A review of small ruminant Cesarean section: case selection, surgical techniques, care of the neonates, and postoperative care of the dam
Keywords:
Hysterotomy, ewe, doe, dystocia, C-section
Abstract
Cesarean section is an important life-saving surgical procedure frequently performed by small ruminant practitioners. Knowledge of normal parturition and indications for obstetrical intervention are necessary for successful outcomes. If a doe or ewe is observed in active labor for more than an hour without signs of progression toward delivery of a fetus, obstetrical examination is indicated to guide appropriate interventions. It is often possible to relieve a dystocia without surgical intervention if the cervix is adequately dilated and the dam’s pelvis is of sufficient size to allow manipulation of the fetus. If vaginal delivery cannot be performed safely, a Cesarean section or fetotomy is indicated. The surgery is generally performed with sedation and local anesthesia, with a lumbosacral epidural preferred by the authors. The dam may be positioned in right lateral recumbency, standing, or dorsal recumbency, based on the surgeon’s preference and specifics of the case. The abdomen is entered routinely, the gravid uterus identified, and gently exteriorized through the abdominal incision. A hysterotomy incision is made over the greater curvature of the uterus to allow removal of the fetus(es). The uterus is closed with absorbable suture using an inverting pattern. The abdominal incision is closed routinely. Systemic antibiotics, ecbolic agents, and analgesic agents are recommended for the dam postoperatively. Survival of the dam is reported at 81–99% with post-surgical complications encountered in 33–77% of cases. Females may be retained for future breeding following surgery, with 84–100% of females reported to become pregnant in the subsequent breeding season.
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References
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12. Ennen S, Scholz M, Voigt K, et al: Puerperal development of ewes following dystocia: a retrospective analysis of two approaches to caesarean section. Vet Rec 2013;172:554. doi: 10.1136/vr.101370
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24. Tibary A, Pearson LK, Van Metre DC, et al: Surgery of the sheep and goat reproductive system and urinary tract. In: Fubini SL, Ducharme NG: editors. Farm Animal Surgery. 2nd edition, St. Louis, MO; Elsevier: 2017:571–595.
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27. Anderson DE, Edmondson MA: Prevention and management of surgical pain in cattle. Vet Clin North Am Food Anim Pract 2013;29:157–184. doi: 10.1016/j.cvfa.2012.11.006
28. Clarke KW, Trim CM, Hall LW: Anaesthesia of sheep, goats, and other herbivores. In: Clarke KW, Trim CM, Hall LW: editors. Veterinary Anaesthesia. 11th edition, Edinburgh; Saunders/Elsevier: 2014:345–383.
29. Venkatachalam D, Chambers P, Kongara K, et al: Toxicity and pharmacokinetic studies of lidocaine and its active metabolite, monoethylglycinexylidide, in goat kids. Animals 2018;8:142. doi: 10.1016/j.cvfa.2012.11.006
30. Nancarrow C, Rutten AJ, Runciman WB, et al: Myocardial and cerebral drug concentrations and the mechanisms of death after fatal intravenous doses of lidocaine, bupivacaine, and ropivacaine in the sheep. Anesth Analg 1989;69:276–283. doi: 10.1213/00000539-198909000-00002
31. Lin H: Standing sedation and chemical restraint. In: Lin H, Passler T, Clark-Price S: editors. Farm Animal Anesthesia. 2nd edition, Hoboken; Wiley-Blackwell: 2022:37–59.
32. Sakamoto H, Misumi K, Nakama M, et al: The effects of xylazine on intrauterine pressure, uterine blood flow, maternal and fetal cardiovascular and pulmonary function in pregnant goats. J Vet Med Sci 1996;58:211–217. doi: 10.1292/jvms.58.211
33. Vivrette S: Cesarean section in goats. In: Morrow DA: editor. Current Therapy in Theriogenology. 2nd edition, Philadelphia, PA; Saunders: 1986:592–593.
34. Waage S, Wangensteen G: Short-term and long-term outcomes of ewes and their offspring after elective cesarean section. Theriogenology 2013;79:486–494. doi: 10.1016/j.theriogenology.2012.11.001
35. Hartnack A, Jones M: Surgery of sheep and goat digestive system. In: Fubini SL, Ducharma NG: editors. Farm Animal Surgery. 2nd edition, St. Louis, MO; Elsevier: 2017:561–567.
36. Wallace C: A technique for performing cesarean section in goats. Vet Med Small Anil Clin 1982;77:791–793.
37. Baird AN: Surgery of the uterus. Cattle, sheep, and goats. In: Wolfe DF, Moll HD: editors. Large Animal Urogenital Surgery. Baltimore, MD; Williams & Wilkins: 1999. p. 417–420.
