2 Clinical Investigation

Transcript

Welcome back to the Intestinal Ileus in cattle.

In the last lesson, we have seen about Anamnesis and the rectal examination of the Intestinal Ileus in cattle. In this lesson, we are going to see the various Clinical investigation that we are focused on on Intestinal Ileus.

Restraining the cattle for doing Thoracocentesis is more important; put the animal in the Travis, keep the particular side, left side, or right side forelimb in a forward stance, how to do that?- tie the forelimb in a forward stance on the Travis, so that the area just began the elbow is free for your investigations. Aesthetically prepare the area by shaving the particular area, and applying surgical spirit.

Thoracocentesis or Pleurocentesis: the site which we are going to use is the 6th or 7th intercostal space and then prepare the area as we have been doing it for surgical conditions and what is the material needed? the material needle is a sixteenth gauge needle or Thoracocentesis needle and a syringe.

(Showing pictures in the slide) this shows the Thoracocentesis being done with the help of a catheter and the fluid is watery. On the right side, we get zero sanguineous fluid. So this shows the different stages of the disease in these two cattle.

(Showing video in the slide) Thoracocentesis that is being done with the catheter, here we can see the free flow of the fluid, normally we do not get more than 1 or 2 ml at the most. so here you get a free flow of fluid and watery and crystal clear. The most important is the sediment of this fluid and the subject to cytology.

(Showing pictures in the slide) This is another case of Thoracocentesis, which is being done in a buffalo, where we can collect more than 5 liters of fluid, so there is already one can with the 5 liters the another can we are collecting the fluid.

Thoracocentesis or Pleurocentesis following collection of the fluid, we are subject to analysis of the fluid, normal volume is very little but in case of an effusion, we get a lot of fluids. We need to analyze this fluid bacteriologically as well as cytologically, the important point is these fluids do not clot and the nucleated cells are less than 10*109 /liter mostly Neutrophils, mononuclear cells, mesothelial type of cells.

Thoracocentesis do we have any complications; rarely will get complications sometimes there is a collapse of the animal, Pneumothorax or Puncture of Heart/lung may be encountered, but if the proper site is being selected, properly restrain is being followed, no on toward incidence has been encountered.

The procedure is Pericardiocentesis; the site has 4th or 5th intercostal space, again the restrain is the same as we have discussed for Thoracocentesis.

(Showing pictures in the slide) describes the Clinical signs of animals with pericardial involvement where there is jowl edema, brisket edema, and positive stasis test. Pericardiocentesis was done with a chest drainage tube, we can get the serous angular fluid, copious amount, and in large volume.

(Showing video in the slide) This is a Pericardiocentesis in other cattle where you get purulent fluid effusion.

(Showing video in the slide) here we have fixed the chest drainage tube and we have been doing lavage with warm saline and then subsequently irrigation with metronidazole.

Abdominocentesis: Abdominocentesis is otherwise called paracentesis abdominis, this we are doing it to rule out Ascites, Peritonitis, Uroabdomen, and Neoplasia. So let us see what are the site? the site is 8-10 centimeters caudle to the xiphoid and 8-10 centimeters lateral to the midline.

This site aseptically prepares the area following shaving the area and then application of surgical spirit. Introduce the needle very carefully till you get a blup sound and a free flow of fluid is obtained. Normally 0.5 to 1ml is obtained, in the case of peritonitis, it is a free flow of fluid is obtained. So this site which you have described is called a cranial site.

Paracentesis abdominis; this is a caudal site, where we are going to introduce the needle on the right side lower flank in front of the udder. So have you are going to get fluid on the caudal side of the cranial side, it is localized peritonitis. If we get fluid on both sides then it is generally spectronitis.

Paracentesis abdominis; In this as we have seen in Thoracocentesis, subject the fluid for analysis both physically as well as microbiologically and the sediment needs to be analyzed. It is amber-colored and is normal. Cloudy indicates the increased concentration of the protein, Serosanguineous indicates Ischemic necrosis and if it is Turbid fluid then devitalization of the intestine.

Thoraco-reticulocentesis: this is a special procedure we are adopting to diagnose diaphragmatically. What is the material needed? It is a 16 gauge needle, the site is the identification of the peristaltic sound by auscultation in the thoracic area. Once that area is identified and then shaving the area, the surgical spirit is applied, and introduce the needle very slowly and collects the fluid as we do it for the Liptak test. The collected fluid is tested for its pH as well as microbial assessment.

(Showing pictures in the slide) This slide describes the site for Thoraco-reticulocentesis, we are introducing the needle fixed with the 5ml syringe, introduce the needle very slowly and keep aspirating in the area which has been predetermined by the area of auscultation, where you get peristaltic sound.

Liptak test: the collected fluid is checked for pH, where the pH is alkaline. The alkaline indicates the reticulum as herniate into the thorax and a drop of this fluid is kept under a microscope and examined. You will be able to see the Rumen protozoa again which indicates the reticular rumen is herniated into the thorax.

Clinical Pathology/ Laboratory analysis: usually complete blood count indicates inflammatory changes and hyperglycemia, hypochloremia, and hyperkalemia are noticed in the blood changes.

The summary, now in this lesson, we have seen the Clinical exploration or interpretation in the case of Thoracocentesis, Abdominocentesis, and Thoraco-reticulocentesis we have seen elaborately following the surgical precautions.

In the next class, we are going to see the other investigation namely the Radiography and Ultrasonography.

Thank you!