Caesarean section : The cow Indication physical immaturity of the mother Failure of the uterine cervix fully to dilate Irreducible uterine torsion Preparturient recumbency acute reticuloperitonitis or pericarditis Shistosoma reflexus gross oversize of the fetus Pregnancy toxaemia gross swelling of the vagina and vulva Irreducible mal-presentation hydroallantois , hydrammnios mummified foetus Others diseases and complication

Position of the cow and operative site Left paralumbar or Upper left flank approaches Upper right flank laparotomy Ventral midline approach or paramedian approach Ventrolateral oblique approach

Caesarean section Left flank Standing No omentum, intestine Reduce shock Good healing Disadvantage More assistants Recumbency Fetal Delivery

Caesarean section Right flank Oversize fatal Standing Small incision One assitant Disadvantage Omentum & intestinal Restraint & infection

Caesarean section Ventral midline or paramedian Emphysema fetal Easy to find uterine horn Abnormally uterine content Disadvantage Intestine Lateral recumbency

Caesarean section Ventrolateral oblique approach lateral recumbency Vessels Disadvantage Long incision Hernia

Fetotomy

Fetotomy Embryotomy Dividing foetus into small pieces Dead feotus Common in cattle Techniques Percutaneous Subcutaneoues

Indications Fetal maldisposition Fetopelvic disproportion Obstruction by hip-lock Caesarean section Fetotomny only in feotal dead Caesarean section in foetal alive

Fetotomy equipment Tubular embryotome Fetotomy wire Handles for wire Handle for embryotome Screw to tighten handle Introducer Threader Cleaning brush

Fetotomy Partial or complete Assistant Restraint Skills Technique Anterior presentation Head-> forelegs-> thorax-> pelvis-> Posterior presentation Hind limbs -> body -> forelegs

Partial fetotomy Deviation of the neck Shoulder flexion Bilateral hip flexion (Breech presentation) Hock flexion Fetal monsters

Hip flexion

Hock flexion

Dystocia in the mare Incidence less than cattle 4 % in Thoroughbred Common in Shetland ponies Causes of dystocia - Anterior presentation - Posterior presentation - Transverse presentation

Specific causes of equine dyctocia Uterine inertia Bony tissue obstruction Soft tissue obstruction Uterine torsion Downward deviation of the uterus Fetal monster Malpresentation Malposition Malposture

Dorsotransverse position

Dystocia in the sow Incidence 0.25-1.0 % Gilts or old sows Welsh gilts -> small pelvis Large white -> uterine inertia

Causes of dystocia Uterine inertia 37 % Obstruction of the birth canal 13 % Deviation of the uterus 9.5 % Maternal excitement 3 % Fetal maldisposition 33.5 % Fetopelvic disproportion 4 %

Uterine inertia Primary uterine inertia 20 % stillborn Secondary uterine inertia 49 % Idiopathic uterine inertia 31 % Fat sows Calcium Treatments : oxytocin

Obstruction of the birth canal Bony tissue abnormality Soft tissue abnormality Distension of the urinary bladder Vulval abnormalities Persistent hymen Non-dilation of the cervix Obstruction of the uterine lumen Downward deviation of the uterus

Maternal excitement Gilts Delay or inhibit the farrowing process Late movement Innate nervousness Treatments : azaperone IM 2 mg/kg oxytocin 20 IU

Signs of dyctocia Discharge and placenta at the vulva Signs of imminent but no farrowing Straining but no piglets Premature cessation of labour Prolonged farrowing >½-4 hrs. (2.5 hrs.) Placenta

Dystocia in the dog and cat Incidence cat lower than dog Exotic breed Causes Uterine inertia 36 % Fetopelvic disproportion 22 % Fetal maldisposition 11 % Abnormalities of birth canal 9 % Other causes 22 %

Failure of the expulsive forces Primary uterine inertia Scottish terrier Single pup syndrome and single kitten Hysteria  Cocker spaniels Secondary uterine inertia Abdominal muscle tone -> old or fat animals

Obstruction of the birth canal Bony abnormalities - pelvic fracture -> accidents - Scottish terrier - Brachycephalic toy breeds Soft tissue abnormalities Deviation of uterus  Boxer Torsion of uterus

Fetal maldisposition Posterior presentation Deviation of the head normal whelping 40 % Bilateral hip flexion Deviation of the head Long neck  Collies Long head  Sealyham and Scottish terrier

Fetopelvic disproportion Small breed Low litter size Yorkshire terrier Fetal monster - hydrocephalus - Anasarca - Conjoined twins

Diagnosis Examination of genital system Inspection of vulva Vaginal examination Abdominal palpation Abdominal auscultation/ Ultrasound X-rays

Treatment of dystocia Ecbolic therapy Assisted delivery of the fetus oxytocin 2-5 IU IM 20-30 minutes Calcium borogluconate 10% 5-15 ml slow IV Assisted delivery of the fetus Episiotomy Manual delivery Forceps delivery