Clinica chirurgica veterinaria 2

Oggetto:

Clinica chirurgica veterinaria 2

Oggetto:

Veterinary Surgery 2

Oggetto:

Anno accademico 2021/2022

Codice dell'attività didattica

VET0030

Docenti

Prof. Laura Zarucco (Responsabile)
Prof. Paolo Buracco (Affidatario)
Prof. Marco Gandini (Affidatario)
Dr. Gessica Giusto (Affidatario)
Prof. Emanuela Maria Morello (Affidatario)
Dr. Matteo Olimpo (Affidatario)
Prof. Alberto Valazza (Affidatario)

Anno

5° anno

Periodo didattico

Nono semestre

Tipologia

Corso integrato

Crediti/Valenza

SSD dell'attività didattica

VET/09 - clinica chirurgica veterinaria

Modalità di erogazione

Mista

Lingua di insegnamento

Italiano

Modalità di frequenza

Obbligo frequenza 80% delle ore esercitative

Tipologia d'esame

Scritto più orale obbligatorio

Prerequisiti

Italiano
English

Lo studente deve avere le conoscenze di base concernenti l'anatomia applicata (chirurgica), la fisiologia e la farmacologia.
Deve altresì conoscere le tecniche operatorie di base e i principi di anestesiologia e aver sostenuto e superato i seguenti esami:
Patologia generale e fisiopatologia veterinaria (VET0015)
Semeiotica e diagnostica veterinaria (VET0018)
Patologia e diagnostica chirurgica e radiologia veterinaria (VET0025)

The student is required to have a basic knowledge concerning applied (surgical) anatomy, physiology and pharmacology.
He must also know the basic surgical techniques and principles of anesthesiology and have sustained and passed the following exams:
General pathology and veterinary pathophysiology (VET0015)
Semeiotics and veterinary diagnostics (VET0018)
Pathology and surgical diagnostics and veterinary radiology (VET0025)

Oggetto:

Scopo del corso è l'apprendimento di approfondite conoscenze necessarie per la valutazione e l'inquadramento di casi clinici di interesse chirurgico nei piccoli e grossi animali. In particolare lo scopo è quello di aiutare lo studente ad a acquisire la capacità di condensare le conoscenze acquisite in precedenza in altre materie cliniche del corso di laurea per arrivare ad una corretta gestione e trattamento della patologia chirurgica.

Verranno fornite informazioni sulla diagnostica clinica e sull'approccio chirurgico delle principali malattie chirurgiche degli apparati: tegumentario, gastroenterico, urinario, genitale maschile, nervoso, visivo e uditivo dei piccoli animali (cani e gatti) e dell'apparato gastroenterico, respiratorio, muscoloscheletrico, urogenitale e tegumentario dei grossi animali e opzioni terapeutiche.

L'insegnamento si compone dei seguenti moduli:

1. SEMEIOTICA E CLINICA CHIRURGICA 3 (A) ha l'obiettivo di fornire conoscenze e competenze specifiche riguardanti i seguenti apparati (Grossi animali):

APPARATO MUSCOLOSCHELETRICO, e RESPIRATORIO dei GROSSI ANIMALI (Equini e Ruminanti)

APPARATO DIGERENTE dei GROSSI ANIMALI (Equini e Ruminanti)

APPARATO GENITO-URINARIO dei GROSSI ANIMALI (Equini e Ruminanti)

APPARATO TEGUMENTARIO dei GROSSI ANIMALI (Equini)

2. SEMEIOTICA E CLINICA CHIRURGICA 2 (B) ha l'obiettivo di fornire conoscenze e competenze specifiche riguardanti i seguenti apparati (Piccoli animali):

APPARATO TEGUMENTARIO dei PICCOLI ANIMALI (Cane e Gatto)

APPARATO URINARIO dei PICCOLI ANIMALI (Cane e Gatto)

APPARATO DIGERENTE, UDITIVO e GENITALE MASCHILE dei PICCOLI ANIMALI (Cane e Gatto)

NEUROCHIRURGIA e APPARATO VISIVO dei PICCOLI ANIMALI (Cane e Gatto)

Educational Objectives

The objective of the course is providing students with in-depth knowledge required for clinical assessment and evaluation of small and large animal patients requiring surgical treatment. The course aims to convey to the student skills to:

Acquire the basic concepts for the clinical assessment of patients suffering from one of the main surgical diseases discussed in the program
Evaluate the cost / benefit ratio of diagnostic and therapeutic procedures applied in animals suffering from one of the main surgical diseases
Recognize and diagnose a surgical disease condition and prescribe an appropriate treatment option (medical vs. surgical) as well as to define priorities in cases with complex lesions or those that require immediate attention that is not deferrable.
Being able to select the surgical treatment options considered most suitable both in terms of the clinical indication and technical applicability.
Acquire the skills to apply techniques most frequently employed in the discipline of veterinary surgery (i.e. in plastic and reconstructive surgery, gastrointestinal, upper airway, thoracic, genitourinary, orthopedic, ophthalmic, neurosurgery).
Apply basic knowledge of traditional and minimally invasive techniques and surgical methods,
Acquire adequate skills to tackle problems associated with post-operative patient care and to implement follow-up controls throughout post-surgical case management.

