Surgery of Exotic Animals. Группа авторов

Scott Weber, III, MSc., VMD, Dipl ACVPM, CertAqVet White Marsh Hollow Conestoga, PA, USA

      Allison D. Woody, DVM, DAVDC Clinical Veterinarian The Colyer Institute San Diego, CA, USA San Diego Animal Dentistry San Diego, CA, USA

      Preface

      We have two main goals with the “Surgery of Exotic Animals”: (i) collate surgical information on exotic species into one book rather than have it scattered throughout the literature and (ii) ensure that every chapter is written and/or edited by a surgery specialist. Exotic animal surgery developed along a different pathway compared to domestic species because surgery specialists have felt out of depth with species with which they had no familiarity. Consequently, surgical techniques were developed by veterinarians with a special interest in exotics, but no specialized training in surgery. Principles instilled during a formal training program in surgery apply across species, including humans, but are only touched on during veterinary school. Veterinary surgeons are able to perform the procedures; however, they feel uncomfortable with the husbandry, anesthesia, and preoperative and postoperative patient care. Occasionally, a specialist surgeon is found with a special interest in exotic species. For the majority of this book, it is these rare individuals that have written chapters using sound surgical principles paired with knowledge of exotic species. An exotic specialist with a special interest in surgery or the pairing of a surgery specialist with an exotic animal specialist is used for some chapters. The latter was also used for editing the book to ensure both aspects were considered in every chapter. These partnerships should be encouraged as it can be hugely beneficial for the animal as each person will bring their skillset to the table. The surgeon can bring strong surgical principles and the exotic animal specialist can help them extrapolate those to the unique anatomy of and what may or may not work for the exotic species. Diplomates of the American College of Veterinary Surgeons, Diplomates of the American Veterinary Dental College, and specialist surgeons from the human medicine field are great resources for exotic animal veterinarians and are at the cutting edge of new techniques, equipment, and products that could be used in exotic patients. These specialists need to be encouraged to take the leap into the unknown that exotic animal veterinarians take on a routine basis. Solid surgical principles used in domestic species and humans can be readily extrapolated for use in exotic animals in most cases.

      Avery and Geoff

      FL, USA

      2020

      About the Editors

      Dr. R. Avery Bennett recently retired from Louisiana State University where he served for four years as professor of Companion Animal Surgery and now remains as an adjunct professor. He has served in senior positions in academia and the public sector in both surgical and exotic animal fields at the University of Florida, University of Pennsylvania, University of Illinois, Animal Medical Center – New York, San Francisco Zoo, and private surgical referral practices in California and Florida. Avery earned his doctorate of Veterinary Medicine with high honors from Michigan State University (1983). He completed a rotating internship in small animal medicine and surgery at Texas A&M University (1984) and a small animal surgery residency at Colorado State University along with a master's degree in veterinary clinical sciences (1987). Avery is a Diplomate of the American College of Veterinary Surgeons (1988). While Avery is competent in both soft tissue and orthopedic surgery, his areas of interest include surgery of exotic animals, minimally invasive surgery – laparoscopic and thoracoscopic surgery, oncologic surgery, and microsurgery.

      Dr. Geoffrey W. Pye serves Disney's Animals, Science, and Environment team as the Animal Health Director and joined the team in 2014 to lead the animal health and animal nutrition teams at Disney's Animal Kingdom, the Seas with Nemo and Friends at Epcot, the TriCircle D Ranch, Castaway Cay, and the Aulani Resort. He has also served a senior veterinarian for the San Diego Zoo, Werribee Open Range Zoo, and Currumbin Sanctuary. Geoff completed his bachelor of veterinary science at the University of Melbourne (1988) and earned a master of science in wild animal health from the University of London in association with the London Zoo (1995). He completed an internship in zoological medicine at Kansas State University (1998) and a residency in zoological medicine at the University of Florida (2001). Geoff is a Diplomate of the American College of Zoological Medicine (2001).

1 General Principles, Instruments, and Equipment

       R. Avery Bennett

Introduction

      Many surgeries in exotic animal are analogous to those performed in other species. The size of some patients makes surgery more challenging. Appropriate preoperative work up, patient preparation, surgeon preparation, perioperative antibiotic therapy, thermal support, and hemostasis are essential for a successful outcome. Preemptive, multimodal analgesia has long been known to improve recovery from surgery and is especially important with wildlife and exotic prey species. Additionally, in recent years, patients’ anxiety has become an important consideration when these patients have to be hospitalized. Use medications evaluated for the species having surgery to develop a preemptive analgesic and antianxiety treatment plan. When prey species experience anxiety, stress, fear, and pain, they often die for no apparent reason. Alternatively, they may recover from the surgical event only to die a day or two later, likely from these stresses. In pet species, it appears that if they are accustomed to being handled by humans they are more likely to survive the perioperative period. If multiple procedures need to be accomplished, as a general rule, it is better to perform multiple short anesthetic events and surgeries than to try to do everything under one long anesthetic event. This is especially true when imaging is needed for surgical planning. It is best to anesthetize the patient for imaging, then recover it and evaluate the study. Once a diagnosis is made and a plan developed, anesthetize the patient the next day for the surgical procedure.

      It is important that patients resume eating for nutritional support as soon as possible after surgery. Many small patients are not able to undergo long periods of anorexia because they do not have the energy stores to support themselves because in their natural environment they are constantly eating. The nutritional needs of the patient must be addressed and supplemented as needed either per os, using a feeding tube, or intravenously.

Presurgical Considerations

      Prior to performing surgery, it is vital to evaluate the patient and address any abnormalities. In many situations, fasting is recommended; however, sometimes it is not necessary. Hemodynamic support is important for all but the shortest surgical procedures. Patient and surgeon aseptic techniques should be followed for all surgeries regardless of size and species. Perioperative or therapeutic antibiotic therapy needs to be considered. Because small patients become hypothermic quickly, thermal support is essential even for diagnostic procedures done under anesthesia.

      Patient Support

      Small exotic animals are especially prone to developing perioperative complications such as hypovolemia from blood loss, hypothermia, and renal and respiratory compromise. It is important to evaluate the patient systemically prior to anesthesia and surgery and to address any abnormalities preoperatively. During anesthesia and surgery, provide fluid therapy to support the cardiovascular system. Monitor body temperature and take measures to minimize hypothermia. Take appropriate steps to minimize blood loss and take precautions to minimize the risk of surgical site infections.