38. Ewoldt JM, Anderson DE, Hardy J, et al: Evaluation of a sheep laparoscopic uterine trauma model and repeat laparoscopy for evaluation of adhesion formation and prevention with sodium carboxymethylcellulose. Vet Surg 2004;33:668–672. doi: 10.1111/j.1532-950x.2004.04090.x
39. Moll HD, Wolfe DF, Schumacher J, et al: Evaluation of sodium carboxymethylcellulose for prevention of adhesions after uterine trauma in ewes. Am J Vet Res 1992;53:1454–1456.
40. Mansour M, Wilhite R, Rowe J: The pelvis and reproductive organs. In: Mansour M, Wilhite R, Rowe J: editors. Guide to Ruminant Anatomy: Dissection and Clinical Aspects. Hoboken; John Wiley & Sons: 2017:168.
41. Fajt V, Brown KR, Pugh DG: Appendix 1 – Commonly used drugs and veterinary feed directive in sheep, goats, and cervids. In: Pugh DG, Baird AN, Edmondson MA, et al: editors. Sheep, Goat, and Cervid Medicine. 3rd edition, Oxford; Elsevier: 2021:517–538.
42. Simpson KM, Taylor JD, Streeter RN: Evaluation of prgonostic indicators for goats with pregnancy toxemia. J Am Vet Med Assoc 2019;254:859–868. doi: 10.2460/javma.254.7.859
43. Lima MS, Silveira JM, Carolino L, et al: Usefulness of clinical observations and blood chemistry values for predicting clinical outcomes in dairy goats with pregnancy toxaemia. Ir Vet J 2016;69:16. doi: 10.1186/s13620-016-0075-4
44. Seddighi R, Doherty TJ: Field sedation and anesthesia of ruminants. Vet Clin North Am Food Anim Pract 2016;32:553–570. doi: 10.1016/j.cvfa.2016.05.002
45. Berge A, Hassid G, Leibovich H, et al: A field trial evaluating the health and performance of lambs fed a bovine colostrum replacement. J Anim Res Nutr 2018;3:1:6.
46. Batmaz H, KAÇAR Y, Topal O, et al: Evaluation of passive transfer in goat kids with Brix refractometer and comparison with other semiquantitative tests. Turk J Vet Anim Sci 2019;43:596–602. doi: 10.3906/vet-1905-31
47. O’brien J, Sherman D: Field methods for estimating serum immunoglobulin concentrations in newborn kids. Small Rumin Res 1993;11:79–84. doi: 10.1016/0921-4488(93)90120-7
48. Roberson JR: Surgical considerations. In: Fubini SL, Ducharme NG: editors. Farm Animal Surgery. 1st edition, St. Louis, MO; Saunders: 2004:58–74.
2. Smith M, Sherman D: Reproductive system. In: Smith M, Sherman D: editors. Goat Medicine. 2nd edition, Ames; Wiley-Blackwell: 2009:571–645.
3. Engum J, Lyngset O: Gynecology and obstetrics in the goat. Iowa State Univ Vet 1969;32:120–124.
4. Edmondson MA, Shipley CF: Theriogenology of sheep, goats, and cervids. In: Pugh D, Baird A, Edmondson M, et al: editors. Sheep, Goat, and Cervid Medicine. 3rd edition, Oxford; Elsevier: 2021: 141–208.
5. Wittek T, Elze K: A contribution to the clinical puerperium and different parameters of blood serum in dairy goats during early puerperium. Tierarztliche Umschau 2001;56:369–375.
6. Smith M: Caprine reproduction In: Morrow DA: editor. Current Therapy in Theriogenology: Diagnosis, Treatment, and Prevention of Reproductive Diseases in Animals. 1st edition, Philadelphia, PA; WB Saunders Company: 1980: 971–1004.
