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This Concept Map, created with IHMC CmapTools, has information related to: Case 2, Post-operative Considerations Complications: • Incisional dehiscence (rare) • Incisional infection (common) • Peritonitis, Rumenotomy After Post-operative Considerations, Case 2: Grain Overload Includes Advantages (Mouse Over), Rumenotomy ???? Drugs, Pre-operative Considerations ???? Physical Examination (Mouse Over) - A proper physical examination should be carried out to determine whether the cow is sytemically healthy or if there are any abnormalities and underlying conditions. - Special attention should be paid to station 2 of the cow during the physical examination to ensure the rumen is thoroughly assessed using the 5 modalities. - An ASA grade can be determined based on these findings., Rumenotomy ???? Equipment, Rumenotomy During Intra-operative Considerations, Case 2: Grain Overload Treatment Rumenotomy, Case 2: Grain Overload How Diagnosis (Mouse Over), Pre-operative Considerations ???? ASA Grade Cows with grain overload would have an ASA grade of ASA 2- ASA 4. This would depend on the severity of the overload, the length of time before treatment and whether medical management is sufficient or surgical intervention is required. Mild cases of grain overload may be medically managed while more severe cases may require surgical intervention via rumenotomy., Rumenotomy Before Pre-operative Considerations, Post-operative Considerations Post-operative Care: • Suture removal in 10-14 days. • Monitor the cow for any signs of infection or peritonitis. • Consider rumen transfaunation if available., Post-operative Considerations Farmer Client Communication: The farmer should be advised not to over-feed concentrate to the cattle and ensure they do not have access to the feeding room. The farmer can include ionophores like monensin in the concentrate to reduce the incidence of frothy bloat. Poloxalene can be added to the feed or in molasses to prevent frothy bloat also., Pre-operative Considerations ???? Area Preparation Surgery can be performed while the cow is standing in stanchions with just a local block or can be performed with the animal under sedation in a lateral recumbent position. Ensure the area is clean. The flank is clipped, scrubbed with chlrohexidine solution, and the block either: line block, inverted L or paravertebral performed. After the block, a final scrub is done followed by an alcohol rinse. Apply a sterile drape to the skin of the back using towel clamps. Double gloves are useful if a contaminated procedure is expected as the top layer of gloves can be removed quickly., Case 2: Grain Overload Treatment Medical Treatment