The course consists of the following modules:

1. SEMEIOTICS (CLINICAL SURGICAL EXAMINATION) AND SURGERY 3 (A): the objective of the course is to provide fundamental knowledge in principles of surgery as they relate to the following organ systems (large animal species):

MUSCULOSKELETAL, AND RESPIRATORY SYSTEM of LARGE ANIMALS (Equine and Ruminants)

UROGENITAL SYSTEM of LARGE ANIMALS (Equine and Ruminants)

DIGESTIVE SYSTEM of LARGE ANIMALS (Equine and Ruminants)

INTEGUMENTARY SYSTEM of LARGE ANIMALS (Equine)

2. SEMEIOTICS (CLINICAL SURGICAL EXAMINATION) AND SURGERY 2 (B): the objective of the course is to provide fundamental knowledge in principles of surgery as they relate to the following organ systems (small animal species):

INTEGUMENTARY SYSTEM of SMALL ANIMALS (Dog and Cat):

URINARY SYSTEM of SMALL ANIMALS (Dog and Cat)

NEUROSURGERY and VISUAL SYSTEM of SMALL ANIMALS (Dog and Cat):

DIGESTIVE, AUDITORY and MALE REPRODUCTIVE SYSTEM of SMALL ANIMALS (Dog and Cat):

Oggetto:

Risultati dell'apprendimento attesi

Italiano
English

Al termine dell'insegnamento lo studente dovrà dimostrare di:

Essere in grado di scegliere le soluzioni diagnostiche e terapeutiche chirurgiche ritenute più idonee nel trattamento della malattia chirurgica sia sotto il profilo delle indicazioni che tecnico.

Possedere le conoscenze operative su le tecniche chirurgiche di base riguardo ai vari apparati e tessuti (duri e molli).

Dovrà inoltre essere in grado di:

Giudicare in modo critico le informazioni anamnestiche e i segni clinici, identificando il percorso diagnostico e le diagnosi differenziali, insieme a una buona pratica clinica basata su evidenze scientifiche.
Affinare le proprie capacità e acquisire i mezzi corretti e innovativi per giungere a un sospetto diagnostico e/o alla formulazione di un protocollo terapeutico.
Scegliere una tecnica o un approccio chirurgico e la strumentazione da utilizzare.
Saper riconoscere e gestire le varie complicanze
Essere in grado di fare un piano diagnostico e terapeutico per le principali patologie chirurgiche d'urgenza dei piccoli e grossi animali.

Clinical competencies

PA_1.17_3: The student properly writes the physical examination results in the medical records (bovine)

PA_1.17_5: The student correctly performs the general physical examination methods (small ruminants)

PA_1.18_8: The student correctly identifies the preferred site for subcutaneous and

intramuscular injection in ruminants

PA_1.18_10: The student correctly performs an intravenous injection in a ruminant

PA_1.19_3: The student knows how to assist and manage fractures and diseases affecting the tendons

PA_1.21_3: The student chooses appropriate tubes and correctly prepares the samples for the transport to the laboratory

PA_1.26_3: The student administers the medicine via the correct route

PA_1.26_4: The student properly deposits waste for selective collection with biosecurity conditions

PA_1.28_3: The student cleans and disinfects all the equipment after use, mainly non-disposable equipment such as thermometers, nose clips and speculums or similar

PA_1.29_1: The student is able to handle and restrain a surgical patient in field condition

PA_1.29_2: The student correctly performs the aseptic personal preparation in field condition

PA_1.29_3: The student correctly performs the surgical scrub in field condition

PA_1.29_4: The student knows the instruments suitable for most soft tissue surgeries

PA_1.29_5: The student is able to provide assistance during a surgery in field condition

PA_1.29_6: The student correctly applies the procedures for tying and cutting a suture knot

PA_1.30_1: The student knows the main sedatives and tranquilizers used in production animals and how to prescribe them

PA_1.30_2: The student knows the main anesthetic agents used in production animals

PA_1.30_3: The student knows the main local anesthetic agents used in production animals

PA_1.30_4: The student correctly performs a local/regional anesthetic block in field condition

PA_1.33_7: The student correctly performs procedures, preparation and processing of specimens with particular regard to package samples for storage and transfer to the diagnostic laboratories

