Читать книгу Medicine and Surgery of Camelids - Группа авторов - Страница 42
Rectal Palpation and Transrectal Ultrasound
ОглавлениеThese procedures do not require restraint, but they do require containment. A trailer, mini‐catch pen or a chute as described is more than enough in most cases. The author finds it useful to walk the animal into the chute and restrict them to the chute from the back with the butt board, even though it will have to be removed to do the exam. There is normally a bit of preparation required for a rectal exam and the animal will be more likely to stand quietly for preparation with a rear barrier in place. After the animal has been prepped, remove the butt board. Once the rectal exam begins, it is unlikely the animal will attempt to back up!
The practice of tying a female's head high for rectal exams is not recommended. When the head is tied high, the back drops. This posture causes the animal to tighten the whole body including the anal sphincter, making the procedure less comfortable (Figure 2.39).
Also, holding the tail directly over the back to get it out of the way or as a means of restraint hurts; moving the tail gently to the side is more comfortable. The tail is another location that offers a potential attacker considerable leverage and is, therefore, high on the list of places for the llama or alpaca to protect. Therefore, a rectal exam is both uncomfortable and threatening. The underside of a camelid's tail is bare skin. The skin‐to‐skin contact that occurs when a person slides their hand under the tail can be shocking. It is preferable to slide the wool from the top of the tail head to act as a buffer between a person's skin and that of the patient.
Figure 2.38 This is a brilliant technique from a handling perspective. It allows for one person to draw blood; once the head is down the leverage belongs to the handler. Getting the head down is best done by incrementally moving the head down not by pushing steadily.
Figure 2.39 This photo illustrates performing a rectal ultrasound using balancing techniques and panels for containment.
Relaxing the tail before the exam helps both the animal and the examiner (Figure 2.40). One should stand just to one side facing the front of the animal and slide his or her hand under the tail close to the body. The other hand should rest on the top of the hips. The animal's tail may be clamped firmly against the body; this is normal but is a sign that the whole body is tense (this animal is likely holding her breath). The tail can be relaxed by rotating in a circle from the base. The tail should be pushed toward the body and rotated around the tail‐head. The tail will begin relaxing. Next, gentle traction should be placed on the tail. The person doing this technique should inhale as traction is applied and exhale as tension is released. Usually, the animal will take a deep breath during this procedure. The tail can also be relaxed by gently moving the small tailbones back and forth from the tail head to the end of the tail. The tail work can be done as preparation for a rectal exam or it can be done while the animal is standing freely in a catch pen with or without a helper. The tail should always be worked when the animal is standing in balance. It is important to remember to work in line with the animal's body; never twist the tail or hold it over the back.
Figure 2.40 Llamas and alpacas often do not object to being touched even around the tail when they are not restrained. Working with an animal's tail decreases tension in the hind quarters and assists with reactivity to ultrasounds, helps to decrease kicking and makes toenail trimming easier.
Other tips to help a camelid relax during these invasive procedures include the use of warm lubricant and the offering of food. Warm lubricant is preferred over cold lubricant as warm lubricant is more physiologic and helps to relax the anal sphincter. One might think that animals would not be willing to eat during these invasive procedures, but the author has witnessed many camelids willingly eat during rectal examinations. Eating makes the animal feel more relaxed and diverts their attention from the procedure.