7. Venes D: Taber’s Cyclopedic Medical Dictionary. Pennsylvania, PA; F. A. Davis Company: 2013.
8. Yankovich L: You’re not kidding! Dairy Goat J 1990;67:798–799. doi: 10.1111/j.1751-0813.1990.tb07404.x
9. Voigt K, Najm NA, Zablotski Y, et al: Factors associated with ewe and lamb survival, and subsequent reproductive performance of sheep undergoing emergency caesarean section. Reprod Domest Anim 2021;56:120–129. doi: 10.1111/rda.13855
10. Scott PR: Ovine caesarean operations: a study of 137 field cases. Br Vet J 1989;145:558–564. doi: 10.1016/0007-1935(89)90118-8
11. Ali AMH: Causes and management of dystocia in small ruminants in Saudi Arabia. J Agri Vet Sci 2011;4:95–108.
12. Ennen S, Scholz M, Voigt K, et al: Puerperal development of ewes following dystocia: a retrospective analysis of two approaches to caesarean section. Vet Rec 2013;172:554. doi: 10.1136/vr.101370
13. Brounts SH, Hawkins JF, Baird A, et al: Outcome and subsequent fertility of sheep and goats undergoing cesarean section because of dystocia: 110 cases (1981–2001). J Am Vet Med Assoc 2004;224:275–281. doi: 10.2460/javma.2004.224.275
14. Majeed A, Taha M, Azawi O: Caprine caesarean section. Small Rumin Res 1992;9:93–97. doi: 10.1016/0921-4488(92)90059-D
15. Barbagianni M, Spanos S, Ioannidi K, et al: Increased incidence of peri-parturient problems in ewes with pregnancy toxaemia. Small Rumin Res 2015;132:111–114. doi: 10.1016/j.smallrumres.2015.10.017
16. Thorne M, Jackson P: Caesarean section in the ewe. In Pract 2000;22:546–553. doi: 10.1136/inpract.22.9.546
17. Caulkett N, Cribb PH, Duke T: Xylazine epidural analgesia for cesarian section in cattle. Can Vet J 1993;34:674–676.
18. Navarre CB: Numbing-nose to tail. In: Proc Am Assoc Bovine Pract 2006: 53–55. doi: 10.21423/aabppro20064668
19. Rush J, Stockler J: Local and regional anesthesia in food animals. In: Lin H, Passler T, Clark-Price S: editors. Farm Animal Anesthesia. 2nd edition, Hoboken; Wiley-Blackwell: 2022: 159–188.
20. Bhattacharyya HK, Bhat FA, Buchoo BA: Prevalence of dystocia in sheep and goats: a study of 70 cases (2004–2011). J Adv Vet Res 2015;5:14–20.
21. Sharma A, Kumar P, Singh M, et al: Retrospective analysis of dystocia in small ruminants. Intas Polivet 2014;15:287–289.
22. Winter A: Dealing with dystocia in the ewe. In Pract 1999;21:2–9. doi: 10.1136/inpract.21.1.2
23. Newcomer B: Anesthetic management of specific procedures. In: Lin H, Passler T, Clark-Price S: editors. Farm Animal Anesthesia. 2nd edition, Hoboken; Wiley-Blackwell: 2022: 189–206.
24. Tibary A, Pearson LK, Van Metre DC, et al: Surgery of the sheep and goat reproductive system and urinary tract. In: Fubini SL, Ducharme NG: editors. Farm Animal Surgery. 2nd edition, St. Louis, MO; Elsevier: 2017:571–595.
25. Valverde A, Sinclair M: Ruminant and swine local anesthetic and analgesic techniques. In: Grimm K, Lamont L, Tranquilli W, et al: editors. Veterinary Anesthesia and Analgesia. 5th edition, Ames; Wiley-Blackwell: 2015:941–959.
26. Elane GL, Pablo L, Fackler B, et al: Lumbosacral intrathecal lidocaine provides adequate analgesia for cesarean sections in goats: 7 cases (2020–2021). J Am Vet Med Assoc 2022;1:1–4. doi: 10.2460/javma.22.05.0191
27. Anderson DE, Edmondson MA: Prevention and management of surgical pain in cattle. Vet Clin North Am Food Anim Pract 2013;29:157–184. doi: 10.1016/j.cvfa.2012.11.006
28. Clarke KW, Trim CM, Hall LW: Anaesthesia of sheep, goats, and other herbivores. In: Clarke KW, Trim CM, Hall LW: editors. Veterinary Anaesthesia. 11th edition, Edinburgh; Saunders/Elsevier: 2014:345–383.
29. Venkatachalam D, Chambers P, Kongara K, et al: Toxicity and pharmacokinetic studies of lidocaine and its active metabolite, monoethylglycinexylidide, in goat kids. Animals 2018;8:142. doi: 10.1016/j.cvfa.2012.11.006
30. Nancarrow C, Rutten AJ, Runciman WB, et al: Myocardial and cerebral drug concentrations and the mechanisms of death after fatal intravenous doses of lidocaine, bupivacaine, and ropivacaine in the sheep. Anesth Analg 1989;69:276–283. doi: 10.1213/00000539-198909000-00002
31. Lin H: Standing sedation and chemical restraint. In: Lin H, Passler T, Clark-Price S: editors. Farm Animal Anesthesia. 2nd edition, Hoboken; Wiley-Blackwell: 2022:37–59.