EQ_1.15_1: The student obtains a medical history in a structured way taking into account the main questions: what?, since or when?, whether improved or worsened?, other animals affected? and information on feeling, deworming,vaccination and reproduction statuts (if applicable)

EQ_1.15_3: The student asks about the main signs of diseases such as lameness, colic episodes, weight loss, loss of appetite, cough, alopecia, and behavioural changes

EQ_1.15_4: The student correctly writes the medical history findings using the appropriate Veterinary Medical terminology. The student is able to transform the owner’s description in a brief and accurate way for a quick clinical history reading

EQ_1.16_1: The student shows confidence and safely approaches to a horse

EQ_1.16_2: The student shows confidence and handles hospitalized horses in a safe manner

EQ_1.17_1: The student performs appropriately the inspection from distance, collects the information, and performs the physical examination with method in a horse

EQ_1.17_2: The student correctly collects the vital signs (TPR=temperature/pulse/respiratory rate) in a horse

EQ_1.17_3: The student properly reports findings of the physical examination in the medical records of the hospital

EQ_1.17_4: The student correctly identifies all relevant musculoskeletal anatomical structures in the equine foot

EQ_1.17_5: The student is able to perform a static musculoskeletal clinical examination in a horse

EQ_1.17_6: The student is able to assist during a dynamic musculoskeletal clinical examination in a horse

EQ_1.18_1: The student completes the initial assessment of a patient: evaluation of hydration, tissue perfusion, and fluid volume/loss

EQ_1.18_2: The student correctly selects the fluid dictated by the patient’s needs, including volume, rate, and fluid composition requirements

EQ_1.18_3: The student calculates the Fluid Rate (ml/kg/hr), including maintenance and replacement fluids

EQ_1.19_1: The student correctly performs first aid management on a patient with colic

EQ_1.19_3: The student correctly performs first aid management of a patient with a wound

EQ_1.19_4: The student correctly performs the limb immobilization (RJ bandage, splint) on a simulator

EQ_1.19_5: The student correctly performs the limb immobilization on a patient (RJ bandage, splint) with severe lameness

EQ_1.20_2: The student recognizes the nutritional status of the horse

EQ_1.21_1: The student properly collects blood samples, uses appropriate tubes and correctly completes the lab form (for inhouse and referral labs)

EQ_1.21_2: The student correctly collects a sample of blood/faeces for diagnosis of parasitological and/or infectious diseases, and correctly completes the lab submission form

EQ_1.21_3: The student is able to perform basic haematological and serobiochemical tests on blood samples from a patient

EQ_1.22_1: The student is able to transfer clinical details between different specialists in the hospital and report consistently medical report in the process of referral

EQ_1.23_2: The student properly places a horse to be radiographically examined according to standard recommendations and radiographic atlas

EQ_1.23_3: The student describes the radiological findings using the appropriate clinical terms, and completes a differential diagnosis list

EQ_1.23_7: The student performs the US examination of the abdomen in a horse (surgery/medicine)

EQ_1.26_2: The student calculates a drug dosage for a patient

EQ_1.26_3: The student administers the medicine via the correct route

EQ_1.26_4: The student properly deposits waste for selective collection with biosecurity conditions

EQ_1.28_1: The student wears correctly gloves, gowns, footwear, headcovers and surgical facemask in the surgical room

EQ_1.28_2: The student correctly performs the hair clipping and a standard surgical scrubbing

EQ_1.28_4: The student clearly identifies and holds correctly at least the following surgical instruments: needle holder, blades, scalpel handle, scissors (Mayo & Metzenbaum), curettes, forceps (Babcock, Allis, Mosquito), Backhaus towel clamps &retractors (hand-held, Gelpi & Weitlaner)

EQ_1.28_5: The student names the suture material and selects the appropriate type of suture and needle for the proposed surgical need

EQ_1.29_1: The student assists the surgeon performing a sterile surgical procedure (laparotomy, castration, arthroscopy, wound repair, osteosynthesis surgery)

EQ_1.30_1: The student assesses the animal prior to performing the sedation or anaesthesia

EQ_1.30_2: The student calculates and applies correctly the most adequate sedation and anaesthetic protocol to the animal demonstrating that is able to use at least the following drugs: Butorphanol, Diazepam, Midazolam, alpha-2 agonists, dissociative agents, barbiturates, inhalant anaestethics

EQ_1.30_3: The student induces the anaesthesia correctly and knows how to place an endotracheal tube

EQ_1.30_4: The student maintains the anaesthesia correctly using the monitoring equipment to prevent poor patient outcome and contributes to oxygen delivery to tissues, acid base balance, and anaesthetic triad of narcosis, analgesia and muscle relaxation

EQ_1.31_1: The student recognizes or assesses the pain with the proposed scale in the clinical daily record

EQ_1.31_2: The student is familiar with the most important analgesics used in the hospital on horses

EQ_1.31_3: The student is able to calculate and dose the analgesia in a patient within the hospitalization

EQ_1.32_1: The student recognizes and understands when the euthanasia is ethically and scientifically justified in a horse

EQ_1.32_2: The student performs a simulated euthanasia on a mannequin head. The student is expected to describe all measures adopted before and after inoculation of euthanasia solution.

