[Revised by B. T. Woodward, V. M. D.]
Surgery is both a science and an art. The success of surgical operations
depends on the judgment, skill, and dexterity, as well as upon the
knowledge of the operator. The same fundamental principles underlie and
govern animal and human surgery, although their applications have a wide
range and are very different in many essential particulars. We must not
lose sight of the fact that hygiene and sanitation are essential to the
best results in veterinary as well as in human surgery.
Asepsis is an ideal condition which, although not always possible in animal
surgery, is highly important in connection with the mechanical details of
all surgical operations in proportion to the nature and seriousness of the
same.
Aseptic surgery is considered to be the performance of operations with
sterile instruments with the hands of the operator and the site of
operation being rendered as nearly sterile as possible, and the wound
treated during operation with sterile solutions and protected following the
operation with sterile bandage material. In other words, it is the
preservation of the highest degree of cleanliness in connection with
operations.
Local or general anesthesia should be resorted to in painful and serious
surgical operations, as operations upon all living creatures should be
humanely performed and all unnecessary pain and suffering avoided.
Anesthesia is necessary where absolute immobility of the patient is
essential and where entire muscular relaxation is indispensable. The
anesthetic condition is also favorable for the adjustment of displaced
organs.
Large animals have to be cast and secured before an anesthetic is
administered. For complete anesthesia inhalations of chloroform are
generally employed; sometimes of both ether and chloroform. The quantity of
chloroform required to produce insensibility to external impressions varies
much in different cases and must be regulated, as well as the admixture of
air, by a competent assistant.
If the probability of the success of an operation is remote and the animal
is in healthy physical condition, so that its flesh is good for human food,
it is more advisable to butcher the animal than to attempt a surgical
operation that offers little encouragement to the owner. The best judgment
has to be exercised in determining a matter of this kind, for no animal
suffering from inflammation or that is in a feverish condition is fit for
human food.
All cases of major operative surgery require the skill and dexterity of the
experienced veterinary surgeon, and no one else should attempt such an
operation, for unnecessary suffering must be prevented. Nevertheless, the
more knowledge and understanding an owner of animals has of the principles
of surgical operations and manipulations, the better for all concerned. In
the first place, such an owner will appreciate more fully the skill of the
qualified veterinarian, and, in the second place, he will be the better
prepared and equipped to render assistance to his suffering dumb dependents
where no practitioner is accessible and in cases of emergency. There are,
moreover, some minor operations upon cattle, some of which can hardly be
classed as surgical, that the stockman and farmer should be able to perform
himself.
In the performance of any operation upon an animal of the size and strength
of the bull or cow, the first consideration is to secure the animal in such
a manner as to preclude the possibility of its injuring either itself or
those taking any part in the operation. The nature and time likely to be
occupied by an operation must, of course, largely determine the method to
be adopted.
The majority of operations with which the present chapter is concerned are
usually performed on the animal in a standing position. A bull should
always be held by a staff attached to the ring in his nose. To secure the
cow in a standing position, grasp the nose, the finger and thumb being
introduced into the nostrils, and press against the cartilage which makes a
division between them. If she has horns, grasp one of them with the
disengaged hand. If this is insufficient the animal should be secured to a
post, along the side of a fence, or put into a stanchion. An excellent
method of restraint is to tie a long rope in a slip noose over the horns,
pass it around the chest just behind the forelegs, taking a half hitch on
itself, taking another half hitch in front of the hind limbs, passing the
free end under the tail, bringing it forward and making it fast either to
the head or one of the hitches. The head should be raised to the level of
the back before the final knot is tied, so as to render it too serious and
painful a matter for her to repeat the first attempt she makes to lower it.
Should the nature or extent of the operation be likely to take up
considerable time, it is invariably the best plan to throw the animal. In
the case of the ox this is very easily done, either by use of horse
hobbles, should they be at hand, or by the application of a simple rope. If
the horse hobbles are used, they should be fastened on the leg just above
the fetlocks (ankle joints), as in that position they are less liable to
come off than if placed around the pastern.
