Cesarean section and ovariohysterectomy after severe uterine torsion in four cows.

OBJECTIVE: To report a technique for intra-partum ovariohysterectomy (OVH) in cows after severe uterine compromise after uterine torsion. STUDY DESIGN: Clinical case report. ANIMALS: Four cows with uterine torsion. METHODS: After a ventrolateral cesarean section, uterine closure, and uterine detorsion, the laparotomy incision was elongated (20 cm) caudally so that the uterus can be completely exteriorized. The uterus was separated from broad ligaments by transection between 2 rows of overlapping interrupted sutures placed in the broad ligaments to a point approximately 2 cm caudal to the external os of the cervix. The vagina was occluded with 2 clamps directly caudal to the external os of the cervix and closed with 5 single cruciate sutures that penetrated all layers, and then the vagina was transected between the suture line and external os to remove the uterus. The abdominal incision was closed in layers. Results- All cows survived the surgery; however, 1 died the next day from Escherichia coli sepsis and 1 was euthanatized at 8 days because of unresponsive E. coli mastitis. One cow, 28 days after surgery developed a 15 cm perivaginal abscess, which resolved after drainage. This cow and the fourth cow survived and lactated. CONCLUSIONS: Intra partum OVH is technically possible after cesarean section in cows with uterine compromise or necrosis after uterine torsion. CLINICAL RELEVANCE: Ovariohysterectomy should be considered in cows with severe uterine torsion that have uterine tissue compromise to improve survival.

A vaginal mucosal pedicle flap technique for repair of rectovaginal fistula in mares.

OBJECTIVE: To describe the use of a vaginal mucosal pedicle flap for repair of rectovaginal fistulae (RVF) in mares. STUDY DESIGN: Clinical case report. ANIMALS: Three mares with RVF. METHODS: After debriding the RVF, a dorsally based U-shaped mucosal and submucosal pedicle flap (2-4 mm thick) was dissected from the vaginal wall, rotated approximately 90 degrees angle to close the ventral aspect of the fistula and sutured in position with 10-13 single sutures that did not penetrate the rectal mucosa. This positioned the vaginal mucosa so that it was continuous with the rectal mucosa. RESULTS: Two RVF healed by 1st intention whereas for the 3rd RVF, 2 additional single sutures were required to repair partial dehiscence after 10 days. At 6 weeks and 6 months all RVF were healed. One mare subsequently foaled without complications. CONCLUSIONS: RVF can be closed by use of a rotation flap of vaginal tissue. CLINICAL RELEVANCE: Tension-free closure of RVF can be achieved by rotating a pedicle flap of vaginal mucosal tissue without undue wound tension, and should be considered as an alternative to conventional appositional techniques.