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SURGICAL MANAGEMENT OF
INTUSSUSCEPTION IN A COW
UNDER DOUBLE DRIP
ANAESTHESIA
ARULRAJ
BVN20007
Weight : 245 kg
Age : 3 year
Sex : Female
Breed : HF cross
Species : Bovine
Address : Tirupanjali,Thiruchirapalli
Owners name : Mr. Mathivanan
Case number : C48699
SIGNALMENT
ANAMNESIS
Anorexia
Not voiding Dung
Since 4 days
Milk yield reduced
Inseminated 1 month
before
Abdominal kicking
GENERAL CLINICAL
EXAMINATION
Appearance : Normal
Posture : Standing
Behaviour :Dull & depressed
Expression : Woebegone
CMM : Pale pink & Dry
Temperature : 38.2属c
H/R :84 beats/min
R/R :60 breaths/min
Eyeball : sunken
GENERAL CLINICAL
EXAMINATION
Examination of Abdomen :
Bilateral Abdominal distension
Examination of Rumen :
Rumen motility Sluggish,Rumen
protozoa slightly present
RECTAL EXAMINATION
RECTAL
EXAMINATION
Sausage mass like structure
could be felt on the right
paralumbar fossa
RECTAL EXAMINATION
Empty rectum with blood tinged mucous
(RASPBERRY JAM APPEARANCE DUNG)
HAEMATOLOGICAL
PARAMETERS
HAEMATOLOGY
PARAMETERS
REFERENCE
VALUE
OBSERVED
VALUE
Total RBC (x106
/袖l) 5.0  10.0 7.8
Total WBC (x/袖l) 4.0  12.0 7
PCV (%) 24 46 31
Haemoglobin (g/dl) 8.0  15.0 12
Neutrophils (/袖l) 15  45 40
Lymphocytes (/袖l) 48  75 35
Monocytes (/袖l) 2 - 7 5
Thrombocytes (/袖l) 1 - 8 6.5
BIOCHEMICAL
PARAMETERS
BIOCHEMICAL
PARAMETERS
REFERENCE
VALUE
OBSERVED
VALUE
Glucose (mg/dl) 45-75 62
Total protein
(g/dl)
6.7 7.4 5.7
Albumin (g/dl) 3.0  3.5 2.4
Calcium (mg/dl) 9.7  12.4 7.5
Phosphorus
(mg/dl)
5.5  8.0 4.5
Sodium (mEq/L) 126 144 126
Potassium
(mEq/L)
3.6  5.8 2.5
RADIOGRAPHY
No Radio opaque Foregin Body could be
detected
H R
L
ULTRASONOGRAPHY
Distended intestinal
loops was noticed
Reveals
Bulls eye
appearance
DIAGNOSIS
Clinical
signs
USG
History
INTUSSUSCEPTION
ANAESTHESIA
ANAESTHESIA
Regional Anaesthesia :
 Paravertebral Nerve block
Maintanence
 Double drip Anaesthesia  10.71
ml/kg/hr maintained
Ketamine  2mg/ml and
Guaifenesin  50mg/ml
SURGICAL PROCEDURE
Preparation of surgical site ( Aseptic surgery)
SURGICAL PROCEDURE
Incision  Right flank region
Surgical site was draped
SURGICAL PROCEDURE
Muscle Incision Peritoneal Incision
SURGICAL PROCEDURE
Exploration of Intestine Intussusception Mass
SURGICAL PROCEDURE
Ligation Intussusception mass
Enterectomy
SURGICAL PROCEDURE
Enteroanastomosis
( End to End) Skin closure
Muscle closure
POST OPERATIVE CARE
Inj. Ringers Lactate
Inj. Dextrose Normal saline
Inj.Metronidazole
Inj. Streptopenicillin
Inj. Cholrpheneramine maleate
Inj. Flunixin meglumine
Name Dose
Rate(/
Kg.b.wt)
No.of
days
Inj. Ringers Lactate 10 mL 5 days
Inj. Dextrose Normal saline 10 mL 5 days
Inj.Metronidazole 5 mL 3 days
Inj. Streptopenicillin 2000 I.U 5 days
Inj. Cholrpheniramine
maleate
0.5 mg 3rd
-5th
Inj. Flunixin meglumine 1.1 mg 2 days
Name Dose
Rate(/
Kg.b.wt)
Route
Inj. Ringers Lactate 10 mL I/V
Inj. Dextrose Normal
saline
10 mL I/V
Inj.Metronidazole 10 mg I/V
Inj. Streptopenicillin Streptomycin
10 mg
I/M
Inj. Chlorpheniramine
maleate
0.5 mg I/M
Inj. Flunixin meglumine 1.1 mg I/V
POST OPERATIVE CARE
 Introduction of water  3 rd day
Introduction of feed  5 th day
 Voiding large amount of semi solid dung within 12
hrs after the surgery
 After 12 days the suture was removed.
RECOVERY
On 3 rd day
RECOVERY
On 5 th day
RECOVERY
After 15 days
CASE DISCUSSION
INTUSSUSCEPTION
Intussusception is the invagination of portion of
intestine into the lumen of adjacent bowel.
 Telescoping of bowel
 Invagination of bowel
CASE DISCUSSION
Etiology
 Abnormal  peristalsis
 GI disease, Enteritis
 FB
 Heavy parasitism
 Previous intestinal surgery
 Intramural abscess/Tumour
 Motility disorders
 Sudden change in diet
CASE DISCUSSION
Treatment
Medical management :
Fluid therapy
NSAIDs
Calcium solutions
Antibiotics
Prokinetics
Surgery management :
Right flank laparotomy
Enterectomy
Enteroanastomosis
End to end
End to side
Side to side
Differential Diagnosis
Diaphragmatic hernia,
Caecal dilatation,
Abomasal impaction,
Abomasal displacement,
Rumen impaction,
Intestinal obstruction
SUMMARY
 Intussusception was surgically treated by
enterectomy followed by end to end
enteroanastamosis in a HF cow
 Paravertebral nerve block and double drip infusion
were found to be adequate throughout the
enterectomy procedure
REFERENCE
1.Farm animal surgery by SUSAN L. FUBINI and
NORM G . DUCHARME.
2.Ruminant surgery by R.P.S. TYAGI & JIT SINGH.
Successful management of intussusception  in a cow under double drip anaesthesia

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Successful management of intussusception in a cow under double drip anaesthesia