Of the many ways of applying the rope for this purpose we will describe
only two, which we consider the best and simplest:
First. Take a long, strong rope (one which has been used a few times is
more flexible), double it, and at 2 or 3 feet from the doubled end,
according to the size of the animal, make a knot and pass the collar thus
formed over the animal's head, allowing it to rest on what would be the
collar place in a horse. Now, pass the ends of the rope between the
forelegs, carry one around each hind leg just above the fetlock joint, from
outside in, under itself once, and bring the free ends forward, passing
each through the collar loop on its own side and bringing the slack back
toward and beyond the hind quarters. (Pl. XXVI, fig. 2.) Two or three men
should then take hold of each rope and at a given signal pull. The animal's
hind legs being drawn forward, the balance is lost, and if the animal does
not fall or lie down he can be readily pushed over on his side and secured
in the desired position.
Second. The three half hitches. Take a rope 30 or more feet long, make a
slip noose at the end and pass it over the animal's horns, leaving the knot
in the loop between the horns; then pass the rope backward along the neck
to the withers, just in front of which take a half hitch on it, passing it
along the back, take one half hitch just behind the forelegs and a second
in front of the hind limbs round the flank. (Pl. XXVI, fig. 1.) The free
end of the rope is taken hold of by one or two assistants while another
holds the animal's head. By pulling firmly on the rope, or inducing the
animal to make a step or two forward while steady traction is made on the
rope, the beast will lie down, when his feet can be secured in the way most
convenient for the operator.
There are numerous other methods, involving more or less complete
restraint, which may be equally efficacious, but one or other of the ways
indicated will doubtless be found to meet fully all ordinary cases.
RINGING THE BULL.
This is usually and ought always to be done before the calf has attained
sufficient weight or strength to make his restraint a matter of serious
difficulty. An ordinary halter is usually all that is required, the strap
being secured to a tree or post. A jointed steel or copper ring is
ordinarily used. Those made of the latter metal are preferable.
The common method of punching a round piece out of the nasal septum for the
introduction of the ring is, I think, open to objection, as portions of the
fine nervous filaments are destroyed. The sensibility of the parts is thus
lessened and the object of ringing to some extent defeated. The insertion
of the ring by means of a trocar and cannula is preferable, as the method
is not open to this objection.
For some years we have used a little instrument, which can be made by any
worker in metal, consisting of a steel point riveted into a short cannula
made to fit on one end of the ring while open. (Pl. XXVII, fig. 11.) When
attached to the ring it is easily and quickly passed through the septum,
the half of the ring following as a matter of course. It can then be
removed and the ends of the ring brought together and fastened by means of
the screw for that purpose.
DEHORNING.
In the wild state the utility of the horns of cattle as weapons of offense
and defense is apparent, but with domestication of cattle and their
confinement the presence of horns constitutes a menace to the safety of
their companions. Horned cattle frequently inflict with their horns painful
and serious injuries to others. Deaths as a result of such injuries are not
unusual. The operation of dehorning would therefore be indicated as a
matter of general safety.
On farms where breeding is conducted, the most desirable method is to
prevent the horns from growing on the young calves. This action results in
a more symmetrical appearance of the poll and eliminates the dangers which
would result from the presence of horns on the young cattle prior to their
operative removal at a later age. A calf should be treated not later than
one week after it is born--preferably when it is from 3 to 5 days old. The
agent to be used may be either caustic soda or potash in the form of sticks
about the thickness of an ordinary lead pencil. These caustics must be
handled with care, as they dissolve the cuticle and may make the hands or
fingers sore. The preparation of the calf first consists in clipping the
hair from the parts, washing clean with soap or warm water, and thoroughly
drying with a cloth or towel. The stick of caustic should be wrapped in a
piece of paper to protect the hands and fingers, leaving one end of the
stick uncovered. Moisten the uncovered end slightly and rub it on the horn
buttons or little points which may be felt on the calf's head--first on
one, then on the other--two or three times, allowing the caustic to dry
after each application. Be careful to apply the caustic to the horn button
only, for if it is brought in contact with the surrounding skin it will
cause pain. Too much moisture on the stick of caustic will allow the
application to spread to the surrounding skin. After treatment keep the
calf protected from rain, as water on the head after application of the
caustic will cause it to run down over the face.
