Left flank Cesarean section

Overview

Csections in cattle, ACVS

Csections can be performed from many different approaches. Left flank standing Csection is standard for large ruminants.

A left flank approach is easier than the right because the rumen functions to keep everything else inside the cow so you don’t have to worry about intestines getting contaminated or traumatized, etc. An oblique incision (rather than a vertical incision) provides more direct exposure to the uterus. This can be beneficial for smaller surgeons.

Complications

Almost all cattle will develop retained placentas. There is recent evidence that flunixin meglumine increases this risk. However, NSAIDs do a lot of good things and retained placenta is readily treated in cattle. These are not as life threatening as in horses and are left to resolve on their own.

Incisional infections may develop and are treated by removal of a distal suture to allow drainage

Prognosis is good for fertility if the uterus was healthy at the time of surgery.

Resources

Surgical approaches for Csection in cattle, 2008 CVJ- Nice review of approach options (with pictures) and general dos/don’ts. While he says monofilament suture for the uterine closure, I do like braided absorbable suture to close the uterus; the uterus doesn’t tear as easily if you take decent bites.

Field Csections, 2008 VCNA – Very detailed, step-by-step approach. Lots of hints so good for future reference. I would not give 2.2 mg/kg banamine BID to a fresh cow; too ulcerogenic. Either 2.2 mg/kg SID or 1.1 mg/kg BID and always iv. His PPG dose is what I recommend (22000 IU/kg) but needs to be BID. And not my first choice of antibiotics for a lactating animal due to milk withholding times. Please don’t do abdominal lavage– with or without antibiotics! Cattle try to wall things off. If you spread it around, you are making it harder.

Perioperative antibiotics chapter

Trent Csection notes-covers a variety of species

Youtube video – this guy does it all: builds his own restraint wall, creates his own surgery table and does a Csection. The videography is great as are some of the “special” effects. I laugh each time I watch this. Useful and entertaining.

Utrecht suture pattern