Case 1(6)-Jade Jelinek
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Baker College, Owosso *
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Medicine
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Apr 3, 2024
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Uploaded by DrArtFalcon43
Case #1- Presurgical set up and surgical procedures
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Diagnostic abnormalities
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CBC and full serum chemistry ▪
No abnormalities noted at this time
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Diagnosis- Apparently healthy rabbit
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Tx- Schedule spay procedure ●
Due week 3
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Explain how the diagnostic abnormalities fit into this case. What presurgical differences will you find with rabbits compared to other small animals (presurgical instructions)? What differences do rabbits have with their reproductive tract compared to cats/dogs? What is different about rabbit intubation vs small animal? What tools can be helpful with this? How does surgical incision closure differ in rabbits compared to cats and dogs?
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Unlike dogs and cats rabbits do not need to be fasted before surgery as they cannot vomit and are not at risk for aspiration pneumonia and fasting can delay their recovery (FVAWL). ▪
Rabbits have a duplex uterus with each uterine horn having its cervix meaning they have no uterine body and 8-10 mammary glands. (Ballard & Cheek, p.288)
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The oral cavity of the rabbit is long and narrow, the mandible has a limited range of abduction, and entry into the oral cavity is partially occluded by the large incisors and cheek teeth. The tongue protrudes dorsally, the epiglottis is relatively large, U-shaped, soft, and flexible, and the larynx slopes ventrally. Also
the laryngeal tone and potential to laryngospasm are high. (Ballard & Cheek, p. 305)
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Prior to intubation diazepam or midazolam can be given IV to effect to help relax. A laryngoscope or rigid endoscope can aid in the visualization of the necessary structures. A metal dowel or cotton-tipped applicator may also be used to prevent the bending of the tube and can be employed. (Ballard & Cheek, p. 305)
▪
The abdominal fascia is repaired in a single layer with continuous or simple interrupted sutures using PDS or Monocryl. Sutures are less likely to be removed
if the skin incision is comfortable and repaired without tension on the sutures. A
subcuticular suture or skin staple reduces the risk or patient interference and subsequent wound breakdown. (Smith, 2023)
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Due week 4
o
Discuss an appropriate anesthetic protocol (preanesthetic, induction, intra-op meds, inhalent post op meds). Why did you choose this protocol? ▪
Preanesthetic:
Butorphanol 0.2mg/kg Acepromazine 0.75mg/kg IM to sedate if the animal is fractious and to help intubate and place a catheter. Diazepam or midazolam may be given 0.05-2 mg/kg IV before intubation if additional relaxation is necessary. 2% xylocaine may be sprayed on the larynx to help decrease laryngospasm when intubating as well.
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Induction: Propofol 1-2 mg/kg IV given to effect starting with ½ dose over 1-2 minutes
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Inhalant:
Isoflurane 2-3% maintenance in 100 % oxygen. It is recommended to pre-oxygenate for 1 to 5 minutes with a tight-fitted mask with 100% oxygen to avoid apnea during induction and intubation. Monitor parameters during surgery and adjust gas as needed. ▪
Post-op med: Meloxicam 1-1.5 mg/kg SQ loading dose given preemptively before the procedure and 0.5 mg/kg PO maintenance. Ensure good water intake
and monitor hydration status during the treatment period. ▪
All of these drugs have approved use in rabbits during routine procedures and this is a healthy patient with no preemptive concerns.
(McGill, 2021), (Ballard & Cheek p.304-307)
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Discuss surgical equipment needed (general equipment) and any specific equipment for this case. Are there any procedures that may be required during procedure (ie checking for leaks in organs) ▪
General spay pack for rabbits:
5″ (12.7 cm) straight and curved Criles and Halstead forceps, Martin splinter forceps, Debakey (2 mm) and Adson (1/2tm 5″) dissecting forceps, an Olsen hegar scissor needle holder and 5″ (12.7 cm) straight sharp/blunt and 4.5″ (11.5 cm) Strabismus scissors. A no. 9 scalpel blade
and a pair of 6″ (15 cm) straight Metzenbaum scissors are also included.
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Small-gauge (3/0, 4/0, or 5/0) modern suture materials, swaged on needles, are ideal for rabbit surgery: 3/0 suture material is suitable for skin repair, 4/0 suture
material is required for subcuticular repair of abdominal incisions, and 5/0 suture material is required for intestinal surgery. PDS 11 or monocryl suture material. (Smith, 2023)
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Should check for any abdominal pooling of blood and should be closely monitored after as rabbits are notorious for chewing wounds. The calcium
channel blocker verapamil (200 μg/kg) can be given subcutaneously every 8 hours for a total of nine doses and may be used in situations where adhesions are likely to develop.
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For Weeks 5-6
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Prepare powerpoint presentation (10 min max) of surgical procedure given weeks 5-6 ▪
Include basic overview of case (presenting complaint, diagnostics and findings)
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For Week 8-Prepare discharge instructions to be given in person. See Discharge assignment on Canvas
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References
Ballard, B., & Cheek, R. (2016). Exotic Animal Medicine for the veterinary technician
(3rd ed.). John Wiley
& Sons.
McGill . (2021a, January 11). Rabbit analgesia
. www.mcgill.ca/. https://www.mcgill.ca/research/files/research/102-rabbit_analgesia_-_dec_2021_v2.pdf
McGill . (2021b, January 13). Rabbit anesthesia. https://www.mcgill.ca/research/files/research/114-
rabbit_anesthesia_-_jan_2021_v2.pdf
Rabbit pre-surgical instructions: Fox Valley Animal Welfare League
. fvawl. (2016). https://www.fvawl.org/pre-surgical-instructions#:~:text=Food%20And%20Water,are
%20brought%20in%20for%20surgery.
Smith, M. (2023). Rabbit surgery
. Rabbit Surgery - an overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/rabbit-
surgery