Dehorning of adult animals is usually performed after the age of 2 years,
as after that age there is less probability of the horns again growing. The
horns should be severed from the head from a quarter to a half-inch below
where the skin joins the base of the horn, cutting from the back toward the
front if a saw is used. If the horn is not cut close enough to the head, an
irregular, gnarly growth of horn is liable to follow.
Before attempting to dehorn the animal, it should be securely controlled by
ropes in a stanchion or by casting. Upon the range the cattle are usually
controlled by casting or by placing them in a "squeezer" connected with a
corral. A clean, sharp meat saw or a miter saw with a rigid back may be
used. Various types of dehorning shears or clippers are in general use. One
type of dehorner has a stationary knife edge with its cutting edge shaped
like a very wide V, and opposing this, another knife of similar shape
moving in a slide, so that the cutting edges act upon the horn from all
four sides at once, all the edges passing the center at the same time.
Another type has a movable knife, with one oblique or one curved edge, and
the cutting is done in one direction only. The power for cutting with these
instruments is supplied by pulling together two long handles which, in
order to transmit a greater force, are generally so constructed that they
act through the medium of a series of cogs. In dehorning with these
instruments the cutting edges should be slipped down over the horn and the
knives closed, so that their edges set firmly against the horn in such
position that the cut will be made in the right place and in the right
direction. The handles should then be drawn together with a quick, firm,
strong pull so that the horn will be completely severed by the first act
and without twisting.
Dehorning should, when possible, be performed in cool weather when the
flies are not plentiful. The loss of blood from the operation is not
sufficient, as a rule, to be of consequence, and after care being taken to
prevent substances from getting into the openings left after the removal of
the horns it is not usual to apply any dressing. Pine tar or a mixture of
pine tar and tannic acid may be applied, particularly if the weather is
warm.
SETONING.
The ordinary use of a seton is to keep up constant drainage from a cavity
containing matter or to act as a stimulant or counterirritant. To insert a
seton, the place of entrance and exit having been decided on, with the
finger and thumb make a small fold of the skin transversely to the
direction the seton is to be inserted, and cut it through, either with a
sharp knife or a pair of scissors (this should be done at both the entrance
and exit); then with a steady pressure and slight lateral movement insert
the seton by means of a seton needle. (Pl. XXVII, figs. 1 and 2.) The seton
should consist of a piece of strong tape, varying in breadth according to
circumstances, and should be kept in place either by a knot on each end or
by tying the ends together.
Setons should be gently moved once a day after suppuration is set up, and
they should not be allowed to remain in over three weeks, or a month at the
outside.
TRACHEOTOMY.
This operation consists in making an opening in the trachea, or windpipe.
It is indicated whenever there is an obstruction from any cause in the
upper part of the respiratory tract which threatens the death of the animal
by asphyxia (suffocation). The mode of procedure is as follows: Have an
assistant extend the animal's head as far as possible to make the trachea
tense and prominent; make a longitudinal incision about 2 to 2-1/2 inches
long through the skin and deeper tissues and trachea at the most prominent
part of the trachea, which is about the middle or upper third, and then
insert the tracheotomy tube. The latter should be removed once or twice
daily and cleansed, and the wound dressed antiseptically. To ascertain when
it is time to discontinue the use of the tube and to allow the wound to
close, the hand should be held over the opening, which will require the
animal to use its natural passages in breathing. Observe whether it is
performed in a natural manner, and if so, remove the tube and allow the
wound to close. Often the operation has to be performed in great haste
without the proper instruments and under great disadvantages, the operator
having to cut down quickly, open the trachea and spread the parts, using
some instrument improvised by him at the time. This operation only gives
the animal relief in breathing, and therefore the proper remedial treatment
should be adopted at the onset of the attack and continued until the cause
(the disease) has been overcome.
