Cows that are severely dehydrated may need IV fluids prior to surgery. If the cow is straining she may need an epidural a nerve block of her perineal region prior to surgery to reduce the amount of straining. A relatively large incision is made into the abdomen so that one horn of the uterus can be brought to the outside Figure 3 and 4. The uterus is carefully incised, chains are placed around the calf's limbs, and the calf is delivered Figure 5.
The uterus is then closed, the area is rinsed with sterile fluids, and the abdominal incision is closed Figure 6. In some instances it may be possible to perform a fetotomy vaginal removal of portions of the calf's body rather than a C-section if the fetus is dead-this is a decision best made by an experienced bovine practitioner.
If the cow has a uterine torsion a twisted uterus it may be necessary to correct the torsion prior to delivering the calf. This can be done by rolling the cow. A person stands on the plank to keep the uterus in position. If this is not successful, then the uterine torsion can be corrected at surgery either before or after delivering the calf.
Prognosis for recovery after C-section is generally good. To avoid C-sections, the cow and bull being bred should be of similar size and cows should be monitored carefully when they are close to delivery. Your veterinarian should be contacted immediately in the event of a difficult birthing to maximize the chances of cow and fetus survival.
Postoperatively, the cow should be watched for dehydration and mastitis mammary gland infection. Incisional complications and retained placentas a placenta which is not passed within 24 hours may also occur following C-section and may require treatment with antibiotics and anti-inflammatories.
Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons. The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.
Your feedback helps us make the Animal Health topics serve you better. The cow is typically positioned in dorsal recumbency, leaning toward the surgeon at a 45 degree angle Figure 2. Both front and hind feet are tied to a gate or wall. This positioning is critical. If the cow is positioned either in exact dorsal recumbency or leaning away from the surgeon, exteriorization of the uterus becomes problematic, if not impossible. Once the peritoneal cavity has been opened, it may be necessary to pull the greater omentum cranially to expose the uterus.
Exteriorizing the uterus is facilitated by untying the hind feet only and temporarily laying the hind limbs flat on the ground. After removal of the fetus and closure of the uterus, the cow is repositioned in dorsal recumbency and the linea alba is closed.
Closure of the abdominal wall is often difficult. Eversion of the linea permits the surgeon to oversew the linea with relative ease and safety. Other appositional suture patterns, including simple continuous, may be used. Some practitioners may choose to close the linea alba with a braided nonabsorbable suture; however, this choice will cause carcass contamination with foreign material. In cases where closure of the abdomen wall is difficult, loosening the back legs and using Bachaus towel clamps to appose the 2 sides of the incision will help to relieve the tension prior to tying the knots.
Integrity of abdominal wall closure is critical. Less than optimal closure may result in either abdominal wall herniation or, in severe cases, evisceration of the cow. The ease with which the uterus is exteriorized with this approach makes it optimal for exteriorizing the uterus, a critical issue when the surgeon is attempting to remove an emphysematous fetus.
This approach is also ideally suited to 1st calf heifers of the beef breeds, because the incision is somewhat hidden and does not involve retail cuts, suggesting that this approach would be preferable, if the producer is likely to sell the animal for slaughter soon after the procedure. This approach should be used when the large udder of older beef and dairy cows precludes extending the incision sufficiently caudad to permit ready exteriorization of the uterus, and when udder edema and the increased ventral vasculature make this approach more complicated.
Recumbent ventral midline celiotomy and recumbent ventral paramedian celiotomy. This approach is similar in most respects, including the advantages and contraindications, to the ventral midline approach 1 , The abdominal wall incision is placed parallel and approximately 5 cm lateral to the linea alba Figure 2. Some authors have postulated that the abdominal wall closure of the paramedian approach is more secure than that of the ventral midline approach. This makes little sense. Neither the internal sheath of the rectus abdominis muscle, nor the rectus abdominis muscle has substantial holding properties and it would seem that a 1-layer abdominal closure is easier and, hence, preferable to a 3-layer closure.
This approach is similar to the other ventral approaches, but it may be better suited for the older dairy or beef cow 1 , The cow is positioned in right lateral recumbency. The hindlimbs should be extended caudally and the upper limb abducted for the best exposure to the incision site Figure 3. This approach uses a curvilinear incision that is roughly parallel to the last rib; it starts approximately 5 cm lateral to the umbilicus and courses caudodorsally toward the inguinal area Figure 3.
This approach readily permits exteriorization of the uterus, making it suitable for removal of a large emphysematous fetus. In cattle with a large udder, the incision is more readily extended caudally than when the ventral midline or ventral paramedian approach is used. Consequently, this approach may have utility in dairy cows and older beef cows. In addition, this incision is not readily visible in a standing cow, which may be an advantage if the cow is going to be sold soon after the operation.
Closure of the incision is often more difficult than with the other approaches, as more tension is placed on the muscle layers. The integrity of the abdominal wall closure is less secure than that of either the ventral midline or ventral paramedian approaches and therefore, more prone to herniation and evisceration of the cow.
The proper positioning of the cow and incision site for the ventrolateral celiotomy. This described variation of the left paralumbar celiotomy approach has distinct advantages 4 , In this approach, the incision starts 4 to 6 cm ventral and cranial to the tuber coxae, extends cranioventrad at a 45 degree angle to the ground, and terminates at the last rib Figure 4.
This incision extends further cranially and more ventrally than the traditional left paralumbar incision; it can also be used in the recumbent left approach.
The external abdominal oblique muscle is incised in the same direction as the skin. The internal abdominal oblique and transversus abdominus muscles can then be gridded parallel to the incision using a combination of sharp and blunt dissection.
Herniation is less problematic than with the ventral approaches; however, the apex of the gravid uterus is far more readily exteriorized in this procedure compared with the other standing procedures. This approach holds distinct advantages for surgeons with either smaller stature or less physical strength. The patient must be adequately restrained and must be able to remain standing, but as with the other standing procedures, minimal assistance is needed.
Standing left oblique celiotomy. Most surgeons use a standing left paramedian celiotomy to perform cesarean section in the cow. The left oblique approach is preferable under most circumstances, because the uterus is readily exteriorized, limiting peritoneal cavity contamination. Alternative approaches are available that will further limit the potential for contamination.
Practitioners are encouraged to consider alternate approaches for certain conditions. Author contributions. Schultz, Tyler, and Moll collaborated in the writing of the manuscript and Dr. Constantinescu provided editing and the illustrations. National Center for Biotechnology Information , U. Journal List Can Vet J v. Can Vet J. Loren G. Schultz , Jeff W.
Tyler , H. David Moll , and Gheorghe M. Author information Copyright and License information Disclaimer. Address all correspondence and reprint requests to Dr. Schultz; e-mail: ude. Case selection is the most important and often overlooked variable. In addition, skin preparation,surgical technique, calf viability at the time of surgery, and exteriorizing the uterus can affect outcome.
Minimizing excessive adhesion formation is equally important because it may affect reproductive efficiency adversely.
0コメント