CA_1.15_2: The student shows ability to formulate questions to the dog/cat owner and to collect information about the animal and its surroundings before examination: what?, since or when?, whether improved or worsened?, other animals affected? information on feeding, deworming, vaccination and reproduction status (if applicable)

CA_1.17_44: The student is able to perform differential diagnosis according to age, breed and pain localization

CA_1.18_1: The student correctly identifies the main objectives of the therapy in relation to the clinical case presented

CA_1.18_8: The student is able to read and interpret laboratory results concerning microorganism sensitivity/resistance to antibiotics

CA_1.18_9: The student knows first line antibiotics for specific infectious pathologies (urinary tract infections, respiratory diseases, gastrointestinal diseases, skin, eye)

CA_1.18_12: The student knows the diagnostic and therapeutic approach to an otoematoma

CA_1.18_13: The student knows the therapeutic approach to conjunctivitis and ulcer lesions

CA_1.18_23: The student handles, prepares and marks surgical specimens of different neoplastic tissues and fills in a regular pathology submission form

CA_1.18_24: The student shows ability to address the owner of a dog/cat with a neoplastic disease to a specialist (medical, surgical and radiation oncologist) based on a risk/benefit ratio

CA_1.19_1: The student supervised by the veterinarian correctly performs first aid management of a patient with an ear injury

CA_1.19_2: The student supervised by the veterinarian correctly performs first aid management of a patient with an eye injury

CA_1.19_10: The student knows how to stabilize the animal and the emergency procedures in case of abdominal organ rupture

CA_1.19_11: The student knows the main procedures for collecting biological samples in an emergency

CA_1.19_12: The student knows how to perform a drainage and/or centesis

CA_1.19_13: The student correctly applies a bandage on a patient

CA_1.23_14: The student knows how to collect urine samples by ultrasound-guided cistocentesis

CA_1.26_2: The student calculates a drug dosage for a patient

CA_1.29_1: The student knows how to remove a cutaneous node and to perform a cystotomy, enterotomy/enterectomy, and splenectomy

CA_1.29_3: The student knows how to perform a laparotomy

CA_1.29_8: The student knows how to perform herniorrhaphy

CA_1.30_6: The student correctly performs postsurgical care

CA_1.28_3: The student clearly identifies and holds correctly at least the following surgical instruments: needle holder, blades, scalpel handle, scissors (Mayo & Metzenbaum), courettes, forceps (Babcock, Allis, Mosquito), Backhaus towel clamps & retractors (hand-held, Gelpi & Weitlaner)

CA_1.28_4: The student names the suture material and selects the appropriate type of suture and needle for a proposed wound closure

CA_1.28_5: The student sutures a wound at least with the following suture pattern: interrupted (simple interrupted & simple and cruciate mattress) and continuous (simple continuous, continuous lock or Ford interlocking, Cushing, Lembert)

CA_1.28_6: The student correctly performs the clipping of the hair, scrubbing of the skin and drapes the patient for an aseptic abdominal surgery

Expected learning outcomes

At completion of the course, students shall have demonstrated knowledge and understanding with respect to:

Surgical anatomy of equids and domestic carnivores and interpretation of clinical signs of localized surgical diseases.
Clinical diagnostic skills with respect to most common surgical diseases of the following systems: integumentary, gastrointestinal, urinary, male reproductive, nervous, visual and hearing for small animals (dogs and cats), and gastrointestinal, respiratory, musculoskeletal, and urogenital for large animals , and respective treatment options.
Basic surgical techniques with respect to the different systems and tissues (hard and soft).
Deepening of acquired knowledge and skills through studying of scientific publications and literature searches in an attempt to confirm diagnostic hypotheses or identify and explore new working methodologies.

Students must also be able to:

Judge critically the medical history and information as it relates to clinical signs, to describe a sound diagnostic workup approach with differential diagnoses to be considered, thereby following good clinical practice based on scientific evidence.
Refine their skills and acquire proper and innovative understanding to arrive at a presumptive diagnosis and / or develop the formulation of a treatment plan.
Choose a technique or a surgical approach and describe the instrumentation to be used.
Develop an examination strategy that allows proper diagnosing through a critical thinking process, and to apply this strategy to future cases.
Analyze and independently solve problems associated with surgical diseases of domestic carnivores and equids.
Interact with colleagues using appropriate demeanor professional approach and communication skills.
Develop self-learning skills and self-assessment capabilities.

Clinical Competencies