RUMENOTOMY.
The opening of the paunch, or rumen, in cattle and the removal of a part or
the whole of the ingesta through said opening is termed rumenotomy. The
operation should be performed in severe cases only, where the rumen is
excessively overloaded and distended. The animal is placed with its right
side against a wall and firmly held in position by strong assistants. The
incision is made in the same place that the trocar is inserted for
puncturing that organ in cases of hoven. The opening is increased in size
until the operator's hand can be inserted into the rumen. Before any of the
contents are removed from that organ a linen cloth should be placed from
the outer wound into the rumen in order to prevent any of the ingesta from
getting into the abdominal cavity. Some practitioners, after removing a
portion of the contents of the rumen, introduce such medicine as may be
indicated before closing the wound. Clean the wound and close the opening
in the rumen with uninterrupted (Pl. XXVII, fig. 8) carbolized catgut
sutures. Next close the external wound, consisting of the integument,
muscle, and peritoneum, with stout, interrupted (Pl. XXVII, fig. 6)
metallic sutures. No feed should be given for several hours after the
operation, and then gruels only. (See "Distention of rumen or paunch with
feed," p. 26.)
TREATMENT OF ABSCESSES.
An abscess may be detected, if situated externally, by heat, pain, redness,
and swelling in the early stages, and, if further developed, by the
fluctuation which is present. When any of these symptoms are absent, the
suppuration should be encouraged by the means of hot fomentations and
poultices. Care must be taken that the abscess is not opened too soon, or
to some extent it may cause it to scatter, and the escape of pus will be
lessened. The time to open an abscess is just before it is ready to break,
and should be done with a sharp lance, a crucial incision sometimes being
necessary. The cavity should be syringed out with an antiseptic solution.
Care should be taken not to allow the wound to close too rapidly, to
prevent which a tent of lint or oakum should be introduced.
WOUNDS.
For the purposes of the present work wounds may be divided into three
classes: (1) Incised; (2) punctured; (3) lacerated or contused. In any
wound all that the most suitable applications can accomplish is, in the
first place, to prevent the access of those poisonous germs which exist in
the animal's surroundings, such as the soil and the manure, and, in the
second place, when the process of repair is for some reason temporarily
inactive or altogether arrested, to incite that curative inflammation that
is the invariable method by which the cure is effected.
INCISED WOUND.--This is one with clean-cut edges, and may be either
superficial or deep. In wounds of all descriptions there is necessarily
more or less bleeding, and this is especially liable to be the case in
incised wounds, particularly when they penetrate to a considerable depth,
or when inflicted on a part where blood vessels of any considerable size
approach the surface. To arrest the hemorrhage must therefore be the first
consideration. If slight, a generous use of cold water is all that is
necessary, but if one or more vessels of any size have been wounded or
entirely severed, they should be taken up and ligated. If the blood flows
continuously and is dark in color, it proceeds from a vein, but if
bright-colored and jerky in its flow, it is arterial.
The taking up of an artery simply means the tying up of the bleeding
vessel, which should be accomplished as follows: To discover the bleeding
artery take a piece of clean absorbent cotton, dip it in cold water, and by
gentle pressure on the wound clear it of the accumulated blood. The jet of
fresh blood reveals the end of the vessel, which is readily recognized by
its whitish-yellow or buff color. It should be seized with a forceps or
pincers and slightly drawn clear of the surrounding tissues. Now take the
thread and place the middle of it under the artery, take up the ends, tie
one simple knot tightly, pressing the thread down with the forefinger so as
not to include the forceps, then a second one over it and cut off the ends.