32. Sakamoto H, Misumi K, Nakama M, et al: The effects of xylazine on intrauterine pressure, uterine blood flow, maternal and fetal cardiovascular and pulmonary function in pregnant goats. J Vet Med Sci 1996;58:211–217. doi: 10.1292/jvms.58.211
33. Vivrette S: Cesarean section in goats. In: Morrow DA: editor. Current Therapy in Theriogenology. 2nd edition, Philadelphia, PA; Saunders: 1986:592–593.
34. Waage S, Wangensteen G: Short-term and long-term outcomes of ewes and their offspring after elective cesarean section. Theriogenology 2013;79:486–494. doi: 10.1016/j.theriogenology.2012.11.001
35. Hartnack A, Jones M: Surgery of sheep and goat digestive system. In: Fubini SL, Ducharma NG: editors. Farm Animal Surgery. 2nd edition, St. Louis, MO; Elsevier: 2017:561–567.
36. Wallace C: A technique for performing cesarean section in goats. Vet Med Small Anil Clin 1982;77:791–793.
37. Baird AN: Surgery of the uterus. Cattle, sheep, and goats. In: Wolfe DF, Moll HD: editors. Large Animal Urogenital Surgery. Baltimore, MD; Williams & Wilkins: 1999. p. 417–420.
38. Ewoldt JM, Anderson DE, Hardy J, et al: Evaluation of a sheep laparoscopic uterine trauma model and repeat laparoscopy for evaluation of adhesion formation and prevention with sodium carboxymethylcellulose. Vet Surg 2004;33:668–672. doi: 10.1111/j.1532-950x.2004.04090.x
39. Moll HD, Wolfe DF, Schumacher J, et al: Evaluation of sodium carboxymethylcellulose for prevention of adhesions after uterine trauma in ewes. Am J Vet Res 1992;53:1454–1456.
40. Mansour M, Wilhite R, Rowe J: The pelvis and reproductive organs. In: Mansour M, Wilhite R, Rowe J: editors. Guide to Ruminant Anatomy: Dissection and Clinical Aspects. Hoboken; John Wiley & Sons: 2017:168.
41. Fajt V, Brown KR, Pugh DG: Appendix 1 – Commonly used drugs and veterinary feed directive in sheep, goats, and cervids. In: Pugh DG, Baird AN, Edmondson MA, et al: editors. Sheep, Goat, and Cervid Medicine. 3rd edition, Oxford; Elsevier: 2021:517–538.
42. Simpson KM, Taylor JD, Streeter RN: Evaluation of prgonostic indicators for goats with pregnancy toxemia. J Am Vet Med Assoc 2019;254:859–868. doi: 10.2460/javma.254.7.859
43. Lima MS, Silveira JM, Carolino L, et al: Usefulness of clinical observations and blood chemistry values for predicting clinical outcomes in dairy goats with pregnancy toxaemia. Ir Vet J 2016;69:16. doi: 10.1186/s13620-016-0075-4
44. Seddighi R, Doherty TJ: Field sedation and anesthesia of ruminants. Vet Clin North Am Food Anim Pract 2016;32:553–570. doi: 10.1016/j.cvfa.2016.05.002
45. Berge A, Hassid G, Leibovich H, et al: A field trial evaluating the health and performance of lambs fed a bovine colostrum replacement. J Anim Res Nutr 2018;3:1:6.
46. Batmaz H, KAÇAR Y, Topal O, et al: Evaluation of passive transfer in goat kids with Brix refractometer and comparison with other semiquantitative tests. Turk J Vet Anim Sci 2019;43:596–602. doi: 10.3906/vet-1905-31
47. O’brien J, Sherman D: Field methods for estimating serum immunoglobulin concentrations in newborn kids. Small Rumin Res 1993;11:79–84. doi: 10.1016/0921-4488(93)90120-7
48. Roberson JR: Surgical considerations. In: Fubini SL, Ducharme NG: editors. Farm Animal Surgery. 1st edition, St. Louis, MO; Saunders: 2004:58–74.
Published
2023-07-07
How to Cite
Cowley J., Stockler J., & Maxwell H. (2023). A review of small ruminant Cesarean section: case selection, surgical techniques, care of the neonates, and postoperative care of the dam. Clinical Theriogenology, 15, 70-81. https://doi.org/10.58292/ct.v.9620
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