal Protective Equipment and Zoonotic Concerns During Surgery

Integument and Appendages

Respiratory Tract

Orthopedics

Abdominal Surgery

Hernias

Retroperitoneal and Abdominal Abscesses

Intestinal Acanthocephala Infestation (Thorny‐Headed Worms)

Trichobezoar and Phytobezoar

Cholecystectomy

Choledochotomy, Choledochal Tube Stenting, and Cholecystoenterostomy

Gastrointestinal Neoplasms

Reproductive Surgery

Acknowledgment

References

25 Marine Mammal Surgery

Background

Surgery of Pinnipeds. Ocular Surgery

Phacoemulsification

Extracapsular Lens Extraction

Intracapsular Lens Extraction

Conjunctival Graft

Cyclosporine Implants for Keratopathy

Orthopedic Surgery

Abdominal Surgery. Castration/Ovariectomy

Telemetry Implantation

MIS Procedures

Surgery of Cetaceans. Oral Surgery

Ocular Surgery

Abdominal Surgery

Closure of Surgical Incisions

References

26 Megavertebrate Laparoscopy

Instrumentation

Elephant Laparoscopy and Minimally Invasive Surgery

Vasectomy

Functional Ovariectomy

Body Wall Closure

Rhinoceros Laparoscopy

Ovariectomy

Hippopotamus Laparoscopy

References

27 Zoo Animal Surgery

General Considerations

Partnerships

Diversity

Forces

Postoperative Management

Surgeries. Contraception. Melengestrol Acetate Implants (MGA)

Deslorelin Implants

Vasectomy

Epididymectomy in Hoof Stock

Castration in Big Cats

Castration in Large Rodents

Ovariectomy and Ovariohysterectomy in Big Cats

Miscellaneous. Onychectomy (Declaw) in Exotic Felids

Defanging Primates and Carnivores

Tail Removal in Primates

References

28 Surgical Oncology in Exotics

Principles of Surgical Oncology and Application to Exotics

Birds

Integumentary and Musculoskeletal Tumors

Lipomas/Liposarcomas

Soft Tissue Sarcomas

Bone Tumors

Hemangioma/Hemangiosarcoma

Alimentary Tumors

Adjuvant Therapies. Radiation Therapy

Chemotherapy

Rabbits

Tumors of the Reproductive Tract

Urinary Tract Tumors

Thymic Neoplasia

Tumors of the Skin

Tumors of Bone

Ferrets

Endocrine. Adrenal Tumors

Pancreatic Tumors

Integumentary

Reproductive

Rodents

Tumors in Rats and Mice. Skin and SQ

Reproductive/Mammary Tumors

Endocrine

Hamsters

Chinchillas

Guinea Pigs. Skin and SQ

Reproductive/Mammary

Endocrine

Respiratory

Reptiles

Hepatic Tumors

Cutaneous Tumors

Endocrine Tumors

Musculoskeletal Tumors

Urogenital Tumors

Gastrointestinal Tumors

Treatment Options. Surgery

Radiation Therapy

Chemotherapy/Electrochemotherapy

Cryosurgery and Photodynamic Therapy

References

Index. a

b

c

d

e

f

g

h

i

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k

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o

p

r

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u

v

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The bipolar electrosurgical forceps are primarily used for hemostasis, but can also be used for tissue dissection resulting in minimal hemorrhage. The same generator is used, but the patient is not within the electrical circuit so the current only affects tissue within the tips of the forceps. Bipolar forceps are most useful near structures that would be adversely affected by the current such as the heart, brain, spinal cord, etc., or for hemostasis deep within body cavities. When using bipolar to dissect or cut tissue, grasp the tissue in the forceps and activate the current while pulling the forceps. The tissue within the tips will be affected by the current providing hemostasis for small vessels within the tissue grasped. In birds, this technique is useful for making a skin incision. Grasp the skin with the forceps and activate the current to create a small defect in the skin. Then insert one limb of the forceps under the skin for 1–2 cm, oppose the other limb of the forceps, activate the current, and withdraw the forceps, thus cutting the skin. Bipolar mode is available on most electrosurgical units including the Surgitron®.

LigaSure™ (Medtronic, Minneaplis, MN) is a vessel/tissue sealing system that is commonly used in veterinary surgery. The ForceTriad™ (Medtronics, Minneapolis, MN) combines the LigaSure technology with monopolar and bipolar electrosurgery. While the specific technology is proprietary, LigaSureTM is a type of bipolar electrosurgery. The generator senses the electrical impedance of the tissues within the tips and delivers the amount of current needed to melt the elastin and collagen; it then allows the elastin and collagen to re‐form, creating a permanent seal in a single application. It generates less than 1 mm of heat lateral to the seal and is Food and Drug Administration (FDA)‐approved to seal vessels up to 7 mm diameter. A wide range of handpieces are available for open surgical procedures and for minimally invasive surgeries.

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