The bleeding being arrested, the operator can now carefully clean and
inspect the wound, taking care to remove all blood and foreign matters and
clip the hair around the edges before proceeding to stitch it up. If the
wound is superficial, the lips may be brought together by a series of
independent stitches (Pl. XXVII, fig. 6) about one-half of an inch to
three-fourths of an inch apart. The stitches should not be drawn tightly;
it is sufficient to bring the edges of the wound in apposition.
If the wound is deep, the needle should be introduced perpendicularly at as
great a distance from the lip of the wound as the depth it is to be
inserted, so as to give the thread sufficient hold. All the stitches should
be as nearly as possible at equal distances from the border of the wound,
to prevent unequal strain, and the knots should be made at the side, not
over the wound. (Pl. XXVII, fig. 6.) When the wound is large and deep, care
should be taken to have an opening in the lowest part to allow for the
escape of the discharges.
In deep wounds which run crosswise of a limb or muscle it is often
advisable to use what is technically known as the "quilled suture," which
is most readily understood by reference to Plate XXVII, figure 7. To
accomplish this method a curved needle with an eye in the point and a
strong double thread should be used. The needle thus threaded is introduced
perpendicularly at least an inch from the wound on one side, carried across
below and brought out the same distance from the border of the cut on the
opposite side, the thread being seized and held in position while the
needle is withdrawn, leaving a loop of thread protruding on one side and
two loose ends on the other side of each stitch. When enough stitches have
been made, take a light piece of wood about the size of a lead pencil,
corresponding in length to the size of the wound or slightly longer, and
insert it through each of the loops, drawing up the free ends of the
threads, which should in turn be tied securely on a similar piece of wood
on that side.
PUNCTURED WOUNDS.--Owing to the uncertainty of their depth and the
structures they may involve, punctured wounds are by far the most dangerous
and difficult to treat. Not only is the extent of the damage hidden from
view, but the very character of the injury, as can be readily understood,
implies at least the possibility of deep-seated inflammation and
consequent discharge of pus (matter), which, when formed, is kept pent up
until it has accumulated to such an extent that it burrows by simple
gravity, as no other exit is possible. In this way foreign matters, such as
a broken piece of the stake or snag, or whatever caused the wound, may be
carried to an indefinite depth, or the cavity of a joint may be invaded and
very serious, if not fatal, consequences occur.
The danger is especially marked when the injury is inflicted on parts
liable to frequent and extensive motion, but all cases of punctured wounds
should receive unusual care, as no judgment can be accurately formed from
the external appearance of the wound. While a probe can ascertain the
depth, it throws but little light on the extent or exact nature of the
internal injury. For this reason all punctured wounds should invariably be
carefully searched by means of a probe or some substitute devised for the
occasion, such as a piece of wire with a smooth blunt end, or a piece of
hard wood shaped for the purpose. Stitching is not admissible in the case
of punctured wounds. After thoroughly cleansing the opening of the wound
and its surroundings, tincture of iodin should be injected directly into
the wound.
If a punctured wound is not very deep, and when the bruising and laceration
are slight, it is possible for healing to take place by adhesion, and this
should always be encouraged, as the process of repair by this method is far
superior to that by granulation, which will be referred to later. With this
object in view, the animal should be kept as quiet as possible. A dose of
physic, such as a pound of Glauber's or Epsom salt, should be administered,
and warm antiseptic fomentations or poultices, when this is practicable,
applied frequently to the surface of the wound.
In wounds of this description the process of repair may be complicated by
the appearance of exuberant granulations, popularly known as "proud flesh,"
which is really an overgrowth of new tissue--granulation tissue; but these
should not be interfered with unless they continue after the acute stage of
inflammation has been subdued. If, after this, they persist, they may be
treated with a 10 per cent solution of sulphate of copper (bluestone) or
nitrate of silver (lunar caustic) in water.